The Sex Education Practicum: Medical Students in the Elementary School Classroom

By Cora-Bramble, Denice; Bradshaw, Mary Ellen et al. | Journal of School Health, January 1992 | Go to article overview

The Sex Education Practicum: Medical Students in the Elementary School Classroom


Cora-Bramble, Denice, Bradshaw, Mary Ellen, Sklarew, Bruce, Journal of School Health


Between January 31, 1989 and February 1, 1990, the number of AIDS cases among individuals ages 13-19 increased by 40%.[1] As of May 31, 1991, 691 cases of AIDS among adolescents were reported to the Centers for Disease Control.[2] In addition, many young adults ages 20-24 may have acquired HIV infection as teen-agers due to the latency period between HIV infection and onset of symptoms. Experts believe a combination of risk-taking behavior and lack of knowledge increases the likelihood of infection.[3] In recent surveys of senior high school students,[4] as well as junior high school students,[5] many respondents demonstrated general knowledge about AIDS. However, many continue to hold misconceptions about the disease. Furthermore, students more anxious about AIDS were more likely to hold these misconceptions and less likely to feel students with AIDS should be allowed to attend school.[5]

Other sexually transmitted disease (STDs) threaten this vulnerable group. Every year, 2.5 million U.S. teen-agers are infected with a STD, representing approximately one of every six sexually active teens.[6] Adolescents record the highest rate for any age group of chlamydial infection and its associated complications, such as pelvic inflammatory disease, ectopic pregnancy, and infertility.[7] Furthermore, of sexually active U.S. females, those ages 10-19 record the highest rate of gonorrhea.[8]

Problems associated with sexual activity by adolescents intensified in the 1980s. Recent data suggest more adolescents are becoming sexually active at younger ages. Among young women ages 15-19, the number claiming to have had sexual intercourse grew from 47% in 1982 to 53% in 1988; among young urban men ages 17-19, the proportion rose from 66% in 1979 to 76% in 1988, the most recent year for which data are available.[9,10]

A successful approach to the enormous task of reducing high risk sexual behavior and its consequences among adolescents must involve various modalities. Sexuality education presented during early adolescence provides an important tool in reducing high-risk sexual behavior. Imparting relevant information is an important step in helping youth make health-promoting decisions. The role of skilled, experienced health professionals, particularly physicians, in providing information to patients and to the community is of paramount importance. Though medical students and physicians may be equipped to teach human sexuality on the level of anatomy and physiology, they need practical training to develop teaching skills and to address their own values and attitudes regarding sexuality education.[11] Elementary schools provide an optimal setting to accomplish this task since students are an accessible audience. Groups can be targeted so students can be reached prior to becoming sexually active.

PROGRAM DEVELOPMENT

The Sex Education Practicum was developed in 1975 as a community collaborative effort to offer medical students in their psychiatry clerkship practical learning experiences in human sexuality, and to provide sexuality education in the District of Columbia public schools. The D.C. Dept. of Human Resources attempted to address the need for sexuality education programs in the D.C. public schools but found the demand for their services exceeded the supply of trained personnel. Planned Parenthood of Metropolitan Washington, a private agency, joined the effort to answer the need. Agency members appealed to the Howard University Dept. of Psychiatry for coordination in training medical students for the task.[12]

Subsequently, the Dept. of Psychiatry and the Bureau of Maternal and Child Health and, since 1980, the Bureau of School Health Services collaborated to present a program of sexuality education to elementary school students in selected D.C. public schools. The program was expanded in 1987 to include junior medical students during their psychiatry clerkship at the George Washington University School of Medicine.

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