| Research Article (Open access) |
|---|
SSR Inst. Int. J. Life.
Sci., 5(4): 2349-2354, July 2019
A
Bricolage on Perception of Sexuality Education among
Medical Students
Lata Ajay Tapnikar*
Associate Professor, Department of Community
Medicine, NKP Salve Institute of Medical Sciences, Nagpur, Maharashtra, India
*Address for Correspondence: Dr. Lata Ajay Tapnikar, 1 Sanjivani, Nelson square, Byramji
Town, Chhindwada Road, Nagpur, Maharashtra-440013, India
E-mail: lataajay@rediffmail.com
Methods- A semi-structured, self-administered questionnaire was used as an instrument for data collection 58 medical students. Convenient sampling method was used to select medical school students in central India. A qualitative study using bricolage and inductive responses was used to construct the article.
Results- There were 75
pre-degree students in faculty of Medicine. Results and data were statistically
analyzed. Only 58 forms could be analyzed. More than 57% did not know that
sexuality education was taught in schools. Most participants did not know of
alternative names for sexuality education. 62% of the teachers were female. 50%
of the students said that anatomy and contraception were taught to them, while
all the students 100% said that sexuality education is important. 50% referred
to the internet for educating themselves, most participants 67.2% preferred to
discuss among friends. 78% did not discuss sexuality issues with parents
Sexuality education was the need of the hour.
Key Words:
Bricolage, Inductive response, Medical school
students, Perception, Sexuality education
INTRODUCTION- Sexuality behavior amongst young people is seriously going through a transformation from what
it was previously. It is therefore important that young people have adequate
information about their sexuality so that they can make informed choices [1]. Comprehensive sexuality education received
higher ratings than abstinence-only or no sexuality education [2] sexuality education/ family life education
(FLE) has been one of the highly controversial issues in Indian society. Due to
increasing incidences of HIV/AIDS, RTIs/STIs, and teenage pregnancies, there is
a rising need to impart sexuality education. Undergraduates of tertiary
institutions are predominantly adolescents and young adults who are at various
stages in a continuum of physical and psychological changes associated with
enormous social interactions, relationships, and risk behavior [3]. However, introducing sexuality education
at school level always received a mixed response from
various segments of Indian society. More often than not it’s their perception
towards sexuality and the gaps that are left behind in the present system of
teaching sexuality needs to be adequately filled.
The problem of over-population also demands family life education, including
family planning as a priority, as many of the young people are about to be
married and should be aware of the responsibilities they have [2,3].
The FLHE program has had positive effects in the states and among schools where
the implementation has been effective, underscoring the need for more effective
implementation of the program throughout
the country [4,5]. A comprehensive and uniform curriculum on human
sexuality at the medical school level may substantially enhance the capacity of
tomorrow's physicians to provide optimal care for their patients irrespective
of gender, sexual orientation, and individual sexual mores/beliefs [6]. To assess the present status by a bricolage, something constructed using whatever comes to
hand gives a fairly good idea as to what needs to be recommended. Using these
multiple frameworks and methodologies, researchers are empowered to produce
more rigorous and praxiological insights into
socio-political and educational phenomena [7]. The inferential thesis with an inductive approach
would come near the end of the essay [8]. intent being reaching a purposeful course of action
thereafter [9]. Seymour Papert
discusses two styles of solving problems. Contrary to the analytical style of
solving problems, he describes bricolage as a way to
learn and solve problems by trying, testing, playing around [10,11]. An inductive
format builds toward a conclusion since an inductive process is
"emergent," one thing leading to another, building upon another, like
scaffolding, applying a “bricolage” approach” [12,13].
MATERIAL AND METHODS-
A qualitative study design using bricolage was
attempted. This study was conducted using questionnaires distributed to 75
pre-degree students in Faculty of Medicine, MUHS, Nagpur,
India between the months of August 2016 to September 2016. A semi-structured,
self-administered questionnaire was used as an instrument for data
collection. Convenient sampling method
was used to select medical school students in department of Community Medicine,
NKP Salve Institute of Medical sciences and research centre in Nagpur,
Maharashtra in central India.
Informed consent was taken from every subject in the form of their signatures. Data collection was done in batches of 8 - 10 after regular community medicine classes with a pre-tested questionnaire. Each student was made to sit in separate row so that the answers given by them were exclusive to the participant and not through mutual discussion. Before conducting the study, ethical clearance was taken from college ethical committee. Obtained data were statistically analyzed. Only 58 forms could be analyzed as 12 did not return the forms, 2 did not give consent, 3 forms were incomplete. The inductive responses were obtained in the form of open ended question at the end of the questionnaire.
Statistical analysis- P-value <0.05 was considered statistically significant. Statistical analysis was analyzed using Epi Info version 7.2.0.1. Categorical variable were expressed as percentages (%).
