Development and evaluation of a sexual history-taking curriculum for first- and second-year family practice residents

Primary care physicians need to assess their patients' sexual behaviors to help prevent, diagnose, and treat sexually transmitted diseases. However, few physicians take sexual histories. We developed an educational curriculum aimed at increasing the frequency with which our residents take sexual histories from patients.

Residents were observed for 5 months through video monitoring of patient encounters to document the precurriculum rate of taking sexual histories. Residents also completed a sexuality questionnaire about the likelihood of encountering certain patient problems and the residents' degree of comfort and competence with these problems. They then completed the educational curriculum and were monitored for 3 months for any change in taking sexual histories. We added follow-up telephone interviews with the residents to determine the effect of the curriculum and the extent of taking sexual histories.

Due to insufficient data collected with video monitoring in the postcurriculum phase, we used telephone interviews to evaluate the curriculum. Prior to the curriculum, only 7% of the residents reported routinely asking patients about their sexual history, compared to 36% of residents 6 months after implementation of the curriculum.

The sexual history-taking curriculum improved the frequency with which residents collected information from patients on sexual activity. In addition, this article addresses the development of the curriculum based on a needs assessment, and the difficulties in and possible solutions to evaluating curricular changes within family practice residency programs.