ABSAME Conference 2013, Newport, RI
Medical Education; Sexual Reproduction; Abortion; Unplanned Pregnancy
Background/Objective: As a controversial topic in American society, abortion occupies a precarious place in medical school curricula. Although medical students believe abortion is a valid and acceptable topic, fewer than 20% of U.S. medical schools offer formal abortion education in either the pre-clinical or clinical years. Only 40% provide abortion lectures during clerkships. According to Association of Professors of Gynecology and Obstetrics student learning objectives, abortion education should be included at a minimum in the third year core clerkship. In the absence of published curricula, health professional schools must develop their own methods to teach the medical aspects of the subject while respecting all points of view. This research presents a reproducible structure for addressing both medical and ethical considerations in educating pre-clinical students about abortion.
Methods: After being informed of the study, second year medical students enrolled in Practice of Medicine, Problem Oriented Case-Based Learning (PCL) attended a required Ethics Lecture, during which they used an audience response system to answer questions. Their answers were tabulated to measure the range of student opinions. Students were then invited to post questions to the library blog. Over the next three weeks, students in established small groups discussed a case that illustrated reproductive decision-making. They were invited to post reflections about abortion issues to a monitored Blackboard Discussion Board. Though allowed to post anonymously, ground rules required them to adhere to basic standards of professionalism. All identifiers were removed from the Blackboard postings. Content was coded to identify themes and subthemes. At the end of the case, 140 students completed a qualitative/quantitative survey and 112 agreed to participate in the study.
Results: Over 80% percent of students who responded to the survey found the case helpful in identifying physician’s roles with respect to reproduction. Ninety six percent agreed that abortion was an appropriate topic to cover. The Blackboard postings identified major themes including physician responsibilities, unbiased information, and abortion laws. A constant theme that emerged was students’ acknowledgement of the complications of abortion and the ethical dilemmas physicians face.
Conclusion: Case based learning, a framing lecture, and a safe place to express and challenge opinions together constitute an effective strategy for introducing a controversial topic in medical education. In order to better assess the impact of the Case, we plan to follow up with the students and conduct a focus group of third-year medical students after completing their OBGYN rotation.
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