Assessment of Knowledge, Attitude and Practice Regarding Medico-Legal Cases, Informed Consent and Medical Negligence and its Association with Physiological Stress Response Among Medical Students and House Officers at Ayub Medical College, Abbottabad

Abstract

Background: Medical negligence awareness, informed consent, and comprehension of medical neglect is a vital feature in professional medical practice. Lack of knowledge and insufficient clinical practice can lead to confusion in ethically and legally complex scenarios that can affect the medical trainees' responses to psychological and physiological stress.

Objective: To assess knowledge, attitude, and practice regarding medico-legal cases, informed consent, and medical negligence and examine their association with perceived stress and physiological stress responses among medical students and house officers at Ayub Medical College, Abbottabad.

Methods: An analytical cross-sectional study was designed for a period of March to October 2025 in Ayub Medical College, Abbottabad and will include 81 medical students and house officers. The knowledge, attitude, and practices of medicos and lawyers was evaluated by a structured questionnaire. Perceived Stress Scale (PSS-10) was used to measure psychological stress and heart rate and blood pressure to measure physiological. Descriptive data, independent-samples t-tests, chi-square tests and correlation analyses were performed as appropriate, with the criterion of statistical significance being p<0.05.

Results: The analysis included 81 participants, comprising 45 medical students and 36 house officers. The mean knowledge score was 8.27 ± 2.06, with higher scores among house officers than medical students (9.25 ± 1.54 versus 7.49 ± 2.11; p<0.001). House officers also demonstrated higher attitude and practice scores (both p<0.001). Medical students had higher perceived stress scores (23.32 ± 5.54 versus 16.02 ± 5.71; p<0.001) and a greater mean increase in heart rate following the simulated medico-legal scenario (16.55 ± 5.98 versus 11.15 ± 5.62 beats/minute; p<0.001). Knowledge scores were negatively correlated with perceived stress (r=−0.250; p=0.024) and change in heart rate (r=−0.516; p<0.001).

Conclusion: The findings suggest that greater medico-legal knowledge and clinical exposure may be associated with better professional preparedness and lower stress responses. Structured medico-legal education, simulation-based training, and stress-management interventions may support the development of ethical competence and clinical confidence among medical trainees.