Dealing with female sexuality: training, attitude, and practice of obstetrics and gynecology residents from a developing country.

There is little research on how obstetrics and gynecology (Ob/Gyn) residents deal with female sexuality, especially during pregnancy. The aim of this study was to assess the training, attitude, and practice of Ob/Gyn residents about sexuality. A cross-sectional survey of Brazilian Ob/Gyn residents enrolling in an online sexology course was conducted. A questionnaire assessed their training in sexuality during medical school and residency and their attitude and practice on sexual issues during pregnancy. Training, attitude, and practice of Ob/Gyn residents regarding sexuality were the main outcome measures. A total of 197 residents, from 21 different programs, answered the online questionnaire. Mean age was 27.9 ± 2.2, most were female (87%), single (79%), and had graduated in the last 5 years (91%). Almost two-thirds (63%) stated that they did not receive any training at all and 28% reported having only up to 6 hours of training about sexuality in medical school. Approximately half of the respondents (49%) stated that they had received no formal training about sexuality during their residency up to that moment and 29% had received ≤6 hours of training. Over half (56%) never or rarely took a sexual history, 51% stated that they did not feel competent or confident to answer their pregnant patients' questions about sexuality, and 84% attributed their difficulties in dealing with sexual complaints to their lack of specific knowledge on the topic. The vast majority of Brazilian Ob/Gyn residents enrolling in a sexuality course had little previous formal training on this topic in medical school and during their residency programs. Most residents do not take sexual histories of pregnant patients, do not feel confident in answering questions about sexuality in pregnancy, and attribute these difficulties to lack of knowledge. These findings point to a clear need for additional training in sexuality among Brazilian Ob/Gyn residents.

Vieira TC ，de Souza E ，da Silva I ，Torloni MR ，Ribeiro MC ，Nakamura MU ... -  《-》

Experience of an online course on sexuality during pregnancy for residents.

Many obstetrics and gynecology (Ob/Gyn) residents report insufficient knowledge about female sexuality and this has a negative impact on their capacity to manage their patients. The aim of this study was to describe an online course about sexuality during pregnancy for Brazilian Ob/Gyn residents and evaluate their knowledge acquisition. This longitudinal educational intervention study involved 219 Brazilian Ob/Gyn residents. The online course lasted 24h (10 video lectures and discussion chats). Upon enrollment, the participants answered a questionnaire in regard to their training, attitudes and practices about sexuality during pregnancy. Participants' knowledge acquisition was assessed using a pre- and post-course test about sexuality during pregnancy. At the end of the course, participants were asked to evaluate their educational experience. Student's t and chi-square tests were used to analyze the pre- and post-course test scores. P values<0.05 were considered statistically significant. A total of 143 Ob/Gyns (65.3% of those enrolled) completed the course. At baseline, most participants reported that they did not have any sexology classes as undergraduates (62.5%) or in their residency (52.1%), and that they lacked specific knowledge in this area to manage their patients. Mean test scores increased significantly at the end of the course: 4.4 (±1.6) versus 6.0 (±1.3) (out of a maximum score of 10), before and after the course, respectively (p<0.0001). Most of the residents rated the overall quality of the course as "higher than expected". An online course for Ob/Gyn residents was associated with a significant increase in knowledge about sexuality during pregnancy.

Vieira TCSB ，Nakamura MU ，da Silva I ，Torloni MR ，Ribeiro MC ，Scanavino MT ，de Souza E ... -  《-》

Brazilian residents' attitude and practice toward sexual health issues in pregnant patients.

Sexual difficulties and questions regarding sexual function are frequent in pregnancy, yet they are infrequently discussed in academic communities, medical schools, and residency programs. Embarrassment, lack of experience, inadequate communication skills and insufficient knowledge on how to deal with sexual complaints, and questions in pregnancy are common, especially among young health professionals. The aim of this study was to assess and compare the attitude and behavior of Brazilian residents in three different medical programs (obstetrics-gynecology, internal medicine, and psychiatry) toward sexual health issues of pregnant patients. Survey conducted in a single Brazilian university using anonymous self-responsive questionnaires on how residents deal with sexual health issues of obstetric patients. A total of 154 residents from the three different programs (47 obstetrics-gynecology, 33 psychiatry, 74 internal medicine) participated. Attitude and practice of medical residents regarding sexual health issues of pregnant patients. Less than 20% of the residents reported that they routinely asked obstetric patients about their sexual health, although almost 70% stated this should be part of every history. Psychiatry residents were significantly more likely to actively seek information about the sexual health of obstetric patients than others (57.6%, 17%, 4.1%, psychiatry, obstetrics-gynecology, internal medicine, respectively, P<0.001). Although over 80% answered that most obstetric patients react well or indifferently to questions about sexual function, less than 25% of the residents reported being completely confident answering these questions, and 71% of them admitted that they lacked specific knowledge in the area of sexual dysfunctions. The two main obstacles in evaluating patients' sexuality were lack of specific knowledge and not enough time to explore these aspects in medical consultations, reported by 71% and 20% of all participants, respectively. Most residents do not feel comfortable or confident and lack specific knowledge and skills to deal with questions related to sexual problems during pregnancy.

