“We don’t know what we need to learn”: Medical student perceptions of preparedness for practice in men’s health
Keywords:men’s health, medical education, curriculum, implementation
AbstractIntroduction: In response to poorer health status and lower use of healthcare services by men compared to women, the Australian National Male Health Policy (2010) includes a commitment to better workforce training. We present a formative evaluation assessing medical students’ preparedness and learning needs in relation to the care of men in order to inform the development of a commensurate curriculum framework. Method: A 4-item Likert scale survey was administered to final-year students from one Australian medical school (n=170; 64% female, 36% male; 74% response). The survey assessed coverage of male health topics in the curriculum and preparedness for men’s health practice. Additional focus groups with 13 students from four Australian medical schools aimed to provide context for the survey data and better understanding of learning needs. Results: Overall, 65% of students (67% male, 64% female) reported no or brief coverage of men’s health in the curriculum; 20% of students (14% male, 23% female) felt minimally prepared in men’s health practice. Students’ perceived learning needs mostly related to male reproductive system disorders. Focus group data highlighted a difference between the content/opportunities that exist in men’s health education compared with women’s health, stating that men’s health education tends to be “scattered” variably through the medical course and that student or educators’ personal interest tended to drive men’s health education. In addition, unlike opportunities to undertake sensitive examinations on females, practice opportunities for male genital and prostate examination were limited, with some reporting no coverage in their medical course.Conclusion: From a student perspective, there is a need to enhance men’s health education in Australian medical schools by incorporating clinically relevant men’s health across curricula using a defined framework.
Australian Government Department of Health and Ageing. (2010). National male health policy: Building on the strengths of Australian males. Canberra, Australia: Commonwealth of Australia.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77‒101.
Chehade, M. J., Burgess, T. A., & Bentley, D. J. (2011).
Ensuring quality of care through implementation of a competency-based musculoskeletal education framework. Arthritis Care and Research, 63(1), 58‒64.
Creswell, J. W. (2003). Research design: Qualitative, quantitative and mixed methods approaches. Thousand Oaks, CA: Sage.
Dauphinee, W. D. (2009). Forgetting lessons past: Failure to consider context and resources in curricular change. Medical Education, 43, 502‒504.
Evans, J., Frank, B., Oliffe, J. L., & Gregory, D. (2011). Health, illness, men and masculinities (HIMM): A theoretical framework for understanding men and their health. Journal of Men’s Health, 8(1), 7‒15.
Fairbank, C. (2011). Men's health: It is imperative to teach scrotal and rectal examination. The Clinical Teacher, 8(2), 101‒104.
Fayers, T., Crowley, T., Jenkins, J., & Cahill, D. (2003). Medical student awareness of sexual health is poor. International Journal of STD and AIDS, 14(6), 386‒389.
Graham, I. S., Gleason, A. J., Keogh, G. W., Paltridge, D., Rogers, I. R., Walton, M., . . . McGrath, B. P. (2007). Australian curriculum framework for junior doctors. Medical Journal of Australia, 186(7 Suppl.), S14–S19.
Henrich, J. B., Viscoli, C. M., & Abraham, G. D. (2008). Medical students’ assessment of education and training in women’s health and in sex and gender differences. Journal of Womens Health, 17(5), 815–827.
Holden, C. A., Allan, C. A., & McLachlan, R. I. (2010). Male friendly services: A matter of semantics. Australian Family Physician, 39(1/2), 9–10.
Kerfoot, B. P., Baker, H., Volkan, K., Church, P. A., Federman, D. D., Masser, B. A., & De, W. W. (2004). Development of validated instrument to measure medical student learning in clinical urology: A step toward evidence based education. Journal of Urology, 172(1), 282–285.
Kerfoot, B. P., & Turek, P. J. (2008). What every graduating medical student should know about urology: The stakeholder viewpoint. Urology, 71(4), 549–553.
Kerkering, K. W., & Novick, L. F. (2008). An enhancement strategy for integration of population health into medical school education: Employing the framework developed by the Healthy People Curriculum Task Force. Academic Medicine, 83(4), 345–351.
McCullagh, J. (2011). The invisible man: Development of a national men’s health training programme for public health practitioners. Challenges and successes. Public Health, 125, 401–406.
McEvoy, P., & Richards, D. (2006). A critical realist rationale for using a combination of quantitative and qualitative methods. Journal of Nursing Research, 11(1), 66–78.
McGarvey, E., Peterson, C., Pinkerton, R., Keller, A., & Clayton, A. (2003). Medical students’ perceptions of sexual health issues prior to a curriculum enhancement. International Journal of Impotence Research, 15(Suppl. 5), S58–S66.
National Health and Hospitals Reform Commission. (2009). A healthier future for all Australians: Final report of the National Health and Hospitals Reform Commission. June 2009. Commonwealth of Australia. Retrieved from http://www.health.gov.au/internet/nhhrc/publishing.nsf/content/nhhrc-report
Patton, M. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks, CA: Sage.
Phillips, G. (2004). CDAMS Indigenous health curriculum framework. Sydney, Australia: Committee of Deans of Australian Medical Schools.
Poljski, C., Tasker, C., Andrews, C., Wijesinha, S., Piterman, L., & de Kretser, D. (2003). GP attitudes to male reproductive and sexual health education and promotion: A qualitative study. Australian Family Physician, 32(6), 462–465.
Powell, H., Bridge, J., Eskesen, S., Estrada, F., & Laya, M. (2006). Medical students’ self-reported experiences performing pelvic, breast, and male genital examinations and the influence of student gender and physician supervision. Academic Medicine, 81(3), 286–289.
Shindel, A. W., & Parish, S. J. (2013). Sexuality education in North American medical schools: Current status and future directions (CME). The Journal of Sexual Medicine, 10(1), 3–18.
Turner, D., Jopt, K., Nieder, T. O., & Briken, P. (2014). German medical students’ interest in and knowledge about human sexuality in 1972 and 2012. The Journal of Sexual Medicine, 11(8), 1914–1926.
Wittenberg, A., & Gerber, J. (2009). Recommendations for improving sexual health curricula in medical schools: Results from a two-arm study collecting data from patients and medical students. The Journal of Sexual Medicine, 6(2), 362–368.
Wittert, G. A., & Nelson, A. J. (2009). Medical education: Revolution, devolution and evolution in curriculum philosophy and design. The Medical Journal of Australia, 191(1), 35–37.
On acceptance for publication in FoHPE the copyright of the manuscript is signed over to ANZAHPE, the publisher of FoHPE.
Any reproduction of material published in FoHPE must have the express permission of the publisher.
ANZAHPE has licence agreements with third parties allowing world wide access to material published in FoHPE and these require the honouring of copyright.
This policy is under review by the ANZAHPE Committee of Management.