"I'd have no idea how to go about this…" - a survey of Australian medical students' perspectives on their men's health education.

Curriculum Gender Medical education Men’s health

Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
08 Mar 2024
Historique:
received: 24 05 2023
accepted: 09 01 2024
medline: 9 3 2024
pubmed: 9 3 2024
entrez: 8 3 2024
Statut: epublish

Résumé

While there have been calls over the last 15 years for the inclusion of training in sex and gender-based medicine in medical school curricula and to sustain such improvements through a more gender responsive health system, little progress has been made. A related objective of the Australian National Men's Health Strategy (2020-30) is to improve practitioner core learning competencies in men's health as a critical step to reducing the burden of disease in men and disparities between men in health care access and outcomes. The aim of this study was therefore to obtain Australian medical student perspectives on the extent to which men's health and sex and gender-based medicine education is delivered in their curricula, their preparedness for engaging with men in clinical practice, and the men's health content they would have found useful during their training. Eighty-three students (48% male) from 17 accredited medical schools, and in at least their fourth year of training, completed an online survey. The survey was co-designed by a multidisciplinary team of men's health researchers and clinicians, alongside a student representative. A mix of quantitative and qualitative survey items inquired about students' preparedness for men's health clinical practice, and coverage of men's health and sex- and gender-based medicine in their curricula. Most students reported minimal to no men's health coverage in their medical school education (65%). While few were offered optional men's health units (10.5%), the majority would have liked more formal training on the topic (78%). Accompanying qualitative findings substantiated a lack of preparedness among medical students to engage male patients, likely stemming from minimal coverage of men's health in their medical education. Australian medical students may feel underprepared for contemporary men's health clinical practice, as well as, albeit to a lesser extent, women's health clinical practice. There is a clear need and desire amongst medical students to enhance curricula with sex and gender-based medicine training.

Sections du résumé

BACKGROUND BACKGROUND
While there have been calls over the last 15 years for the inclusion of training in sex and gender-based medicine in medical school curricula and to sustain such improvements through a more gender responsive health system, little progress has been made. A related objective of the Australian National Men's Health Strategy (2020-30) is to improve practitioner core learning competencies in men's health as a critical step to reducing the burden of disease in men and disparities between men in health care access and outcomes. The aim of this study was therefore to obtain Australian medical student perspectives on the extent to which men's health and sex and gender-based medicine education is delivered in their curricula, their preparedness for engaging with men in clinical practice, and the men's health content they would have found useful during their training.
METHODS METHODS
Eighty-three students (48% male) from 17 accredited medical schools, and in at least their fourth year of training, completed an online survey. The survey was co-designed by a multidisciplinary team of men's health researchers and clinicians, alongside a student representative. A mix of quantitative and qualitative survey items inquired about students' preparedness for men's health clinical practice, and coverage of men's health and sex- and gender-based medicine in their curricula.
RESULTS RESULTS
Most students reported minimal to no men's health coverage in their medical school education (65%). While few were offered optional men's health units (10.5%), the majority would have liked more formal training on the topic (78%). Accompanying qualitative findings substantiated a lack of preparedness among medical students to engage male patients, likely stemming from minimal coverage of men's health in their medical education.
CONCLUSIONS CONCLUSIONS
Australian medical students may feel underprepared for contemporary men's health clinical practice, as well as, albeit to a lesser extent, women's health clinical practice. There is a clear need and desire amongst medical students to enhance curricula with sex and gender-based medicine training.

Identifiants

pubmed: 38459497
doi: 10.1186/s12909-024-05045-6
pii: 10.1186/s12909-024-05045-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

260

Subventions

Organisme : Australian Government Department of Health and Movember Foundation (Australia)
ID : HEALTH/ 21-22/D21-5427311

Informations de copyright

© 2024. The Author(s).