RESULTS- The study group consisted of 58 medical students. Mean age of participants: 21.84, in that batch of medical student participants it was observed that 81.03% of them were from the age group 20 to 22 years and only 19% were 23 to 25 years. Female students were more than 60% as compared to 40% among male students.
Table 1: Age and Sex wise distribution
|
Age (Yrs.) |
Female (%) |
Male (%) |
Total (%) |
|
20-22 |
29 (50) |
18 (31.03) |
47 (81.03) |
|
23-25 |
6 (10.34) |
5 (8.63) |
11 (18.97) |
|
Total |
35 (60.34) |
23 (39.66) |
58 (100) |
Demographic Information- Type of board education and medium of school was analyzed and it was found that 22 (37.93%) CBSE board, only 2 (3.44%) ICSE board, 34 (58.62%), and state board. Total 19 (55.88%) were from completely English medium schools. All were from Co-ed schools except one from Marathi medium boy’s school.
Table 2: Perception of existence of
Sexuality education
|
|
Yes (%) |
No (%) |
|
SE Taught |
25 (43.10) |
33 (56.90) |
|
Alternative
name of SE |
8 (13.79) |
50 (86.21) |
|
Attend all
sessions |
18 (31.30) |
40 (68.70) |
|
SE by
female teacher |
22 (37.93) |
36 (62.07) |
|
SE was
embarrassing |
4 (6.90) |
54 (93.10) |
|
SE was
Interesting |
24 (41.37) |
34 (58.63) |
|
Anatomy
taught |
29 (50.00) |
29 (50) |
|
Contraception
taught |
28 (48.28) |
30 (51.72) |
More than 57% did not know that sexuality education was taught in schools. Total 86.2% did not know of alternative names for sexuality education. Total 62% of the teachers were female. Total 50% of the students said that anatomy and contraception were taught to them. The interesting part of the study was that 93.1% did not find sexuality education embarrassing and nearly 58.6% did not find it interesting.
Table 3: Perception of attitude towards
Sexuality Education
|
|
Yes (%) |
No (%) |
|
SE should be
taught in schools |
50 (86.21) |
8 (13.79) |
|
SE is
Important |
58 (100) |
0 (0.00) |
|
SE should
be part of Medical curriculum |
53 (91.38) |
5 (8.62) |
|
Doubts
regarding sexuality issues |
27 (46.55) |
31 (53.45) |
|
Doubts to
be cleared by teacher |
38 (65.52) |
20 (34.48) |
|
Believe in
Gender equality |
53 (91.38) |
5 (8.62) |
|
Men
superior to women |
4 (5.90) |
54 (94.10) |
|
Sexuality
counseling need of the hour |
46 (79.31) |
12 (20.69) |
It was found that 86.2% said, sexuality education should be taught in schools. While all the students 100% said that sexuality education was important. Nearly 50% of the participants had doubts regarding sexuality issues and 79.3% felt that Sexuality education was the need of the hour.91.3% of them believed in gender equality and 94.1% did not think that men were superior to women.
Table 4: Perception of prevailing practices
in Sexuality Education
|
|
Yes (%) |
No (%) |
p-value |
|
Refer to
Internet |
26 (44.83) |
32 (55.17) |
P<0.013 |
|
Discuss
among friends |
39 (67.24) |
19 (32.76) |
|
|
Discuss
with Parents |
13 (22.41) |
45 (77.59) |
|
|
Discuss
with siblings |
19 (32.76) |
39 (67.24) |
|
|
Do your
friends see Adult films |
30 (51.72) |
28 (48.28) |
|
|
Are your
friends sexually active |
30 (51.72) |
28 (48.28) |
|
|
Premarital
sex is common practice |
48 (82.76) |
10 (17.24) |
|
|
Are you in
a relationship |
11 (18.97) |
47 (81.03) |
P<0.013 M>F
In this study it was found that only 50% referred to internet for educating themselves, 67.2% preferred to discuss among friends. Total 78% did not discuss sexuality issues with parents but 67% did discuss with siblings. Total 50% participants admitted to their friends watching adult films and their friends being sexually active. When gender was assessed then it was found that male watched adult film significantly more than female with p-value less than 0.013. 82.7% opined that premarital sex is a common practice and when asked if they were in a relationship 81.03% denied being in it.
Inductive
response- Five females and six male students responses have
been shared here “Sexuality education should be taught in a way that students,
who have not taken up medicine, should not feel embarrassed. Maybe starting in
school from an early grade would let young students indulge in acts that they
might regret later.”
“Sexuality
education should be started as early as possible in schools so that
difficulties faced by young boys and girls in their adolescence phase can be
tackled by them easily and they become more open about issues going on in their
minds to people around them, they were free to talk with.”
“It
should be given to students from school life itself because nowadays due to
media students get to indulge in sexual activity very early. Even though, they
knew all about contraception and safe period still can commit unwanted
mistakes, so it is really necessary. A questionnaire must also include whether
they have physically indulged in opposite-sex yet or not? Really this issue
must be included compulsorily in all Govt/non-Govt schools.”
