Qualitative Assessment of Bias and Comfort in Inclusive Sexual History Taking Skills of Physician Assistant Students

Sexual history taking is an integral skill for clinicians, as sexual health is a component of a complete medical evaluation. Medical curricula lack effective sexual history instruction, creating gaps in clinicians' confidence and proficiency. Average sexual and gender minority (SGM) curricular inclusion content is 5 hours over a 4-year span. This study investigated how students perceive their comfort level and biases during a simulated sexual history taking encounter.

Data were derived from student reflection assignments following simulated sexual history interviews. Researchers analyzed and coded data. Themes were labeled and paired with corresponding quotes from data.

Comfort and bias were predetermined main themes, each with eight subcategories that emerged including embarrassment, insight, lack of exposure, comfort/discomfort with sexual subject matter, and preparedness. Students' personal perceptions of comfort and biases represented a broad spectrum within the overarching concepts.

Trainee insight can guide educational and instructional modifications on proficient, inclusive sexual history taking. Exercises with sexual history inter¬views inclusive of SGM populations are essential tools to build student comfort with sexual content topics and diminish potential for invasive biases to undermine the integrity of sexual history taking. Future research is necessary, including implementation of pre and post surveys to gauge efficacy of instruction.