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Jewell TI, Petty EM. LGBTQ+ health education for medical students in the United States: a narrative literature review. MEDICAL EDUCATION ONLINE 2024; 29:2312716. [PMID: 38359164 PMCID: PMC10877666 DOI: 10.1080/10872981.2024.2312716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/26/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION People who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual/gender minorities (LGBTQ+) may experience discrimination when seeking healthcare. Medical students should be trained in inclusive and affirming care for LGBTQ+ patients. This narrative literature review explores the landscape of interventions and evaluations related to LGBTQ+ health content taught in medical schools in the USA and suggests strategies for further curriculum development. METHODS PubMed, ERIC, and Education Research Complete databases were systematically searched for peer-reviewed articles on LGBTQ+ health in medical student education in the USA published between 1 January 2011-6 February 2023. Articles were screened for eligibility and data was abstracted from all eligible articles. Data abstraction included the type of intervention or evaluation, sample population and size, and key outcomes. RESULTS One hundred thirty-four articles met inclusion criteria and were reviewed. This includes 6 (4.5%) that evaluate existing curriculum, 77 (57.5%) study the impact of curriculum components and interventions, 36 (26.9%) evaluate student knowledge and learning experiences, and 15 (11.2%) describe the development of broad learning objectives and curriculum. Eight studies identified student knowledge gaps related to gender identity and affirming care and these topics were covered in 34 curriculum interventions. CONCLUSION Medical student education is important to address health disparities faced by the LGBTQ+ community, and has been an increasingly studied topic in the USA. A variety of curriculum interventions at single institutions show promise in enhancing student knowledge and training in LGBTQ+ health. Despite this, multiple studies indicate that students report inadequate education on certain topics with limitations in their knowledge and preparedness to care for LGBTQ+ patients, particularly transgender and gender diverse patients. Additional integration of LGBTQ+ curriculum content in areas of perceived deficits could help better prepare future physicians to care for LGBTQ+ patients and populations.
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Affiliation(s)
- Tess I. Jewell
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Elizabeth M. Petty
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Ginaldi L, De Martinis M. Who needs education on LGBTQIA+ healthcare inclusion? MEDICAL EDUCATION ONLINE 2024; 29:2329403. [PMID: 38484289 PMCID: PMC10946259 DOI: 10.1080/10872981.2024.2329403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/19/2024]
Abstract
The topic of education on healthcare needs and equity of care for LGBTQIA+ populations is an extremely current issue. There is a demand for education on these topics not only from medical and other health sciences students but also from established healthcare professionals. Given this widespread educational deficiency, it is natural to ask whether the teaching class is prepared to satisfy these requests or in turn needs training on these issues and above all whether it is capable of transmitting attention and sensitivity on the issues of inclusion and equality in needs of healthcare.
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Affiliation(s)
- Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Teramo, Italy
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Teramo, Italy
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
- Long-Term Care Unit, “Maria SS. dello Splendore” Hospital, Giulianova, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
- President bachelor’s degree in Nursing, “Teramo hub” University of L’Aquila, Teramo, Italy
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Lim F, Eda OS. Methods of Teaching Transgender Health in Undergraduate Nursing Programs: A Narrative Review. Nurse Educ 2024; 49:130-136. [PMID: 37939349 DOI: 10.1097/nne.0000000000001558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Transgender populations experience disproportionately higher rates of mental and physical health issues such as suicidality and heart disease than their cisgender counterparts. Education of health professions students and providers is recognized as an effective method in mitigating transgender health disparities. PURPOSE This narrative review investigated the methods in which transgender health is taught in undergraduate nursing programs. Suggestions for optimizing transgender health education are presented. METHOD This review critically appraised and synthesized 28 articles that met these inclusion criteria: articles in English describing teaching strategies used in transgender health education with samples that include undergraduate nursing students. RESULTS Didactic lecture is the most widely used method, followed by role-play simulation, use of film and video, guest presentation, and high-fidelity and standardized patient simulation. CONCLUSION Lectures remain the dominant method of delivering transgender health content. Improvements in students' knowledge and attitude related to transgender care were noted posteducation.
