Sexual History Taking Curriculum: Lecture and Standardized Patient Cases

Abstract

This sexual history taking module engages medical students in discussion and practice with standardized patients in taking an inclusive (orientation-and gender-neutral) sexual history. An inclusive sexual history is critical to providing comprehensive patient care and an environment supportive of lesbian, gay, bisexual, and transgender (LGBT) patients. This case was developed for first-and second-year medical students who have had basic communication skills training. This session was designed to be delivered in one 40-minute large-group session followed by three 1hour-long small-group sessions (with one third of the class participating in each session) with standardized patients. Four students per group is optimal. Faculty training should take approximately 30 minutes prior to the session as well as participation in the large-group session. The materials associated with this publication include guidelines for faculty facilitators and students to prepare them for the large-group discussion and small-group practice sessions with standardized patients. Also included are four standardized patient cases, a slide presentation using an audience response system for the large-group session, and an evaluation form. The average response to "Overall, this session was effective in improving my sexual history taking skills" has been out of 5. Our communication needs assessment has shown a statistically significant improvement in those reporting increased importance, confidence, and performance of a sexual history between the first and second year of medical school (before and after the curriculum). In addition, students reported performing more components of the sexual history after the session. This sexual history taking module has been incorporated into our Foundations of Doctoring communications curriculum and has been rated as highly effective by learners. Performing an inclusive sexual history is critical to providing comprehensive patient care as well as providing an environment supportive of LGBT patients. Educational Objectives By the end of this module, the learner will be able to: 1. Describe the rationale and steps for performing a gender-and orientation-neutral sexual history. 2. Recognize the breadth of expression of sexuality and gender identity. 3. Practice performing a gender-and orientation-neutral sexual history.

Cultural Competency Interventions During Medical School: a Scoping Review and Narrative Synthesis

“…Eighteen articles were identified as focusing on cultural competency training on gender and sexual minorities. [147][148][149][150][151][152][153][154][155][156][157][158][159][160][161][162][163] Most of the interventions (16/18) were designed as 1-3-h sessions, used lectures as a teaching modality (8/18), and used surveys as an assessment tool (15/ 18). SP sessions were also commonly used to teach and assess students' ability to take an inclusive sexual history.…”

Introductory Learning of Inclusive Sexual History Taking: An E-Lecture, Standardized Patient Case, and Facilitated Debrief

“…Therefore, utilizing resources from MedEdPORTAL, the 2014 AAMC report, and the Fenway Institute, our team created a three-part module that was implemented with first-year medical students in September 2015 as an introduction to SGM terminology and inclusive sexual history taking. 9–11,13 This module can be implemented any time in the medical school curriculum, but it was used in the first year of training at our institution to normalize the topic and create a foundation for future SGM health curricula. 14 As repetitive reinforcement and reflection have been shown to improve learning, the module consisted of three parts: an e-lecture, an SP activity, and a facilitated debrief.…”

LGBTQ+ Health—a Novel Course for Undergraduate Students

“…Particularly in the setting of health professional student involvement, there would be an increased emphasis on demonstrable skills. The addition of standardized patient encounters has shown evidence of benefit in this regard and would allow a greater depth of engagement of the LGBTQ+ health concepts through simulated application of the concepts addressed [20][21][22]. Our assessments would require expansion in a complementary fashion, beyond the written exam-based assessments of competence in place for the course's first iteration, to include the objective structured clinical evaluation (OSCE) format.…”