Sex Education

Sexuality, Society and Learning

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Puberty, health and sexual education in Australian

regional primary schools: Year 5 and 6 teacher
perceptions

Bernadette Duffy , Nina Fotinatos , Amanda Smith & Jenene Burke

To cite this article: Bernadette Duffy , Nina Fotinatos , Amanda Smith & Jenene Burke (2013)
Puberty, health and sexual education in Australian regional primary schools: Year 5 and 6
teacher perceptions, Sex Education, 13:2, 186-203, DOI: 10.1080/14681811.2012.678324

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 Sex Education, 2013
Vol. 13, No. 2, 186–203, [Link]

Puberty, health and sexual education in Australian regional primary

schools: Year 5 and 6 teacher perceptions
Bernadette Duffya, Nina Fotinatosb*, Amanda Smitha and Jenene Burkec
a
Ballarat Community Health Centre, Ballarat, Australia; bSchool of Health Sciences,
University of Ballarat, Ballarat, Australia; cSchool of Education, University of Ballarat,
Ballarat, Australia

The research reported in this paper investigates why teachers in regional primary
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schools in the Ballarat region of Victoria, Australia, are choosing to outsource the
teaching of sexuality education. A survey was conducted of 29 Year 5 and Year 6
teachers from local primary schools. The teachers provided information about: their
confidence in delivering sexuality-related topics; their perceptions of the relevance of
given sexuality topics to their students; the teachers’ own professional development
preferences; and what they saw as their personal limitations in teaching sexuality
education. Teachers tended to report low confidence in teaching topics that are
considered ‘sensitive’, such as menstruation, wet dreams and sexual intercourse.
Furthermore, they indicated a need for professional development in teaching sexuality
education. The greatest hurdle identified lies in identifying how to motivate, engage
and support teachers to take a professional interest in teaching sexuality education.
Keywords: sex education; topic confidence; professional development; Australia

Introduction
Learning about sexuality is an important part of the curriculum for young people in
schools. Comprehensive sexuality education (CSE) is defined as curriculum in which both
abstinence and contraceptive use are taught (Jeffries et al. 2010), and its value is widely
acknowledged in the literature (Goldman 2010; Ito et al. 2006; Kontula 2010; Ollis 2010;
Powell 2007). CSE is considered an appropriate teaching and learning space to engage
students between the ages of 5 and 15 years with familiar teachers and within existing
learning structures (Department of Education and Early Childhood Development
[DEECD] 2008a; Goldman 2010). In Australian schools, CSE is expected to provide
students with developmentally appropriate information and skills with the intention of
influencing positive behaviours. It is important to note, however, that the design, planning,
quality, implementation and effectiveness of the majority of current sexuality education
programmes in Australia are not closely monitored, and do not always meet the needs of
young people (Goldman 2010; Kontula 2010; Ollis 2010).
Currently, the existing teaching workforce is targeted as a key provider of CSE
programmes without necessarily providing support for educators to fulfil this role
adequately (Alldred, David, and Smith 2003; Goldman 2011; Jeffries et al. 2010). Powell
(2007), however, stresses that sexuality education must be tackled from a broad
community perspective. As she puts it, schools ‘do not have the sole responsibility in this

*Corresponding author. Email: [Link]@[Link]

q 2013 Taylor & Francis

 Sex Education 187

area’ and further: ‘the promotion of safe and consensual sex is a community-wide issue
and requires a community-wide response’ (2007, 26).
A complex mix of internal and external factors influences a teacher’s capacity to teach
effectively within the CSE curriculum. These include teacher pre-service education,
teaching background, confidence, practical experience, values, level of professional
development, access to classroom resources, support in delivery, timetabling and financial
resources (Goldman 2010; Ollis 2010). While teachers are considered the primary
providers within school environments, their perceptions of delivery are crucial in
sustaining long-term successful CSE programmes (Parker, Wellings, and Lazarus 2009).
The research reported in this paper explores why primary teachers in the Ballarat,
Australia region are choosing to outsource the teaching of sexuality education. Ballarat is
Victoria’s third largest city, located in southeastern Australia, 110 km from Melbourne
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(Travel Victoria 2011), and has a population of close to 100,000. The paper explores the
perceived confidence of a sample of Year 5 and 6 teachers (of students aged 10 – 13 years)
to teach CSE and their understanding of the relevance of puberty and sexual health topics
within primary schools that currently offer sexuality education programmes. In addition,
this paper explores regional primary school teaching professionals’ perceived current
barriers and future views towards CSE within Ballarat.