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Affiliation(s)
- Fidelindo Lim
- Author Affiliations: Clinical Associate Professor (Dr Lim) and Clinical Assistant Professor (Dr Ozkara San), New York University Rory Meyers College of Nursing, New York
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Jecke L, Zepf FD. Delivering transgender-specific knowledge and skills into health and allied health studies and training: a systematic review. Eur Child Adolesc Psychiatry 2024; 33:1327-1354. [PMID: 37115277 PMCID: PMC11098887 DOI: 10.1007/s00787-023-02195-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/11/2023] [Indexed: 04/29/2023]
Abstract
Many transgender individuals face inequities, discrimination, and sometimes even a lack of transgender-specific knowledge in health care settings. Educational curricula can address such disparities and help future health professionals to become more knowledgeable, confident, and well-prepared for addressing the needs of transgender individuals. This systematic review aims to summarize current training interventions about care of transgender individuals for health and allied health students, and to analyse the effects of the respective intervention. A total of six databases (Pubmed, MEDLINE, Scopus, Web of Science, Embase and SciSearch) were screened for original articles published between 2017 and June 2021. Search terms and eligibility criteria were pre-specified, and after a structured selection process 21 studies were included into further analysis. Extracted data contained information on general study properties, population, design, program format and outcomes of interest. A narrative synthesis was used to summarize detected results. Study quality was assessed for each individual study. A self-developed 18-item checklist combining criteria of two prior published tools was used to assess overall quality of quantitative studies. For qualitative studies a 10-item checklist by Kmet et al. [HTA Initiat, 2004] was applied. Eligible studies were designed for multiple health or allied health profession students, and varied widely regarding program format, duration, content, and assessed outcomes. Almost all (N = 19) interventions indicated improvements in knowledge, attitude, confidence and comfort levels or practical skills concerning care for transgender clients. Major limitations included the lack of long-term data, validated assessment tools, control groups and comparative studies. Training interventions contribute to prepare future health professionals to deliver competent and sensitive care and which may improve the prospective experienced health care reality of transgender individuals. However, currently there is no common consensus about best practice of education. Additionally, little is known about whether detected effects of training interventions translate into noticeable improvements for transgender clients. Further studies are warranted to assess the direct impact of specific interventions in the light of the respective target populations.
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Affiliation(s)
- L Jecke
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - F D Zepf
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
- German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Jena, Germany.
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Jena, Germany.
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Elboga G, Kocamer Sahin S, Demir B, Ozdamar Unal G, Alparslan B, Altıntaş E, Marangoz TK, Guneyligil Kazaz T, Altindag A. LGBTI Healthcare in Medical Education. J Nerv Ment Dis 2024; 212:284-288. [PMID: 38598728 DOI: 10.1097/nmd.0000000000001729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
ABSTRACT Our aim is to reveal the interaction of cultural and religious influences with professional equipment by determining the level of knowledge, sexual attitudes, and homophobia of medical students about LGBTI+ individuals. The study included 324 students from our faculty of medicine. The Hudson and Ricketts Homophobia scale, the Attitudes Towards Lesbians and Gay Men scale, and the Hendrick Sexual Attitudes scale were used with the sociodemograpic data form. Data were collected and analyzed using descriptive and inferential statistical tests. The mean score of the students from the Hudson and Ricketts Homophobia scale was 58.50. The findings of our study support that medical students consider that the education they receive in this regard is inadequate. One of the goals of undergraduate medical education is the provision of health services to all segments of society; therefore, it is recommended to make improvements in the curriculum in this regard.
