SRFP025: Consent for Trainee Participation in Abortion Care: A Clinical Survey

Lara Crystal-Ornelas, MD; Jessica Ma, BA; Kelsey Holt; Christine Dehlendorf, MD, MAS

Abstract

Context: Abortion care is an essential form of primary healthcare and is included in primary care medical training. Obtaining informed consent for trainee involvement in abortion care requires careful attention to avoid harm for patients while ensuring adequate training for the future provision of healthcare. Policies and practices related to obtaining this consent have not previously been documented; doing so has the potential to inform the development of future guidelines. Objective: To identify current clinical practices, policies, and perspectives related to informed consent for trainee participation in abortion care. Study Design: Cross-sectional study using a REDCap survey. Setting: Abortion clinics training medical students and Family Medicine (FM) and/or Obstetrics and Gynecology (OBGYN) residents. Population Studied: Surveys were disseminated via email to directors of resident abortion training programs, with 46 responses (one per site) were collected in total. Of these sites, 67% were located in large cities, 44% were ambulatory care clinics within hospitals, and 20% were resident primary care clinics. The most common trainees at these sites were OBGYN residents (83%), medical students (70%), and FM residents (30%). Results: Just under half - 48% - reported their site has an informed consent form that mentions trainee involvement in abortion care, while 52% reported no mention of trainee involvement in their forms. With respect to policy, 65% reported their site has a general policy for trainee involvement in healthcare while 15% reported having no such policy. Notably, 20% reported not knowing whether such a policy exists. While 46% expressed the belief that asking patients specifically about trainee involvement in abortion care is very or extremely important, 80% of respondents reported that their clinical site does not provide training on obtaining this consent. Answers varied widely as to who conducts consent for trainee involvement and when consent occurs. Conclusions: Survey responses illustrated a wide variability in clinical practices and perspectives around consent for trainee involvement in abortion care. Given the sensitive and stigmatized nature of abortion care, guidelines for the consent process can ensure that patient needs are met and their autonomy respected. Research is needed to assess patient perspectives to inform the development of these guidelines.
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Emily Godfrey
godfreye@uw.edu 11/20/2021

Great to see the findings of this study! Im curious what the actual response rate was? How many programs received the invitation to respond to the survey?

Jack Westfall
jwestfall@aafp.org 11/21/2021

This is a great topic and research study. Nice work. Thanks for sharing at NAPCRG

Gillian Bartlett
gillian.bartlett@health.missouri.edu 11/21/2021

This is important work in an area that you have rightly described as sensitive and stigmatizing - I look forward to seeing your suggestions on how we can improve the training in this important topic.

William R. Phillips
wphllps@uw.edu 11/21/2021

Great study very nicely presented in this poster. Did respondents express any concern over a lack of a policy or problems in implementing their teaching protocols. Do we need this type of survey on policies around engaging patients seeking abortion services in our research studies? Thanks for sharing your work here at NAPCRG.

Diane Harper
harperdi@med.umich.edu 11/22/2021

VERY IMPORTANT STUDY! Thank you for sharing your work with NAPCRG!

Andy Pasternak
avpiv711@sbcglobal.net 11/26/2021

Fascinating research and an area I haven't really thought of until now. Thanks for shining a light on this

Louise Acheson
11/29/2021

Thanks for raising this as a QI and policy issue and for presenting at NAPGRG.

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