Sexual History Taking Curriculum: Lecture and Standardized Patient Cases

This sexual history taking module engages medical students in discussion and practice with standardized patients in taking an inclusive (orientationand 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 firstand 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 1-hour-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 4.3 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. Please see the end of the Educational Summary Report for author-supplied information and links to peer-reviewed digital content associated with this publication. Introduction It is well known in the literature that health care providers do not routinely perform a complete sexual history.1,2 One of the most commonly cited reasons is lack of education and lack of comfort around how to do this. We recognized that our core communications curriculum did not include sexual history taking. Thus, this session was created to address this need and to allow students to practice a challenging communications skill. In addition, an inclusive sexual history is one method lesbian, gay, bisexual, and transgender (LGBT) patients use to recognize a health care provider as being LGBT-friendly.3 A secondary goal of this educational session was to improve student awareness of LGBT health disparities and to provide foundational skills in caring for LGBT patients, predominantly from a cultural standpoint. Most medical schools, including our own curriculum, provide minimal education on LGBT health topics.4 In 2008, we conducted a needs assessment of our communications curriculum. We found that while 87.7% of our students felt a sexual history was important, only 70.1% (p < .0001) felt confident in conducting and 51.9% (p < .0001) routinely performed a sexual history. Of the students, 72% and 85% reported wanting to learn about and practice sexual history taking skills, respectively. Thus, this curriculum was developed to address this need. This curriculum was implemented at the University of Colorado School of Medicine in 2009 and has been held annually since. The original materials were based on existing literature on sexual history taking and were modified using the Centers for Disease Control 5 “P”s model.5-7 This session can be held at any point in the medical school Lee R, Loeb D, Butterfield A. Sexual history taking curriculum: lecture and standardized patient cases. MedEdPORTAL Publications. 2014;10:9856. http://dx.doi.org/10.15766/mep_2374-8265.9856 Published: July 30, 2014