Improving the preparation of preclinical students for taking sexual histories

Vollmer, Shirah; Wells, Kenneth B.; Blacker, Kay H.; Ulrey, Gordon

doi:10.1097/00001888-198908000-00012

Cited by 22 publications

(19 citation statements)

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“…Lack of knowledge is often described in literature as an important barrier to discussing sexual health, with Bachmann reporting in his survey including physicians and gynecologists, amongst others, that 22 % of respondents rated their knowledge and comfort level of discussing sexual female health as poor [34]. This advocates the incorporation of counseling on sexual health in the curriculum, as was proposed by other authors [35,36]. What this study adds to current knowledge, is that the majority of participants is eager to enhance their knowledge, especially young doctors, which offers opportunities to invest in counseling training early in residencies.…”

Section: Discussionmentioning

confidence: 91%

Discussing sexual health in spinal care

et al. 2015

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Background The possible detrimental effects of spinal disease on sexual health are widely recognized; however, it is not known to what extent neurosurgeons discuss this topic with their patients. The aim of this study is to identify knowledge, attitude and practice patterns of neurosurgeons counseling their patients about sexual health. Methods All members of the Dutch Association of Neurosurgery (neurosurgeons and residents) were sent a questionnaire addressing their attitudes, knowledge and practice patterns regarding discussing sexual health. Results Response rate was 62 % with 89 questionnaires suitable for analysis. The majority of participants (83 %) were male; mean age, 42.4 years. The mean experience in neurosurgical practice was 9 years. Respondents assumed that in 34 % of their patients, sexual health was affected due to spinal disease. The majority of respondents (64 %) stated that responsibility for discussing sexual health lies (partly) with the neurosurgeon; however, 73 % indicated to (almost) never do this. The main reasons for not discussing sexual health were patients' old age (42 %), lack of knowledge (38 %) and lack of patients' initiative to bring up the subject (36 %). Twenty-six percent indicated lack of time as a reason. There was no evidence for gender or doctor's age discordance as important barriers. Fifty percent of participants wished to gain more knowledge on discussing sexual health with patients. Conclusion This study shows that despite high prevalence of sexual dysfunction (SD) in spinal patients, counseling about sexual health is not often done in neurosurgical care. More training on sexual health counseling early in the residency program seems critical. By initiating the discussion, clinicians who deal with spinal patients have the potential to detect sexual dysfunction (SD) and to refer adequately when necessary, thereby improving overall quality of life of their patients.

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Section: Discussionmentioning

confidence: 91%

Discussing sexual health in spinal care

et al. 2015

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“…15,18 Education on sexuality should incorporate training on how to relate to persons of the other sex and the potential for sexual attraction between patient and physician. Such responses are predictable and normal; they should be explicitly addressed and coping skills should be taught.…”

Section: Addressing Sexuality With Patients Of Opposite Sexmentioning

confidence: 99%

“…14 Students with limited sexual experience and/or social anxiety also are more likely to report discomfort in addressing sexuality in the clinical context. 7,9,15 In contrast, some studies have suggested that religious affiliation is predictive of greater attention to safer sex counseling. 10 The cultural milieu of a given medical school also will have profound effects on how sexuality is viewed by the student body and likely by their teachers; religious and/or cultural traditions in the larger society surrounding a medical school will influence how many medical undergraduates view sexuality and indeed can influence how the topic can be legally taught.…”

Section: Introductionmentioning

confidence: 98%

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

Shindel

Baazeem

Eardley

et al. 2016

The Journal of Sexual Medicine

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Introduction This article explores the evolution and current delivery of undergraduate medical education in human sexuality. Aim To make recommendations regarding future educational needs, principles of curricular development, and how the International Society for Sexual Medicine (ISSM) should address the need to enhance and promote human sexuality education around the world. Methods The existing literature was reviewed for sexuality education, curriculum development, learning strategies, educational formats, evaluation of programs, evaluation of students, and faculty development. Main Outcome Measures The prevailing theme of most publications in this vein is that sexuality education in undergraduate medical education is currently not adequate to prepare students for future practice. Results We identified components of the principles of attitudes, knowledge, and skills that should be contained in a comprehensive curriculum for undergraduate medical education in human sexuality. Management of sexual dysfunction; lesbian, gay, bisexual, and transgender health care; sexuality across genders and lifespan; understanding of non-normative sexual practices; sexually transmitted infections and HIV, contraception; abortion; sexual coercion and violence; and legal aspects were identified as topics meriting particular attention. Conclusion Curricula should be integrated throughout medical school and based on principles of adult learning. Methods of teaching should be multimodal and evaluations of student performance are critical. To realize much of what needs to be done, faculty development is critical. Thus, the ISSM can play a key role in the provision and dissemination of learning opportunities and materials, it can promote educational programs around the world, and it can articulate a universal curriculum with modules that can be adopted. The ISSM can create chapters, review documents, slide decks, small group and roleplay topics, and video-recorded materials and make all this material easily available. An expert consensus conference would be needed to realize these recommendations and fulfill them.

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“…Many studies in this area tend to be case series and descriptive without separate intervention and control groups (Epstein et al, 1998). Others describe intermediate outcomes such as participants' perceived personal skill in taking a sexual history (Vollmer et al, 1989) or belief in the efficacy or acceptance of the intervention (Epstein et al, 2001;Stanton, Anderson, & Szerlip, 1997). In contrast, our SHHIVC workshop was empirically validated through the use of a control group and demonstration of better clinical skills in the intervention group compared to the control group.…”

Section: Discussionmentioning

confidence: 99%

“…To eliminate this barrier, several programs using standardized patients have been developed to train students (Kidd et al, 2001;Cushing, Evans, & Hall, 2005;Vollmer, Wells, Blacker, & Ulrey, 1989;Ng & McCarthy, 2002), residents (Madan, Caruso, Lopes, & Gracely, 1998), and practicing physicians (Rabin et al, 1994;Rabin, 1998;Skelton & Matthews, 2001;Epstein et al, 2001) to thoroughly assess and counsel patients regarding sexual health and STDs. However, many of these studies tend to use intermediary outcomes, such as perceived personal skill in and frequency of taking a sexual history, rather than actual skill measurement (Cushing et al, 2005;Vollmer et al, 1989;Skelton & Matthews, 2001). Therefore, one aim of our project was to develop a standardized and proven approach to teaching sexual history and HIV counseling (SHHIVC) skills.…”

mentioning

confidence: 99%