Improving students’ sexual history inquiry and HIV counseling with an interactive workshop using standardized patients

Haist, Steven A.; Griffith, Charles H.; Hoellein, Andrew R.; Talente, Gregg; Montgomery, Thomas R.; Wilson, John F.

doi:10.1111/j.1525-1497.2004.30204.x

Cited by 51 publications

(45 citation statements)

References 17 publications

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“…The primary outcome, documentation of at least one component of a sexual history, was ascertained using a structured chart extraction tool derived from the Sexual History and HIV Counseling with Subscale Designation Checklist, based on CDC recommendations. 19,20 The extraction tool consisted of 18 components including current and past sexual activity, number of sexual partners, gender of current sexual partner, and history of STIs. 2 We hypothesized that younger patient age, resident-patient gender concordance, visits for Papanicolaou test, and genitourinary or STI concerns would be associated with a documented sexual history.…”

Section: Methodsmentioning

confidence: 99%

Patient, Resident Physician, and Visit Factors Associated with Documentation of Sexual History in the Outpatient Setting

et al. 2011

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BACKGROUND: Providers need an accurate sexual history for appropriate screening and counseling, but data on the patient, visit, and physician factors associated with sexual history-taking are limited. OBJECTIVES: To assess patient, resident physician, and visit factors associated with documentation of a sexual history at health care maintenance (HCM) visits. DESIGN: Retrospective cross-sectional chart review. PARTICIPANTS: Review of all HCM clinic notes (n=360) by 26 internal medicine residents from February to August of 2007 at two university-based outpatient clinics. MEASUREMENTS: Documentation of sexual history and patient, resident, and visit factors were abstracted using structured tools. We employed a generalized estimating equations method to control for correlation between patients within residents. We performed multivariate analysis of the factors significantly associated with the outcome of documentation of at least one component of a sexual history. KEY RESULTS: Among 360 charts reviewed, 25% documented at least one component of a sexual history with a mean percent by resident of 23% (SD=18%). Factors positively associated with documentation were: concern about sexually transmitted infection (referent: no concern; OR=4. Factors negatively associated with documentation were: age groups [46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] ORs=0.1, 0.1,, and 0.1-0.6]), and no specified marital status (referent: married; OR= 0.5 [0.3-0.8]). CONCLUSIONS: Our findings highlight the need for an emphasis on documentation of a sexual history by internal medicine residents during routine HCM visits, especially in older and asymptomatic patients, to ensure adequate screening and counseling.

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Section: Methodsmentioning

confidence: 99%

Patient, Resident Physician, and Visit Factors Associated with Documentation of Sexual History in the Outpatient Setting

et al. 2011

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“…While the literature features a great deal on sexual health, it weighs in favour of management (Skrine 1997), advice (Levy 1997) teaching methods (Schweickert & Heeran 1999;Leeper et al 2007), evaluations (Wagner et al 2006), skills development (Haist et al 2004), etc., and often in secondary care contexts. Skelton and Matthews (2001) reported specifically on teaching the sexual history in ( postgraduate) primary care, and while other periodic references exist (Wenrich et al 1997), the work is not prolific.…”

Section: Practice Pointsmentioning

confidence: 99%

The impact of discussing a sexual history in role-play simulation teaching on pre-clinical student attitudes towards people who submit for STI testing

2011

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Sex, sexuality and sexual health beliefs are individual, impacting on physical and mental health. Sexual history taking is rarely taught in General Practice (GP). However, 'sex' is routinely relevant in this setting. Birmingham students practice discussing sexual history with a simulated-patient in GP. Simulated-patient inclusion in teaching/assessment is well-documented, but no study evaluating the impact of role play on attitudes to people who need STI testing was identified. We aimed to identify whether facilitated simulations featuring a sexual history scenario effected change in students' attitudes towards people who need STI testing. A randomised-controlled-trial was used to compare attitudinal scores between students exposed to an STI role play and a control group who did not receive the role-play teaching until after data capture. There were no significant differences in attitude, either in negative or positive direction, observed between control and intervention groups. Ethnicity was a significant variable, with white-British students self-reporting more positive attitudes. Twenty five percent students admitted personal STI exposure. Again response varied significantly between ethnic groups (the white-British group reporting 4Â the exposure). Females reported more positive attitudes than males, most marked in relation to 'willingness to date' someone who admitted to STI testing.

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“…This clinical competency lends itself to assessment via observed patient encounters or the use of simulated patients for teaching purposes. 36,37 The purpose of talking with patients about sexual orientation and gender identity extends beyond identifying behaviours that may lead to HIV or STIs. These conversations may allow clinical trainees to gain awareness of a wide range of disparities that have been identified in LGBT patients.…”

mentioning

confidence: 99%

Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments

2017

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Abstract. Lesbian, gay, bisexual and transgender (LGBT) people face pervasive health disparities and barriers to highquality care. Adequate LGBT sexual health education for emerging health professionals is currently lacking. Clinical training programs and healthcare organisations are well poised to start addressing these disparities and affirming LGBT patients through curricula designed to cultivate core competencies in LBGT health as well as health care environments that welcome, include and protect LGBT patients, students and staff. Health education programs can emphasise mastery of basic LGBT concepts and terminology, as well as openness towards and acceptance of LGBT people. Core concepts, language and positive attitudes can be instilled alongside clinical skill in delivering inclusive sexual health care, through novel educational strategies and paradigms for clinical implementation. Caring for the health needs of LGBT patients also involves the creation of health care settings that affirm LGBT communities in a manner that is responsive to culturally specific needs, sensitivities and challenges that vary across the globe.Received 18 July 2016, accepted 9 January 2017, published online 6 February 2017Despite recent advances in the recognition of lesbian, gay, bisexual and transgender (LGBT) people, with data demonstrating a rapid increase in the acceptance of LGBT people 1,2 and attainment of equality in many sectors, 3 education on LGBT health needs for health professionals still lags greatly. 4,5 As recently as a decade ago there were no standard texts that included information about care for LGBT people, and numerous studies and reviews of health issues have documented a continued gap in health care education. [4][5][6][7] A study of LGBT topics in medical education published in 2011 showed a median of 5 h of education in both the US and Canada. 8 It is not surprising that despite demonstration of health disparities experienced by LGBT people across the life cycle, many LGBT people find it difficult to access quality care. 6,9 In addition, studies have shown that many LGBT students question being open about their sexual orientation or gender identity when studying to be health professionals due to concerns of bias affecting their professional futures. 10 These findings point to a need in the area of LGBT health care training for development of core competencies that students can use regardless of their eventual speciality or practice setting, 11 in addition to creating health care environments that are welcoming and affirming for LGBT patients, students and staff. 12,13 Participants in health care settings will only engage effectively and thrive if they can comfortably and openly express their true selves. 10,14,15 With regard to education, especially in the context of principles of adult learning, existing studies call for developing competencies that encompass critical knowledge, skills and attitudes needed to provide affirmative care to LGBT people. [4][5][6][7][8]11 These cannot be measured in hours, b...

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Improving students’ sexual history inquiry and HIV counseling with an interactive workshop using standardized patients

Cited by 51 publications

References 17 publications

Patient, Resident Physician, and Visit Factors Associated with Documentation of Sexual History in the Outpatient Setting

Patient, Resident Physician, and Visit Factors Associated with Documentation of Sexual History in the Outpatient Setting

The impact of discussing a sexual history in role-play simulation teaching on pre-clinical student attitudes towards people who submit for STI testing

Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments

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