Tuesday, April 19, 2011

Finding ones voice in the delivery of sex education

By: Melvin

The work of a[ human sexuality educator], I propose includes all that is proper for a human, and is one in which all men who are born into this world should share… Our first wish is that all persons should be educated fully to the maximum capacity of humanity; not only one individual, nor a few, nor even many, but all humans together and single, young and old, rich and poor, of high and low birth, men and women- in a word, all whose fate it is to be born human beings; so that at last the whole of the human race may become educated, men and women of all ages, all conditions, both sexes and all nations. Our second wish is that every man and women should be wholly educated, rightly formed not only is one single matter or in a few or even in many, but in all things which perfect human nature.

John Amos Comenius

The Great Didactic, 1632

Excerpt from Crisis in the Classroom, 1970

Education is an ongoing journey. As any weary traveler can contest, the road to the most desirable destination can have many challenges, self-discoveries and feelings too powerful to fully understand. The same can be said of education. Learning can be riddled with feelings that can only be summed up as painful. Yet, it is also a process of self-awareness and growth. This growth is both physical and intellectual. Taking this into account, I see each student as a unique individual searching for sustenance while making a pilgrimage through life (Sears, 1992).

As an aspiring sexuality educator, I serve as the nutrient to stimulate growth for learners. I have a responsibility to those that I meet. That is, I have a duty to adapt to each and every student. The role as a facilitator of learning does not entitle me to treat a student as a number, a test score or a test of my abilities. Rather, I am being allowed into a student’s mind to nurture growth and I recognize that this is a privilege that I must respect. Therefore, I am not only teacher but also a student of that student’s story. His sharing allows me to grow, and perhaps, in return, I am helping him to grow. In prescribing to a modified constructional model, I try to allow each student to search for his or her strengths and likes. My goal is to teach tools for future endeavors. Making a connection to something relevant in the student’s life may feed a hidden passion. In meeting the students’ desire for knowledge, I am fully aware of the fact that I am the passenger in the student’s journey (Hedgepeth & Helmich 1996).

Everywhere in society today, newspaper headlines, evening news shows, talk radio, and local town meetings, the public is bombarded with the message that students cannot read and graduates cannot compete in the world market place with graduates from other countries. Over and over the message sent is that all these conditions would change if teachers would just teach and force children to learn. The failure of this simplistic solution is that it does not recognize the multiple pressing issues that learners carry with them into the classroom. Today’s sexologist is responsible for possessing more than mastery of their respective content area in order to be successful educators ( Eggen & Kauchak, 2006). Upon observation of the most homogenous student populations lie hidden diversities, which make teaching the masses a task for the most hardened educator. Thus, there is no one designated way to create a learning environment. Teaching eschews prescribed ideas about normalcy, which are most often subjective, dated, and ethnocentric. A good sex educator is able to bridge educational, social, and emotional gaps in order to produce successful members of society—sex positive and sexually healthy. Yes, there are as many good sexuality educators in our schools as there are varieties of good apples in our supermarkets ( Reinhartz & Beach, 2004).

The first quality of a good teacher is the ability to acknowledge and validate each student. This concept seems very basic; however, with the demographics changes within many of traditionally homogenous school districts, teachers are faced with the challenge of meeting the needs of an ever-growing diverse population. This diversity comes in the form of socioeconomics, English as a second language, and ethnicity. It is imperative that sex educators acknowledge these differences and adapt their pedagogical perspectives to embrace the richness of a heterogeneous student population. Teachers must be dedicated educators in order to embrace this quality because one must be a lifelong learner and continuously grow as a professional educator in order to meet the changing needs of the American student (Breuss & Greenberg, 2004).

