Cohen D L, McCullough L B, Kessel R W, Apostolides A Y, Heiderich K J, Alden E R
Department of Pediatrics, Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Bethesda, Maryland.
J Med Educ. 1988 Nov;63(11):821-9. doi: 10.1097/00001888-198811000-00001.
The authors surveyed a national random sample of medical students (10 percent of the graduating class of 1985) to identify the ways in which the students obtained informed consent from their patients and to learn the students' views of certain issues concerning informed consent. The results showed that the students introduced themselves to patients using methods that the authors grouped by levels of forthrightness. Those students who introduced themselves as medical students differed in their views on selected informed consent issues from students who introduced themselves as physicians. In general, all the students were less forthright about their status when given the opportunity to perform invasive procedures. Student gender, type of patient, and type of hospital were statistically associated with the students' behavior, according to bivariate analysis. After multivariate regression analysis, however, only the actions of the students' role models (residents and attending physicians) remained significantly associated with the students' behavior. The authors conclude that because some aspects of student behavior are at odds with the requirements of informed consent, medical educators must scrutinize the ethical dimensions of the policies they establish.
作者对全国范围内的医学生随机样本(1985年毕业班的10%)进行了调查,以确定学生从患者那里获得知情同意的方式,并了解学生对某些与知情同意相关问题的看法。结果显示,学生们通过作者按坦率程度分类的方法向患者介绍自己。那些表明自己是医学生的学生在选定的知情同意问题上的观点与表明自己是医生的学生不同。总体而言,当有机会进行侵入性操作时,所有学生对自己身份的表述都不那么坦率。根据双变量分析,学生性别、患者类型和医院类型与学生的行为在统计学上相关。然而,经过多变量回归分析后,只有学生榜样(住院医师和主治医生)的行为与学生的行为仍存在显著关联。作者得出结论,由于学生行为的某些方面与知情同意的要求不一致,医学教育工作者必须审视他们制定的政策的伦理层面。