Medical student views on teaching about sexual dysfunction

Dear Sir

Talking about sexual issues with patients can be difficult and requires training in good communication skills. Whilst most health care professionals think that medical staff should discuss psychosexual issues only a quarter actually do (Stead et al. 2001). Students should gain an understanding of how sexual behaviour has an impact on health, be able to broach the subject of their patient's sex life and to be comfortable when discussing sexual practices and sexual orientation (BASHH 1999).

To evaluate attitudes to the relevance of training in sexual dysfunction all medical students in our School were emailed background information and a request to participate in an online anonymous survey. We sought information on aspects of teaching in sexual dysfunction: the perceived need for delivery of teaching on sexual problems and intimate examinations; actual experience of patients with sexual problems and difficulties in talking about sex (both doctors and patients).

More than 95% of students considered that genital examination, management of sexual dysfunction and communication about sex with patients should be included in teaching. Interestingly they considered the subjective response of the patient and the doctor to be less relevant which may explain in part the difficulty around acknowledging the anxiety evoked by this subject.

Small group work, not large lectures, was considered the optimal way of delivering these topics. Over three quarters of respondents accepted the clinical significance of sexual dysfunction and wanted to know how and when to refer people with it. A major concern to us about the learning experience is that most (73%) reported that rarely actually encountering sexual problems during their training. We also noted that 2–3% of students across all years felt that sexual problems were of no concern or that there was no need for training in this area; this belief is likely to hold beyond graduation and this aspect of health will be ignored by a proportion of doctors.

Overall it does seem that our students largely do understand and value the role of this aspect of their teaching. We need to continue to protect the need for high quality teaching in this matter, ensuring that the appropriate environment is available for it to be taught effectively. This must include small group teaching.

Naomi Jobson

Obstetrics and Gynaecology

St. Michael Hospital

Bristol

Tessa Crowley

Milne Clinic

Bristol Royal Infirmary

Bristol

Catherine Coulson

Obstetrics and Gynaecology

St. Michael Hospital

Bristol

David Cahill

Academic Unit of Obstetrics and Gynaecology

University of Bristol

Level D, St. Michael's Hospital

Southwell St.

Bristol BS2 8EG UK

Email: [email protected]