Scientific Paper Abstracts Originally Presented at the National Abortion Federation's Annual Meeting; April 23, 2007; Boston, Massachusetts

In This Article

The Medical Students for Choice Reproductive Health Externship Program: Impact on Medical Students' Knowledge, Attitudes, and Intention to Provide Abortions

Lydia Pace; Yarrow Sandahl, MPA; Lois Backus, MPH; Maria Silveira, MPH; Jody Steinauer, MD, MAS

Introduction and Purpose/Objective(s): Medical Students for Choice (MSFC) is a bi-national nonprofit organization that supports U.S. and Canadian medical students and residents working to enhance abortion education in medical training. Each year MSFC coordinates the Reproductive Health Externship (RHE), which provides about 60 medical students with a month-long clinical experience in family planning clinics. We sought to examine the impact of the RHE on students' knowledge and attitudes about abortion, and their intention to provide abortions in the future.

Data-Collection Methods: From 2004 to 2006, MSFC administered confidential paper surveys to students before and after their participation in the RHE. Surveys assessed students' knowledge about abortion and unintended pregnancy, their attitudes about performing abortions based on various reasons a woman might choose to terminate a pregnancy, and their intention to provide abortions in the future. The 2006 surveys also assessed whether students felt knowledgeable enough to counsel patients about abortion.

Summary of Results: From 2004 to 2006, 163 students participated in the RHE. 161 students' pre- and post- surveys were available for analysis. 124 (77%) of participating students were in their preclinical (1st and 2nd years) of medical training, while 37 (23%) were in their clinical years. Students from schools throughout the U.S. and Canada went to 91 different sites including 39 free-standing clinics, 30 Planned Parenthood clinics and 13 academic medical centers. All students were exposed to or participated in first-trimester surgical abortions, 83% to second-trimester abortions, 86% to medical abortions, and 86% to abortion counseling.

Following the RHE, students demonstrated improved knowledge, with 15% more students answering at least 75% of questions correctly (p=0.0063). They also experienced a change in their attitudes toward abortion, with paired analysis revealing a shift toward increased support for abortion provision (p<0.001). Even among this group of students who were already remarkably inclined to provide abortions in the future, there was an increase in their intention to provide after the RHE (82% vs. 89.4%; paired analysis: p = 0.008). Finally, 44 respondents that participated in an RHE in 2006 were twice as likely to feel comfortable counseling patients about abortion (46.5% vs. 93.2%; paired analysis: p<0.001).

Conclusions: Early clinical experiences with abortion and family planning significantly impact medical students' knowledge and attitudes about abortion, and their intention to provide abortions in the future. By hosting medical students, freestanding clinics and academic medical centers make important contributions to the training of tomorrow's abortion providers and pro-choice physicians.

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