The second quality of a good teacher is the ability to guide a student through the learning process. In years past, teachers have relied on the one size fits all formula for educating American children. With the expectation of memorization and recitation as a measure of competence in a given content area, many students were left behind. As a result of this deficit, sexuality education needs to look beyond the test scores and inspire children to learn. To do this effectively, educators must take ownership of what they are doing or not doing to facilitate learning in the classroom. When sex educators stifle the students’ ability to grow academically by forcing a status quo classroom culture, the learning process is severely hindered (Reinhartz & Beach, 2004). Thus, sexologists must take the time to focus on the strengths of the student and motivate students to capitalize on their assets

The third quality of a good teacher is acceptance. Too often, teachers assume that their perspective is the only appropriate view point. This can be problematic for a student who is from a different culture or socioeconomic group ( McCollum, 2010). Rather than criticize a student for thinking that appears “out of the box” it is important to consider culture and embrace the diversity of perspectives. A good teacher is able to focus on the strengths of a student and not be critical of the student’s social status.

In today’s complex educational world, simply being a content expert does not make for a good sex educator. A quality educator is at the mercy of creating a quality culture for learning that considers a student’s socioeconomic and cultural background in order to ensure academic success. We strive to bridge the educational, social, and emotional gaps in order to produce successful members of society who are sex positive and sexually healthy. While each child and sexologist represents a good apple, it is their shared flavor that makes all the quality of the great American pie.


Breuss, C., & Greenberg, J. (2004). Sexuality education: Theory & Practice (4th Ed.). Boston: Jones & Bartlett.

Brown, J., Keller, S., & Stern, S.( 2009). Sex,sexuality, Sexting, and SexEd: Adolescents and the Media. The Prevention Researcher. 16(4), 12-16.
Eggen, P. D., & Kauchak, D. P. (2006). Strategies and methods for teachers: Teaching content and thinking skills. Boston: Pearson.
Gilbert, G. C , & Sawyer, R. S. (2000). Health education: Creating strategies for school and community health. Boston: Jones & Bartlett.
Hedgepeth, E. & Helmich, J. (1996). Teaching about sexuality and HIV. New York: NYU Press.
McCollum, S. (Fall 2010). Country Outpost: Teaching Tolerance, 38, 32-34.
Reinhartz, J. & Beach, D. (2004). Educational Leadership: Changing School, Changing Roles. Boston: Allyn and Bacon.

Sears, J. (1992). Sexuality and The Curriculum: The Politicss and Practices of Sexuality Education. New York: Teachers College Press.

Saturday, April 16, 2011

16 and Pregnant – A teachable moment?

I have to admit it: one of my guilty pleasures these days has been watching the TV dramas 16 and Pregnant and Teen Mom 1 & 2 (soon to be 3).  At first I rationalized my interest in these shows as research for my job, though this quickly faded as I became consumed with the characters and plot.  I speak about them like they’re any other drama on TV but the difference is that these shows depict true life examples of teen parents, their challenges and triumphs, and general life paths throughout a season on MTV.

Though these shows are highly dramatic and entertaining for the audience, I can’t help but think about the potential impact they have on teen attitudes and beliefs regarding parenting.  What I’ve heard from my own students is that “the teens on TV don’t seem to have trouble being parents.”  It’s no wonder why young people in our society are so confused by the messages about teen parenting.  The media often sensationalizes it while we educators are caught trying to impart the consequences and realities that most teens face (albeit not always those teens featured on MTV).  While these shows are presented as docu-dramas, what “reality” are they really depicting?  Are they creating misperceptions about teen parenting, or are they offering some great teachable moments on which we can capitalize?  How can we use these popular teen TV shows for great sex education?

Enter media literacy.

According to the Media Literacy Project, media literacy is “the ability to access, analyze, evaluate, and create media. Media literate youth and adults are better able to understand the complex messages we receive from television, radio, Internet, newspapers, magazines, books, billboards, video games, music, and all other forms of media”  All of this analysis helps to differentiate between fantasy and reality and give youth the tools necessary to make informed decisions.  Great sex ed opportunity..? I think so!

Media has been shown to be a significant influence on young people’s lives and media literacy skills are an important aspect in education (Gilbert & Sawyer, 2000).  Even the National Health Education Standards address media literacy as essential to education.  

