Development and evaluation of an interdisciplinary learning module on first trimester abortion within the consultation clause for medical students in Germany

In Germany, abortion on demand is legal up to the 12th week of pregnancy, under the condition that a counselling session in a state-approved advice center has taken place. The federal government passed in their coalition agreement a plan to ameliorate future abortion care especially emphasizing on patient-centered communication. Hence for the first time in 2021 the new version of the nationally mandatory competence-based learning catalogue for medical students included theoretical aspects on abortion provision in Germany.

Based on the catalogue, our goal was to develop a comprehensive, interdisciplinary, and active learning module for medical students. At first, we conducted a medical school-wide online-based survey on the students" attitudes and self-assessed knowledge on the subject using simple Likert scales and pre-defined statements derived from similar studies worldwide. Secondly, we designed a multi-staged module consisting of (a) three expert talks about ethical considerations, abortion provision and patient-centered communication, (b) performance of a role play in small groups with actors to train patient-practitioner-interaction in the context of an unwanted pregnancy and (c) structured group discussions on legal, ethical, and practical aspects of abortion provision. We partnered with the institute for medical ethics and Profamilia. In 2022, we piloted the module in two sessions giving access to all medical students as an extracurricular learning opportunity. The evaluation of our course is based on Kirkpatrick"s four level model for course evaluation. After evaluation the first level, we have now integrated the module in our regular teaching catalogue and will be conducting another survey to estimate the subsequent levels of the model.

Through our medical school-wide survey we received 297 answers from medical students of all education levels. According to the survey data, most of the students (79%) are in favor of liberal abortion laws. At the same time only one third self-assessed their knowledge of the medical and legal basis on abortion provision to be sufficient. Around 40% of the students showed the willingness to perform abortions within the consultation clause and 43% of the students agreed to consult patients on abortion provision but would not perform the abortion themselves. The right for practitioners to conscientiously object to perform abortions was highly agreed with (78%). After our two pilot sessions we received 35 evaluation surveys from 60 participants, which showed an overall positive reaction. All students found the course to be good and 60% found it to be even outstanding. All students showed great interest in the subject. After the second pilot course we observed an increase of interest by 26%.

We are eager to further evaluate the course to see whether the medical learning units can affect the attitudes towards abortion provision of our future generation of medical doctors.

Publication History

Article published online:
15 November 2023