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Understanding Sexual Complaints and History Taking: A Standardized Patient Case on Dyspareunia for Obstetrics and Gynecology Clerkship Students.

ABSTRACT: Introduction:Learning to elicit a sexual history and counsel patients on sexual pain aligns with the Association of Professors of Gynecology and Obstetrics clerkship objectives. This topic can be challenging to cover due to lack of exposure in clinical encounters and inadequate coverage in preclinical studies. Methods:Second-year medical students in the OB/GYN clerkship participated in a standardized patient (SP) encounter on dyspareunia, receiving formative feedback on sexual history taking, differential diagnosis and management plan, and their SP's comfort during the encounter. Student feedback was obtained mid- and postclerkship. Summary statistics and regression models comparing SP encounter scores with shelf exam and clerkship scores are reported. Results:From September 2018 through July 2019, 101 students completed the encounter. Students asked an average of 3.9 of 13 sexual history questions. Sixty-six percent of students identified a correct diagnosis; 48% provided a management plan. The majority of students were very good or excellent at creating a safe environment. Most reported the encounter enhanced their learning (62%) and identified knowledge gaps (72%). SP encounter score was not associated with shelf exam score or clerkship letter grade but was associated with final clerkship score (unadjusted ß = 0.2, p = .009; adjusted ß = 0.1, p = .2). A summary didactic session was developed following student feedback. Discussion:This SP encounter and summary didactic session allowed students to improve their sexual history taking and may be associated with clerkship performance. These skills are necessary to advocate for patients with sensitive complaints across specialties.

SUBMITTER: Hagey JM

PROVIDER: S-EPMC7597941 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Understanding Sexual Complaints and History Taking: A Standardized Patient Case on Dyspareunia for Obstetrics and Gynecology Clerkship Students.

Hagey Jill M JM Toole Jordan J Branford Kelly K Reynolds Tracey T Livingston Elizabeth E Dotters-Katz Sarah K SK

MedEdPORTAL : the journal of teaching and learning resources 20201029

<h4>Introduction</h4>Learning to elicit a sexual history and counsel patients on sexual pain aligns with the Association of Professors of Gynecology and Obstetrics clerkship objectives. This topic can be challenging to cover due to lack of exposure in clinical encounters and inadequate coverage in preclinical studies.<h4>Methods</h4>Second-year medical students in the OB/GYN clerkship participated in a standardized patient (SP) encounter on dyspareunia, receiving formative feedback on sexual his ...[more]

PMID: 33150201

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Project description:BackgroundMany foreign students have difficulty taking histories from Chinese patients, especially in clinical context of the Department of Obstetrics and Gynaecology. The efficacy of using standardized patients to prepare foreign students for communicating with Chinese patients and taking their histories was evaluated in this study.MethodsNinety-four four-year foreign students were assigned to one of three clinical sub-departments (gynaecology, obstetrics, and reproductive endocrinology) to practice history-taking; after practicing in one sub-department, the students were then crossed over to a different department. The histories were taken from real patients in the sub-departments of obstetrics and reproductive endocrinology and from standardized patients in the sub-department of gynaecology. Prior to contact with real patients in the sub-department of reproductive endocrinology, the students practised with standardized patients. The quality levels of the case reports generated in the three departments were compared by repeated measures ANOVA. The attitudes, satisfaction and suggestions of the students were also investigated through a questionnaire.ResultsThe local Chinese language spoken by the patients was thought to be the most common difficulty students (76.7%) encountered while taking patient histories. Two-thirds and one-third of the students were interested in taking histories from standardized and real patients, respectively. Most students (94.2%) thought that working with standardized patients was useful for practising communication skills with Chinese patients. The total scores of the case reports were significantly different among the three groups (P < 0.001), and compared with case reports collected from real patients, case reports collected from standardized patients were of better quality. However, the quality of the case reports taken from real patients was better when the case reports were generated by students who had previous practice with standardized patients than when they were generated by students lacking such experience (P < 0.001).ConclusionsStandardized patient training for practising history-taking can be included as part of the clinical training curriculum for foreign medical undergraduates in the Department of Obstetrics and Gynaecology in China.

Dataset Information

Understanding Sexual Complaints and History Taking: A Standardized Patient Case on Dyspareunia for Obstetrics and Gynecology Clerkship Students.

Publications

Understanding Sexual Complaints and History Taking: A Standardized Patient Case on Dyspareunia for Obstetrics and Gynecology Clerkship Students.

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