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REVIEW ARTICLE
Year : 2022  |  Volume : 49  |  Issue : 1  |  Page : 17-19

Inclusion of sexual health-related competencies in undergraduate medical education


1 Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission04-Jul-2021
Date of Acceptance15-Sep-2021
Date of Web Publication22-Apr-2022

Correspondence Address:
Prateek Saurabh Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.jss_91_21

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  Abstract 


Sexual health has been recognized as an essential component of the overall health of humans. The purpose of current review is to explore the need and opportunities for the incorporation of sexual health-related competencies in the undergraduate medical curriculum. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of 9 articles were selected based upon the suitability with the current review objectives and analyzed. Keywords used in the search include sexual health and medical education in the title alone only. In general, the health professionals are not ready for this role on their own, and this establishes the need that undergraduate medical students should be exposed to competencies pertaining to sexual health during their training period. In the current setup, we cannot ignore the fact that not many teaching hours are assigned to sexual health, there is absence of standard competencies, lack of plans for teaching-learning or assessment of the same, and the discomfort among both doctors and patients to openly talk about the same. The competencies for sexual health should be formulated, and subsequently, a thorough curriculum mapping should be done. In conclusion, regardless of the specialty branch which an undergraduate medical student might opt in the future, there is an indispensable need to expose them to competencies pertaining to the maintenance of sexual health and well-being.

Keywords: Curriculum, medical education, sexual health


How to cite this article:
Shrivastava SR, Shrivastava PS. Inclusion of sexual health-related competencies in undergraduate medical education. J Sci Soc 2022;49:17-9

How to cite this URL:
Shrivastava SR, Shrivastava PS. Inclusion of sexual health-related competencies in undergraduate medical education. J Sci Soc [serial online] 2022 [cited 2022 Aug 15];49:17-9. Available from: https://www.jscisociety.com/text.asp?2022/49/1/17/343711




  Introduction Top


Sexual health has been recognized as an essential component of the overall health of humans, especially considering the rising trends of sexually transmitted infections and the social issues prevailing in the community.[1] At the same time, the role of health-care personnel in the management of sexual health (namely contraception, sexually transmitted infections, acceptance of discussion pertaining to sexual health/illnesses, etc.) has shown a significant rise.[1],[2] In addition, the health professionals have to also respond to the mental concerns arising because of the sexual issues, and thus in general, they have to be knowledgeable and confident about a wide range of topics.[2] There is an immense need to encourage the existing medical professionals to get sensitized to the recent developments in the sexual health, so that they can effectively discharge their role in clinical practice.[3] The purpose of current review is to explore the need and opportunities for the incorporation of sexual health-related competencies in the undergraduate medical curriculum.


  Methods Top


An extensive search of all materials related to the topic was carried out in the PubMed search engine. Relevant research articles focusing on sexual health in undergraduate medical education published in the period 2003–2021 were included in the review. A total of 10 studies similar to current study objectives were identified initially, of which, 1 was excluded due to the unavailability of the complete version of the articles. Overall, 9 articles were selected based upon the suitability with the current review objectives and analyzed. Keywords used in the search include sexual health and medical education in the title alone only (namely sexual health [ti] AND medical education [ti]; sexual health [ti] AND undergraduate medical education [ti]). The articles published only in English language were included for the current review [Figure 1]. The collected information is presented under the following subheadings, namely ground reality, medical education and sexual health, sexual health-related competencies, and implementation considerations.
Figure 1: Framework for selection of studies

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Ground reality

In general, the health professionals are not ready for their role in delivering sexual health on their own, and this establishes the need that undergraduate medical students should be exposed to competencies pertaining to sexual health during their training period.[4] In the current setup, we cannot ignore the fact that not many teaching hours are assigned to sexual health, there is absence of standard competencies, lack of plans for teaching-learning or assessment of the same, and the discomfort among both doctors and patients to openly talk about the same.[2] Owing to the reluctance, most of the problems pertaining to the sexual health goes unaddressed, and eventually, the patient has to pay the price for the same in the form of impairment of quality of life and the development of complications (all of which could have been avoided, if timely intervention would have been done).[2],[4]