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Affiliation(s)
- Gulcin Elboga
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Sengul Kocamer Sahin
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Bahadır Demir
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Gulin Ozdamar Unal
- Department of Psychiatry, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Beyza Alparslan
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ezel Altıntaş
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | | | | | - Abdurrahman Altindag
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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Streed CG, Michals A, Quinn E, Davis JA, Blume K, Dalke KB, Fetterman D, Garcia G, Goldsmith E, Greene RE, Halem J, Hedian HF, Moring I, Navarra M, Potter J, Siegel J, White W, Lunn MR, Obedin-Maliver J. Sexual and gender minority content in undergraduate medical education in the United States and Canada: current state and changes since 2011. BMC MEDICAL EDUCATION 2024; 24:482. [PMID: 38693525 PMCID: PMC11064371 DOI: 10.1186/s12909-024-05469-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/25/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE To characterize current lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI +) health-related undergraduate medical education (UME) curricular content and associated changes since a 2011 study and to determine the frequency and extent of institutional instruction in 17 LGBTQI + health-related topics, strategies for increasing LGBTQI + health-related content, and faculty development opportunities. METHOD Deans of medical education (or equivalent) at 214 allopathic or osteopathic medical schools in Canada and the United States were invited to complete a 36-question, Web-based questionnaire between June 2021 and September 2022. The main outcome measured was reported hours of LGBTQI + health-related curricular content. RESULTS Of 214 schools, 100 (46.7%) responded, of which 85 (85.0%) fully completed the questionnaire. Compared to 5 median hours dedicated to LGBTQI + health-related in a 2011 study, the 2022 median reported time was 11 h (interquartile range [IQR], 6-16 h, p < 0.0001). Two UME institutions (2.4%; 95% CI, 0.0%-5.8%) reported 0 h during the pre-clerkship phase; 21 institutions (24.7%; CI, 15.5%-33.9%) reported 0 h during the clerkship phase; and 1 institution (1.2%; CI, 0%-3.5%) reported 0 h across the curriculum. Median US allopathic clerkship hours were significantly different from US osteopathic clerkship hours (4 h [IQR, 1-6 h] versus 0 h [IQR, 0-0 h]; p = 0.01). Suggested strategies to increase content included more curricular material focusing on LGBTQI + health and health disparities at 55 schools (64.7%; CI, 54.6%-74.9%), more faculty willing and able to teach LGBTQI + -related content at 49 schools (57.7%; CI, 47.1%-68.2%), and more evidence-based research on LGBTQI + health and health disparities at 24 schools (28.2%; CI, 18.7%-37.8%). CONCLUSION Compared to a 2011 study, the median reported time dedicated to LGBTQI + health-related topics in 2022 increased across US and Canadian UME institutions, but the breadth, efficacy, or quality of instruction continued to vary substantially. Despite the increased hours, this still falls short of the number of hours based on recommended LGBTQI + health competencies from the Association of American Medical Colleges. While most deans of medical education reported their institutions' coverage of LGBTQI + health as 'fair,' 'good,' or 'very good,' there continues to be a call from UME leadership to increase curricular content. This requires dedicated training for faculty and students.
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Affiliation(s)
- Carl G Streed
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, 801 Massachusetts Ave., Room 2082, Boston, MA, 02118, USA.
- GenderCare Center, Boston Medical Center, Boston, MA, USA.
