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The Cardinal Edge

Program/Event

Arts and Research Showcase 2025

Abstract

BACKGROUND

Many medical students lack confidence when navigating a patient sexual history. Discomfort may stem from a lack of experience, societal taboos surrounding sexual health discussions, or concerns about maintaining professionalism while addressing sensitive topics. We aimed to investigate comfort and confidence among student genders and patient age.

METHODS

We analyzed 107 standardized patient (SP) encounters of second-year students across three sexual health cases with different presenting complaints. Perceived comfort and confidence were inferred from student body language, language, and conversational tone, which were categorized as: comfortable/confident, fairly comfortable/confident, not comfortable/confident.

RESULTS

Across cases, students were comfortable/confident in half (50%). Most students (66%) were comfortable/confident with patients presenting for Erectile Dysfunction (ED) while fewer students were comfortable/confident for the Vaginal Pain (41%) and Bleeding and Itching (36%) complaints. Feminine-presenting students completed more comfortable/confident encounters compared to masculine-presenting students (58% vs 38%). Students were comfortable/confident with 57% of SPs perceived to be older adults, which was higher than for middle-aged (47%) or peer-aged SPs (39%). Notably, 70% of cases with older adults were ED.

DISCUSSION

Students’ comfort and confidence in sexual history-taking may be influenced by the presenting complaint (such as with ED, which had a clear diagnosis/plan) or perceived age differences, as students were rated as more comfortable/confident when the age gap between them and the SP was larger. Exploring how these factors influence students’ experiences can provide valuable insight about where additional training or support is needed, enabling educators to tailor their teaching approaches for these critical conversations.

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