“Sex
education is not a matter of embarrassing moments or any shame in discussing in
a group, so this kind of stigma should be removed by doing regular sessions on
it which can do an ice-breaking for those people. And same should be done for
gender equality”.
“Sex
education should be taught to every student as it is very important regarding
the health point of view. Since people feel shy talking about this so we need a
proper knowledge about this” “Teachers shouldn’t focus on these things; as
students feel very embarrassed”.
“Premarital
sex should not occur in society coz it has a bad result which can harm society
as well as a partner. Equality i.e. Gender should be there in society, no
discrimination in society”.
“In
my school, they have not given an education; we have taken the knowledge from
the internet. Must take class of sexual educations because many students boys /girls were shy about the sex. Most of the
students are shy about talking to girls and boys. Mostly rural area boys are
shy for talking” .
“Whenever
anything we hide from children, they think usually get attracted towards it and
they think it’s something incredible and the same happening regarding son in developing
countries like India. They used to indulge in it in the wrong way. This can be
preferred by giving them proper sexual education from childhood.”
“Sexuality
education is important. Many schools not did it. We have to teach sexual
education into the school or to the brother sister. School teachers have to
teach properly (khulke)”.
DISCUSSION-
A Bricolage
qualitative research approach was carried out. Participation was based on
informed consent [11,12]. We found
substantial gap between the proportion of youth, who perceived sexuality
education to be important and those who actually received it, revealing
considerable unmet need for sexuality education. Mean age of students 21.84 in
our study. The mean age of the participants studied by Duru
et al. [5] was 22.3±3.3
years and in a study by Opora et al. [1] the students
were aged 10 - 20 years, with a median age of 15 [1]. Attitudes about reproductive health among males and
females aged 15 - 19 years were studied [15]. The study found
93% did not find sexuality education embarrassing. The participants wanted
their doubts to be cleared by teachers. Majority of the participants,
irrespective of their age and sex, favored introduction of sexuality education
at school level. Increasing the awareness on these topics starting from the
school age, young people may understand the right behaviors to adopt for living
a healthier life in the interests of themselves and of the entire society [16]. Introducing sexual education in schools is generally
accepted by respondents of the present study [17]. It was found that 86.2% said that sexuality
education should be taught in schools. While all the students 100% said that
sexuality education is important. Around 83% of
young men and 78% of young women felt that it is important to impart family
life/sex education to youth [6].
We believe that all types of secondary school should introduce a course of sex
education in the curriculum. Science teachers could be responsible for teaching
these courses [16]. In this study 78% did not discuss sexuality
issues with parents but 67% did discuss with friends. Peer education and conventional education strategies were effective in
improving the reproductive health knowledge [18]. Parent-adolescent communication about
sexuality has increased during the last few decades; both the occurrence and
the quality of this communication could still be greatly improved [19]. These results have provided some
insight towards the perception of the knowledge attitude and present practices
of sexuality among the participants. Sexuality education is the need of the
hour. Another study
results revealed the feasibility and effectiveness of school based reproductive
and sexual health education intervention programs for adolescents [20].
In our study 44.83% referred to internet while another study indicated that for adolescent students the Internet,
media, friends, books and magazines were the main sources of information [21]. The inductive responses give an
honest account of the prevailing situation on sexuality education which often
emphasizes that sexuality education is need of the hour for adolescents.
Increasing the awareness on these topics starting from the school age, young
people may understand the right behaviors to adopt for living a healthier life
in the interests of themselves and of the entire society [16]. Shyness being the major
concern it should be taught by properly trained facilitators thus coming to a
purposive conclusion and future studies should be designed to center on factors
that influence sexual behavior [3,14].
CONCLUSIONS-
A bricolage on perception of sexuality education
among medical students was done as a unique qualitative with inclusion of
inductive responses from female and male students which has been reproduced per
se without any modifications. The age mean of students was late adolescence.
The demographic profile revealed that most students came from English medium
schools and their schools did teach sexuality education in the form of anatomy
classes taken mostly by female teacher. 100% of the students agreed that
sexuality education should be taught in schools. Perception of prevailing
practices in sexuality education, internet and adult films seem a common source
of information. Students did not discuss sexuality issues with parents or
siblings but most often with friends. Male students were significantly more
used to seeing adult films as compared to female students. Medical school
students were aware of the subject of sexuality education and need adequate
information on sexuality issues.
Outcome of our study suggested a future
need to incorporate sexuality education in schools as well as in medical
curriculum.
ACKNOWLEDGEMENTS-
The author gratefully acknowledges the cooperation and support received from
the NKP Salve Institute of Medical sciences and research center, medical
students, who were the participants, Dr. Shilpa Hajare for critically reviewing the article and the ethical
committee members for allowing me to perform the study successfully.
CONTRIBUTIONS OF AUTHORS- The author has singly contributed
in this research article.
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