A teaching intervention for medical undergraduates to practice skills and attitudes necessary for providing sexual health care

Dear Sir

Rates of sexually transmitted infections continue to rise in the UK. Many clinicians, in particular general practitioners, are required to discuss sexual health matters with patients. Yet many feel uncomfortable doing so, citing inadequate training (Wittenberg & Gerber 2009). We developed a teaching intervention for medical students at the University of Edinburgh, focusing on experiential learning for sexual health consultations.

Four stations were created for students to rotate through in small groups. Three stations utilised simulated patients to act out common sexual health consultations: a patient with symptoms of urethritis, for HIV testing and for referral for termination of pregnancy (TOP). An “interactive demonstration” learning method was trialled, whereby the whole group controlled the consultation using one student to act as their “mouthpiece”. Consultations could be “paused” and “rewinded” by the facilitators, allowing students to test alternative approaches for communication. A fourth novel station was developed as a small group discussion; aiming to explore and broaden students’ attitudes around sexual health matters.

The experiential learning session was first piloted with 100 students in the academic year 2011–12. Each student was asked to rate their level of “enjoyment” and “usefulness” of the session by awarding a mark out of 10. Post-pilot, the teaching was formally implemented into the undergraduate programme of 2012–13. The same feedback questions were asked to students, with additional questions relating to any changes in attitudes towards specific sexual health issues following the teaching.

A mean value of 8/10 for both level of “enjoyment” and “usefulness” was achieved, in both the pilot and established programme. Of 211 post-pilot students who completed the questionnaire; 101 (47.8%), 124 (58.7%) and 99 (46.9%) reported they “thought differently” about sexual orientation, sexual lifestyle choices and TOP, respectively. Students reporting being more comfortable when dealing with differing sexual orientations, behaviours and TOP were 133 (63%), 155 (73.5%) and 130 (61.6%), respectively.

In view of these positive results, the teaching session is now permanent within Edinburgh’s undergraduate curriculum. This technique could be considered by other sexual health departments struggling to deliver experiential learning to students.