Teaching sexual history-taking: a systematic review of educational programs.
OBJECTIVE
Because of the importance of sexual history-taking, the authors attempted to identify all randomized controlled trials on teaching this topic and reviewed the methods used for teaching and the efficacy of the educational interventions.


METHODS
From June to November 2010, the authors searched the published English-language literature indexed in PubMed, PsycINFO, and SCOPUS, using the key terms sexual history-taking, teaching, medical students, residents, sexual health, sexually transmitted infections, HIV, and AIDS. The authors selected and critically appraised randomized controlled trials and controlled nonrandomized trials of educational programs designed to enhance sexual history-taking skills.


RESULTS
Of 11 trials identified, 7 included medical students, 2 included residents, 1 involved community-based physicians, and 1 involved attendings, fellows, and residents. The educational interventions and outcome measures were heterogeneous, and the quality of study methodologies varied widely. The authors judged only 1 study to be of very high quality, although 8 studies explicitly mentioned at least one of the following: group differences at baseline, blinding, follow-up, and validated measurement tools. In the highest-quality study, primary care physicians who were mailed educational materials and received an unannounced instructor visit performed better in risk assessment and counseling than two comparison groups. Evidence also supported interactive workshops over didactic presentations.


CONCLUSIONS
The dearth of high-quality controlled studies hampers the development of sexual history-taking curricula for medical students and residents. The available literature supports formal opportunities to directly practice and receive feedback on interviewing skills. More rigorous research on sexual history-taking education is needed.
Department of Psychiatry and Behavioral Sciences and Center for Ethics, Baylor College of Medicine, Houston, Texas 77030, USA. jhc@bcm.edu
John H
JH
Coverdale
Richard
R
Balon
Laura Weiss
LW
Roberts
D000328:Adult; D002982:Clinical Clerkship / Q000458:organization & administration; D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical / Q000458:organization & administration*; D004503:Education, Medical, Graduate / Q000458:organization & administration; D004504:Education, Medical, Undergraduate / Q000458:organization & administration; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D008297:Male; D008487:Medical History Taking; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D012725:Sexual Behavior; D014481:United States