Pregnancy options counseling in medical education and professionalism development

Recent changes in both federal and state-level legislation have made accessing abortion care challenging, if not impossible, for some patients. As a result, patients' reliance on comprehensive, accurate pregnancy options counseling from trusted health providers has become critical to patient access and health equity. The current generation of medical students will play an increasingly important role in counseling patients on pregnancy options.

To analyze the utility of a novel pregnancy options counseling curriculum by examining preclinical medical student perspectives on professional identity development as elicited by the curriculum.

This qualitative study investigated second-year medical students' perspectives on pregnancy options counseling after attending a virtual "Pregnancy Options Counseling Panel." The panel consisted of an interactive, case-based discussion of a patient diagnosed with an unintended pregnancy. After the panel, students submitted a prompt-driven reflection on professional identity development as it applies to pregnancy options counseling. The responses were coded using the AAMC Physician Competencies for Professionalism to identify themes and insights; competencies included "Physician Accountability," "Compassion, Integrity, Respect," "Patient Needs," "Patient Autonomy," "Sensitivity to Diverse Populations," and "Commitment to Ethical Principles." Coding was performed using the software Dedoose.

348 student responses were included in this analysis. The most common codes applied were "Physician Accountability" (n=416), "Compassion, Integrity, Respect" (n=201), and "Patient Needs" (n=178). Inter-reviewer reliability tests showed significant agreement for all codes (k>0.63). The majority of student responses demonstrated accountability to patients while emphasizing the importance of compassionate, nonjudgmental care.

Education on pregnancy options counseling is useful in professional identity development for medical students. The curriculum challenged students to reconcile their personal beliefs with their professional obligations, and most student responses were thoughtful and empathic. Pregnancy options counseling serves as an ideal vehicle for introducing value conflict as a measure of professionalism, while simultaneously improving students' medical knowledge on pregnancy termination and family planning.