What should medical students be taught about abortion? An evaluation of student attitudes towards their abortion teaching and their future involvement in abortion care

Abstract

Background One in three women in the United Kingdom (UK) will have an abortion before age 45, making abortion provision an essential aspect of reproductive healthcare. Despite this, abortion remains ethically contested and stigmatised, with variable teaching in UK medical schools and concerns about falling numbers of doctors willing to participate in abortion care. University College London Medical School (UCLMS) has designed practical, inclusive, teaching that aims to give students an understanding of the importance of abortion care and prepare them to be competent practitioners in this area. This study aimed to determine students’ opinions of this teaching and their wider attitudes towards abortion. Methods We invited all 357 final-year UCL medical students to complete an online survey consisting of closed-ended questions, exploring their opinions on their abortion teaching, their personal beliefs about abortion and their future willingness to be involved in abortion care. We analysed responses using non-parametric tests. Results One hundred and forty-six questionnaires (41% response rate) showed 83% of students identified as pro-choice (agree with the right to choose an abortion). Fifty-seven percent felt they received the right amount of abortion teaching, 39% would have liked more and 4% stated they received too much. There was no correlation between students’ attitudes to abortion and the rating of teaching; both pro-choice and pro-life (opposed to the right to choose an abortion) students generally rated the teaching as important and valued the range of methods used. Students requested more simulated practice speaking to patients requesting an abortion. Students with pro-life beliefs expressed lower willingness to discuss, refer, certify and provide future abortions. Students interested in careers in specialties where they may encounter abortion were more likely to be pro-choice than pro-life. Conclusions The majority of participating UCL medical students were pro-choice and willing to be involved in future abortion care. Efforts to make teaching on abortion practical, engaging, sensitive and inclusive were appreciated. As well as preparing students to be competent and caring practitioners, the teaching appears to contribute towards them viewing abortion as an essential aspect of women’s healthcare, and may contribute to destigmatising abortion.

Self-assessment of attitudes towards conditions to provide safe abortion among new medical graduates in Thailand, 2018: an application of cross-sectional survey with factor analysis

“…As mentioned earlier, we intended to use region of domicile in the early years of life of the respondents as a proxy for religious belief. Since the southern part of Thailand is the main habitat for Muslim Thais, we expected that participants from Southern Thailand would show a more negative attitudes towards abortion in all conditions-in line with the report in much prior literature [31][32][33]. However, the results revealed no specific association pattern between regional domicile and abortion views.…”

A qualitative analysis of medical students’ attitudes to abortion education in UK medical schools

“…Discussion: Our findings confirm the results of previous research indicating that medical students support the inclusion of abortion teaching in their curriculum, view abortion care as an essential part of reproductive healthcare and wish to have more training on it at undergraduate level. [5,6,[10][11][12] Previous research has also found that students' attitudes towards abortion differed according to religious and educational exposure, [6,13] and this diversity must be considered when delivering education. In line with this, our interviewees recognised the importance of teaching on conscientious objection and of facilitating communication between students holding differing views.…”

“…(5) Furthermore, legal complexities and ethical concerns can make teaching abortion to medical students challenging. Research has found that the majority of UK medical students support the right to choose an abortion (are pro-choice) and support the inclusion of abortion teaching in their curriculum [5][6][7]. A survey of University College London medical students reported 83% of students identified as pro-choice, and that, regardless of their opinion on the right to choose, 96% of students rated abortion teaching as important.…”

“…A survey of University College London medical students reported 83% of students identified as pro-choice, and that, regardless of their opinion on the right to choose, 96% of students rated abortion teaching as important. [6] An earlier survey of 733 medical students reported that 45% of medical students believe that doctors should have the right to opt out of providing any procedure (including, but not confined to abortion) on moral grounds once qualified. [8] There has not been a published qualitative study of UK medical students' opinions on the importance of abortion education, their teaching, and what effective teaching might look like.…”

Abortion in Countries with Restrictive Abortion Laws—Possible Directions and Solutions from the Perspective of Poland

“…A study conducted in China including almost 18000 students revealed that individuals who had the basic knowledge concerning sexual health became pregnant and underwent terminations less commonly (OR < 1, p < 0.05) [47]. Moreover, preparing medical students to be competent practitioners appears to contribute towards them viewing abortion as an essential aspect of women's healthcare [48]. A study carried out in Greece showed that despite the possibility of using contraception without prescription it was not frequently used.…”