The importance of sexuality education

Sexuality is an integral part of the lives of many young people. Globally, 1.2 billion
adolescents are preparing to enter adulthood (World Health Organization [WHO] 2008).
Several large international organisations, such as the WHO (2008) and United Nations
Educational, Scientific and Cultural Organisation (UNESCO; Kirby and Ecker 2009),
strongly advocate for sexuality education conversations within schools, homes and in
community settings. Sexuality education is commonly defined as: ‘the process of
acquiring information and forming attitudes and beliefs about sex, sexual identity,
relationships and intimacy’ (AVERT 2010, 1). CSE programmes are designed to
contribute to the overall well-being and resilience of young people and are fundamental
public health measures that are consistent with the 2005 Millennium Development Goals
(WHO 2008). It is imperative that relevant and timely learning opportunities reach young
people, within a safe cultural and social context to assist them in healthy and informed
decision making (Ashcraft 2008; Parker et al. 2009).
It is crucial to clearly define the objectives of any health promotion/prevention
programme, and CSE is no exception. The literature suggests that it is unethical and futile
to dictate sexual decisions to young people, but instead, CSE should be taught within a
holistic health framework that aims to empower and inform decision-making skills
(Formby et al. 2010; Jeffries et al. 2010; Milton and Berne 2003).
Goldman (2010) supports the presence of sexuality education within schools for four
main reasons. First, children are reaching puberty at earlier ages than previous generations
and therefore, informing students ahead of physical and psychological changes can better
prepare them for the associated changes in their lives. Second, although the age of
beginning sexual relationships has not altered (generally between 15 and 19 years), the age
for marriage-like commitment in Australia has extended into the 20s and 30s (ABS 2009),
thus this 15-year gap means that information about safer sexual behaviour is imperative
to improve the overall sexual health of individuals. Third, the effectiveness of parents
and carers as primary sources of sexuality education varies and can be limited by
individual factors such as parental inhibitions, parental availability, communication
 188 B. Duffy et al.

misunderstandings and a lack of knowledge by parents. Finally, schools have an obligation

to foster children’s overall development and to empower students to express values of
equity, dignity, respect, tolerance and degrees of resilience regarding their sexual well-
being (DEECD 2010; Goldman 2010; Kirby and Ecker 2009).
Recent research by Formby et al. (2010) suggests that young people who engage with
facilitators and the information presented to them within school-based sexuality education
demonstrate increased knowledge of sexual health life skills. In addition, good quality
sexuality education programmes have been linked with numerous measurable outcomes,
including: a delay in the initiation of sex (Fullerton et al. 1997; Kirby 2007; Kirby and
Ecker 2009; McKeon 2006; Mueller, Gavin, and Kulkarni 2007); a reduction in the
incidence of unprotected sex (Kirby 2007; Kirby and Ecker 2009); a reduction in
unwanted pregnancies (Fullerton et al. 1997; Kirby 2007); a reduction in sexually
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transmitted infection rates (Kirby 2007; Kirby and Ecker 2009); an increase in
contraceptive use (Fullerton et al. 1997; Kirby 2007; Kirby and Ecker 2009); a reduction in
sexual partner numbers (Formby et al. 2010; Kirby and Ecker 2009); informed sexual
decision making (Ashcraft 2008); and learning about inequalities of race, class, sexuality
and gender (Connell and Elliot 2009). Furthermore, by utilising behavioural change
theories, health promotion initiatives based on CSE have the ability to improve self-
efficacy, self-esteem, empowerment and the ability to assess personal risk (Ashcraft 2008,
2009; Marie Stopes International 2009; Wight 1999, 2008).

Literature on variables within a CSE framework

The literature demonstrates that there are many variables and inconsistencies that
influence the translation of intended learning and teaching into actual knowledge and deep
learning regarding CSE (Ashcraft 2008; Connell and Elliot 2009; Formby et al. 2010;
Goldman 2010). Key variables currently identified within sexuality education programmes
include the following:
(1) The importance of appropriate policies, pedagogies and curriculum resources
within CSE programmes (Allen 2008; Connell and Elliot 2009; Goldman 2010;
Sinkinson 2009).
(2) The confidence and training of personnel delivering CSE programmes (Aggleton
and Campbell 2000; Formby et al. 2010; Goldman 2010; Leahy, Horne, and
Harrison 2004; Ollis 2010).
(3) The importance of topics within CSE programmes (Allen 2008; Formby et al.
2010; Goldman 2010; Hilton 2003; Ninomiya 2010; Ollis 2010; Sinkinson
2009).
(4) Miscellaneous factors affecting the success and effectiveness of CSE
programmes (Wilson and Wiley 2009).
Each of these key variables will be discussed in detail below; however, points (2) and (3)
are considered most relevant to this paper.