One example of using a media literacy activity to promote critical thinking skills is to choose a program for students to analyze (i.e. 16 and Pregnant).  Divide the class into small groups and give each group a character from the show to watch and evaluate.  Ask them to observe how parenting affects the teen’s life, considering the challenges and types of support that teen may receive (familial, financial, etc.).  After watching the program, discuss what the students noticed about teen parenting.  Also, ask them to make up their own ending to the teen’s life (since their life lasts much longer than a season on MTV). 

While this is only one example of a media literacy activity, there are many others available.  MTV even puts out discussion guides for the shows available on www. stayteen.org (great website for sex ed info) which also provides stats, resources and questions to consider.  Discussion around these shows is critical for students to examine the realities about teen parenting and also be able to better personalize how parenting would affect their own lives.

I am always interested to hear how other educators are using the media to connect with youth and capitalize on those teachable moments in order to provide great sex ed.   What methods and activities have you found effective in getting students to analyze media messages? 

-Rebecca Roberts


Brown, J. (Ed). (2008). Managing the media monster: The influence of media (from television to text messages) on teen sexual behavior and attitudes. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy. Retrieved from www.thenationalcampaign.org/resources/monster/Media_Monster.pdf

Gilbert, G.G. & Sawyer, R.G. (2000). Health education: Creating strategies for school & community health (2nd ed). Sudbury, MA: Jones and Bartlett Publishers.

Palante Technology & Bazant, M. (n.d.). Media Literacy Project. Albuquerque, NM. Retrieved from http://medialiteracyproject.org/learn/media-literacy

The Joint Committee on National Health Education Standards (2007). National Health Education Standards: Achieving Excellence (2nd Edition). Atlanta, GA. American Cancer Society.  Retrieved from http://www.cdc.gov/HealthyYouth/SHER/standards/index.htm

Sunday, April 10, 2011

Enhancing Educators’ Presence “On Stage” – Importance of Platform Skills

By: Emily Yantis
As a trainer of peer educators in my practicum experience, I have begun to understand the importance and need for educator “platform skills.”  As a student myself, I have very little understanding of teaching platform skills and have started researching the subject to try and add this to the training plans for my peer educators.  My own knowledge of platform skills comes from my background in theatre and music; having good posture, making significant eye contact, wearing the correct things, managing gestures, etc.  Other than personal experiences, I don’t have much knowledge to train with.

While searching through the various books we have for 625/626, I did find some information.  Eggen and Kauchak (2006) include platform skills and other effective techniques under “Essential Teaching Strategies.”  Teacher characteristics such as modeling and enthusiasm and personal teaching efficacy promote learner motivation and increased student achievement (Eggen & Kauchak, 2006). Some of the most important key factors to teacher effectiveness are communication, organization, and feedback (Eggen & Kauchak, 2006).  Although I find it mighty obvious that educators need to communicate clearly, connectedly, and with emphasis (Eggen & Kauchak, 2006); these qualities may not be natural to educators and need to be taught…but HOW?  Part of the effectiveness of platform skills comes from the educators’ ability to understand their audience feedback (Eggen & Kauchak, 2006).  What skills does it take a trainer to teach others how to feel for audience feedback?  And give their audiences appropriate and helpful feedback in return?

These are just a couple of the questions that have surfaced throughout my search to train undergraduate students about educator effectiveness and platform skills.  Unfortunately, I have not found much to help so far so I look forward to hearing others’ stories about their own experiences enhancing their platform skills and even teaching platform skills to others.


Eggen, P.D. & Kauchak, D.P. (2006). Strategies and models for teachers: Teaching content and thinking skills. Boston, MA: Pearson Education Inc. 

Saturday, April 9, 2011

Tips on Co-Teaching

There are many complicated things about teaching sex education but the most difficult for me has been learning to work with other people; other people that have different ideas about what education looks like. This is something that teachers no matter what they teach face when they are co-teaching. It takes a special set of skills to work with someone you do not necessarily agree with on a regular basis. 

There are a lot of times that co- teaching can be advantageous to both the students and the teachers. The students can learn from two or more teachers that may have different ways of teaching the same material. The teachers have more support when co-teaching. They are able to share both their success on their good days and their hard days (Hurley-Chamberlain & Friend, 2010). To figure out how to co-teach effectively you first have to know what co- teaching is not. The first being the most obvious co-teaching is not a process where each teacher teaches a different subject and there is no communication between the two teachers. 

