Trainee participation in abortion care: A patient-centered analysis
Awarded 2021
Complex Family Planning Fellowship Research
Lara Crystal-Ornelas, MD
University of California, San Francisco

Medical education relies on patient consent to provide trainees with the experiences to become competent doctors and ensure future access to healthcare. Abortion care in the United States is uniquely stigmatized, politicized, and has ongoing barriers to access, including a lack of new providers in training. Obtaining consent for trainee participation in a patient-centered manner is both uniquely challenging and of utmost importance for facilitating continued access to abortion care.

We propose a mixed-methods study in two parts. The first part is a landscape analysis of abortion training clinics using a REDCap survey. Data from the survey will inform the second part, consisting of semi-structured qualitative interviews with participants to explore their experiences and preferences around consent for trainee involvement in abortion care, and to determine the acceptability of potential strategies for obtaining consent.

While there are many studies addressing the unethical practice of pelvic exams under anesthesia and others examining how to integrate medical students into patient care, no studies exist investigating consent for learners’ involvement in abortion care. This study aims to produce guidelines to disseminate to abortion training clinics.

We foresee potential challenges in survey participation and in uploading consent documents. Anticipating this, we have asked a breadth of strategic survey questions regarding consent processes, making the need for uploading documentation additional rather than necessary. Recruiting diverse interview participants during a global pandemic compounded by abortion stigma may be challenging. Use of social media and adequate compensation have been successful in other studies during this time.