The importance of appropriate policies, pedagogies and curriculum within CSE

programmes
Sexuality education policies have recently been introduced into schools in Australia and
New Zealand (DEECD 2010; Sinkinson 2009). Since 2004, the Victorian Department of
Education and Early Childhood Development (DEECD) incorporated curriculum changes
 Sex Education 189

into the Victorian Essential Learning Standards (VELS) advocating for a comprehensive,
school-based learning approach to sexuality education delivery (DEECD 2008a, 2010).
Puberty education is now a compulsory component within the Health and Physical
Education domain. However, it is important to acknowledge that although sexuality
education is compulsory, without the implementation of consistent models of delivery and
monitoring, the final discretion as to what is actually taught in a school often lies within the
school community, including teachers (Goldman 2010), the local curriculum committees,
school administration and parents (Sinkinson 2009).
Sexuality education researchers commonly use the terminology ‘whole school-based
approach’ to encompass a broad range of inter-related elements. According to Dyson
(2010), a whole school-based approach has three key aspects: learning and teaching;
community links, partnerships and services; and school organisations, ethos and environ-
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ment. Although further subdivisions address each element in detail, without policies and
guidelines that have solid foundations, the effectiveness of these elements is markedly
reduced. In Australia, several academic institutions and various government bodies have
developed strategic frameworks and teacher resources which support puberty and sexual
health education (PSHE) delivery. The Talking Sexual Health National Framework (Ollis,
Mitchell, and Watson 1999) and associated teacher resources (Ollis and Mitchell 2001)
were developed by the Australian Research Centre in Sex, Health and Society (ARCSHS).
Catching On Early (DEECD 2011) was developed by ARCSHS for DEECD in the state
of Victoria. DEECD also developed the Catching On sexuality education programme
including the Catching On for Years 9 and 10 curriculum resource (2004) and the
Catching On Everywhere programme development training and support resource (2008b).
Growing and Developing Healthy Relationships Curriculum Support Materials
(Government of Western Australia 2011) is a Western Australian Government-produced
resource. These resources are currently available for use in Australian schools, and have
been developed as a result of evidence-based practice and scrutiny by numerous agencies.
However, there is no mandate for schools to adopt these programmes or others like them.
In all likelihood, for many schools, the amount and quality of curriculum material actually
being delivered are inconsistent, and taught in an ad hoc manner with little additional
support. Dyson (2010) acknowledges the significant contribution of curriculum developers
such as ARCSHS, but she quickly adds that simply providing curriculum without the
support of broader policies (political and otherwise) and appropriate teacher development
is not likely to produce a ‘whole school-based approach’.

The confidence, professional development and attitudes of personnel delivering CSE

programmes
The confidence, professional development, specialist skills, attitudes and ability of
sexuality education teachers at the school level are pivotal to the success of any CSE
programme (Aggleton and Campbell 2000; Formby et al. 2010; Goldman 2010). School-
based information has been considered a more trustworthy source of learning than friends,
therefore the confidence, training and attitude of teachers involved in CSE programmes are
paramount when engaging with young people (Ollis 2010).
Comprehensive professional development can have a remarkable effect on the
confidence and attitude levels of teachers within CSE programmes at both primary school
level (Leahy et al. 2004; Sinkinson 2009) and secondary school level (Ollis 2010;
Sinkinson 2009). In Australia, sexuality education is taught by teachers who primarily have
Physical Education, Home Economics or Science backgrounds (Ollis 2010). Given these
 190 B. Duffy et al.

varied backgrounds, it is not surprising that professional perspectives regarding CSE

programmes sometimes differ. An example identified by Goldman (2010) stated that in the
Australian state of Queensland (located in the North East of Australia), sexual health
programmes are left too much to the discretion of individual teachers to teach what and how
they choose: ‘Queensland has quality resources to support sexuality education teaching,
insufficient curriculum guidance for teachers and excessive flexibility in school-based
curriculum planning allows teachers to avoid teaching the concepts and facts relating to
sexual and reproductive health’ (50). Goldman also suggests that providing stronger
curriculum advice where teachers are offered less flexibility would ensure better quality
delivery of sexuality education.
In the Bass Coast of Victoria, however, teachers have reported several barriers to
implementing sexuality education including a lack of resources, knowledge, confidence and
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comfort (Leahy et al. 2004). They also reported that fear of parental opposition and the
logistics of inclusion within an increasingly crowded curriculum were barriers to sexuality
education provision. Teachers indicated that a programme ‘set in stone’ would reduce
anxiety as it could be consistently provided across all schools in a given region. Professional
learning should be more than just the provision of classroom resources for teachers. It
should also challenge their knowledge, values and attitudes to pave the way for effective
learning and teaching (Mitchell, Ollis, and Watson 2000; Ollis 2010). Teachers’
professional perceptions are influenced by personal values, beliefs and attitudes. Therefore,
professional learning that allows for an exploration of personal values, beliefs and attitudes
towards CSE programmes may indirectly increase teacher confidence in delivering this type
of curriculum. For effective delivery within school-based programmes, teachers need to
deeply understand the intended curriculum. Practical guidance and specific training in CSE
programme material and knowledge of proven, evidence-based, successful pedagogies
specific for this field (Goldman 2010) should enhance teaching. Ollis’ (2010) research
demonstrated, via focus groups and teacher interviews, that teachers’ involvement in
workshops could enhance their confidence to teach several sensitive sexual education topics
(e.g. sexual diversity). The workshops alone, however, were unable to alter the confidence
of all teachers involved to teach sexuality education. Ollis (2005) concluded that lack of
experience in teaching these topics, inadequate formal qualifications, inappropriate
academic background and undergraduate education together with insufficient professional
development opportunities, could negatively impact on the effectiveness of a teacher as a
sexuality educator within CSE programmes.
According to Formby et al. (2010), ancillary support to complement CSE resources is
highly desirable in addition to formal and informal professional development
opportunities. This support may be in the form of guest speakers (i.e. health promotion
officers or community health nurses), supplementary teaching material, youth engagement
protocols and specific facilitator training before delivering the material to students
(Powell 2007; Wilson and Wiley 2009). Often these ancillary methods and techniques can
increase the programme uptake and long-term effectiveness within the school
environment (Formby et al. 2010). Several researchers highlight the importance of
having subject experts who are comfortable in delivering potentially sensitive topics, not
necessarily the in-house teachers delivering within structured Prep to Year 12 programmes
(Gawlinski 2007; Goldman 2011; Parker et al. 2009; Tietjen-Smith, Balkin, and
Kimbrough 2008). In contrast, qualitative research by Hilton (2003) involving adolescent
male students in the UK suggested that the use of external providers to deliver such
programmes was not ideal. Participants cited that a lack of familiarity and no pre-formed
trust relationship with external providers could negatively impact on student learning.
 Sex Education 191

