Best Practices in North American Pre-Clinical Medical Education in Sexual History Taking: Consensus From the Summits in Medical Education in Sexual Health

Rubin, Elizabeth S.; Rullo, Jordan; Tsai, Perry; Criniti, Shannon; Elders, Joycelyn; Thielen, Jacqueline M.; Parish, Sharon J.

doi:10.1016/j.jsxm.2018.08.008

Cited by 77 publications

(24 citation statements)

References 49 publications

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“…This is a big shortfall, because sexual history-taking is an essential skill that physicians need to sensitively address patients’ sexual health 41 . For this reason, it is highly recommended that sexual history-taking play an important part in sexual health education at medical universities 42 …”

Section: Discussionmentioning

confidence: 99%

Medical Students Indicate the Need for Increased Sexuality Education at an Austrian Medical University

2019

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Introduction: The quantity and quality of education in the field of human sexuality vary greatly in medical education programs in the United States and Europe. Aim: The current state of medical school education with regard to human sexuality was assessed at an Austrian medical university. Methods: Self-constructed questionnaires and the Beliefs About Sexual Functioning Scale were filled out by 391 medical students (mean age ¼ 24.0, SD ¼ 2.5; 52.4% women, 47.6% men). Descriptive statistics are reported for summarizing students' responses, and structural equation models were calculated to reveal associations between variables of interest. Main Outcome Measures: The outcome variable in the structural equation models was students' confidence in addressing sexual health concerns of patients. Results: Most students were not instructed in sexual history taking (96.9%), sexual behavior (94.3%), love (97.4%) or sexuality in elderly persons (95.1%), and they reported having poor knowledge of these topics. Most students (72.5%) reported having little or no confidence in addressing patients' sexual health concerns. The number of addressed topics was positively associated with male (b ¼ 0.47, P < .001) and female students' (b ¼ 0.52, P < .001) knowledge. Knowledge was positively associated with male (b ¼ .49, P < 0.001) and female students' (b ¼ 0.33, P < .001) confidence in addressing sexual health concerns and was negatively associated with stereotypical sexual functioning beliefs in the male subsample (b ¼ À0.26, P ¼ .009). Conclusions: Most medical students revealed that the teaching of important sexual health content (eg, sexual history taking) was deficient at this medical university. Education in sexual health issues needs to be increased to positively influence students' knowledge of and consequently their confidence regarding dealing with patients' sexual health concerns. Komlenac N, Siller H, Hochleitner M. Medical Students Indicate the Need for Increased Sexuality Education at an Austrian Medical University. Sex Med 2019;7:318e325.

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Section: Discussionmentioning

confidence: 99%

Medical Students Indicate the Need for Increased Sexuality Education at an Austrian Medical University

2019

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“…The former topic in particular does not get significant coverage in US medical school curricula. 25 While we also found that LGBTQ-identifying respondents report a greater increase in self-efficacy in discussing sexual health topics than non-LGBTQ identifying participants, further research should analyze potential reasons for this difference.…”

Section: Discussionmentioning

confidence: 55%

Impact of Teaching Sexual Health Education on Medical Students

Bourne

Lee

Taliaferro

et al. 2020

Fam Med

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Background and Objectives: Physician discomfort, embarrassment, and perceived lack of time and/or training all play a role in preventing physicians from discussing sexual health with patients. Past research shows this discomfort begins in medical school. We aimed to determine whether teaching sexual health education increases medical students’ self-efficacy in discussing sexual health topics with adolescents. Methods: We emailed a retrospective pre/postsurvey to all medical students who taught sexual health education in a local middle school through Sex Ed by Brown Med (N=61). Results: Participation in Sex Ed by Brown Med improves self-efficacy in discussing nine sexual health topics and in performing nine advanced interviewing skills relevant to sexual health in a retrospective analysis using self-reported data. Conclusions: Programs similar to Sex Ed by Brown Med may be useful in improving medical students’ ability to adequately care for their patients’ sexual health by making future clinicians more comfortable when discussing the important topic of sexuality, and concurrently providing evidence-based comprehensive sexual health education to middle school students. Further research is needed to determine the impact of our program (and similar programs) before disseminating this model of sexual education.

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“…Valid screening methods 18 and patients' preferences for history taking 20 are important considerations in efforts to improve routine screening for sexual problems, as is improving medical student education following best practices for sexual history taking. 21 Notably, while a similar proportion of lesbian women reported persistent problems compared with other groups, fewer had talked to a clinician, and only 6% reported having ever received care or treatment for a sexual problem or concern. Our data do not provide insight into reasons for this finding, and it should be explored in future research.…”

Section: Discussionmentioning

confidence: 95%

Sexual Orientation and Patient-Provider Communication About Sexual Problems or Concerns Among US Adults

et al. 2019

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BACKGROUND: Limited patient-provider communication about sexual health is a crucial barrier to patients receiving treatment for sexual problems, and little is known about how patient sexual orientation is associated with patient-provider communication about sexual problems. OBJECTIVE: To describe the prevalence of patientprovider communication about sexual problems and the associations between communication and (1) persistent sexual problems and (2) whether those who identified as lesbian, gay, or bisexual had disclosed their sexual orientation to their clinicians. DESIGN: Cross-sectional, online survey PARTICIPANTS: 4325 English-speaking US adults from KnowledgePanel®, a probability-based sample of the civilian, noninstitutionalized population. MAIN MEASURES: Sexual orientation, disclosure of sexual orientation (being "out") to a health care provider, communication with health care providers regarding sexual problems or concerns, and persistent sexual problems or concerns. KEY RESULTS: In the past year, 8-15% of US adults discussed a sexual problem or concern with a health care provider. Between 23 and 42% of US adults reported persistent sexual problem(s) in the past year, and of those, 18% of gay/lesbian women, 20% of heterosexual women, 22% of bisexual women, 30% of gay men, 31% of heterosexual men, and 37% of bisexual men had discussed a sexual concern with a clinician. Eighty percent of gay/ lesbian women and 70% of gay men had disclosed their sexual orientation to their regular health care provider, versus only 24% of bisexual men and women. Among those who were "out," 30% had ever talked to a clinician about a sexual problem compared with 17% of those who were not "out." A smaller proportion of lesbian women had ever received care or treatment for a sexual problem, 6% compared with 14-23% in the other groups. CONCLUSIONS: There are significant unmet needs among US adults with regard to patient-provider communication about sexual problems or concerns. Improving patient-provider communication about sexual health is critical.

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Best Practices in North American Pre-Clinical Medical Education in Sexual History Taking: Consensus From the Summits in Medical Education in Sexual Health

Cited by 77 publications

References 49 publications

Medical Students Indicate the Need for Increased Sexuality Education at an Austrian Medical University

Medical Students Indicate the Need for Increased Sexuality Education at an Austrian Medical University

Impact of Teaching Sexual Health Education on Medical Students

Sexual Orientation and Patient-Provider Communication About Sexual Problems or Concerns Among US Adults

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