Vieira TC ，de Souza E ，Abdo CH ，Torloni MR ，Santana TG ，Leite AP ，Nakamura MU ... -  《-》

Sexual Health Education in Obstetrics and Gynecology (Ob-Gyn) Residencies-A Resident Physician Survey.

Many women will experience a sexual health concern and present to their Obstetrics and Gynecology (Ob-Gyn) care provider, yet a large portion of graduating Ob-Gyn resident physicians in the United States may not feel comfortable helping patients with some sexual health issues. To perform a cross-sectional study of U.S. Ob-Gyn resident physicians that assesses sexual health education didactic sessions and comfort level with sexual health clinical vignettes. A 32-item anonymous survey was sent to all 4,065 Ob-Gyn residents on June 7, 2016. Respondents voluntarily completed the survey electronically. The primary outcome measures are the comfort level of Ob-Gyn resident physicians in taking a sexual history and providing counseling to patients represented in clinical vignettes, which were based on sexual health learning objectives from the Council on Resident Education in Obstetrics and Gynecology (CREOG). Of the 4,065 eligible U.S. examinees, 968 (23.8%) agreed to participate in the study, and 802 (19.7%) completed the survey and were included in the final analysis. Nearly two-thirds of the residents indicated that sexual health training was a priority in residency. However, more than half were not able to describe the disorders of sexual function or list common medications that effect sexual function. When posed with clinical vignettes, residents felt very comfortable obtaining a sexual history (98.5%) and providing counseling (97.0%) for a 16-year-old seeking contraception, yet fewer felt very comfortable obtaining a history and providing counseling for a 26-year-old who is a refugee from Somalia (77.2% and 73.8%). Smaller cohorts felt prepared to take a sexual history and provide counseling for a 17-year-old who discloses that she is a victim of sex trafficking (61.2% and 57.7%), and for a 58-year-old transgender patient planning hormone therapy and surgery (49.9% and 37.9%). In logistic regression analysis, the factors that were influential in an Ob-Gyn resident physician's program to prepare them to describe the disorders of sexual function were post-graduate year (OR 1.387, 95% CI 1.189, 1.618; P = .0001), those that rated the importance of a sexual health curriculum highly (OR 0.701, 95% CI 0.569, 0.864; P = .0012), and a greater number of didactic sessions on sexual health in the residency curriculum (OR 0.685, 95% CI 0.626, 0.750; P < .0001). These findings highlight strengths in the comfort of Ob-Gyn resident physicians about sexual health and illustrate areas of opportunity to engage resident learners by improving the sexual health curriculum. Worly B, Manriquez M, Stagg A, et al. Sexual Health Education in Obstetrics and Gynecology (Ob-Gyn) Residencies-A Resident Physician Survey. J Sex Med 2021;18:1042-1052.

Worly B ，Manriquez M ，Stagg A ，Blanchard MH ，Ogburn T ，Carson SA ，Woodland MB ... -  《-》

Women with physical disability in pregnancy resident education: a national survey as a needs assessment for curriculum improvement in obstetrics and gynaecology in Canada.

To explore the current status to which Canadian obstetrics and gynaecology (Ob-Gyn) programmes teach residents about pregnancy in patients with physical disabilities, and to assess the level of interested in providing formal education sessions in this field. This study also assesses the residents' perception of their knowledge and their comfort level caring for women with physical disabilities (WWPD), which will further determine the need for incorporation of this topic into the residency curriculum. Cross-sectional survey. All Canadian English accredited Ob-Gyn residency programmes. Programme directors and residents. The current self-reported education and exposure Canadian Ob-Gyn residents have surrounding WWPD in pregnancy, and if there is an interest in further education in this area. An online survey was developed and distributed to all Canadian English accredited Ob-Gyn residency programme directors and residents. Answers were collected over a 2-month period in 2017, which consisted of an initial email and two email reminders. Questions were in three key areas: demographic characteristics, knowledge gap and level of interest in a formal method of education. Eighty-four residents and nine programme directors participated in the surveys. Eighty-six per cent of residents and all programme directors responded that there are no formal scheduled training sessions on WWPD as part of the residency curriculum. Two-thirds of the residents reported being uncomfortable with the management issues surrounding a woman with a disability in pregnancy. A vast majority of residents (91.67%) and all programme directors have an interest in incorporating this topic into the residency curriculum to meet the need of pregnant women with disabilities. This survey indicated that there is both a need for and interest in education in the area of pregnancy and physical disability in the Canadian Ob-Gyn residency programme. This information suggests that the development of educational materials in this area should be considered to address an unmet need with the ultimate goal of improving the care provided to WWPD in pregnancy. Future projects in this area should focus on content development taking into account the CanMEDS and competency-based medical education framework.

Bekdache GN ，Berndl A 《BMJ Open》