Assessing Medical Students\u27 Competence in Obtaining Informed Consent

BACKGROUND: Medical schools increasingly place emphasis on preparing students to perform routine, ethically important clinical activities with sensitivity and acumen. A method for evaluating students skills in obtaining informed consent that was created at our institution is described. METHODS: Formal assessment of medical students\u27 professional attitudes, values, and ethics skills occurs in the context of three required and developmentally attuned comprehensive examinations. A videotaped station tested senior medical students\u27 ability to obtain informed consent from a standardized patient who expresses concern about undergoing cardiac catheterization. Two checklists were completed by the patient. Videotapes were reviewed by a faculty member, and students\u27 reactions to the assessment experience were documented. RESULTS: Seventy-one senior students participated, and all performed well. Mean scores of 6.3 out of 7 (range 5 to 7, SD 5 0.5) on the informed consent checklist and 8.7 out of 9 (range 6 to 9, SD 5 0.5) on the communication skills checklist were obtained. Students endorsed the importance of the skills tested. CONCLUSIONS: This method of examining medical students\u27 abilities to obtain informed consent has several positive features and holds promise as an ethics competence assessment tool. Am J Surg. 1999;178:351—355. \xa9 1999 by Excerpta Medica, Inc.\u2

Professional Decisions and Ethical Values in Medical and Law Students

The purpose of this project is to evaluate and compare the values used by medical and law students when dealing with ethical dilemmas in the professional practice of law and medicine. It is assumed that conflict between doctors and lawyers often arises out of the different values that members of each profession apply to similar dilemmas

Evaluating Medical Students' Skills in Obtaining Informed Consent for HIV Testing

OBJECTIVE: To evaluate fourth-year medical students' abilities to obtain informed consent or refusal for HIV testing through a performance-based evaluation method. DESIGN: Student competence was assessed in a standardized patient interaction in which the student obtained informed consent or refusal for HIV testing. A previously validated 16-item checklist was completed by the standardized patient. A subset was independently reviewed and scored by a faculty member to calculate interrater reliability for this report. Student feedback on the assessment was elicited. SETTING: School of Medicine at the University of New Mexico. PATIENTS/PARTICIPANTS: All senior medical students in the class of 2000 were included. INTERVENTIONS: A 10-minute standardized patient interaction was administered within the context of a formal comprehensive performance assessment. MEASUREMENTS AND MAIN RESULTS: Seventy-nine students participated, and most (96%) demonstrated competence on the station. For the 15 specific items, the mean score was 25.5 out of 30 possible points (range, 13 to 30; SD, 3.5) on the checklist. A strong positive correlation (r(s) = .79) was found between the total score on the 15 Likert-scaled items and the score in response to the global item, “I would return to this clinician” (mean, 3.5; SD, 1.0). Scores given by the standardized patients and the faculty rater were well correlated. The station was generally well received by students, many of whom were stimulated to pursue further learning. CONCLUSIONS: This method of assessing medical students' abilities to obtain informed consent or refusal for HIV testing can be translated to a variety of clinical settings. Such efforts may help in demonstrating competence in performing key ethics skills and may help ensure ethically sound clinical care for people at risk for HIV infection