| | - Amy Michals
- Biostatistics & Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - Emily Quinn
- Biostatistics & Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - John A Davis
- Division of Infectious Diseases, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Kylie Blume
- Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Katharine B Dalke
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Pennsylvania, PA, USA
| | - David Fetterman
- Fetterman & Associates, Hadley, MA, USA
- Claremont Graduate University, Claremont, CA, USA
| | - Gabriel Garcia
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Elizabeth Goldsmith
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Richard E Greene
- Division of General Internal Medicine, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Jessica Halem
- Eidos LGBTQ+ Health Initiative, University of Pennsylvania, Philadelphia, PA, USA
| | - Helene F Hedian
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Transgender and Gender Expansive Health, Johns Hopkins, Baltimore, MD, USA
| | | | - May Navarra
- GenderCare Center, Boston Medical Center, Boston, MA, USA
| | - Jennifer Potter
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jennifer Siegel
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Transgender Health Program, Massachusetts General Hospital, Boston, MA, USA
| | - William White
- San Francisco Emergency Medical Associates, California Pacific Medical Center, San Francisco, CA, USA
- Department of Emergency Medicine, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Mitchell R Lunn
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Juno Obedin-Maliver
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
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7
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McLean M, Bogle D, Diggins C, MacInnis M, MacDonald A, Wilby KJ. A Scoping Review of Interprofessional Education Training Aimed to Improve 2SLGBTQ+ Health. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100683. [PMID: 38471638 DOI: 10.1016/j.ajpe.2024.100683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/18/2024] [Accepted: 03/07/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVES This scoping review aims to identify and summarize the available literature on 2-spirited, lesbian, gay, bisexual, transgender, queer, plus (2SLGBTQ+) interprofessional health education and to identify optimal methods of interprofessional training to improve health care professional competency for this patient population. METHODS A search of PubMed and Embase was conducted and supplemented with a manual search of reference lists from identified articles. Articles were included if they reported an interprofessional education event on the topic of 2SLGBTQ+ health to at least 2 or more groups of health care professionals or students. Article screening was completed independently by 2 reviewers. Data from the included articles were extracted and mapped according to the type of participant (health care students or working health care professionals), type of event (workshop, case-based, course/curriculum, or forum), and type of assessment. RESULTS One hundred articles were screened, of which 15 articles met the inclusion criteria. Twelve articles focused on interprofessional health education for entry-to-practice students, with the remaining 3 articles involving practicing health care professionals. When mapped by type of event, 1-time case-based and workshop style events were the most used to deliver training. All 15 studies used an immediate presurvey and postsurvey design to evaluate the knowledge and competence of the participants after training. CONCLUSIONS Interprofessional education for improving 2SLGBTQ+ health is largely delivered within entry-to-practice degree programs via 1-time events with knowledge- and confidence-based assessments. Further research is needed to determine the impact of this training in practice, as well as the applicability for the training of practicing health care professionals.
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Affiliation(s)
- Madison McLean
- IWK Health, Halifax, Nova Scotia, Canada; Dalhousie University, Faculty of Health, College of Pharmacy, Halifax, Nova Scotia, Canada
| | | | | | | | | | - Kyle John Wilby
- Dalhousie University, Faculty of Health, College of Pharmacy, Halifax, Nova Scotia, Canada.
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Bleasdale J, Wilson K, Aidoo-Frimpong G, Gabriel SJ, Przybyla SM. Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Education in Healthcare Professional Graduate Programs: A Comparison of Medical, Nursing, and Pharmacy Students. JOURNAL OF HOMOSEXUALITY 2024; 71:193-206. [PMID: 35984396 PMCID: PMC10804216 DOI: 10.1080/00918369.2022.2111535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Relative to cisgender heterosexual persons, lesbian, gay, bisexual, and transgender (LGBT) people experience greater health inequities, thereby affecting their engagement in care. One strategy to address these disparities is to educate future healthcare professionals to provide nondiscriminatory care to LGBT people. The goal of this study was to explore the perceived coverage of LGBT health education topics in graduate-level medical (MD), pharmacy (PharmD) and nursing (DNP) curricula. Cross-sectional data were collected from web-based surveys (N = 733) completed by healthcare professional students enrolled at two universities in New York State. Of those who responded, 50.5% were MD, 38.9% were PharmD, and 10.6% were DNP students. Overall, mean scores indicated a dearth of perceived LGBT health coverage. Results demonstrated variations in coverage by degree program. Findings highlight the need to develop educational curricula inclusive of topics concerning LGBT patient health. Adequately educating the next generation of healthcare professionals can further promote healthcare engagement among LGBT persons and improve pedagogical practices in healthcare professional education programs.
