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

Authors

  • Laura Weiss Roberts MD,

    Corresponding author
    1. Received from the Empirical Ethics Group, Department of Psychiatry (LWR, CG, TM), and the Departments of Pediatrics and Family and Community Medicine (SSO), University of New Mexico School of Medicine; and the Institute for Ethics, University of New Mexico Health Sciences Center (LWR), Albuquerque, NM.
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  • Cynthia Geppert MD, PhD,

    1. Received from the Empirical Ethics Group, Department of Psychiatry (LWR, CG, TM), and the Departments of Pediatrics and Family and Community Medicine (SSO), University of New Mexico School of Medicine; and the Institute for Ethics, University of New Mexico Health Sciences Center (LWR), Albuquerque, NM.
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  • Teresita Mc Carty MD,

    1. Received from the Empirical Ethics Group, Department of Psychiatry (LWR, CG, TM), and the Departments of Pediatrics and Family and Community Medicine (SSO), University of New Mexico School of Medicine; and the Institute for Ethics, University of New Mexico Health Sciences Center (LWR), Albuquerque, NM.
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  • S. Scott Obenshain MD

    1. Received from the Empirical Ethics Group, Department of Psychiatry (LWR, CG, TM), and the Departments of Pediatrics and Family and Community Medicine (SSO), University of New Mexico School of Medicine; and the Institute for Ethics, University of New Mexico Health Sciences Center (LWR), Albuquerque, NM.
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Address correspondence and requests for reprints to Dr. Roberts: Department of Psychiatry, University of New Mexico Health Sciences Center, 2400 Tucker NE, Albuquerque, NM 87131-5326 (e-mail: lroberts@salud.unm.edu).

Abstract

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 (rs = .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.

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