Let’s talk about sex history: impact of a communication curriculum on medical student performance and perceived competency
Introduction: Communication in general, but especially regarding difficult topics such as sexual health is inadequately addressed in undergraduate medical education. Students often feel they are poorly trained in this area due to a lack of opportunities to practice taking sexual history. Thus, a communication curriculum was implemented to address this gap, including formal small group practice sessions on taking a sexual history during the Obstetrics and Gynecology (OB/GYN) clerkship.
Aim: Determine whether medical students who completed a sexual history communication curriculum performed better during a formal standardized patient based assessment (PBA) at the conclusion of the OB/GYN clerkship than historical control medical students, and assess medical student perception about taking a sexual history.
Methods: Retrospective study comparing 3 specific PBA standardized patient rating questions and 5 questions gathering medical student feedback at a single academic institution. All (n=71) medical students between January and June 2011 were queried at the conclusion of their OB/GYN clerkship prior to implementation of the sexual history curriculum in July 2011 with responses compared to all subsequent (n=432) medical students through June 2014.
Main Outcome Measures: Cochran-Mantel-Haenszel was used to compare scores by clerkship year and block with p<0.05 significant.
Results: There was no change in medical student PBA performance or medical student perception regarding ability to take a sexual history following implementation of the sexual history communication curriculum. However, in response to “what other instruction or experiences could the clerkship provide to help you gain competency,” the theme was more practical experience.
Conclusion: Learners require different formats to promote and enhance learning which may not have been measured with the outcomes chosen for this study. This may be best achieved by implementation of a formal curriculum including explicit supplementation to incorporate additional experience with sexual history taking.