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Affiliation(s)
- Jacob Bleasdale
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Kennethea Wilson
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Gloria Aidoo-Frimpong
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Steven J Gabriel
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Sarahmona M Przybyla
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
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Harmanci Seren AK, Eşkin Bacaksiz F, Çakir H, Yilmaz S, Sükut Ö, Turan S, Maghsoudi N. A Cross-Sectional Survey Study on Homophobia Among Medical, Nursing, Pharmacy, and Other Health Sciences Students. JOURNAL OF HOMOSEXUALITY 2023; 70:3108-3124. [PMID: 35759634 DOI: 10.1080/00918369.2022.2087480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Since the lesbian, gay, bisexual, transgender, and intersex (LGBTI) community may be exposed to violence, discrimination, stigma, exclusion, and maltreatment due to their sexual orientation while accessing healthcare services, understanding, and improving the attitudes of future's health care professionals toward LGBTI individuals seem essential. This descriptive and cross-sectional study aimed to investigate the homophobia among medical, nursing, pharmacy, and healthcare sciences students and examine the related factors. The study included 2,531 students from medicine, nursing, pharmacy, and other health sciences (midwifery, nutrition and dietetics, physiotherapy, management of healthcare facilities) disciplines. Homophobia was measured with the Hudson and Ricketts Homophobia Scale. After getting ethical and institutional approvals, data were collected and analyzed using descriptive and inferential statistical tests. Medical students had the lowest homophobia score, and their mean score was significantly lower than other students. There was a significant difference between students' scores according to years of study, age, sex, acquaintance with LGBTI individuals, providing healthcare services to an LGBTI person, and opinions on providing care. Although homophobia scores of nursing, pharmacy, and other health sciences students were lower than the medical students', policies and expansive content regarding LGBTI should be in place in all health science educational institutes, including medical schools, to prevent students from holding homophobic and prejudicial attitudes against LGBTI individuals.
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Affiliation(s)
| | - Feride Eşkin Bacaksiz
- Department of Nursing Management, Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey
| | - Hanife Çakir
- Bakırkoy Prof. Dr. Mazhar Osman Mental and Neurological Diseases Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Sevil Yilmaz
- Department of Psychiatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Özge Sükut
- Department of Psychiatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Suzan Turan
- Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Nurten Maghsoudi
- Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
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Yu H, Flores DD, Bonett S, Bauermeister JA. LGBTQ + cultural competency training for health professionals: a systematic review. BMC MEDICAL EDUCATION 2023; 23:558. [PMID: 37559033 PMCID: PMC10410776 DOI: 10.1186/s12909-023-04373-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 05/17/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Health disparities experienced by LGBTQ + individuals have been partially attributed to health professionals' lack of cultural competence to work with them. Cultural competence, the intricate integration of knowledge, skills, attitudes, and behaviors that improve cross-cultural communication and interpersonal relationships, has been used as a training framework to enhance interactions between LGBTQ + patients and health professionals. Despite multiple published LGBTQ + cultural competency trainings, there has been no quantitative appraisal and synthesis of them. This systematic review assessed articles evaluating the design and effectiveness of these trainings and examined the magnitude of their effect on cultural competence outcomes. METHODS Included studies quantitatively examined the effectiveness of LGBTQ + cultural competency trainings for health professionals across all disciplines in various healthcare settings. 