Translation, cross-cultural adaptation of longitudinal curriculum objectives in sexual health to Brazilian medical education

Background The absence of a structured framework for sexual health education in undergraduate medical training contributes to fragmented teaching and insufficient preparation of future physicians. Aim To translate, cross-culturally adapt and implement the Longitudinal Sexual Health Curricular Objectives for Undergraduate Medical Education instrument for the Brazilian Portuguese context. Methods This descriptive, cross-sectional methodological study followed established international guidelines for translation and cross-cultural adaptation (Beaton methodology). The process included forward translation by two independent bilingual physicians, synthesis into a single version (T12), back-translation by independent native English translators blinded to the original instrument, expert committee review, and pretesting. A multidisciplinary expert panel (n = 6) assessed semantic, cultural, and conceptual equivalence using a 4-point Likert scale. The Content Validity Index (CVI) was calculated for individual items and for the overall instrument. Pretesting was conducted with medical school faculty members (n = 20) to evaluate clarity and comprehensibility. After final validation, the curricular objectives were longitudinally mapped and integrated into the undergraduate medical curriculum of a Brazilian medical school, aligned with competency-based educational principles. Outcomes Primary outcomes were content validity (CVI) and clarity/comprehensibility of the adapted instrument; secondary outcomes included feasibility of curricular implementation. Results The final Brazilian Portuguese version demonstrated excellent content validity, with an overall CVI of 0.97. Most items were rated as fully representative by the expert panel, with minor terminological and conceptual adjustments to ensure cultural appropriateness. During pretesting, 14 of 30 (46.6%) of items raised some interpretative doubts; following consensus review, 8 of 14 these items were revised to improve clarity. Faculty feedback confirmed overall comprehensibility and acceptability. Curricular mapping demonstrated feasibility of longitudinal integration without the need for stand-alone courses, distributing competency-based sexual health curriculum objectives progressively across the first three years of training. Clinical Implications The adapted instrument provides a structured framework to guide competency-based integration of sexual health education into undergraduate medical curricula. Strengths and Limitations Strengths include a rigorous methodological adaptation process, high content validity, multidisciplinary expert evaluation, and practical curricular implementation. Limitations include the absence of evaluation of student learning outcomes or long-term educational impact. Conclusion The Brazilian Portuguese version of the Longitudinal Sexual Health Curricular Objectives instrument is valid and feasible for implementation, supporting structured, longitudinal, and competency-based sexual health education in medical training.