Effect of a specialized prenatal clinic on medical student attitudes toward women with drinking problems

Objective. To determine if student attendance at a specialized prenatal clinic would yield any change in their comfort level and in their attitudes toward pregnant women with drinking problems. Methods. A total of 117 third-year students rotating consecutively on our core obstetrics - gynecology clerkship consented to enrolling in this prospective cohort study between February 2004 and June 2005. Each was assigned either to attend a half-day prenatal clinic designed specifically for women with alcohol and substance use disorders ( study group) or not to attend the clinic ( control group). The students answered anonymously a 15-question survey ( using a 5-point Likert scale from 'strongly disagree' to 'strongly agree') at the beginning and at the midway point of the eight-week clerkship. Scores averaged for each question at the two points were compared within and between the two groups using paired-samples and independent-samples t-tests. Results. No differences in responses to the survey were found between the study and control groups at the beginning of the clerkship. Students who attended the clinic became more comfortable in inquiring about patient alcohol consumption (p < 0.001) and about social problems such as domestic violence (p < 0.001). After attending the clinic, students reported that alcoholism was associated less with a weak will (p < 0.01) and that group therapy has more importance (p < 0.05). In contrast, the control group disagreed less that alcohol use was more of a moral and legal problem than a medical problem (p < 0.05). Conclusions. An experience at this special prenatal clinic improved medical student awareness of complexities faced by problem drinkers, enhanced their comfort in talking to pregnant alcohol drinkers, and favored more sympathy toward alcoholism in general but not necessarily during pregnancy.