The literature strongly suggests that the personal attributes of those delivering sexuality
education influence the effectiveness of teaching (Goldman 2010; Sinkinson 2009).
Puberty and sexuality educators with positive attributes (i.e. compassionate, approachable,
trustworthy, open, good listener, non-judgemental, empathetic and confident) are more
likely to succeed in effective delivery and engagement. Teachers or facilitators should be
able to create a safe classroom environment using appropriate relaxed and informal
pedagogies to enhance the content and delivery (Gawlinski 2007; Hilton 2003; Ollis 2005;
Sinkinson 2009; Tietjen-Smith et al. 2008). Tietjen-Smith et al. (2008) developed and
validated the Sex Education Confidence Scale (SECS) to measure several factors that
influence the effectiveness of any given facilitator in sexuality education delivery, although
this scale is yet to be proven successful in all environments.
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The importance of topics within CSE programmes

International and national literature suggests that sexuality education is still considered a
sensitive area for some people, and thus is often presented as a series of disconnected
topics by teachers with inadequate specialist skills (Formby et al. 2010; Goldman 2010;
Hilton 2003; Ninomiya 2010; Ollis 2010; Sinkinson 2009). Updated programmes should
dispel myths about sexuality and provide reliable, age-appropriate and relevant
information to students within the school environment (Ninomiya 2010; Ollis 2010).
Allen (2008) and Sinkinson (2009) also comment on current PSHE topics which are
often clinical, de-eroticised, didactic and considered dull to the target audience. Similarly,
Ninomiya (2010) argues that developing topics, broadening themes and including
sufficient depth, detail and critical emphasis on sexuality issues, is fundamental in
delivering accurate and informed messages to students. The subject matter included within
CSE programmes is crucial in meeting the short- and long-term learning needs of the
students. Ideally, educators should feel confident in delivering all PSHE topics to a range
of classes and similarly understand that such topics are relevant in the context of
school-based programmes.

Miscellaneous factors affecting the success and effectiveness of CSE programmes

Wilson and Wiley (2009) identified additional variables that may affect the delivery of
sexuality education within schools. These include school funding and resources, teacher
personal compatibility in the area, teacher ethnicity and religious beliefs and support
available from the greater school community including parents, colleagues and principals.
Similarly, a positive symbiotic relationship between parents/guardians, school
environments (teacher, school counsellor and school nurse) and the wider community
workforce (nurses and health promotion officers) has been linked to an increase in CSE
successful outcomes (Milton and Berne 2003; WHO 2008). Alldred et al. (2003) also
reported that the degree of inclusiveness in society, such as having open views and
attitudes towards sex and sexual education, is paramount in moving forward within
discrimination-free school environments.
Measuring the effectiveness of CSE programmes within curriculum is complicated.
According to Kirby (2007), the effectiveness of sexual health knowledge and behaviours is
best measured by student learning, not necessarily by the resources used within the
classroom. He further states that a reliable measure of effectiveness will have a control and
trial group and comparable outcomes.
 192 B. Duffy et al.