It is not co-teaching when one teacher’s ideas and thoughts are the only ones used in teaching the students. This has a tendency to happen when one of the co-teachers is older and has been teaching the topic longer than the other teacher (Hurley-Chamberlain & Friend, 2010).  This is an example of a power dynamic that is not helpful to the co-teaching process.  

So now that we have touched on what co-teaching is NOT we need to look at what it really is. Co teaching is two or more teachers that are sharing the responsibility for teaching one group of student’s specific content. There is a need for communication and trust in order for co-teaching to be a successful venture.
Cook (2004) came up with some elements to the cooperative process of co-teaching. The first element is Face to face interactions. Co-teachers have to decide when where and how often they are going to meet. They are also going to have to decide how much of that meeting time will be during school hours. They also need to develop a way to communicate between meetings. 

                Positive interdependence is also something that is essential to the cooperative working of co-teaching. There needs to be a feeling that the teachers are each individually responsible for all of the students learning and that they are pooling their knowledge and skills for the benefit of the students that they are teaching. 

                Interpersonal skills include the both the verbal and nonverbal components of communication and of trust-building. They are also useful skills in conflict management and creative problem solving. Effective co-teaching and any partnerships in general encourages each member to improve their social skills. Without this development co-teaching would be at a disadvantage.

                Monitoring the progress is important in any partnership and any teaching adventure. It is equally important when dealing with co-teaching because both teachers have to be on the same page about improvements in the classroom. 

                Individual accountability is very important because each person has to be personally accountable for what they have agreed to do and contribute to the learning process for these students. 

I believe that if some of these elements are taken into consideration then co-teaching can be a great experience and be great for both the students and the teachers, but if they are not then I think a co-teaching experience can be very draining and unproductive.  (Hurley-Chamberlain & Friend, 2010)



cook, L. (2004). Co-Teaching: Principles, Practices and Pragmatics. California State University , 2-33.

Hurley-Chamberlain, D., & Friend, M. (2010). Is Co-Teahcing Effective? Retrieved April 9, 2011, from Council for Exceptional Children: http://www.cec.sped.org/AM/Template.cfm?Section=Home&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=7504

Tuesday, April 5, 2011

Improv Theater is an Effective Sexuality Education Teaching Method: “Imagine That”!

As a teenager in high school I was a proud member of an improvisational (improv) theater troupe in Spartanburg, SC called “Imagine That.”  Improv theater is defined simply as: acting without a prepared script (United Nations Y-PEER, 2003). We would perform skits or scenes on social issues affecting our peers and adults such as: individuality, depression, suicide, teen pregnancy, discrimination, racism, drug and alcohol abuse, violence, STD’s including HIV, date rape, peer pressure, bullying, etc.  We would perform about 5 of these scenes at schools, churches, community centers, public libraries, special events, correctional facilities, as well as at national youth conferences around the country. Our director would process each scene with the audience facilitating discussion about what they experience, and the positive and negative outcomes they perceived, thus forming an hour-long show or presentation.
Why should you care about this? Well, besides it being a really special time in my life that helped shape who I am as a person today that has helped steer me towards a career as a sex educator, I participated and witnessed first hand an extraordinarily effective teaching method.  I believe the interactive education we carried out by performing improvisational theater scenes was much more effective than programs such as “D.A.R.E.,” that was determined to either have no effect or a detrimental effect on lowering rates of teen drug use (Kanof, 2003). “D.A.R.E.” was a federally funded Drug Abuse Resistance Education curriculum used by schools nationwide in the 1990’s.  It and other programs like it used in classroom and authoritative instruction settings informed students that whenever they were tempted by their peers to use drugs to remember the “NO USE” pledge they signed, refuse the offer, and encourage the student to report the incident to an officer of the law (www.dare.org).
I believed that our method of using improv theater was effective, especially with our teenage peers, because it drew in or “hooked” the audience from the beginning.  At the start of every show we would perform an opening scene that was loud, eye-catching, attention grabbing, unnerving, scary, but most importantly thought provoking and emotional. It would usually involve us (the cast) coming to life from frozen positions dispersed throughout the audience wearing white facemasks interacting with one another and the audience as we worked our way up to a picture portrait grouping in front of the auditorium, cafeteria, or stage. Trust me, people would scream, gasp, and have to go use the restroom sometimes to prevent spoiling themselves because they became so excited!
However, looking back, I think it was the “hook” we provided with the opening scene as well as the interactive audience participation in verbally processing their feelings and thoughts about what they just saw us perform theatrically. Therefore, I have always planned to use improv theater as a teaching method someday when I am advising a peer health education group on a college campus. Yet, I started to wonder if improv theater was a truly effective teaching method or if my involvement in the troupe just made me leap to assumptions. Therefore, I have sought out research that supports my theory that improv theater is in fact an effective teaching method for health and sexuality education, especially when using peer educators.

