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Current Sexual Health Reports

, Volume 7, Issue 3, pp 133–139 | Cite as

Moving Medical Education and Sexuality Education Forward

Current Controversies (P Kleinplatz and C Moser, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Current Controversies

Abstract

Despite well-documented sexual health disparities, medical school training in human sexuality remains limited. Our intents with this paper are to deconstruct the successes and challenges in including sexuality education in medical education and to pose critical questions for moving medical education and sexuality education forward. We offer future systematic level strategies for consideration, including the role of health policy in addressing this problem in training. It is imperative that all physicians are well equipped to address sexual health with patients in order to help eliminate sexual health disparities. Finding solutions to bridge the patient realities with the medical training realities is one step in creating sexually healthy societies.

Keywords

Medical education Sexuality education Health professional education Sexual health Health policy 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Carey Roth Bayer and David Satcher declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Centers for Disease Control and Prevention. Disparities in HIV/AIDS, viral hepatitis, STDs, and TB. June 16, 2014. Online at: http://www.cdc.gov/nchhstp/healthdisparities/. Accessed 26 Jan 2015.
  2. 2.
    Buhi ER, Marhefka SL, Wheldon CW, Tilley DL, Klinkenberger N, Lescano C, et al. Sexual and reproductive health disparities in a national sample of Hispanic and non-Hispanic White US college students. J Health Disparities Res Pract. 2014;7(1, Article 3). Available at http://digitalscholarship.unlv.edu/jhdrp/vol7/iss1/3. Accessed 9 Jan 2015.
  3. 3.
    Centers for Disease Control and Prevention. Violence prevention. December 2, 2014. Online at: http://www.cdc.gov/violenceprevention/. Accessed 26 Jan 2015.
  4. 4.
    Guttmacher Institute. Data center. 2014. Online at: http://www.guttmacher.org/datacenter/index.jsp. Accessed 26 Jan 2015.
  5. 5.
    Johnson NB, Hayes LD, Brown K, Hoo E, Ethier K. CDC national health report: leading causes of morbidity and mortality and associated behavioral risk and protective factors—United States, 2005-2013. Morb Mortal Wkly Rep. 2014;63(4):3–27.Google Scholar
  6. 6.
    Dean HD, Fenton KF. Addressing social determinants of health in the prevention and control of HIV/AIDS, viral hepatitis, sexually transmitted infections, and tuberculosis. Public Health Rep. 2010;125(4):1–5.PubMedCentralPubMedGoogle Scholar
  7. 7.•
    Criniti S, Andellous M, Woodland MB, Montgomery OC, Urdaneta HS. The state of sexual health education in U.S. medicine. Am J Sex Educ. 2014;9(1):65–80. A summary of current sexual health and medical education paradigms and programs is included.CrossRefGoogle Scholar
  8. 8.•
    Coleman E, Elders J, Satcher D, Shindel A, Parish S, Kenagy G, et al. Summit on medical school education in sexual health: report of an expert consultation. J Sex Med. 2013;10:924–38. A summary of the key findings from the 2012 Summit on Medical School Education in Sexual Health is included in addition to recommendations for content inclusion in undergraduate and graduate medical education.PubMedCrossRefGoogle Scholar
  9. 9.
    Shindel A, Parish S. Sexuality education in North American medical schools: current status and future directions. J Sex Med. 2013;10:3–18.PubMedCrossRefGoogle Scholar
  10. 10.
    Dyer K, das Nair R. Why don’t healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the United Kingdom. J Sex Med. 2013;10:2658–70.PubMedCrossRefGoogle Scholar
  11. 11.
    Barrett M, McKay A, Dickson C, Seto J, Fisher W, Read R, et al. Sexual health curriculum and training in Canadian medical schools: a study of family medicine, obstetrics and gynaecology and undergraduate medicine programs in 2011 with comparisons to 1996. Can J Hum Sex. 2012;21(2):63–73.Google Scholar
  12. 12.
