Conscientious refusal in reproductive medicine: an educational intervention

Abstract

This study evaluates an educational intervention focusing on the ethical reasoning and communication skills necessary in counseling patients about morally objectionable medical interventions. All students on the core clerkship in obstetrics and gynecology at the University of Miami Miller School of Medicine participated in a structured workshop. Students completed anonymous surveys before and after the workshop. Associations between the participants' change in comfort level in providing nondirective counseling and measured demographic variables were analyzed. Of 140 students, 37% (n = 52) positively changed their comfort level with nondirective options counseling; 10% (n = 14) negatively changed. Change in understanding of the physician's role was reported by 60% (n = 84). The exercise was rated as educationally valuable by 95% (n = 128), with 84% (n = 115) attesting that the workshop would help them "approach things differently." Evaluation of multiple parameters demonstrated that this workshop heightened student awareness of the ethical and communications skills challenges posed by this clinical situation.