Training Non-Directiveness? A Transdisciplinary Survey of Medical Students' Perspective Towards Prenatal Counseling and Down Syndrome

The non-invasive prenatal test (NIPT) is a highly sensitive blood analysis tool that allows for the early detection of multiple chromosomal abnormalities, including Down syndrome. Prenatal testing in general and a positive test outcome in particular leave pregnant parents facing difficult ethical decisions and life-changing dilemmas. The language used by medical practitioners in this context has the potential to exert a strong influence on parents in their decision-making process. During counseling, health care professionals (HCPs) are expected to encourage parents to make an informed yet autonomous decision, which hinges on maximally unbiased, clear and consistent communication from the HCP. It is still unclear whether medical students are aware of this importance of unbiased communication, how they perceive the role of HCPs in the prenatal counseling process, and what perspectives they have regarding the disabilities screened for. Our research project aims to address this gap, presenting the results of a transdisciplinary survey completed by 245 medical students at KU Leuven. In particular, the survey investigates: (1) the students' view on the ideal prenatal counseling process; (2) their knowledge of NIPT and Down syndrome (the most prevalent disability NIPT screens for); and (3) their general attitudes towards disabilities. Results reveal that more than 50% of medical students do not feel prepared for genetic counseling. The survey further shows a lack of knowledge and some clearly negative attitudes towards life with disability; 20% of medical students agree that a life with Down syndrome should be avoided. Overall, results indicate fairly heterogeneous distribution of knowledge and fairly diverse attitudes of the students, suggesting revisions in the current curriculum might be needed to increase the homogeneity towards counseling and disabilities in the medical student population.