    Galletly C, Lechuga J, Layde J, Pinkerton S. Sexual health curricula in U.S. medical schools: current educational objectives. Acad Psychiatry. 2010;34(5):333–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Wittenberg A, Gerber J. Recommendations for improving sexual health curricula in medical schools: results from a two-arm study collecting data from patients and medical students. J Sex Med. 2009;6:362–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Malhotra S, Khurshid A, Hendricks K, Mann J. Medical school sexual health curriculum and training in the United States. J Natl Med Assoc. 2008;100(9):1097–106.PubMedGoogle Scholar
  15. 15.
    Parish S, Clayton A. Sexual medicine education: review and commentary. J Sex Med. 2007;4:259–68.PubMedCrossRefGoogle Scholar
  16. 16.
    Solursh DS, Ernst JL, Lewis RW, Prisant LM, Mills TM, Solursh LP, et al. The human sexuality education of physicians in North American medical schools. J Sex Med. 2003;15(supplement 5):S41–5.Google Scholar
  17. 17.
    Coleman E. Sexual health education in medical school: a comprehensive curriculum. Virtual Mentor. 2014;16(11):903–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Dwyer RG, Thornhill JT. Recommendations for teaching sexual health: how to ask and what to do with the answers. Acad Psychiatry. 2010;34(5):339–41.PubMedCrossRefGoogle Scholar
  19. 19.
    Center of Excellence for Sexual Health. Promoting sexual health and responsible sexual behavior: a universal curriculum for health professionals. Atlanta: Morehouse School of Medicine; 2009.Google Scholar
  20. 20.
    Rosen R, Kountz D, Post-Zwicker T, Leiblum S, Wiegel M. Sexual communication skills in residency training: the Robert Wood Johnson model. J Sex Med. 2006;3:37–46.PubMedCrossRefGoogle Scholar
  21. 21.
    Ferrara E, Pugnair MP, Jonassen JA, O’Dell K, Clay M, Hatem D, et al. Sexual health innovations in undergraduate medical education. Int J Impot Res. 2003;15(supplement 5):S46–50.PubMedCrossRefGoogle Scholar
  22. 22.•
    Hollenbach A, Eckstrand K, Dreger A, editors. Implementing curricular and institutional climate changes to improve health care for individuals who are LGBT, gender nonconforming, or born with DSD. Washington, DC: Association of American Medical Colleges; 2014. Includes expansive lists of medical schools and professional organizations focusing on sexual health.Google Scholar
  23. 23.
    Institute of Medicine of the National Academies. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington, D.C.: The National Academies Press; 2011.Google Scholar
  24. 24.
    Obedin-Maliver J, Goldsmith E, Stewart L, White W, Tran E, Brenman S, et al. Lesbian, gay, bisexual, and transgender-related content in undergraduate medical education. J Am Med Assoc. 2011;306(9):971–7.CrossRefGoogle Scholar
  25. 25.
    The Joint Commission. Advancing effective communication, cultural competence, and patient- and family-centered care for the lesbian, gay, bisexual, and transgender (LGBT) community: a field guide. Oak Brook: LGBTFieldGuide.pdf; 2011.Google Scholar
  26. 26.
    Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgenderism. 2011;13:165–232.CrossRefGoogle Scholar
  27. 27.
    Human Rights Campaign Foundation. Healthcare equality index 2011: creating a national standard for equal treatment of lesbian, gay, bisexual and transgender patients and their families. Washington, D.C: Human Rights Campaign Foundation; 2011.Google Scholar
  28. 28.
    Snowdon S. The medical school curriculum and LGBT health concerns. Virtual Mentor. 2010;12:638–43.PubMedCrossRefGoogle Scholar
  29. 29.
    Turner D, Konstantin J, Nieder T, Briken P. German medical students’ interest in and knowledge about human sexuality in 1972 and 2012. J Sex Med. 2014;11:1914–26.PubMedGoogle Scholar
  30. 30.
    Fazli Khalaf Z, Yun Low W, Merghati-Khoei E, Ghorbani B. Sexuality education in Malaysia: perceived issues and barriers by professionals. Asia Pac J Public Health. 2014;26(4):358–66.CrossRefGoogle Scholar
  31. 31.
    Cronemberger Rufino A, Madeiro A, João Batista Castello Girão M. Sexuality education in Brazilian medical schools. J Sex Med. 2014;11:1110–7.CrossRefGoogle Scholar
  32. 32.
