Introduction: Autonomy has been the most frequently compromised ethical principle in research involving human subjects. Even medical students are vulnerable when requests for research participation come from faculty members. The present study was designed to find out if coercion is involved in the decision-making of medical students participating in research.
Methods: Ethics committee approval was obtained and 300 medical students were administered a validated questionnaire, after obtaining their written informed consent. The questionnaire contained questions on motives for participation, coercion assessment scale and recruitment scenarios. The responses were analysed using descriptive statistics.
Results: Of the 300 medical students, 65% (195/300) had participated in <3 and 35% (105/300) had participated in ≥3 research studies. 71% (213/300) had participated in questionnaire-based studies, 21% (63/300) in interventional studies and 8% (24/300) in other observational studies. Among those who participated in <3 studies, 32% (62/195) stated scientific interest as the primary reason for participation whereas 31% (61/195) participated mainly because their participation was requested by a faculty member. An analysis of the coercion assessment scale revealed that 35% (105/300) of students said that participation in the study was not entirely of their own choice and 61% (183/300) said that they participated in the study even though they did not want to. 55% (165/300) thought that their professor would like them to participate and 57% (171/300) felt that the professor would be displeased if they did not participate. Among those who participated in <3 studies, 64% (125/195) said they thought that they could not refuse to participate. 74% (77/105) of those participating in ≥3 studies felt that the participation would help their academic grades. 84% (252/300) said that sufficient time was given to read the consent document and 86% (258/300) stated that they would participate in similar research studies in future.
Conclusion: The results suggest the presence of potential coercion on medical students to participate in research. Also the students were not aware of the subtle coercive influences that can occur during recruitment. Educating medical students and faculty on appropriate recruitment procedures and a careful review of the same by the Institutional Ethics Committees would help to remove these coercive influences and ensure the autonomy of medical students participating in research studies.