From the general population perspective, it is not too much to expect from the doctors to be aware about sexuality and their willingness to discuss sexual health, and the same applies even to primary care practitioners who can address most of such needs at the grassroot level itself.[2],[4] At the same time, we cannot ignore the fact that even the members of the community are not comfortable to open up about their sexual health-related ailments and this calls for the need to intensify advocacy, communication, and social mobilization activities.[2],[5] These awareness activities should predominantly aim toward making people realize that it is normal to have sexual health-related complaints and that they are quite common, most of these issues are manageable and preventable, that people should approach health-care facilities for their complaints, the confidentiality will be maintained in health settings, and finally the range of services available in health-care settings. These awareness activities will significantly aid in responding to the existing barriers and thereby gradually will improve the uptake of health services by the general population.[2],[4],[5]

Medical education and sexual health

Students enrolling for the medical course are from diverse backgrounds, with some being introvert while many finding it extremely difficult to talk about sexual issues with the patients.[1] At the same time, owing to the different cultural and religious backgrounds, the students might have varied perception about sexuality in the medical curriculum. Moreover, the environment in the medical schools also impacts the views of medical students about sexuality.[1],[6],[7] To neutralize all these concerns, it is a must that all undergraduate medical students receive adequate training so that they are comfortable while responding to the issues pertaining to sexuality.[2],[6] In the preclinical medical education delivered in medical institutions in the North American region, specific impetus has been given towards preclinical medical education in sexual history taking.

Sexual health-related competencies

The competencies for sexual health should comprise the details pertaining to the sexual development, differences in sexual development, similarities and dissimilarities between sex and gender, gender identity, confidentiality, skills for eliciting sexual history, and skills for performing gynecological and genitourinary examinations.[4],[6] In addition, students should be also exposed to counseling for the prevention of sexual ailments and demonstrate empathy toward sexual health issues (namely unintended pregnancy and intimate partner violence), implications on health, management of sexual complaints, and social determinants of sexual health.[8],[9] It is always a good approach to identify the needs of the medical students and include them as well in the curriculum.[4],[6],[9]

Implementation considerations

Once the competencies are formulated, specific learning objectives should be derived and thorough curriculum mapping (namely which competencies will be covered when, teaching-learning method, and plan for assessment) should be done.[4],[8],[9] The ideal thing will be to spread the coverage of sexual health competencies throughout the duration of training across all the professional years, including the period of internship. Further, there has to be a mechanism for the evaluation of the entire initiative, so that the desired modifications can be done during the mid-course or for the next batch of medical students.[2],[4],[6]


  Conclusion Top


In conclusion, regardless of the specialty branch which an undergraduate medical student might opt in the future, there is an indispensable need to expose them to competencies pertaining to the maintenance of sexual health and well-being. It is high time that sexual health is given due importance and incorporated within the curriculum for the benefit of both medical students and for the benefit of the society.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Stumbar SE, Brown DR, Lupi CS. Developing and implementing curricular objectives for sexual health in undergraduate medical education: A practical approach. Acad Med 2020;95:77-82.  Back to cited text no. 1
    
2.
Bayer CR, Satcher D. Moving medical education and sexuality education forward. Curr Sex Health Rep 2015;7:133-9.  Back to cited text no. 2
    
3.
Reader F, Marfleet C, Nash K. Development of UPCASH (Update in Contraception and Sexual Health) flexible continuing medical education. J Fam Plann Reprod Health Care 2007;33:78.  Back to cited text no. 3
    
4.
Elfers J, Carlton L, Gibson P, Puffer M, Smith S, Todd K. The core competencies for adolescent sexual and reproductive health. Am J Sex Educ 2014;9:81-98.  Back to cited text no. 4
    
5.
Gordon EG. A medical education recommendation for improving sexual health and humanism and professionalism. Sex Med Rev 2021;9:23-35.  Back to cited text no. 5
    
6.
Shindel AW, Baazeem A, Eardley I, Coleman E. Sexual health in undergraduate medical education: Existing and future needs and platforms. J Sex Med 2016;13:1013-26.  Back to cited text no. 6
    
7.
Rubin ES, Rullo J, Tsai P, Criniti S, Elders J, Thielen JM, et al. Best practices in north American pre-clinical medical education in sexual history taking: Consensus from the summits in medical education in Sexual health. J Sex Med 2018;15:1414-25.  Back to cited text no. 7
    
8.
Ferrara E, Pugnaire 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 Suppl 5:S46-50.  Back to cited text no. 8
    
9.
Bayer CR, Eckstrand KL, Knudson G, Koehler J, Leibowitz S, Tsai P, et al. Sexual health competencies for undergraduate medical education in North America. J Sex Med 2017;14:535-40.  Back to cited text no. 9
    


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