    Wylie K, Weerakoon P. International perspective on teaching human sexuality. Acad Psychiatry. 2010;34(5):397–402.PubMedCrossRefGoogle Scholar
  33. 33.
    Parish S, Rubio-Aurioles E. Education in sexual medicine: proceedings from the international consultation in sexual medicine, 2009. J Sex Med. 2010;7:3305–14.PubMedCrossRefGoogle Scholar
  34. 34.
    Wagner G. Sexual medicine in the medical curriculum. Int J Androl. 2005;28(supplement 2):7–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Sansone R, Wiederman M. Sexuality training for psychiatry residents: a national survey of training directors. J Sex Marital Ther. 2000;26:249–56.PubMedCrossRefGoogle Scholar
  36. 36.
    Waineo E, Arfken C, Morreale M. Sexual health education: a psychiatric resident’s perspective. Acad Psychiatry. 2010;34(5):357–60.PubMedCrossRefGoogle Scholar
  37. 37.
    Levine S, Scott D. Sexual education for psychiatric residents. Acad Psychiatry. 2010;34(5):349–52.PubMedCrossRefGoogle Scholar
  38. 38.
    Persson T, Drury K, Gluch E, Wiviott G. Sex education groups in a psychiatric day hospital: clinical observations. J Sex Marital Ther. 2014. doi: 10.1080/0092623X.2014.999395.PubMedGoogle Scholar
  39. 39.
    Ribeiro S, Alarcãro V, Simões R, Leão Miranda F, Carreira M, Glavão-Teles A. General practitioners’ procedures for sexual history taking and treating sexual dysfunction in primary care. J Sex Med. 2014;11:386–93.PubMedCrossRefGoogle Scholar
  40. 40.
    Clark J, Brey R, Banter A, Khubchandani J. The delivery of sexuality-related patient education to adolescent patients: a preliminary study of family practice resident physicians. J Fam Med Prim Care. 2012;1(1):34–8.CrossRefGoogle Scholar
  41. 41.
    Morreal M, Arfken C, Balon R. Survey of sexual education among residents from different specialties. Acad Psychiatry. 2010;34(5):346–8.CrossRefGoogle Scholar
  42. 42.
    Sobecki J, Curlin F, Rasinski K, Tessler LS. What we don’t talk about when we don’t talk about sex: results of a national survey of U.S. obstetrician/gynecologists. J Sex Med. 2012;9:1285–94.PubMedCentralPubMedCrossRefGoogle Scholar
  43. 43.
    Pancholy A, Goldenhar L, Fellner A, Crisp C, Kleerman S, Pauls R. Resident education and training in female sexuality: results of a national survey. J Sex Med. 2011;8:361–6.PubMedCrossRefGoogle Scholar
  44. 44.
    Marcell A, Ellen J. Core sexual/reproductive health care to deliver to male adolescents: perceptions of clinicians focused on male health. J Adolesc Health. 2012;51(1):38–44.PubMedCentralPubMedCrossRefGoogle Scholar
  45. 45.
    Foley S, Wittmann D, Balon R. A multidisciplinary approach to sexual dysfunction in medical education. Acad Psychiatry. 2010;34(5):386–9.PubMedCrossRefGoogle Scholar
  46. 46.
    Weaver Duldt B, Pokorny ME. Teaching communication about human sexuality to nurses and other healthcare providers. Nurse Educ. 1999;24(5):27–32.CrossRefGoogle Scholar
  47. 47.•
    Althof S, Rosen R, Perelman M, Rubio-Aurioles E. Standard operating procedures for taking a sexual history. J Sex Med. 2013;10:26–35. Provides essential information on sexual-history taking.PubMedCrossRefGoogle Scholar
  48. 48.
    Coverdale J, Balon R, Weiss RL. Teaching sexual history-taking: a systematic review of educational programs. Acad Med. 2011;86(12):1590–5.PubMedCrossRefGoogle Scholar
  49. 49.
    Daniels T. Let’s talk about sex. Virtual Mentor. 2010;12(8):650–3.PubMedCrossRefGoogle Scholar
  50. 50.
    Wimberly Y, Hogben M, Moore-Ruffin J, Moore S, Fry-Johnson Y. Sexual history-taking among primary care physicians. J Natl Med Assoc. 2006;98(12):1924–9.PubMedCentralPubMedGoogle Scholar
  51. 51.
    Pakpreo P. Why do we take a sexual history? Virtual Mentor. 2005;7(10).Google Scholar
  52. 52.
    Nusbaum M, Hamilton C. The proactive sexual health history. Am Fam Physician. 2002;66(9):1705–12.PubMedGoogle Scholar
  53. 53.
    Navy and Marine Corps Public Health Center – Sexual Health and Responsibility Program. Brief guide for sexual risk assessment and intervention, version 11/18/2014. Retrieved online December 10, 2014 from: http://www.med.navy.mil/sites/nmcphc/health-promotion/reproductive-sexual-health/Pages/sexual-health-resources.aspx.
