Abstract
BackgroundSexual health is generally considered an integral part of medical and allied healthcare professional training. However, many medical schools do not offer this as a mandatory curriculum, or minimize it. Sexual health as an academic area was introduced in the 1970s, but there have been few cohort evaluations of its impact. This was limited by the availability of few psychometric scales for evaluation. We evaluated the full, mandatory, sexual health course in year 1 medicine at a large state university in the Midwest US, including the course with lectures; panels and tutorials; a video app to give students feedback on their sexual history taking skills; and a 3-station sexual history OSCE at the end of the course.ResultsSeventy-four medical students (43% of the course cohort) volunteered, for an incentive, to complete evaluation materials pre- and post-course. We used the Sexual Health Education for Professionals Scale (SHEPS), designed and with appropriate psychometric standardization for such evaluation. The SHEPS data covers 7-point Likert scale ratings of 37 patient situations, asking first how well the student could communicate with such a patient, and on the second part how much knowledge they have to care for such a patient. The third subscale examines personal sexual attitudes and beliefs. Data indicated that the matched pretest-posttest ratings for skills and knowledge were all statistically significant and with very large effect sizes. Few of the attitude subscale items were significant and if so, had small effect sizes. Sexual attitudes and beliefs may be well-formed before entry into medical school, and sexual health teaching and learning has minimal effect on sexual attitudes in this US sample. However, using the 3 sexuality OSCE cases scores as outcomes, two of the 26 attitude-belief items predicted > 24% of the variance.ConclusionsThe sexual health course produced major changes in Communications with patients sexual health skills and Knowledge of sexual health, but little change in personal Attitudes about sexuality. These data suggest that personal attitude change is not essential for teaching US medical students to learn about sexual health and sexual function and dysfunction, and comfortably take a comprehensive sexual history.
Highlights
There is widespread support for including sexual health as an integral part of the basic curriculum for medical, physician assistant (PA) and nursing students [1,2,3,4,5]
The lack of robust sexual health training for nursing and medical students may be due to a variety of factors, including competition for space in the curriculum, lack of appropriately trained faculty, and failure to recognize the importance of sexuality in clinical practice
Data comparing the gender of the sample with the medical class indicated that the sample was composed of more women (66%) than men (34%), not significantly different from the sex breakdown of the class (Yates corrected χ2 = 1.68, df = 1, p = 0.19)
Summary
There is widespread support for including sexual health as an integral part of the basic curriculum for medical, physician assistant (PA) and nursing students [1,2,3,4,5]. The lack of robust sexual health training for nursing and medical students may be due to a variety of factors, including competition for space in the curriculum, lack of appropriately trained faculty, and failure to recognize the importance of sexuality in clinical practice. Sometimes it is relegated as an elective area. Mandatory, sexual health course in year 1 medicine at a large state university in the Midwest US, including the course with lectures; panels and tutorials; a video app to give students feedback on their sexual history taking skills; and a 3-station sexual history OSCE at the end of the course
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