Purpose: To determine factors associated with students' comfort in addressing patients' sexuality in the clinical context.
Method: The authors invited students enrolled in MD-degree-granting and osteopathic medical schools in the United States and Canada to participate in an anonymous Internet survey between February and July 2008. The survey assessed ethnodemographic factors and sexual history. Respondents also completed the Center for Epidemiologic Studies Depression Scale. Male respondents completed the International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool. Female respondents completed the Female Sexual Function Index and the Index of Sex Life. The authors used descriptive statistics, ANOVA, and multivariable logistic regression to analyze responses.
Results: The authors' analyses included 2,261 completed survey responses: 910 from men, 1,343 from women, and 8 from individuals who self-identified as “other” gendered. Over 53% of respondents (n = 1,206) stated that they felt they had not received sufficient training in medical school to address sexual concerns clinically. Despite this, 81% of students (n = 1,827) reported feeling comfortable dealing with their patients' sexuality issues. Students with limited sexual experience, students at risk for sexual problems, and students who felt that they had not been trained adequately were less likely to report being comfortable talking to patients about sexual health issues.
Conclusions: Perception of inadequate sexuality training in medical school and personal issues pertaining to sex may be associated with students' difficulty in addressing patients' sexuality. Adequate training is preeminently associated with feeling comfortable addressing patients' sexuality and should be a priority for medical education.
Dr. Shindel is clinical instructor, Department of Urology, University of California at San Francisco, San Francisco, California.
Dr. Ando is educator, Project Prepare, San Francisco, California.
Dr. Nelson is clinical psychologist, Memorial Sloan-Kettering Cancer Center, New York, New York.
Dr. Breyer is clinical instructor, Department of Urology, University of California at San Francisco, San Francisco, California.
Dr. Lue is Emil Tanagho Endowed Chair in Clinical Urology and vice-chair, Department of Urology, Department of Urology, University of California at San Francisco, San Francisco, California.
Dr. Smith is assistant professor, Department of Urology, University of California at San Francisco, San Francisco, California.
Correspondence should be addressed to Dr. Shindel, 400 Parnassus St., Ste A-660, Campus Box 0738, Department of Urology, University of California at San Francisco, San Francisco, CA 94143; telephone: (415) 353-7369; fax: (415) 476-8849; e-mail: email@example.com.