            Using theater as an effective teaching technique in health and sexuality education is supported by numerous theories.  The first theory and the one that offers the most support for theater in health education is the theory of reasoned action that states that “the intention of a person to adopt a recommended behavior is determined by: 1) the person’s attitudes towards this behavior and his or her beliefs about the consequences of the behavior, and 2) the person’s subjective viewpoint about an issue and the normative or society’s standard based on what others think he or she should do, and whether important individuals approve or disapprove the behavior” (Y-PEER, 2003).
            Therefore, peer health educators are the perfect tool because they have the potential to highly motivate their peers to change their behavior based on the fact that adolescents are significantly influenced by the perceived expectations of their peers, displayed through live theater. For example, a young woman who thinks that using contraception will have positive results for her, will have a positive attitude towards contraceptive use” especially if she perceives that her peer (in this case the peer health educator) expects her to do so (Y-PEER, 2003).  This scenario could easily be extrapolated into a 5-7 minute improv theater scene highlighting the positive and negative outcomes of a character debating on whether or not to use contraception. In other words, peer health educators show that it is cool to engage in healthy behaviors, thereby making it a standard in society. If an individual is not using condoms when they have sex, then they could potentially harm their reputation or likability with their friends or peer group.
            While this is just one particular theory, Bandura’s Social Learning Theory, Beck’s Cognitive-Behavioral Therapy, Moreno and Blatner’s Role Theory, Tompkin’s Script Theory, Roger’s Diffusion of Innovations, Kolb’s Experiential Learning Theory, and Miller’s Chunking Theory all provide theoretical support for using theater in peer health and sexuality education. Elaboration of exactly how these theories provide support within the context of peer health education can be found in Y-PEER’s Peer Education: Training of Trainer’s Manual (Y-PEER, 2003) available online at the web address listed below.