Références

AIHW. Australian Institute of Health and Welfare. 2019. Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Australian Burden of Disease series no. 19. Cat. no. BOD 22. Canberra: AIHW. Published online 2019. Accessed 02 Mar 2023.
Hawkes S, Allotey P, Elhadj AS, Clark J, Horton R. The Lancet Commission on gender and Global Health. Lancet (London England). 2020;396:521–2.
pubmed: 32763153 doi: 10.1016/S0140-6736(20)31547-6
Smith JA, Watkins DC, Griffith DM. Equity, gender and health: new directions for global men’s health promotion. Heal Promot J Aust. 2020;31:161–5.
doi: 10.1002/hpja.337
Baker P, Shand T. Men’s health: time for a new approach to policy and practice? J Glob Health. 2017;7:010306.
pubmed: 28400949 pmcid: 5344012 doi: 10.7189/jogh.07.010306
Giorgianni SJ, Porche DJ, Williams ST, Matope JH, Leonard BL. Developing the discipline and practice of comprehensive men’s health. Am J Men’s Health. 2013;7:342–9.
doi: 10.1177/1557988313478649
Seidler ZE, Wilson MJ, Trail K, Rice SM, Kealy D, Ogrodniczuk JS, et al. Challenges working with men: Australian therapists’ perspectives. J Clin Psychol. 2021;77:2781–97.
pubmed: 34599835 doi: 10.1002/jclp.23257
Yousaf O, Grunfeld EA, Hunter MS. A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Health Psychol Rev. 2015;9(2):264–76.
pubmed: 26209212 doi: 10.1080/17437199.2013.840954
Courtenay W. A global perspective on the field of men’s health: an editorial. Int J Mens Health. 2002;31(1):1–4.
doi: 10.3149/jmh.0101.1
Miller VM, Rice M, Schiebinger L, Jenkins MR, Werbinski J, Núñez A, et al. Embedding concepts of sex and gender health differences into medical curricula. J Women’s Health (Larchmont). 2013;22:194–202.
doi: 10.1089/jwh.2012.4193
Dielissen PW, Bottema BJA, Verdonk P, Lagro-Janssen ALM. Incorporating and evaluating an integrated gender-specific medicine curriculum: a survey study in Dutch GP training. BMC Med Ed. 2009;9:58.
doi: 10.1186/1472-6920-9-58
Griffith DM. An intersectional approach to men’s health. J Mens Health. 2012;9:106–12.
doi: 10.1016/j.jomh.2012.03.003
Jenkins MR, Johnson CA, Newman CB, McGregor AJ. Chapter 1 - application of sex and gender health: a practical framework. In: Jenkins MR, Newman CB, editors. How sex and gender impact clinical practice. Academic Press; 2021. pp. 3–8.
Seidler ZE, Dawes AJ, Rice SM, Oliffe JL, Dhillon HM. The role of masculinity in men’s help-seeking for depression: a systematic review. Clin Psychol Rev. 2016;49:106–18.
pubmed: 27664823 doi: 10.1016/j.cpr.2016.09.002
Mursa R, Patterson C, Halcomb E. Men’s help-seeking and engagement with general practice: an integrative review. J Adv Nurs. 2022;78:1938–53.
pubmed: 35384022 pmcid: 9322545 doi: 10.1111/jan.15240
Englar-Carlson M. Masculine norms and the therapy process. In: Englar-Carlson M, Stevens MA, editors. The room with men: a casebook of therapeutic change. American Psychological Association; 2006. pp. 13–47.
Noone JH, Stephens C. Men, masculine identities, and health care utilisation. Soc Health Illness. 2018;30:711–25.
doi: 10.1111/j.1467-9566.2008.01095.x
Cameron E, Bernardes J. Gender and disadvantage in health: men’s health for a change. Soc Health Illness. 2008;20:673–93.
doi: 10.1111/1467-9566.00124
Manandhar M, Hawkes S, Buse K, Nosrati E, Magar V. Gender, health and the 2030 agenda for sustainable development. Bull World Health Organ. 2018;96:644–53.
pubmed: 30262946 pmcid: 6154065 doi: 10.2471/BLT.18.211607
Hale S, Grogan S, Willott S. Male GPs’ views on men seeking medical help: a qualitative study. Br J Health Psychol. 2010;15:697–713.