2,069 citations were retrieved from five electronic databases with 44 articles meeting inclusion criteria. The risk of bias in the included studies was assessed by two authors utilizing the Joanna Briggs Institute critical appraisal checklists. Data extracted included study design, country/region, sample characteristic, training setting, theoretical framework, training topic, modality, duration, trainer, training target, measurement instrument, effect size and key findings. This review followed the PRISMA statement and checklist to ensure proper reporting. RESULTS 75% of the studies were published between 2017 and 2023. Four study designs were used: randomized controlled trial (n = 1), quasi-experimental pretest-posttest without control (n = 39), posttest only with control (n = 1) and posttest only without control (n = 3). Training modalities were multiple modalities with (n = 9) and without simulation (n = 25); single modality with simulation (n = 1); and with didactic lectures (n = 9). Trainings averaged 3.2 h. Ten studies employed LGBTQ + trainers. The training sessions resulted in statistically significant improvements in the following cultural competence constructs: (1) knowledge of LGBTQ + culture and health (n = 28, effect size range = 0.28 - 1.49), (2) skills to work with LGBTQ + clients (n = 8, effect size range = 0.12 - 1.12), (3) attitudes toward LGBTQ + individuals (n = 14, effect size range = 0.19 - 1.03), and (4) behaviors toward LGBTQ + affirming practices (n = 7, effect size range = 0.51 - 1.11). CONCLUSIONS The findings of this review highlight the potential of LGBTQ + cultural competency training to enhance cultural competence constructs, including (1) knowledge of LGBTQ + culture and health, (2) skills to work with LGBTQ + clients, (3) attitudes toward LGBTQ + individuals, and (4) behaviors toward LGBTQ + affirming practices, through an interdisciplinary and multi-modal approach. Despite the promising results of LGBTQ + cultural competency training in improving health professionals' cultural competence, there are limitations in study designs, sample sizes, theoretical framing, and the absence of longitudinal assessments and patient-reported outcomes, which call for more rigorous research. Moreover, the increasing number of state and federal policies that restrict LGBTQ + health services highlight the urgency of equipping health professionals with culturally responsive training. Organizations and health systems must prioritize organizational-level changes that support LGBTQ + inclusive practices to provide access to safe and affirming healthcare services for LGBTQ + individuals.
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Affiliation(s)
- Hyunmin Yu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 USA
| | - Dalmacio Dennis Flores
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 USA
| | - Stephen Bonett
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 USA
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Karsenti N, Chambers J, Espinosa A. Effects of SGM Education for Undergraduate Medical Students in a Canadian Context. MEDICAL SCIENCE EDUCATOR 2023; 33:813-824. [PMID: 37546204 PMCID: PMC10403457 DOI: 10.1007/s40670-023-01831-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/08/2023]
Abstract
Medical schools have been striving to equip students with the tools and skills needed to serve patients from the LGBTQ + community, also called the Sexual and Gender Minority (SGM) community. This study aims to assess student comfort with providing care, and faculty knowledge and preparedness in delivering SGM-centered education at our home institution. We conducted two mixed-methods surveys, one geared towards medical students across four years of study and one towards medicine faculty. Each survey collected first demographic information about participants, then used a validated tool to assess knowledge of the SGM community. The qualitative component of both surveys then consisted of a needs assessment to determine what students felt should be changed about their curriculum, and what faculty felt should change about their training to deliver this curriculum. We received 26 student responses from all 4 years of study and 35 faculty responses from a variety of medical specialties. Difference in knowledge assessment scores was not statistically significant across both cohorts. Most students felt overall comfortable providing care for sexual minority individuals, and faculty similarly felt comfortable teaching, but data showcases that perceived comfort is higher among the student cohort. We propose that students are acquiring knowledge and comfort with providing for SGM individuals from sources outside their curriculum, and that additional training of faculty is vital to ensure students not doing this independent learning do not fall through the cracks. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01831-x.
