Conscientious refusal in reproductive medicine: an educational intervention

Carla S. Lupi, Christopher M. Estes, Monica A. Broome, Nicolette M. Schreiber

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective: This study evaluates an educational intervention focusing on the ethical reasoning and communication skills necessary in counseling patients about morally objectionable medical interventions. Study Design: All students on the core clerkship in obstetrics and gynecology at the University of Miami Miller School of Medicine participated in a structured workshop. Students completed anonymous surveys before and after the workshop. Associations between the participants' change in comfort level in providing nondirective counseling and measured demographic variables were analyzed. Results: Of 140 students, 37% (n = 52) positively changed their comfort level with nondirective options counseling; 10% (n = 14) negatively changed. Change in understanding of the physician's role was reported by 60% (n = 84). The exercise was rated as educationally valuable by 95% (n = 128), with 84% (n = 115) attesting that the workshop would help them "approach things differently.". Conclusion: Evaluation of multiple parameters demonstrated that this workshop heightened student awareness of the ethical and communications skills challenges posed by this clinical situation.

Original languageEnglish (US)
Pages (from-to)502.e1-502.e7
JournalAmerican journal of obstetrics and gynecology
Issue number5
StatePublished - Nov 2009


  • communication
  • evaluation studies
  • medical education
  • medical ethics
  • reproductive health services

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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