pubmed: 19941730 doi: 10.1348/135910709X479113
Wentzell E, Nangia A. Accounting for physicians’ gender expectations improves men’s health medicine. Revista Panam De Salud Pública. 2018;42:e103–5.
Seidler ZE, Rice SM, Kealy D, Oliffe JL, Ogrodniczuk JS. Once bitten, twice shy: dissatisfaction with previous therapy and its implication for future help-seeking among men. Int J Psychiatry Med. 2020;55:255–63.
pubmed: 32019361 doi: 10.1177/0091217420905182
Hammond WP, Matthews D, Mohottige D, Agyemang A, Corbie-Smith G. Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men. J Gen Internal Med. 2010;25:1300–8.
doi: 10.1007/s11606-010-1481-z
Govender V, Penn-Kekana L. Gender biases and discrimination: a review of health care interpersonal interactions. Global Public Heath. 2008;10083(Suppl 1):90–103.
doi: 10.1080/17441690801892208
Mahalik JR, Good GE, Tager D, Levant RF, Mackowiak C. Developing a taxonomy of helpful and harmful practices for clinical work with boys and men. J Couns Psychol. 2012;59:591–603.
pubmed: 23088685 doi: 10.1037/a0030130
Seidler ZE, Rice SM, Dhillon HM, Herrman H. Why it’s time to focus on masculinity in mental health training and clinical practice. Australas Psychiatry Bull R Aust New Zeal Coll Psychiatr. 2019;27:157–9.
Skär L, Söderberg S. Complaints with encounters in healthcare–men’s experiences. Scand J Caring Sciences. 2012;26:279–86.
doi: 10.1111/j.1471-6712.2011.00930.x
Verdonk P, Benschop YWM, de Haes HCJM, Lagro-Janssen TLM. From gender bias to gender awareness in medical education. Adv Health Sci Education: Theory Pract. 2009;14:135–52.
doi: 10.1007/s10459-008-9100-z
Andersson J, Verdonk P, Johansson EE, Lagro-Janssen ALM, Hamberg K. Comparing gender awareness in Dutch and Swedish first-year medical students: results from a questionnaire. BMC Med Educ. 2012;12:3.
pubmed: 22239742 pmcid: 3277467 doi: 10.1186/1472-6920-12-3
Department of Health, Australian Government. (2019). National Men’s Health Strategy 2020–2030. https://www.health.gov.au/sites/default/files/documents/2021/05/national-men-s-health-strategy-2020-2030.pdf . Accessed 9 Aug 2022.
Seidler ZE, Rice SM, River J, Oliffe JL, Dhillon HM. Men’s mental health services: the case for a masculinities model. J Men’s Studies. 2018;26:92–104.
doi: 10.1177/1060826517729406
Miller VM, Kararigas G, Seeland U, Regitz-Zagrosek V, Kublickiene K, Einstein G, et al. Integrating topics of sex and gender into medical curricula-lessons from the international community. Biology of Sex Differences. 2016;7(Suppl 1):44.
pubmed: 27785346 pmcid: 5073937 doi: 10.1186/s13293-016-0093-7
McGregor AJ, Chin EL, Rojek MK, Digr KB, Lopez AM, Jenkins K, et al. Sex and gender Health Education Summit: advancing curricula through a multidisciplinary lens. J Women’s Health (Larchmt). 2019;28:1728–36.
doi: 10.1089/jwh.2018.7301
Holden C, Collins V, Pomeroy S, Turner R, Canny B, Yeap B, et al. We don’t know what we need to learn: medical student perceptions of preparedness for practice in men’s health. Focus Health Prof Ed. 2015;16:23–37.
Young RJ, Lempicki KA. Evaluating men’s health education in US pharmacy practice curriculum. Currents in Pharmacy Teaching and Learning. 2015;7:277–82.
doi: 10.1016/j.cptl.2014.11.002
White A, Connell R, Griffith DM, Baker P. Defining men’s Health towards a more inclusive definition. Int J Mens Social Comm Health. 2023;6:e1–e9.
doi: 10.22374/ijmsch.v6i1.100
Tsang V, Wassersug R. Men’s health research versus andrology—defining the division and closing the divide. J Men’s Health. 2018;14:e20–e32.