Theories are a respectable foundation, but what about real life implementation and evaluation to discover if the theories actually apply and produce sound data that theater in health education is effective? Accordingly, several researchers have evaluated the effectiveness of using theater in peer health and sexuality education.
 Cimini, Page, and Trujillo in 2002 found that peer-led improvisation theater was effective in reducing high-risk behaviors associated with alcohol use and increasing protective behaviors. Another pre-post test analysis study which evaluated Planned Parenthood’s New Image Teen Theater revealed that participants reported “after viewing teen theater, more willingness to discuss sexual topics (t(80)=10.01, p.001), a greater intention to use birth control (t(43)=3.02, p.01), and greater sexual knowledge (t(92)=10.01, p.01) (Hillman, et al, 1991).
A researcher in Canada performed a case-study methodology on four groups of high school students and their peer leaders that resulted in “reports of increased self-confidence to reduce risky behavior, increased communication about sexual health issues, the development of greater compassion and tolerance, along with the desire to avoid stigmatizing HIV-positive individuals and sexual minorities” (MacIntosh, 2006). 
Finally, a WHO and UNAIDS-sponsored review assessed community-based peer education programs that targeted youth in lower-income countries that directly effected behavior change.  This review discovered 3 of 3 programs showed significant reductions in the number of partners, and 5 of 7 programs showed increases in condom use.  Most of the programs included in the review were able to reach large populations of youth, distribute condoms, and in some cases, change community norms around youth and sexual risk taking (Adamchak, 2006).
As one can see, theater peer education has been found effective in changing behavior and attitudes of adolescents across the world. It is also the recommended teaching method of several well-known and respected organization such as the United Nations, World Health Organization, and Youth Peer Net. Therefore, peer education is practiced worldwide despite the lack of a large peer-reviewed body of evidence demonstrating its effectiveness. While we may not currently have the means or methods to determine the extent of effectiveness of theater peer education on participants lives five years out, it has proven a crucial tool to accessing hard to reach audiences in diverse cultures (Y-PEER, 2003, Adamchak, 2006).
My hope for the future is that researchers will be able to show that not only is theater peer education effective, but that it outstrips many other teaching methods that are now outdated, or in other words do not engage the modern student. I encourage sexuality educators to utilize the Training for Trainers Manual (Y-PEER, 2003) listed below as well as any continuing education courses they come across that will prepare one to employ peer theater education. For it, I believe, is the most promising solution today for connecting with adolescents on a level where they become open to discussion and actually begin to change their behavior.

Adamchak, S. E. (2006). Youth peer education in reproductive health and HIV/AIDS: Progress, process, and programming for the future. Youth Issues Paper 7. YouthNet.
Cimini, M.D., Page, J. C., & Trujillo, D. (2002). Using peer theater to deliver social norms information: The Middle Earth Players program. Report on Social Norms 8(2).
Hillman, E., Hovell, MF., Williams, L., Hofstetter, R., Burdyshaw, C., Rugg, D., Atkins, C., Elder, J., Blumberg, E. (1991). Pregnancy, STDS, and AIDS prevention: evaluation of New Image Teen Theatre. AIDS Education Prevention, 3(4), pp. 328-40. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1777341
Kanof, M. E. (2003). Youth Illicit Drug Use Prevention: D.A.R.E. Long-Term Evaluations and Federal Efforts to Identify Effective Programs. Washington, DC: General Accounting Office.
MacIntosh, J.M. (2006). Theatre-based peer education for youth: A powerful medium for HIV prevention, sexuality education and social change. University of Victoria. British Columbia, Canada. Retrieved from http://gradworks.umi.com/NR/30/NR30158.html
The D.A.R.E. Mission: Teaching students good decision making skills to help them lead safe and healthy lives. Retrieved on 4 April 2011 from http://www.dare.org
United Nations Y-PEER. (2003). Joint Interagency Group on Young Peoples Health: Development and protection in Europe and Central Asia – Sub-committee on Peer Education. Peer education: Training of trainers manual. Retrieved on 12 March 2011 from Youth Peer Education Electronic Resource.

Sunday, April 3, 2011

Getting Your Message Across Without Putting People Off

A few weeks ago I attended a presentation on Veganism. It was someone else presenting at my practicum site, so I wasn't there specifically to hear the program, though I generally don't have anything against the veg-eating folk. It's just not something I'm particularly passionate about. Call me neutral. The reason I decided to blog about it is that I left that presentation feeling attacked and completely alienated from the topic. I never want to make anyone feel like that in a presentation. Ever.

In case you aren't familiar with the arguments for Veganism, there are a number of very graphic videos on youtube depicting cruelty to animals. The presenter started with one of these videos and went on to explain how our bodies aren't designed to process meat and that raising animals for food hurts the environment. There was actually quite a bit of evidence that made sense for what was being put forward. The problem was, right from the very beginning, I was made to feel ashamed for eating and liking to eat meat. I have had discussions about Veganism before, as my former boss is vegan and she would explain her view on the subject. Not once did I come away from those discussions feeling ashamed for eating meat like I did from this program. I felt like I was being bullied and when you are in that situation you don't open up to new ideas – you get defensive and shut down.

