Challenging content: a mixed-methods evaluation of a novel sexual health curriculum in doctor of physical therapy education

Despite its importance to patients, sexual health is often overlooked by healthcare providers. Failure to address patients’ sexual healthcare needs may stem from inadequate health professions education. Physical therapists and physical therapy students are among the healthcare providers who may be unprepared to address sexual health in their clinical role. This paper examines a novel approach to teaching physical therapy students to address sexual health and makes recommendations for future curricular design and delivery. This study employed a convergent, parallel mixed methods design to evaluate the longitudinal impacts of a novel, evidence-based curriculum delivered in 2023 and 2024, which was developed to improve physical therapy students’ readiness to address sexual health. The curriculum was student-centered, grounded in prior research, incorporated relevant conceptual frameworks, and infused the lived experience of a patient-educator. Quantitative data were collected using the Students’ Attitudes Towards Addressing Sexual Health (SA-SH) questionnaire at three timepoints: pre-intervention, post-intervention, and post-clinical education. A mixed-effects linear model was used to evaluate changes over time. Qualitative data were collected via six semi-structured focus groups and analyzed using directed content analysis informed by a conceptual framework. A total of 137 students participated across two cohorts. Least squares means (± standard error) for the SA-SH total score were 74.0 (± 1.0) at baseline, 82.8 (± 1.0) post-intervention, and 82.5 (± 1.1) at 10-month post-clinical follow-up. Mixed model results indicated SA-SH scores increased significantly and meaningfully from baseline to post-intervention (estimated mean difference = 8.7, 95% CI 7.7 to 10.4) and were maintained over the 10-month follow-up. Focus group themes supported the quantitative findings, highlighting increased awareness of the PT’s role in sexual health and perceived gains in communication confidence. Integration of data sources reinforced the effectiveness of the intervention and identified areas for continued curricular development. The results obtained in this study indicate that physical therapy students can benefit from brief yet thoughtfully planned educational interventions to support their self-perceived readiness to address sexual health in clinical practice. Recommendations for educators to further improve curricula include baseline and post-education assessments, incorporation of lived experiences, and attention to the personal and interpersonal factors that influence healthcare providers’ approach to addressing sexual health.