Retrospective analysis shows consent for medical students varies in ob-gyn care, highlighting racial inequities.
INTRODUCTION: Medical students’ experience performing breast and pelvic exams is critical to clinical training. However, learning cannot take priority over a patient’s comfort and safety. Prior studies have found that younger patient age, previous gynecological care, and information about student training may positively influence patient attitudes toward student involvement. This study aimed to better understand patients’ attitudes toward student involvement and to ascertain what demographic and health-related factors influence preferences. METHODS: This retrospective chart review examined 26,931 responses to a patient questionnaire regarding comfort with medical students during different parts of the clinical encounter, including overall student presence and performance of breast and pelvic exams. Patients with upcoming ambulatory ob-gyn appointments at a Penn Medicine facility were sent the survey between August 2022 and February 2024. Patient demographic and visit information were analyzed. RESULTS: 79.5% (21,404) of patients consented to student presence, 58.6% (15,772) consented to a student performing a breast exam, and 40.0% (10,766) consented to students performing a pelvic exam. Increasing age ( P =.006), Black race ( P <.001), obstetric visits ( P <.001), and new visits ( P =.003) were associated with decreased patient consent to student presence. CONCLUSIONS/IMPLICATIONS: This study supports the incorporation of an integrated tool to obtain consent for student involvement in ob-gyn care. Additionally, it suggests that racial inequities in trauma exposure and historical practices in ob-gyn care may affect patients’ questionnaire responses.
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Cunningham et al. (2026) studied this question.
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