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 Table of Contents    
LETTERS TO EDITOR  
Year : 2020  |  Volume : 62  |  Issue : 6  |  Page : 749-750
Knowledge about confidentiality among medical students from a tertiary care teaching hospital in South India


1 Intern, Pondicherry Institute of Medical Sciences, Puducherry, India
2 Department of Psychiatry, Pondicherry Institute of Medical Sciences, Puducherry, India
3 Department of Biostatistics, Pondicherry Institute of Medical Sciences, Puducherry, India

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Date of Submission05-Apr-2019
Date of Decision14-Jan-2020
Date of Acceptance23-Oct-2020
Date of Web Publication12-Dec-2020
 

How to cite this article:
Padmanaban H, Simiyon M, Thilakan P, Ravichandran K. Knowledge about confidentiality among medical students from a tertiary care teaching hospital in South India. Indian J Psychiatry 2020;62:749-50

How to cite this URL:
Padmanaban H, Simiyon M, Thilakan P, Ravichandran K. Knowledge about confidentiality among medical students from a tertiary care teaching hospital in South India. Indian J Psychiatry [serial online] 2020 [cited 2021 Jan 22];62:749-50. Available from: https://www.indianjpsychiatry.org/text.asp?2020/62/6/749/303159




Sir,

In a health-care environment, confidentiality, which was described by Hippocrates, refers to the commitment of a health-care professional never to intentionally divulge any personal information disclosed by a patient.[1] It is considered as one of the core virtues of a physician. When this is breached, it leads to mistrust toward the health-care system and untoward consequences. The important aspects of confidentiality are nondisclosure, disclosure, and legal obligations.[2]

As seeds for physician's ethical thoughts are sown during their academic training, it is necessary to teach and assess the ethical knowledge of medical students[1] and the medical institutes have the onus to implement ethical training for their students, till they graduate.[3] The Medical Council of India has recently implemented a new competency-based curriculum known as “Attitude, Ethics and Communication Model” which is a laudable initiative.[4] As we are implementing these revisions, it is essential to understand the current knowledge among the medical students and the lacunae.

This cross-sectional study was conducted in the Pondicherry Institute of Medical Sciences after the approval of the Institutional Ethics committee and obtaining informed consent. We informed the students that participation in the study is purely voluntary and strict confidentiality of their data will be maintained. Part A of the questionnaire was used to collect the personal details of the students and Part B had a structured questionnaire to assess students' knowledge about confidentiality. It was derived from a similar study[5] after obtaining permission from the authors through E-mail, which contains 17 questions with “yes,” “no,” and “don't know” answers.

Among the 109 participants, 33% (36) were males and 67% (73) were females. The mean age was 20.4 ± 0.6 ranging from 19 to 23 years. Majority of the students hailed from urban areas (84%) and belonged to the Hindu religion (76%). When the cutoff was taken as 13 (mean), 63.3% (69) of the students had good knowledge about confidentiality and 36.7% (40) had poor knowledge. The majority (93.6% (102)) of them were sure that they would not disclose the patients' details to others. Knowledge regarding confidentiality during research was good in 91.7% (100) of them. When the question was asked regarding disclosure to concerned authorities, half of them agreed to disclose and half did not. According to 32.1% (35) of the students, secrets about minors need not be confidential. An important ethical knowledge was lacking that 36.7% (40) did not know that written consent is required for taking photographs of patients. Female students had better knowledge than males, which was statistically significant both in univariate and multivariate analysis.

This study was a maiden effort to understand medical students' knowledge of confidentiality. This was done among the students who are in the middle of their medical education training. We, the medical educators, should strive to improve the level of awareness among our students as they have dilemmas with regard to many ethical aspects, especially ethical-legal intersections. Their poor knowledge related to taking photographs of the patients without their consent is an imminent danger of breach to patients' confidentiality with the instant availability of cameras, mobile phones, and social media. Other Indian studies did not find any association between knowledge and gender.[6],[7]

We also acknowledge the random effect that happens with yes or no questionnaires and the limitations of the cross-sectional method conducted in a single institute. A multicentric study with educational interventions related to confidentiality will be scientifically more valid.

By throwing light into the areas of lacunae in students' knowledge about confidentiality, this study would help us to devise educational strategies to tackle the same. As Indian medical curriculum is evolving into a new dimension, policymakers must understand the problems and prospects in teaching confidentiality and other ethical values.

Declaration of patient consent

The authors certify that they have obtained all appropriate participant consent forms. In the form, the participants have given their consent for their images and other clinical information to be reported in the journal. The participants understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

This study was supported by the Bioethics Unit, Pondicherry Institute of Medical Sciences.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Davis L, Domm JA, Konikoff MR, Miller RA. Attitudes of first-year medical students toward the confidentiality of computerized patient records. J Am Med Inform Assoc 1999;6:53-60.  Back to cited text no. 1
    
2.
Health Data in the Information Age Use, Disclosure, and Privacy. Washington: National Academy Press Marston Book Services Ltd. Available from: http://www.vlebooks.com/vleweb/product/openreader?id=none&isbn=9780309538213. [Last accessed on 2020 Jan 20].  Back to cited text no. 2
    
3.
Yamaki VN, Teixeira RK, de Oliveira JP, Yasojima EY, da Silva JA. Secrecy and cconfidentiality in the doctor-patient relationship: Ethical knowledge and opinion of medical students. Rev Bioét 2014;22:176-81.  Back to cited text no. 3
    
4.
UG Curriculum | MCI India. Available from: https://www.mciindia.org/CMS/information-desk/for-colleges/ug-curriculum. [Last accessed on 2019 Feb 11].  Back to cited text no. 4
    
5.
Darwish MA, Sabra AA. Medical ethics: Knowledge about confidentiality among medical university students, Eastern province Saudi Arabia. J Am Sci 2012;8.  Back to cited text no. 5
    
6.
Janakiram C, Gardens SJ. Knowledge, attitudes and practices related to healthcare ethics among medical and dental postgraduate students in south India. Indian J Med Ethics 2014;11:99-104.  Back to cited text no. 6
    
7.
You D, Bebeau MJ. Gender difference in ethical abilities of dental students. J Dent Educ 2012;76:1137-49.  Back to cited text no. 7
    

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Correspondence Address:
Manjula Simiyon
Department of Psychiatry, Pondicherry Institute of Medical Sciences, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_230_19

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