STUDENT DOCTORS AND WOMEN IN LABOR - ATTITUDES AND EXPECTATIONS

Objective: To compare the attitudes and expectations that obstetric pa tients and medical students bring to the student-patient relationship in intrapartum care. Methods: Written questionnaires were distributed to obstetric patients who had students assist in their labor and deliv ery care and to medical students who had completed their clinical cler kship year. Responses of 222 patients and 67 students were analyzed fo r differences in expectations of student participation and assessment of skills. Results: Responses of medical students and patients were si gnificantly different in all attitudes and expectations studied. One h undred thirty-six (61%) patients compared with 27 (40%) students ident ified the patients' wish to contribute to the education of students as the most important reason for agreeing to student participation. All patients felt that student participation should be requested rather th an assigned, with 194 (87%) patients but only 30 (45%) students wishin g to have the student absent from the room at the time of the request. Mean ratings of different student skills tended to be higher from pat ients (1.3-1.8 on a seven-point Likert scale) than from the students t hemselves (range 1.6-2.4). Although students' expectations of particip ation in patient care were high, patients indicated expectations of fa irly low levels of student involvement in communication, examination, labor support, and procedures. Conclusion: Students have high expectat ions for their active involvement in intrapartum care and tend to unde restimate the sense of altruism that motivates patients to allow stude nt participation. Patients have low expectations of levels of student participation in their care, but are overall quite satisfied with the skills of the students. These differences highlight the need for the d evelopment of educational objectives that clarify student roles in cli nical clerkships and the process of informed consent for student parti cipation.