Comment on “Study of Attitude and Knowledge toward Sexual Health among Postgraduate Medical Students”
Year: 2025
Type: article
Abstract: Dear Editor, The original article “Study of Attitude and Knowledge toward Sexual Health among Postgraduate Medical Students” published in the Indian Journal of Social Psychiatry is a valuable contribution.[1] The study’s objective was to assess the knowledge of medical postgraduates about sexual history, their comfort level, and the ability to manage sex-related problems in patients.[1] I agree with the rationale of the study that both undergraduate and postgraduate medical students are not adequately exposed to sex education in their curriculum, and considering its importance, the present study is the need of the hour. I have gone through the article in depth and have some critical observations and suggestions to improve the overall quality of the research article. To start with, the distribution of resident doctors who were enrolled in the study should not be there in the methodology section, as it is a part of the results section.[1] I noticed that the sample size which the authors estimated was 196 and then it was rounded off to 200. In general, whatever sample size we estimate using a statistical formula, we should add 10% as nonresponse, which means in the current study, the ideal sample size should be 216 (196 ± 19.6 ≈ 20 [10% of 196]).[1,2] I am not fully convinced about including students only from the streams of anatomy and physiology, with no representation from subjects such as biochemistry, pathology, and microbiology. Hence, was it systematic random sampling which the authors mentioned, or convenient purposive sampling? In continuation, I feel instead of systematic random sampling, the more appropriate method should have been stratified random sampling, where each department can be considered one separate stratum, and the sample size from each stratum is allocated proportionately to the population size of the stratum.[1,3] In the current study, authors have not mentioned using what scientific rationale they have selected 200 residents out of 400, whether they prepared a line listing or something else.[1] Whenever we write the methodology section, one simple rule is that it has to be self-explanatory, so that if anyone else reads the methods part they can replicate the same thing within their settings, this has been grossly missing, this raises questions on the scientific robustness and internal validity of the study.[4] The process of data collection again is questionable, in the sense that the investigator was not present when resident doctors were filling out the questionnaire, they can either ask their friends or search on the Internet to find the correct answers.[1] This means does the results that were presented, really reflect the actual knowledge of postgraduate residents. The authors mentioned that the questionnaire was validated by four different subject experts, but what type of validation (namely. face validation, content validation, concurrent validation, predictive validation, etc.) has not been mentioned, and even values of the content-validity index are missing.[1,5] Moreover, the process of pilot testing is missing in the methodology section, and this step is extremely vital in refining the questions and making them clear so that residents can understand.[6] In continuation, the values of Cronbach’s Alpha are missing and thus we don’t know anything about the reliability of the semi-structured questionnaire.[5,6] Regarding statistical analysis, the authors have not mentioned in which application data entry was done and using what software the collected data were analyzed.[7] In the results section, quite interesting information has been presented, nevertheless, I would have preferred to see the knowledge distribution year-wise and specialty-wise, as there is a definite possibility that students who are in the 3rd year and if they are from those departments where sexual history is being regularly asked (like dermatology), they are bound to fare well. I would have also liked to see the use of a Chi-square test to study the association between sexual history knowledge and gender of the students, and this would have given valuable insights. The discussion section is written to “discuss” study results and cite reasons for similar or contrasting findings after comparing with other studies.[8] I feel that the authors have not optimally utilized the discussion section.[1,8] Moreover, the authors have not mentioned self-identified limitations, like because the study was done in a single institution, the findings of the study cannot be generalized.[8] To summarize, the current study adds useful information about the knowledge of sexual history, the comfort of residents in asking about sexual history, and the ability to manage sex-related problems. However, the findings of the study would be more valid if the authors had been systematic in their approach while providing details on sample size, sampling method, the data collection process, and statistical analysis. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Author: Saurabh RamBihariLal Shrivastava
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411508513