Attitudes and Personal Attributes Regarding Patient Receptivity towards the Participation of Medical Students in Gynecological Consultations: A Cross-Sectional Study

Abstract

Objective To evaluate the association between the acceptance on the part of the patients and their reasons to consent to or refuse medical student attendance during gynecological outpatient care, considering the participants' demographic characteristics, consultation experience, and gender bias or lack thereof.

Methods Face-to-face interviews with patients waiting for gynecological consultations that had been scheduled in advance at Hospital Universitário de Brasília. Contingency analyses were used to determine the levels of association among the patient variables. The accepted significance level was values of p < 0.05.

Results We interviewed 469 patients. The comfort level with the presence of a student was strongly related to the number of students present during the consultation (Cramér V = 0.671). The inclination to grant consent (a series of reasons to consent to or refuse student attendance) was significantly related (p < 0.001) to the overall receptivity to student participation (ρ = 0.482), the positive appraisal of student-doctor demeanor in previous consultations (ρ = 0.253, N = 408), and to greater levels of schooling (ρ = 0.158). The patients' receptivity was significantly related (p < 0.001) to the lack of bias regarding the gender of the physician (Cramér V = 0.388), previous experience with students (Cramér V = 0.235) and awareness of the fact that they would be present (Cramér V = 0.217), older age (ρ = 0.136, p = 0.003), and multiparity (ρ = 0.102, p = 0.027).

Conclusion Greater receptivity to student participation related significantly to five conditions in decreasing order of strength of association: lack of bias regarding the gender of the Ob-Gyn, previous experience with student involvement, awareness of the presence of students, older age, and multiparity. We also found that a more positive inclination to consent to student attendance correlated positively with a greater receptivity to student participation and to a suitable student-doctor demeanor.

Resumo

Objetivo Avaliar a associação entre as razões das pacientes para consentir ou recusar a presença de estudantes de medicina no ambulatório de Ginecologia, considerando seus fatores demográficos, experiência prévia com alunos, e sensibilidade com relação ao gênero.

Métodos Entrevistas com as pacientes que aguardavam consultas ginecológicas previamente agendadas no Hospital Universitário de Brasília. Análises de contingência foram utilizadas para determinar os níveis de associação entre as variáveis das pacientes. Valores de p < 0.05 foram considerados estatisticamente significativos.

Resultados Foram entrevistadas 469 pacientes. Observou-se forte associação entre o conforto com a presença do estudante e o número destes presentes à consulta (V de Cramér = 0.671). A tendência ao consentimento (relação de motivos para consentir ou discordar da presença do estudante) relacionou-se significativamente (p < 0.001) à maior receptividade à participação dos alunos (ρ = 0.482), a uma avaliação positiva do comportamento aluno-médico em consultas anteriores (ρ =0.253, N = 408), e a maior escolaridade das pacientes (ρ =0.158). Observou-se associação significativa entre receptividade das pacientes (p < 0.001) e ausência de discriminação quanto ao gênero do médico (V de Cramér = 0.388), experiência prévia com estudantes (V de Cramér = 0.235), ciência de que estariam presentes à consulta (V Cramér = 0.217), idade mais avançada (ρ = 0.136; p = 0.003), e multiparidade (ρ = 0.102; p = 0.027).

Conclusão Maior receptividade à participação dos estudantes relacionou-se a cinco condições em ordem decrescente de força de associação: ausência de discriminação quanto ao gênero do médico ginecologista-obstetra, experiência prévia com estudantes, conhecimento antecipado sobre a presença deles, idade mais avançada, e multiparidade. Também foi observada correlação positiva entre maior tendência ao consentimento e maior receptividade à participação dos alunos e comportamento adequado médico-estudante.

Keywords

healthcare - medical student - gender - outpatient care - gynecology

Palavras-chave

atenção à saúde - estudante de medicina - gênero - atendimento ambulatorial - ginecologia

Contributions

All of the authors contributed with the project and data interpretation, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.

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