Medical students in breast clinics--how welcome are they and how can we improve their learning opportunities?

Clinical examination skills are an essential component of medical education, with students having the opportunity to practice important skills to facilitate their learning. The opportunities to practice intimate examinations, however, can be varied, with a number of patients declining to give consent, limiting the learning opportunities in clinic. This study aimed to identify whether patient demographics correlated with varying degrees of consent toward student participation.

A questionnaire was distributed to patients attending a surgical preassessment clinic with confirmed breast pathology regarding their attitudes toward different roles they were happy for students to have in their treatment journey. These results were analyzed using SPSS 20.

Overall, 111 patients responded, aged between 17 and 86 years; 42 (38%) were under the care of a male surgeon. Patients under the care of a female surgeon were less likely to agree to students being in clinic (p = 0.009), take a history (p = 0.012), or examine them (p = 0.019). Increasing age was associated with increased agreement to being examined (p = 0.028), but there was no correlation between clinic attendance frequency and acceptance of students.

Our findings suggest patients under the care of a male surgeon were more likely to consent to history taking and examination by students, though this may be owing to patient selection bias. Older patients were more likely to consent to being examined, though previous clinic attendance did not improve consent to medical students.