A focus on sexuality education provision in Ballarat, Victoria

The Whole-School Sexuality Education Project was an initiative of the Department of
Education and Early Childhood Development in partnership with the Department of
Human Services (DEECD 2008b). Unlike several sexuality education projects in the past
that primarily focused on problem-based issues such as teenage pregnancy and disease
transmission, the researchers of this Victorian initiative broadened their investigation to
include the following elements: the ethos and environment of schools, community links
and partnerships, curriculum, teaching and learning. The aim of this approach was to
improve the sexual health and well-being of young people while still addressing potential
problem areas. This initiative highlighted the valuable contribution of community-based
organisations such as Ballarat Community Health (BCH) as a PSHE provider within
regional and rural Victoria.
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The research reported in this paper was conducted in response to a growing awareness
that local teachers were choosing to outsource the teaching of sexuality education in their
classrooms. Sexuality education in schools at the time was inconsistent in Ballarat. In
addition, there was a recognised shortage of school nurses available to primary schools.
For over 10 years, BCH has played an essential role as an external resource provider of
PSHE, primarily to government primary and secondary schools. BCH has built a solid
relationship with primary and secondary schools within a 30 km radius of the city centre
and played a key role in delivery of PSHE to Year 5 – 10 classes (Duffy 2008).
Since puberty became a compulsory component of the VELS (Health and Physical
Education domain) in 2005, there has been an increased demand by schools in the Ballarat
region for external providers to generate developmentally appropriate learning materials
and assist in class delivery of puberty education. In 2007, BCH designed and delivered a
programme of between three and four PSHE sessions of 60 –90 minutes each, specifically
tailored to suit the needs of 900 students at 15 regional primary schools. During the design
and delivery of these programmes, BCH identified a lack of sufficient motivation for local
school staff to implement and maintain comprehensive and consistent school-based
programmes. As a likely consequence of mandatory curriculum change, BCH reported a
60% increase in school requests to deliver PSHE education between 2006 and 2007. Under
the current funding and resource model, this enormous increase in demand was
unsustainable into the future for BCH and its health promotion officers, and indicated that
more research into teacher perceptions and barriers to teaching PSHE was warranted.

Purpose of the investigation

In an effort to create a sustainable model of PSHE assistance, BCH decided to perform an
evaluation of teacher skills, knowledge and confidence in the topics that had previously been
delivered by BCH educators to primary school students in grades five and six (aged 10 –13
years). This evaluation was possible due to the good working relationship already formed
between BCH and local primary schools in the Ballarat region. The four aims of the research
were: (1) to explore the teachers’ perception of their confidence in delivering specific topics;
(2) to explore the teachers’ perception of relevance of given topics to their students;
(3) to explore the professional development preferences of teachers in local schools;
and (4) to explore self-identified limitations of teachers in delivering sexuality education.

Method
A questionnaire was chosen as a research tool that was capable of capturing the views of
the targeted school personnel. Furthermore, it could be completed time-effectively at the
 Sex Education 193

convenience of the participants. The questionnaire was prepared by BCH Health

Promotion Officers in conjunction with the Sexuality Education Unit of DEECD, who
provided ethics approval. Information packs, including a letter of invitation, were supplied
to all principals of government primary schools within a 30 km radius of Ballarat. Year 5
and 6 teachers from all schools were invited to participate regardless of their background
as sexuality educators (Lingard, Albert, and Levinson 2010). The rationale for this was to
identify the needs and experiences of Year 5 and 6 teachers.
The response rate from the 29 individual teachers was relatively high (81% of 38% of
the schools who initially agreed to participate in the study) compared with similarly
structured studies that were reported in the academic literature. This high response rate
may be artificial due to the small number of schools chosen compared with those in larger
studies (e.g. Tietjen-Smith et al. 2008). Previous good working relationships between the
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schools and BCH may have also positively influenced the response rate.

Questionnaire
The paper-based survey consisted of eight questions. Questions 1 and 2 explored the
perceived confidence of the surveyed teacher and relevance of topics previously taught by
BCH staff to Year 5 and 6 students. There were five topic areas with additional subtopic
headings (see Table 1). Responses from these questions (1 and 2) were closed-ended.
A 3-point Likert scale was used to measure responses. Responses were analysed using

Table 1. Puberty and health education topics.

Topic 1: Background Appropriate/inappropriate places to discuss puberty and
health education
How to say ‘NO!’ (setting boundaries)
Identifying the people to talk to for help and/or information
Topic 2: Reproductive systems Naming the male and female parts of the reproductive system
Describing the function of each part of the reproductive system
Topic 3: Puberty Naming and describing physical changes
Naming and describing emotional changes
Embarrassing situations and how to deal with them
The importance of hygiene
Menstruation
Wet dreams
Topic 4: Reproduction Sexual intercourse
Pregnancy – fertilisation
Pregnancy – stages of foetal development
Childbirth
How the sex of the baby is determined
Twins – fraternal, identical and Siamese
Risks of smoking, alcohol and drug use during pregnancy
Topic 5: Relationships Healthy and unhealthy friendships/relationships
Safe behaviour
Making good decisions and realising that all decisions have
consequences
Topic 6: Nutrition/body image Healthy eating
Body image
Media portrayal and body image
Peer pressure – positive and negative influences
Source: Duffy (2008).
 194 B. Duffy et al.

