Sexual health innovations in undergraduate medical education

Abstract

Recent national and global initiatives have drawn attention to the importance of sexual health to individuals' well-being. These initiatives advocate enhancement of efforts to address this underrepresented topic in health professions curricula. University of Massachusetts Medical School (UMMS) has undertaken a comprehensive effort to develop an integrated curriculum in sexual health. The UMMS project draws upon the expertise of a multidisciplinary faculty of clinicians, basic scientists, a medical ethicist, and educators. This article describes the project's genesis and development at UMMS, and reports on three innovations in sexual health education implemented as part of this endeavor.

Sexual Health in Undergraduate Medical Education: Existing and Future Needs and Platforms

“…51 Because these topics extend beyond issues of sex and sexuality, it is important to incorporate curricular material on social issues; this need not be part of the sexuality curriculum but should be coordinated with this aspect of undergraduate medical education. 19 A 2011 study of North American medical schools reported a median of 5 hours of LGBT-focused content during the entire course of the curriculum; 7% and 33% of those surveyed had no LGBT content during the preclinical and clinical years, respectively. 56 A similar study in South Africa reported that just 10 of 127 respondent schools taught content on LGBT issues.…”

“…Adolescents need information on safer sex, decision making, reproduction and contraception, and establishing boundaries about what is and is not acceptable for them based on maturity and beliefs. 19 Older adults are more likely to present difficulties with sexual functioning. 59 The past few decades have seen a marked increase in the rate of STIs in elderly persons, 60 which could reflect the increasing availability of effective treatments for sexual concerns and a general lack of awareness about safer sex practices in these older persons.…”

“…19,34 The ideal medical school curriculum would involve input from different specialties, most particularly psychiatry, obstetrics and gynecology, urology, and primary care. 2,19 Supplementary instruction from nonphysicians (eg, sex therapists, psychologists, public health workers, sexologists, etc) adds nuance and important diversity of perspective on human sexuality. Ideally, this curriculum should be coordinated to facilitate broad coverage and diversity of opinions.…”

“…Training in sexuality issues is strongly correlated to the expressed comfort in addressing sexuality with patients. 9,11,13,18,19 It has been a longstanding concern that students who experience the most discomfort when addressing sex also are the least likely to supplement their education in sexuality during schooling unless such course work is made mandatory. 20,21 Therefore, it is essential that core sexuality education be made a mandatory requirement for aspiring clinicians.…”

Moving Medical Education and Sexuality Education Forward

“…Examples of limitations and explanations have included lack of faculty time, resources, and training; lack of a standardized goals, objectives, and curricula; lack of consensus on what sexuality topic areas and populations to include; the role of comfort, discomfort, and fear related to the sexuality topic areas; the role of accreditation organizations, licensing examinations, and continuing medical education after licensure; a disconnect between knowledge acquisition and skill practice; and addressing the issues across personal, structural, and organizational levels. Promising solutions for addressing the problem have included the development and piloting of individual institutional curricula [17][18][19][20][21] as well as the convening of the 2012 and 2014 Summits on Medical School Education in Sexual Health where faculty from across the USA and Canada met to continue strategizing ways to advance the inclusion of sexuality education in medical education [8•]. It will clearly take a strategic, multipronged approach to address all the limitations identified in the literature to date.…”