The Effect of Clinical Clerkships on Medical Students' Attitudes Toward Abortion and Contraception [181

Abstract

INTRODUCTION: Research has shown that clinical clerkships can affect medical students' attitudes toward lesbian, gay, bisexual, and transgender issues. Similar research investigating how clinical clerkships affect attitudes toward other human sexuality issues—such as abortion and contraception—is lacking in the literature. METHODS: As part of their required curriculum, second-year medical students at the University of Iowa complete an anonymous survey that presents them with eight clinical scenarios involving abortion and contraception. In follow-up of a pilot study, members of the class of 2014 were invited to retake this survey in their fourth year. Additional questions, asking the students if they felt that clinical clerkships had changed their perspectives on abortion and contraception in general, were also included. RESULTS: Of 173 members of the class of 2014, 124 chose to participate, for a response rate of 71.7%. Twenty-six students (21.0%) felt that clinical clerkships had changed their perspectives on abortion. Thirty-five students (28.2%) felt that clinical clerkships had changed their perspectives on contraception. The percentage of students who would recommend against abortion for an ambivalent patient decreased from 63.9% to 50.8% (P=.01). The percentage of students who would refer a patient for a surgical abortion increased from 76.0% to 85.8% (P=.02). The percentage of students who would offer a medical abortion increased from 61.2% to 70.8% (P=.04). Differences in the other five clinical scenarios were not statistically significant. CONCLUSION AND IMPLICATION: This study demonstrates that clinical clerkships have the ability to affect medical students' attitudes toward abortion and contraception in general as well as toward specific scenarios involving abortion.