Consent and Educational Sensitive Exams on Anesthetized Patients: Experiences of Medical Students Across Canada

J Obstet Gynaecol Can. 2024 Nov;46(11):102585. doi: 10.1016/j.jogc.2024.102585. Epub 2024 Jun 13.

Abstract

Objectives: This study investigates experiences of medical students across Canada related to consent for educational sensitive (i.e., pelvic, rectal) exams under anesthesia (EUAs).

Methods: A bilingual online questionnaire was developed and distributed to medical students across Canada.

Results: Of 134 respondents, 63% had performed a pelvic EUA, 35% a rectal EUA, and 11% another sensitive EUA during their training. For those who had performed pelvic EUA, 28% were unsure if consent had taken place, 26% reported no specific consent, 20% reported specific consent, and 25% had mixed experiences of consent. For rectal EUAs, 48% reported no specific consent, 37% were unsure if consent had taken place, 13% reported that there had been specific consent, and 2% reported mixed experiences. Most respondents were uncomfortable (36%) or not sure if they were comfortable (32%) with how the consent process was handled for student pelvic EUAs; 31% were comfortable. In open-ended responses, respondents described experiences related to variability, discomfort, and authority.

Conclusions: Non-consensual educational sensitive EUAs continue to take place in medical training across Canada, although practices of consent are highly variable. The majority of respondents reported being uncomfortable or unsure if they were comfortable with how consent for educational sensitive EUAs was practised during their training, and some respondents struggled to express their discomfort given the power dynamics at play.

Keywords: informed consent; medical education; medical ethics; physical examination.

MeSH terms

  • Adult
  • Anesthesia
  • Canada
  • Female
  • Humans
  • Informed Consent*
  • Male
  • Students, Medical* / psychology
  • Surveys and Questionnaires