Modest impact of a brief curricular intervention on poor documentation of sexual history in university-based resident internal medicine clinics.
BACKGROUND
Providers need an accurate sexual history for appropriate screening and counseling. While curricula on sexual history taking have been described, the impact of such interventions on resident physician performance of the sexual history remains unknown.


OBJECTIVE
Our aims were to assess the rates of documentation of sexual histories, the rates of documentation of specific components of the sexual history, and the impact of a teaching intervention on this documentation by Internal Medicine residents.


METHODS
The study design was a teaching intervention with a pre- and postintervention chart review. Participants included postgraduate years two (PGY-2) and three (PGY-3) Internal Medicine residents (N=25) at two university-based outpatient continuity clinics. Residents received an educational intervention consisting of three 30-minute, case-based sessions in the fall of 2007.


METHODS
We reviewed charts from health-care maintenance visits pre- and postintervention. We analyzed within resident pre- and postrates of sexual history taking and the number of sexual history components documented using paired t-tests.


RESULTS
In total, we reviewed 369 pre- and 260 postintervention charts. The mean number of charts per resident was 14.8 (range 8-29) pre-intervention and 10.4 (range 3-25) postintervention. The mean documentation rate per resident for one or more components of sexual history pre- and postintervention were 22.5% (standard deviation [SD]=18.1%) and 31.7% (SD=20.4%), respectively, P<0.01. The most frequently documented components of sexual history were current sexual activity, number of current sexual partners, and gender of current sexual partner. The least documented components were history of specific sexually transmitted infections, gender of sexual partners over lifetime, and sexual behaviors.


CONCLUSIONS
An educational intervention modestly improved documentation of sexual histories by Internal Medicine residents. Future studies should examine the effects of more comprehensive educational interventions and the impact of such interventions on physician behavior or patient care outcomes.
Loeb
Danielle F
DF
Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA. danielle.loeb@ucdenver.edu
Aagaard
Eva M
EM
Cali
Steve R
SR
Lee
Rita S
RS
D000046:Academic Medical Centers; D003479:Curriculum; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D008487:Medical History Taking / Q000592:standards; D008875:Middle Aged; D012725:Sexual Behavior