Microsoft Excel [10] software. Questions 3 and 4 investigated whether teachers had
previously taught any PSHE topics and whether they had any prior professional education
in CSE. Questions 5– 8 investigated the professional development opportunities that
teachers would prefer in addition to other forms of assistance. Open-ended questions were
a partial feature in questions 4, 5 and 7, and were analysed using content analysis protocols
in an effort to identify trends from respondents.

Sample
Of the government primary schools that were approached to participate in this research,
38% (14/37) expressed an interest. Each of these interested schools indicated the number
of individual teacher surveys that they would need to be mailed out. Of these individual
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teacher surveys, 81% (29/36) were returned to the researchers with signed consent forms.
Teachers electing to participate in this research (31/36) taught in central Ballarat (18),
Ballarat suburbs (3) and rural areas (10); however, two surveys from rural Ballarat were
returned without consent forms and therefore not included. Of those included, 79% of
respondents were female.

Results
Teacher perception of their confidence and relevance of topics within PSHE
programmes
Figure 1 offers a summary of the perceived confidence levels (not confident, confident
and very confident) that teachers expressed over the entire topic selection open for
discussion. Figure 2 is a summary of the perceived relevance levels (not relevant, relevant
and very relevant) that teachers expressed over the entire topic selection open for
discussion. A brief summary of each topic relating to both teacher confidence and topic
relevance is as follows.

Background topics
The data show that over 95% of teachers expressed confidence in delivering information
concerning safe places to discuss PSHE, boundary setting and identifying reliable
personnel with whom to discuss puberty and sexual health.

Reproductive systems and puberty

These topics are closely aligned with the VELS curriculum expectations for Year 5 and 6
students. The results indicate a marked disparity between what teachers consider as relevant
and how confident they say they are in delivering three specific subtopics: naming parts of
the reproductive system, describing the function of the reproductive system and physical
changes. This disparity is of great concern as these basic PSHE topics are considered to
encompass essential and foundation learning for students at this stage of their development.
‘Puberty’ also deals with menstruation and wet dreams. Teachers strongly agreed that
these topics were highly relevant (over 95%); however, their confidence levels in delivering
this information were markedly low. In fact, when the male and female teacher responses
were analysed separately, just under half (47.83%) of the female sample population
indicated that they were ‘not confident’ in teaching about wet dreams, compared to 30.4%
responding ‘confident’ and 21.7% responding ‘very confident’. In comparison, two-thirds
 Figure 1.

Percentage of Year 5 and 6 primary school teachers

0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%

Appropriate/inappropriate places to
discuss Puberty and health education
How to say 'No!' (setting boundaries)
Identifying people to talk to for help
and/or information
Naming the male and female parts of
the reproductive system
Describing the function of each part
of the reproductive system
Naming and describing physical
changes
Naming and describing emotional
changes
Embarrassing situations and how to
deal with them
The importance of hygiene
Menstruation
Wet dreams
Not confident

Sexual Intercourse
Pregnancy - fertilisation
Confident

Pregnancy - stages of foetal

development
Childbirth
How the sex of the baby is
determined
Very confident

Twins - fraternal, identical and

Siamese
Risks of smoking, alcohol and drug
use during pregnancy

Confidence in teaching puberty, health and sexuality topics for Year 5 and 6 male and female teachers.
Healthy and unhealthy
friendships/relationships
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Safe behaviour
Making good decisions and realising
that all decisions have consequences
Healthy eating
Body Image
Media portrayal and body image
Peer pressure - positive and negative
influences
195 Sex Education
 Percentage of Year 5 and 6 primary school teachers
0%
20%
40%
60%
80%
100%

Appropriate/inappropriate places to discuss

Puberty and health education
How to say 'No!' (setting boundaries)
Identifying people to talk to for help and/or
information
Naming the male and female parts of the
reproductive system
Describing the function of each part of the
reproductive system
Naming and describing physical changes
Naming and describing emotional changes
Embarrassing situations and how to deal with
them
The importance of hygiene
Menstruation
Wet dreams
Very Relevant

Sexual Intercourse
Pregnancy - fertilisation
Relevant

Pregnancy - stages of foetal development

Childbirth
How the sex of the baby is determined
Not Relevant

Twins - fraternal, identical and Siamese

Risks of smoking, alcohol and drug use
during pregnancy

Figure 2. Relevance of teaching puberty, health and sexuality topics for Year 5 and 6 male and female teachers.
Healthy and unhealthy
friendships/relationships
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Safe behaviour
Making good decisions and realising that all
decisions have consequences
Healthy eating
Body Image
Media portrayal and body image
Peer pressure - positive and negative
influences
B. Duffy et al. 196
 Sex Education 197

(66.7%) of the male teachers expressed that they were ‘not confident’ in teaching about wet
dreams. Almost half of the female teachers (47.8%) expressed feeling ‘very confident’ in
teaching menstruation, followed by 17.4% responding ‘confident’ and 34.8% being ‘not
confident’. The majority of male teachers expressed being ‘not confident’ (83.3%) in
teaching menstruation compared to 16.7% expressing ‘confident’ and none being ‘very
confident’.

