OBSTETRIC PATIENTS WHO SELECT AND THOSE WHO REFUSE MEDICAL-STUDENTS PARTICIPATION IN THEIR CARE

Purpose. To assess attitudes and expectations of obstetric patients to ward the involvement of medical students in their care. Method. At the Medical Center Hospital of Vermont in 1998, questionnaire responses w ere collected from 222 obstetric patients who had been assisted by cle rkship students from the University of Vermont College of Medicine and 78 patients who had refused the participation of students. The respon ses were analyzed for differences in demographic backgrounds, prior ho spital experiences, and general expectations of student involvement, u sing chi-square, two-tailed t-tests and analysis of variance. Results. Both groups of respondents consisted primarily of young, well-educate d, married women, who appear to have made their decisions about studen t participation by balancing their personal needs and their sense of a ltruism. For example, 61% of those who had refused the participation o f students ranked the desire for privacy as their primary reason, wher eas 73% of those who had accepted student participation ranked as thei r primary reason the desire to contribute to a student's education. Al though both groups of patients expected the students to perform few cl inical procedures, the patients who had refused student participation expected the students to be more involved in patient care than did the patients who had allowed participation. Of the 25% of the patients wh o had had students involved in prior pregnancy care, those who had cur rently refused student participation had less positive views of prior student care. Conclusion. Patients' needs for privacy, past experience s with student care, and expectations of student performance should be considered to ensure the respectful incorporation of student involvem ent in obstetric care.