  54. 54.
    National LGBT Health Education Center: a program of the Fenway Insitute & National Association of Community Health Centers. Taking routine histories of sexual health: a system-wide approach for health centers. Boston: National LGBT Health Education Center: A Program of the Fenway Institute & National Association of Community Health Centers & National Association of Community Health Centers; 2013.Google Scholar
  55. 55.
    The Fenway Institute & Center for American Progress. Asking patients questions about sexual orientation and gender identity in clinical settings: a study in four health centers. Boston: The Fenway Institute & Center for American Progress; 2013.Google Scholar
  56. 56.
    California Department of Public Health STD Control Branch & California STD/HIV Prevention Training Center. A clinican’s guide to sexual history taking. Sacramento, CA: California Department of Public Health STD Control Branch & California STD/HIV Prevention Training Center; 2011.Google Scholar
  57. 57.
    Monasterio E, Combs N, Warner L, Larsen-Fleming M, St. Andrews A. Sexual health: an adolescent provider toolkit. San Francisco: Adolescent Health Working Group, San Francisco; 2010.Google Scholar
  58. 58.
    Creegan L, Gelt M. Sexual history-taking toolkit: focus on Chlamydia, gonorrhea, and HIV in the family planning clinic. Los Angeles: California Family Health Council, Inc., Center for Health Training, California STD/HIV Prevention Training Center; 2009.Google Scholar
  59. 59.
    U.S. Department of Health and Human Services: Centers for Disease Control and Prevention. Taking a sexual history: a guide to taking a sexual history. CDC Publication 99-8445. Atlanta: Centers for Disease Control and Prevention; 2005.Google Scholar
  60. 60.
    Giorgio M, Kantor L, Levine D, Arons W. Using chat and text technologies to answer sexual and reproductive health questions: planned parenthood pilot study. J Med Internet Res. 2013;15(9), e203.PubMedCentralPubMedCrossRefGoogle Scholar
  61. 61.
    McCarthy O, Carswell K, Murray E, Free C, Stevenson F, Bailey J. What people want from a sexual health website: design and development of Sexunzipped. J Med Internet Res. 2012;14(5), e127.PubMedCentralPubMedCrossRefGoogle Scholar
  62. 62.•
    Englander R, Cameron T, Ballard AJ, Dodge J, Bull J, Aschenbrener CA. Toward a common taxonomy of competency domains for the health professions and competencies for physicians. Acad Med. 2013;88(8):1088–94. Essential for understanding competency-based medical education.PubMedCrossRefGoogle Scholar
  63. 63.
    Boodman S. Medical school done faster, The Washington Post. January 13, 2014. Retrieved from http://www.washingtonpost.com/national/health-science/medical-school-done-faster/2014/01/13/4b6d9e54-5c40-11e3-be07-006c776266ed_story.html.
  64. 64.
    Haberland N, Rogow D. Sexuality education: emerging trends in evidence and practice. J Adolesc Health. 2015;56:S15–21.PubMedCrossRefGoogle Scholar
  65. 65.
    Schalet A, Santelli J, Russell S, Halpern C, Miller S, Pickering S, et al. Invited commentary: broadening the evidence for adolescent sexual and reproductive health and education in the United States. J Youth Adolesc. 2014;43:1595–610.PubMedCentralPubMedCrossRefGoogle Scholar
  66. 66.
    Ketting E, Winkelmann C. New approaches to sexuality education and underlying paradigms. Bundesgesundheitsbl. 2013;56:250–5.CrossRefGoogle Scholar
  67. 67.
    Dorsey R, Graham G, Glied S, Meyers D, Clancy C, Koh H. Implementing health reform: improved data collection and the monitoring of health disparities. Annu Rev Public Health. 2014;35:123–38.PubMedCrossRefGoogle Scholar
  68. 68.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.Google Scholar
  69. 69.
    World Health Organization. Defining sexual health: report of a technical consultation on sexual health, 28-31 January 2002, Geneva. Geneva: World Health Organization; 2006.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2015

Authors and Affiliations

  1. 1.Morehouse School of MedicineSatcher Health Leadership InstituteAtlantaUSA

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