Reproduction
Overall, teachers expressed the highest levels of ‘least relevance’ (up to 18%) for the
‘reproduction’ topic area along with low confidence (45 – 55%). Sexual intercourse and
pregnancy, whose content is likely to be considered sensitive within formal school
environments (Santabarbara, Erbe, and Cooper 2009; Wilson and Wiley 2009), was
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included in this topic area. Although saturation with the topic of human reproduction
within school-based programmes is often commented on in the academic literature, the
content and scope within this topic area can vary according to teacher confidence and
individual teacher perceptions of what is relevant to students.

Relationships
The data demonstrated a very strong alignment between teacher perceived relevance and
confidence to deliver topics such as ‘healthy and unhealthy friendships/relationships’,
‘safe behaviour’ and ‘good decision making’. Over 95% of teachers supported these topics
as having relevance, in addition to expressing confidence in teaching the topics to Year 5
and 6 (10 –13 years old) students.

Nutrition and body image

‘Nutrition and body image’ is considered a long-term social and mental health issue for
young people, particularly females (Richardson and Paxton 2010). This topic showed a
strong alignment between the perceived relevance by teachers (. 95%) compared with the
perceived confidence to deliver (. 90%) to students.

Professional development for primary teachers in local schools

The preparation and support invested into a primary teacher’s capacity to teach PSHE can
have a profound impact on the teacher’s effectiveness. The teaching and professional
learning of the teachers involved in this research are evident in the results of this study.
Only one-third of teachers (34.5%) reported ever having delivered PSHE material during
their careers. The teachers within this research report few teacher professional
development experiences (, 10%) in puberty education (3/29 participants). This is not
entirely unexpected since the participating teachers are not solely responsible for
delivering PSHE within their respective schools. Some reported professional opportunities
included a minor teaching method in health and/or a health and physical education
background at pre-service university courses. However, one teacher, despite having a
health education method qualification, still commented on feeling under-prepared in
several aspects of PSHE delivery.
Professional development sessions were selected by teachers as the fifth (out of 10
options) most requested form of additional teacher support. However, when teachers
were asked specifically about what professional development they required and who they
 198 B. Duffy et al.

would prefer to conduct the sessions, the overwhelming response of 88% favoured the
local provider, BCH, as key facilitator, followed by 8% for Family Planning Victoria
(Melbourne-based). This strong contrast between preferences may be associated with
travel constraints, time and/or cost, and therefore teacher responses may favour the local
provider. This preference for the local provider might also be explained by the rapport
and trust that BCH has been able to foster in the schools. The following comments
further express teacher participant perceptions regarding PSHE programmes and
resources:
I . . . do not believe that it is something we should teach ourselves . . . . We should outsource
somebody to cover this area. (Ebony – primary school teacher)
I would prefer a fun, informative software package with supporting material (books – non
fiction and fiction, pamphlets, CDs, software etc). (Matthew – primary school teacher)
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The variety of views expressed above demonstrates the enormous range of capabilities,
attitudes and underlying beliefs of teachers. This suggests how such individual factors can
impact on the delivery of sexuality education curriculum in local primary schools.

Use of teaching resources

There are currently numerous teaching resources available to Australian primary and
secondary schools (DEECD 2010). These include resource information packs for teachers
preparing to deliver PSHE material and age-specific activities to help students learn in the
classroom. The teachers involved in this research were given the option of selecting up to
three resources, which could potentially be offered by BCH, that they perceived to be most
useful within their school environment (see Figure 3). The two most commonly requested
methods include the three, 1-hour sessions that are delivered to Year 5 and 6 children by
BCH, and access to free teaching resource material from the BCH website. Open-ended
questions that were put to teachers generated the following statements regarding their
preferred forms of assistance:

18

16

14

12
Responses (Counts)

10

0
Puberty library Staff Q & A Email question Worksheets on Links on Ballarat Parent/child Professional Ballarat Free teaching 3 x 1 hour
box website Community information Development Community resources sessions
Health website session Health Skit Team

Forms of resource assistance

Figure 3. Preferred forms of assistance for Year 5 and 6 male and female teachers in teaching
puberty, health and sexuality in their school.
 Sex Education 199

Puberty issues should be introduced to students by outside consultants rather than teaching
staff. (Jessica – primary school teacher)
The programme should be delivered by an experienced/educated person other than [the]
classroom teacher. (Amy – primary school teacher)
[The teaching of sexuality by the classroom teacher] could compromise [the] teacher/student
relationship. (Amy – primary school teacher)
[Teaching sexuality is] difficult for male teachers. (Amy – primary school teacher)
Having a HPO [Health Promotion Officer] at school explaining it helps the children accept
it – sexual physical development – as a more medical perspective. (Stephanie – primary
school teacher)
The concerns of the majority of these classroom teachers seem to be derived from their
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self-perceived lack of personal expertise, which directly relates to their confidence and
their previous experience in the role as a primary school-based sexuality educator.