What does this have to do with sexuality education? Well, there are many an issue that we as sexuality educators can come from a place of “I'm right, what you thought is wrong”. One example is sexual assault prevention. Often the message given to men on college campuses is that “no means no, no matter what”. What about the fact that women in our culture are often taught to play coy? That “no” might mean, “you're going to have to work for it”, or “make me want it”? If the only thing we teach is “no means no”, when often it doesn't, does that really get the students to listen, or do they ignore the message because it is contradictory to their reality?

Another issue that is at the core of my passion is fat sex. I realized half way through that program on Veganism that it would be incredibly easy to alienate participants from my ideas on fat sex because it is hard to give people the space they need to think, reflect and rethink their position about fat and fat people and then connect that to sex. I know that the first step is to own my bias (something the vegan presenter did not do) and let others know that this is not necessarily an easy topic to come around about.

So the questions I want to pose are, how else might I approach this topic without shutting people down? And what are some of your sensitive topics that you have encountered and how did you navigate the hard points well (or not so well)?

           ~Rachel Girard

Developing a Curriculum for Medical Professionals

When you think of where people get their sexual health info, your mind might jump to 10th grade health classes, or friends, or even porn. Perhaps you think about social norms delivered through TV or the most recent Sunday sermon. However, when it comes to questions around sexual health, most adults are still asking their doctors. According to several studies done around the millennium, adults still see their physician as a primary source for addressing sexual health concerns (Metz & Seifert, 1990; Marwick, 1999). While this may change slightly with advancements made online, the physician is still a main-stay in sexual health concerns in the U.S. If you ask a medical student or physician, they may note how common sexual concerns are in a patient visit, often referring to sexuality questions as “hand on the door knob” questions. These “hand on the doorknob” questions suggest the real reason a patient comes to see his or her physician is to address some aspect of their sexuality, but are uncomfortable asking. In fact, a study conducted in 1999 found that while most people would ask their physician about a sexual health concern, they would feel uncomfortable doing it. More so, most people felt that their physician wouldn’t provide them with the information or treatment they were looking for (Marwick, 1999). For men in the 90’s, a study showed that while they wanted to get information from their doctor, they were embarrassed to do so and preferred that the physician initiate the conversation (Metz & Seifert, 1990). This attitude may not have shifted much even today.

One reason people may feel uncomfortable with addressing sexual health concerns with their physician may be that the physician him or herself is uncomfortable. A majority of 4th year medical students reported being uncomfortable with taking sexual histories from older and younger people in particular (Malhotra, Khurshid, Hendricks, & Mann, 2008). Physician attitudes, lack of comfort with sexual histories in general , and general communications issues also added to doctor discomfort (Tsimtsiou et al., 2006), A general discomfort with sexual health issues can make it abundantly clear to a patient that sexual health concerns are off-limits.

So what does all of this mean for us as educators?

1. We want to meet as many people as possible in addressing sexuality, so making sure doctors are just as informed as we are is a great way to do this.

2. Medical schools are obviously not giving the time to train students in taking sexual histories, in addressing student attitudes towards different aspects of sexuality, in working on communication around sexuality, and are probably not taking the time to talk about sexual pleasure or advances in sexual medicine.

3. Our place may be in providing sexual health training for medical students and ongoing education to physicians.

Training medical students or physicians has its pros and cons. Of course the pros are that we are able to make sure another source of sexuality information is on a positive track, but there may be some issues with having this come to pass.

1. First of all, medical students as well as physicians have a reputation of being slightly, umm, big-headed. Many medical students, as surely practicing physicians, may feel they already know everything and that, furthermore, no one outside of the medical community has a right to instruct them. Hopefully this is a rarer occurrence today, but it may be a small battle in organizing a training.
2. Time is an issue for any professional, but for practicing physicians in general, finding the time to enroll in a sexual health training program may be tricky. If you are attempting to add a sexual health training section to a medical school, it may be quickly shot down with the idea that there is already too much in the students’ schedule.

