Medical Education: Patients’ Perspectives on Clinical Training and Informed Consent

Abstract

There are complex ethical dilemmas inherent to medicine teaching, particularly in clinical practice involving actual patients. Questions must be raised on fulfilling medical students’ training needs while still respecting patients’ fundamental rights to autonomy and privacy. We aimed to assess patients’ perspectives regarding medical students’ involvement in their medical care. An observational, cross-sectional study was developed, and a questionnaire was applied randomly to patients waiting for a consultation/admitted to three distinct departments: General Surgery, Obstetrics/Gynaecology, and Infectious Diseases. Of the 77% interviewed patients who reported previous experiences with medical students, only 59% stated that they were asked for consent for their participation, and 28% stated that students had adequately introduced themselves. Patients from Gynaecology/Obstetrics were the ones who reported lower rates of these practices and were also the ones who were most bothered by students’ presence, stating that they would be more comfortable without the presence of medical students. Male patients received more explanations than female patients regarding the same matters. Thirty-five percent of patients stated that they would feel more comfortable without the medical students’ presence. The study shows a need to pay closer attention to fulfilling patients’ fundamental rights.

Patient Perceptions of Medical Students’ Involvement in Clinical Classes: A Cross-Sectional Survey

“…According to a last year’s study, only 28% of patients stated that students had adequately introduced themselves. 43 The comparison of aforementioned results raises concerns whether medical students are adequately presented with the etiquette of the clinical setting. Almost one in four patients felt that students overused their phones during clinical classes.…”

“… 43 , 61 One of them emphasized the fact that patients are often not asked about fundamental elements ensuring comfort during medical procedures. 43 Teaching hospitals frequently overlook the importance of obtaining consent for student-patient interactions, 61 highlighting the relevance of our investigation in this matter and the urgent need to ensure that these principles are applied. 11.66% of all patients believed that they participated in classes with students too often.…”

Importance of Incorporating the Perspectives of People with Cancer into Oncology Education: A Scoping Review

“… 48 Improper practices with gathering patient consent for student involvement in clinical interactions may also be a concern. 49 However, some have argued that volunteerism and proper patient engagement can provide sustainable partnerships between patients and educators. 50 , 51 Survivors of cancer have previously found personal benefit to their involvement in clinical and research teaching.…”

Ethical issues and proposed solutions in conducting practical assessment of medical students involving patients

“…Although patient autonomy has been recognised as a basic right for decades, there is evidence suggesting that medical education often fails to uphold this principle [2,[7][8][9]. Instances have been reported where patients are asked to return to the clinic or are admitted solely for teaching purposes, without being adequately informed about their participation in assessments [10].…”

“…Prior to involvement in any practical assessment or educational programme, it is imperative to obtain valid and explicit informed consent. Regrettably, there have been documented instances in the past that highlight a lack of compliance in this regard [7,8]. This lack of transparency can lead to the occurrence of therapeutic misconception in medical education.…”