Discussion
This research reports results that are consistent with the literature. High levels of
confidence and relevance were expressed in areas such as background topics, relationships
and nutrition and body image compared with lower levels in reproductive systems, puberty
and reproduction. Studies by Allen (2008) and Ninomiya (2010) report that this trend is
particularly evident. When the male and female teacher responses were compared in topics
that examine developmental experiences, such as wet dreams and menstruation, it was
evident that such topics were considered to be sensitive topics by many teachers. These
knowledge and confidence levels may also reflect the paucity of professional learning
undertaken in PSHE by these teachers.
Specific professional learning seems strongly aligned with successful and effective
delivery of sexuality education. Teachers in this study were asked to nominate several
options regarding the assistance they would like with PSHE delivery. Although professional
development opportunities were considered an option to help improve teaching confidence,
the most common teacher-preferred option for the teaching of sexuality education was to
rely on external BCH providers. This reticence of these primary school teachers in this study
to teach sexuality education may indicate that they feel overwhelmed in their teaching
responsibilities in an already crowded curriculum. In addition, DEECD encourages schools
to align staff professional learning needs with, ‘school priorities, goals for student learning
and teacher professional learning’ (DEET 2005, 6). School goals and priorities tend to lie
with finding ways to improve the student data that is collected from various academic testing
regimes and are rarely concerned with sexuality education. Wight (1999) suggests that
teachers probably need individual empowerment before they can empower others, which
may be reflected in the current research. Other research to uncover teachers’ reasons for
their desire to outsource the teaching of sexuality education may provide further
enlightenment of this issue. In addition, these teachers’ views align with the current
literature, indicating that personnel delivering PSHE should undertake specific ongoing
sexuality education learning (Goldman 2010). One female teacher in this study was
concerned about the ‘readiness’ of some children to learn about sexuality compared with
others in the same class. Readiness to learn about sexuality-related issues varies across
children of the same age group, thus topics need to be repeated over a number of years as
students become ‘ready’, mature and receptive to learning (AVERT 2010; Goldman and
Goldman 1982; Jeffries et al. 2010; Kontula 2010; Ollis 2010; Ninomiya 2010).
 200 B. Duffy et al.

A second female teacher in this study supported the need for ‘more emphasis on sexual
relationships, pregnancy and safe sexual behaviours’ than what already existed. This view is
reflected in the necessity to ensure that sufficient detail and critical emphasis, as Ninomiya
(2010) points out, are provided to learners.
This small-scale study into the confidence and relevance of Australian rural and
regional primary teachers and the teaching of sexuality affirms some of the previous
assumptions of the BCH personnel who conducted the study. Two distinct curriculum
areas have emerged from this research: (1) background topics, relationships and nutrition
and body image; and (2) reproductive systems, puberty and reproduction. The age of the
students (10 – 13 years) may also influence teacher perceptions of their personal teaching
confidence and the relevance of sexuality subject matter.
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Limitations of the study

The results of this study must be interpreted with caution. Only 34.5% of this small sample
of teachers had ever delivered PSHE sessions to students in a formal school environment.
Therefore, it is not surprising that sexuality education professional development was not a
priority for these teachers, who taught in a range of curriculum areas. Thus, it is not
unexpected that professional development in sexuality education was rarely undertaken, as
these teachers, would likely see little benefit in having specialist health modules in their
undergraduate degree or future professional development. Some 65.5% of this sample of
teachers estimated their ‘perceived’ confidence and ‘perceived’ relevance of topics,
without having actually delivered sexuality education to their students of varying maturity
and ages. The participants were all primary school teachers, therefore the results cannot be
generalised into local secondary education settings.

Future directions
Future sexuality education research is vital to increase professional learning opportunities
for teachers and to assist them to make full use of already prepared and regionally
supported curricula. The increased teaching demand on external providers such as
BCH is unsustainable into the future, and thus the development of reliable alternatives
is essential for the long-term sexuality education options for local young people. The
greatest hurdle identified by this research and reinforced by previous Australian research
(see Leahy et al. 2004) is identifying how to motivate, engage and support teachers
to take a professional interest in teaching sexuality education. Although the value of
PSHE and its equivalent is not disputed at a local, national or international level, the
programmes used within schools, including the facilitators, curriculum and pedagogies,
need to be fully investigated. The facilitators need more than access to quality packaged
resources.

Conclusion
Although the value and purpose of sexuality education are generally accepted as integral
in promoting well-being for young people, there is still much debate regarding curriculum
delivery and the personnel involved in the process. Internal and external factors dominate
these discussions, which can only be informed by evidence-based practice and the ability
to simultaneously have a broad understanding of the field, and a focused approach towards
young people and meeting their learning needs.
 Sex Education 201

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