When organizing a program for training medical students, its best to first get the backing of a medical organization or medical school. That way, you have some sort of credibility behind you for the nay-sayers. More tempting would be setting up some sort of earned credit or certification if possible. This would help dismiss the previous concerns, especially if the class was an elective for credit. Furthermore, as Rebecca Bak and Alexis Light noted in constructing their Sexual Health Scholars Program for the American Medical Student Association, its best to approach a curriculum set up in a variety of steps. According to this duo, following these 7 steps will help when attempting to set up a sexuality training.

1. Identify a Need
2. Seek Help
3. Approach the Administration
4. Logistics
5. Create the Curriculum
6. Evaluation
7. Sustainability
(Bak & Light, 2011)

It may be easy to identify the need for a training in any medical community by assessing their current classes, but it is also important to get student backing and document it. When you approach the administration, it will be much easier to set up a training if you can show student interest in the program. Bak and Light also make a strong point to not go it alone. Seeking help in this endeavor is needed for success. For educators, this might be someone with interest in the medical community or a medical student. Perhaps you team up with a few members of your Planned Parenthood community. Any way you do it, having help, and backing, is mandatory for success in such an unpaved route.

For those of us who have little experience teaching professionals, #5 on this list may be a bit baffling. What do we teach medical students about? Many, if not all, already have some basic information in STI’s and the reproductive system as well as contractive methods. In fact, some of them may know more than you do on the subject. Thus, when developing a curriculum, its best to assess what is needed and what strengths you can play to. If you are teaming up with someone, hopefully they bring another skills set to the table as well. All in all, though, do not attempt to teach over your head. While it may be helpful to explain the most recent sexual medicine to them and how it affects sexual wellbeing, we can’t all be Dr. Kellogg. It is just as important to facilitate on attitudes towards LGBT sexuality and older adult sexuality. However, the Sexual Health Scholars and Center of Excellence for Sexual Health have come up similar topic lists that may be helpful when developing a curriculum.

1. Value of Sexual Health in the Medical Field
2. Taking a Sexual History
3. Models of Sexuality
4. Sex and Language
5. Sexual Anatomy, Reproduction, Response Cycles
6. Sexual Function and Dysfunction
7. Body Image and Self Esteem
8. Sexuality Across the Lifespan
9. Sexuality and Illness and Disability
10. Common Sexual Concerns and Treatments
11. Infertility
12. The Internet and Sex
13. Sexual Orientation, Attitudes and LGBT Health
14. Sexual Abuse
15. Sex Workers
16. Media, Culture and Religion
17. Behaviors, Values and Expressions
(Morehouse School of Medicine, 2011; Sexual Health Scholars Program, 2011)

The list could continue, but it should be obvious with this that there are multiple topics that could be and should be included in a sexual health training.

Advanced training in sexuality for medical professionals is a much needed thing. Hopefully this post inspires you to think about the connections that should be made between our field and the medical one. While only a starting point, this post attempts to give a good jump on initiating that connection. While I didn’t get around to writing about how to facilitate to professional groups, for those of you who have had experience training medical professionals or other professionals, please comment!

-Meg Augustin

Bak, R. & Light, L. (2011) Creating change, one elective at a time [PowerPoint slides]. Retrieved from

Malhotra, S., Khurshid, A., Hendricks, K.A., & Mann, J.R. (2008) Medical school sexual health curriculum
and training in the United States. Journal of the National Medical Association, 100(9), 1097-1106.

Marwick, C. (1999) Survey says patients expect little physician help on sex. The journal of the American
Medical Association, 281(23), 2173-2174.

Metz, M.E. & Seifert, M.H. (1990) Men’s expectations of physicians in sexual health concerns. Journal of
sex and marital therapy, 16(2), 79-88.

Morehouse School of Medicine (2011) Sexual health curriculum development. Retrieved from

Sexual Health Scholars Program (2001) Tentative Curriculum. Retrieved from

Tsimtsiou, Z., Hatzimouratidis, K., Nakopoulou, E., Kyrana, E., Salpigidis, G., & Hatzichristou, D. (2006)
Predictors of physicians’ involvement in addressing sexual health issues. Journal of sexual
medicine, 3(4), 583-588.