Impact of Educational Messages on Patient Acceptance of Male Medical Students in OB-GYN Encounters

Abstract

Medical student education in obstetrics and gynecology (OB-GYN) is an essential part of training and involves direct patient care experiences (APGO, 2012a; Harrell et al., 1993). However, for male students difficulties in obtaining patient permission to participate in OB-GYN encounters can be a significant barrier to gaining this training (Higham & Steer, 2004; O'Flynn & Rhymer, 2002; Tang & Skye, 2009). One study suggests that at least some patients who initially refuse student participation can be influenced to change their minds through provision of education about students' technical skills and training (Fortier, Hahn, Trueman, and Reid, 2006). Thus, our primary aim was to evaluate whether an educational message that focused on student training in communication and empathic skills would be more effective at increasing patient acceptance than one focused on students' technical training and skills as this type of message may address patient concerns regarding interacting with male students specifically. Participants were 593 college women who were asked to accept a male medical student into a hypothetical well-woman examination. Women who refused were randomly assigned to receive one of the two messages and then asked again to accept participation. Results indicated that both intervention messages were equally efficacious at increasing acceptance with 45% who received the empathic qualifications intervention message accepting participation as did 49% who received the educational qualifications intervention, [chi]² (1, N = 181) = 0.3, p = .58. Also, women who initially refused participation were more likely to report a preference for a female provider (65.2% versus 34.7%), [chi]² (3, N = 593) = 51.59, p < .001. Results supported that for women who refused participation, issues related to the student's gender, discomfort with student involvement in a sensitive exam, as well as privacy concerns were influential in their decision. Additionally, findings supported that providing information about either the communication and empathic skills or the technical skills and medical knowledge of students led a sizable percentage of initial refusers to allow participation. Clinicians should therefore provide information about the empathic and educational qualifications of medical students when asking for acceptance of medical students.