The authors evaluated human sexuality training programs at two California medical schools. In one program, students had no experience taking a sexual history. In the other, students were randomly assigned either to conduct or to observe a brief sexual history interview with a community volunteer. The students who conducted an interview showed more significant improvements in knowledge of human sexuality, perceived appropriateness of taking a sexual history and perceived personal skill in taking a sexual history than did the students who neither observed nor took a sexual history and also developed more critical views of practicing physicians' skills in taking such histories. The students who observed an interview improved more in knowledge and perceived personal skill than did the students who had no interview experience.
The authors assessed the expected degree of comfort among first-year students at two California medical schools in taking a sexual history from four types of patients: heterosexual men; heterosexual women; homosexual (men and women combined); and an AIDS patient. Data were from questionnaires administered at two California medical schools (response rate = 87%). Students expected to be significantly more comfortable with heterosexual patients who were the same sex as the student. Students who had previously taken a sexual history anticipated relatively more comfort with heterosexual patients. The lowest expected comfort was for the AIDS patient. Older students expected to be more comfortable with the AIDS patient, independent of the student's personal sexual experience. Students with a homosexual friend anticipated more comfort with both the AIDS patient and the homosexual patients.
With recent epidemics of sexually transmitted diseases, it is increasingly important for medical students to be well prepared to take sexual histories. The authors studied this issue through a self-administered questionnaire completed by first-year medical students at two western U.S. medical schools (response rate 87%). Students who were better prepared (i.e., more knowledgeable, more comfortable, more appropriate attitudes) had more personal sexual experience and were more likely to have spoken with either a physician or a patient about a personal sexual concern. Different student characteristics were associated with different domains of preparation for taking a sexual history (e.g., knowledge v.s. attitudes). The educational implications of these findings are discussed.
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