Henrich JB, Viscoli CM, Abraham GD. Medical students’ assessment of education and training in women’s health and in sex and gender differences. J Women’s Health (Larchmt). 2008;17:815–27.
doi: 10.1089/jwh.2007.0589
Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62:107–15.
pubmed: 18352969 doi: 10.1111/j.1365-2648.2007.04569.x
Kleinheksel AJ, Rockich-Winston N, Tawfik H, Wyatt TR. Demystifying content analysis. Am J Pharmaceut Ed. 2020;84:7113.
doi: 10.5688/ajpe7113
Medical Schools Outcome Database. Medical Deans Australia and New Zealand. 2023. https://medicaldeans.org.au/ . Accessed 6 Dec 2023.
Holden CA, Collins VR, Anderson CJ, Pomeroy S, Turner R, Canny BJ, et al. Men’s health–a little in the shadow: a formative evaluation of medical curriculum enhancement with men’s health teaching and learning. BMC Med Ed. 2015;15:210.
doi: 10.1186/s12909-015-0489-9
Blundo R. Engaging men in clinical practice: a solution-focused and strengths-based model. Families in Society. 2010;91:307–12.
doi: 10.1606/1044-3894.4010
Englar-Carlson M, Kiselica MS. Affirming the strengths in men: a positive masculinity approach to assisting male clients. J Couns Dev. 2013;91:399–409.
doi: 10.1002/j.1556-6676.2013.00111.x
Rydberg A, Buras MR, Quillen J, Miller V, Kling JM. Sex and gender specific health topics in medical student learners: pulse check eight years later. Biol Sex Differ. 2021;12:53.
pubmed: 34627380 pmcid: 8501372 doi: 10.1186/s13293-021-00397-w
Elterman DS, Pelman RS. Male health: a new paradigm, strategies for care delivery, advocacy, education and research. Revista Médica Clínica Las Condes. 2014;25:35–9.
doi: 10.1016/S0716-8640(14)70008-2
Hall RH. Promoting men’s health. Aus Fam Physician. 2003;32:401–7.
World Health Organization. World Health statistics Overview 2019: monitoring health for the SDGs. World Health Organization; Geneva (Switzerland).
Baker P. Delivering Men’s Health: A Guide for Policymakers and Service Providers. Global Action on Men’s Health. 2021. London (UK).
Hay K, McDougal L, Percival V, Henry S, Klugman J, Wurie H, et al. Disrupting gender norms in health systems: making the case for change. Lancet (London England). 2019;393:2535–49.
pubmed: 31155270 doi: 10.1016/S0140-6736(19)30648-8
Miller VM, Kararigas G, Seeland U, Regitz-Zagrosek V, Kublickiene K, Einstein G et al. (2016). Integrating topics of sex and gender into medical curricula-lessons from the international community. Biology Sex Differences. 2016;7(Suppl 1):44.
Dielissen P, Verdonk P, Bottema B, Kramer A, Lagro-Janssen T. Expert consensus on gender criteria for assessment in medical communication education. Patient Ed Counseling. 2012;88:189–95.
doi: 10.1016/j.pec.2012.01.013

Auteurs

Zac E Seidler (ZE)

Movember, Level 4/21-31 Goodwood St, 3121, Richmond, VIC, Australia. zac.seidler@movember.com.
Orygen, Parkville, VIC, Australia. zac.seidler@movember.com.
Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia. zac.seidler@movember.com.

Ruben Benakovic (R)

Orygen, Parkville, VIC, Australia.
Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia.

Michael J Wilson (MJ)

Orygen, Parkville, VIC, Australia.
Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia.

Jasmine M Davis (JM)

Australian Medical Students' Association, Australian Capital Territory, Barton, Australia.
University of Melbourne, Victoria, Australia.

Michelle Sheldrake (M)

Movember, Level 4/21-31 Goodwood St, 3121, Richmond, VIC, Australia.

Margaret A McGee (MA)

Movember, Level 4/21-31 Goodwood St, 3121, Richmond, VIC, Australia.

Classifications MeSH