This study set out to examine sexual behaviour and knowledge of normal children as perceived by their parents. The study was carried out in two settings; a) general practice and b) an acute paediatric admission ward. Families where there was a history or suspicion of child abuse or neglect were excluded. The parents (62 mothers and 22 fathers) of 84 children aged three to twelve years, from a variety of social backgrounds, were interviewed. The majority of parents saw mothers as the main and most important source of information on sexual matters for their children. Parents believed that their children were able to talk freely to them about sexual matters, and most had discussed general information about reproductive matters without going into detail with their children. Parents perceived their children as having little interest in the genitalia of others, except during nappy changing or bathing of preschool siblings. Few parents were aware that their children masturbated although many mentioned "nervous fiddling" with genitals by male children. More explicit sexual behaviour among children, such as simulated intercourse, were distinctly unusual. The parents of 14% of boys and 44% of girls were unaware of what word (correct or slang) their child used to describe their own genitalia. The results of this study suggest that explicit sexual activities or preoccupations that come to adult attention are distinctly unusual in normal children. While parents can talk in a general way with their children about reproductive matters, specific details about sexual behaviour tend not to be discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Ambulatory primary care medical education in managed care and non-managed care settings.

BACKGROUND AND OBJECTIVES: The transformation of health care delivery to a managed care approach has implications for community-based clinical education in family medicine. In this study, we compare students' clerkship experiences in managed and non-managed care environments. METHODS: Student clerkship encounter logs were used to compare clinical content, level of student-patient interactions, and types of preceptor supervision and teaching activities in five clusters of community-based practice sites. Three of the groups represented managed care settings, and two represented non-managed care settings. RESULTS: The clinical content of students' experiences at the five types of teaching sites was not significantly different. However, teaching methods and responsibility levels were different. Observational student-patient interactions occurred more frequently, and comprehensive, direct student-patient interactions occurred less frequently in both managed and non-managed care private practices. Preceptor observation of students occurred less frequently in two managed care site clusters. A transition of variable degree and timing from observational to direct student-patient interactions occurred in all but one teaching cluster. Intra-site variation existed in both student-patient interactions and preceptor teaching and supervision. CONCLUSIONS: Clinical education can be successfully conducted in managed care settings. Differences in practice settings influence student-patient interactions and preceptor teaching. These differences have implications for faculty development and student education.

Ambulatory Care↗