Impact of structured sexual health training incorporating standardised patients on health professions students' sexual health communication competence: A single-blind randomised controlled trial in Tanzania.
Lukumay G, Kakoko D, Rosser B, Ross M • PloS one • 2026
Structured sexual health training incorporating standardised patients significantly improved health professions students' sexual health communication competence during simulated consultations, particularly in patient-engagement domains, as demonstrated by a significant time-by-group interaction (p = .002) in a randomised controlled trial in Tanzania.
Key Findings
Results
Structured sexual health training incorporating standardised patients significantly improved sexual health communication competence compared to control at six-month follow-up.
Single-blind randomised controlled trial with parallel-group allocation conducted at Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Mixed ANOVA showed a significant time effect (p < .001) and a significant time-by-group interaction (p = .002).
Competence improved in both groups, but with greater gains in the treatment group.
Baseline competence scores were similar across groups, supporting comparability at randomisation.
Results
The training programme produced greater improvements specifically in rapport, empathy, and information-gathering competencies.
Exploratory item-level analyses indicated higher scores in the treatment group across most sexual health communication competencies.
Particularly notable improvements were observed in patient-engagement domains: rapport, empathy, and information-gathering.
No significant difference between groups was observed for the competency of using clear and understandable language.
Competence was assessed using SP-rated checklists at baseline and at six-month follow-up.
Methods
The study enrolled 312 undergraduate medical and nursing students, with the majority being final-year students.
A total of 312 undergraduate medical and nursing students were enrolled; 310 were included in analyses.
73.5% of participants were in their final year of study.
The mean age was 24.29 years (SD = 2.51).
22.6% of participants were female, and 60.0% reported prior sexual health training.
Methods
The structured sexual health training programme incorporated multiple pedagogical modalities including standardised patient practice sessions.
Training components included didactic teaching, small-group discussions, role-play, and SP-based practice sessions.
Standardised patients (SPs) were used both as training partners and as assessors of communication competence.
The intervention was designed to be culturally adapted to a Tanzanian healthcare education setting.
Assessment was conducted at two time points: baseline and six-month follow-up using SP-rated checklists.
Conclusions
The authors conclude that SP-based assessments are a viable method for evaluating communication competence in sensitive clinical contexts such as sexual health.
Findings support incorporating culturally adapted sexual health training into healthcare education curricula.
The authors recommend using SP assessments to evaluate communication competence in sensitive clinical contexts.
The trial was registered on ClinicalTrials.gov (NCT06428058), registered 30 November 2023.
The study was conducted in a single university setting in Tanzania, which may affect generalisability.
What This Means
This research suggests that a structured training programme for medical and nursing students in Tanzania — one that included lectures, small-group discussions, role-play, and practice with trained actors playing patients (called 'standardised patients') — significantly improved students' ability to communicate about sexual health topics. The study randomly assigned 312 students to either receive this training or not, then assessed communication skills six months later using standardised patients who rated the students on a checklist. Students who received the training showed notably greater improvement than those who did not, particularly in their ability to build rapport, show empathy, and gather information from patients.
The improvements were most pronounced in areas that involve connecting with and engaging the patient, rather than technical language skills — there was no significant difference between groups in the ability to use clear and understandable language, which both groups apparently handled similarly. This suggests the training was especially effective at developing the interpersonal and emotional dimensions of sexual health consultations, which can be particularly challenging in contexts where such topics carry social stigma.
This research matters because sexual health communication is a critical but often underdeveloped clinical skill, especially in settings where cultural norms make open discussion of sexual topics difficult. The findings suggest that structured, culturally adapted training programmes that include realistic patient interactions can meaningfully improve how future healthcare providers approach sensitive conversations with patients. The use of standardised patients as both teaching tools and evaluators also provides a practical model for assessing communication skills in areas that are difficult to evaluate in real clinical encounters.
Lukumay G, Kakoko D, Rosser B, Ross M. (2026). Impact of structured sexual health training incorporating standardised patients on health professions students' sexual health communication competence: A single-blind randomised controlled trial in Tanzania.. PloS one. https://doi.org/10.1371/journal.pone.0360630