Increasing medical student confidence in gender and sexual health through a student-initiated lecture series

Sexual health in patient care: shortcomings in medical training and experienced barriers in sexual history taking

BACKGROUND

Sexual health is recognized as a fundamental component of well-being, with implications for individuals, communities, and healthcare practices. This study explores medical residents' perspectives on training in sexual history taking, emphasizing its importance and the challenges faced at the onset of their clinical practice.

METHODS

A survey was conducted among 167 medical residents at the largest medical school in Belgium and their training curriculum was analysed. The participants completed an online questionnaire addressing aspects of sexual history training, skills, knowledge, attitudes, and factors influencing sexual history taking.

RESULTS

The survey revealed several shortcomings in the medical training in sexual history taking. Dissatisfaction is expressed regarding the adequacy of provided training, with a prominent barrier being the lack of skills and knowledge necessary for effective sexual history taking. Discomfort, experienced by physicians and their patients, emerges as a critical factor affecting the initiation and quality of sexual history discussions. Other challenges include biases related to religion, ethnicity, age, and gender, while practical factors, such as time constraints and language barriers, underscore the multitude of obstacles in comprehensive sexual history assessments.

CONCLUSION

This study highlights the opportunities for improved training in sexual history taking in medical education, contributing to more inclusive and effective sexual history taking practices. Recommendations are made, including targeted interventions to improve skills, knowledge and attitude of the students.

Gaps in sexual health content of healthcare professional curriculum: a systematic review of educational interventions

BACKGROUND

Sexual health care, including assessment and patient teaching, is part of comprehensive patient care. Health professional (medical and nursing) students' education in sexual health lacks uniformity in content and assessment skills.

OBJECTIVES

The current systematic review aimed to assess sexual health educational curriculum for health professional students regarding the educational content, duration, and evaluation of these educational interventions.

METHODS

This systematic review followed the preferred reporting guidelines for systematic reviews. A comprehensive search was conducted between May-August, 2023 across four databases (PubMed, Scopus, CINAHL, EMBASE), outlining 614 sources. Following the screening process, 36 educational intervention studies were deemed eligible for inclusion. The quality assessment of these studies was conducted using The Effective Public Health Project tool, which was found appropriate for evaluating this type of research.

RESULTS

The studies had a global representation, with most studies conducted in the US. Limited nursing educational interventions were found. Three main categories emerged from the analysis of the educational interventions: one-time interventions, workshops, and semester courses. These categories differed in terms of their duration. Upon evaluating the educational intervention programs, it was found that the majority relied on participant self-reporting, while only a few included objective evaluations.

CONCLUSIONS

This review revealed inconsistencies in educational content for healthcare professional students and may impact their clinical skills, particularly in sexual health. The variation in content, duration, and evaluation methods created challenges in assessing the interventions. The lack of standardized sexual health education highlighted a significant gap, raising concerns about students' ultimate proficiency in this area. Bridging this divide is essential by integrating comprehensive sexual health content and assessment skills into the health professional curriculum.

Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators

Health disparities faced by transgender people are partly explained by barriers to trans-inclusive healthcare, which in turn are linked to a lack of transgender health education in medical school curricula. We carried out a theory-driven systematic review with the aim to (1) provide an overview of key characteristics of training initiatives and pedagogical features, and (2) analyze barriers and facilitators to implementing this training in medical education. We used queer theory to contextualize our findings. We searched the PubMed/Ovid MEDLINE database (October 2009 to December 2021) for original studies that reported on transgender content within medical schools and residency programs (N = 46). We performed a thematic analysis to identify training characteristics, pedagogical features, barriers and facilitators. Most training consisted of single-session interventions, with varying modes of delivery. Most interventions were facilitated by instructors with a range of professional experience and half covered general LGBT+-content. Thematic analysis highlighted barriers including lack of educational materials, lack of faculty expertise, time/costs constraints, and challenges in recruiting and compensating transgender guest speakers. Facilitators included scaffolding learning throughout the curriculum, drawing on expertise of transgender people and engaging learners in skills-based training. Sustainable implementation of transgender-health objectives in medical education faces persistent institutional barriers. These barriers are rooted in normative biases inherent to biomedical knowledge production, and an understanding of categories of sex and gender as uncomplicated. Medical schools should facilitate trans-inclusive educational strategies to combat transgender-health inequities, which should include a critical stance toward binary conceptualizations of sex and gender throughout the curriculum.