Reinforcing the clinical relevance of sexual history-taking for surgical patients was associated with higher-quality histories and broader differentials but not higher rates of sexual history-taking.
There was no significant difference between cohorts in the frequency of sexual history-taking attempts after the intervention.
Students in the intervention group asked significantly more sexual health questions on average than students in the comparison group.
Students who took a sexual history were substantially more likely to include sexual diagnoses in their differential diagnosis than those who did not.
Overall, a substantial proportion of third-year medical students across both cohorts failed to attempt a sexual history in a clinically relevant standardized patient case.
The integrated didactic intervention improved the quality but not the rate of sexual history-taking among third-year surgery clerkship students.
This study examined whether adding a focused teaching session about sexual history-taking to a third-year medical school surgery rotation would improve students' likelihood of asking patients about their sexual health during a clinical assessment. Researchers compared two groups of students — one that received standard training and one that received an additional session emphasizing why sexual history is important for surgical patients — using video recordings of standardized patient encounters involving a woman with lower abdominal pain. They measured how often students attempted a sexual history, how many questions they asked, and whether they included sexually-related diagnoses in their thinking. This research suggests that the targeted teaching session improved the depth of sexual history-taking — students who received the extra training asked twice as many relevant questions on average (6 vs. 3) — but did not meaningfully increase the overall proportion of students who attempted a sexual history in the first place (65% vs. 61%). Critically, students who did take a sexual history were nearly three times more likely to consider sexual or reproductive diagnoses, highlighting how skipping this part of the clinical interview can lead to important conditions being missed. The findings suggest that simply reinforcing why sexual history matters is not enough to ensure students routinely collect this information. A substantial minority of students — more than one-third — still failed to ask about sexual health even in a case where it was clearly clinically relevant. The authors point to persistent barriers that content-focused teaching alone does not overcome, and argue that medical educators need to more actively identify and address these barriers, particularly given increasing variation in access to reproductive health care across the United States.
Coleman T, Adamson D, Marshall H, Smith J, Wright T, Bohnert C, et al.. (2025). Sexual History-Taking in a Surgery Clerkship Assessment: A Stubborn Clinical Skills Gap With Reproductive Health Care Implications.. Academic medicine : journal of the Association of American Medical Colleges. https://doi.org/10.1097/ACM.0000000000005939