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Affiliation(s)
- Nessika Karsenti
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St., London, ON Canada
| | - Jason Chambers
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St., London, ON Canada
| | - Aldo Espinosa
- Department of Anesthesia, Schulich School of Medicine and Dentistry, Western University, London, ON Canada
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Gisondi MA, Keyes T, Zucker S, Bumgardner D. Teaching LGBTQ+ Health, a Web-Based Faculty Development Course: Program Evaluation Study Using the RE-AIM Framework. JMIR MEDICAL EDUCATION 2023; 9:e47777. [PMID: 37477962 PMCID: PMC10403800 DOI: 10.2196/47777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/07/2023] [Accepted: 06/12/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Many health professions faculty members lack training on fundamental lesbian, gay, bisexual, transgender, and queer (LGBTQ+) health topics. Faculty development is needed to address knowledge gaps, improve teaching, and prepare students to competently care for the growing LGBTQ+ population. OBJECTIVE We conducted a program evaluation of the massive open online course Teaching LGBTQ+ Health: A Faculty Development Course for Health Professions Educators from the Stanford School of Medicine. Our goal was to understand participant demographics, impact, and ongoing maintenance needs to inform decisions about updating the course. METHODS We evaluated the course for the period from March 27, 2021, to February 24, 2023, guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. We assessed impact using participation numbers, evidence of learning, and likelihood of practice change. Data included participant demographics, performance on a pre- and postcourse quiz, open-text entries throughout the course, continuing medical education (CME) credits awarded, and CME course evaluations. We analyzed demographics using descriptive statistics and pre- and postcourse quiz scores using a paired 2-tailed t test. We conducted a qualitative thematic analysis of open-text responses to prompts within the course and CME evaluation questions. RESULTS Results were reported using the 5 framework domains. Regarding Reach, 1782 learners participated in the course, and 1516 (85.07%) accessed it through a main course website. Of the different types of participants, most were physicians (423/1516, 27.9%) and from outside the sponsoring institution and target audience (1452/1516, 95.78%). Regarding Effectiveness, the median change in test scores for the 38.1% (679/1782) of participants who completed both the pre- and postcourse tests was 3 out of 10 points, or a 30% improvement (P<.001). Themes identified from CME evaluations included LGBTQ+ health as a distinct domain, inclusivity in practices, and teaching LGBTQ+ health strategies. A minority of participants (237/1782, 13.3%) earned CME credits. Regarding Adoption, themes identified among responses to prompts in the course included LGBTQ+ health concepts and instructional strategies. Most participants strongly agreed with numerous positive statements about the course content, presentation, and likelihood of practice change. Regarding Implementation, the course cost US $57,000 to build and was intramurally funded through grants and subsidies. The course faculty spent an estimated 600 hours on the project, and educational technologists spent another 712 hours. Regarding Maintenance, much of the course is evergreen, and ongoing oversight and quality assurance require minimal faculty time. New content will likely include modules on transgender health and gender-affirming care. CONCLUSIONS Teaching LGBTQ+ Health improved participants' knowledge of fundamental queer health topics. Overall participation has been modest to date. Most participants indicated an intention to change clinical or teaching practices. Maintenance costs are minimal. The web-based course will continue to be offered, and new content will likely be added.
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Affiliation(s)
- Michael Albert Gisondi
- Department of Emergency Medicine, Stanford School of Medicine, Palo Alto, CA, United States
| | - Timothy Keyes
- Stanford School of Medicine, Stanford, CA, United States
| | - Shana Zucker
- Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Deila Bumgardner
- Stanford Educational Technology, Stanford School of Medicine, Stanford, CA, United States
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Primeau CA, Philpott HT, Vader K, Unger J, Le CY, Birmingham TB, MacDermid JC. Knowledge, behaviours, and training related to 2SLGBTQIA+ health education amongst entry-level physiotherapy students in Canada: results of a nationwide, cross-sectional survey. BMC MEDICAL EDUCATION 2023; 23:519. [PMID: 37468895 DOI: 10.1186/s12909-023-04499-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 07/04/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Individuals who identify as 2SLGBTQIA+ report worse health outcomes than heterosexual/cisgender counterparts, in part due to poor experiences with healthcare professionals. This may stem from inadequate 2SLGBTQIA+ health and inclusiveness training in health professional student education. The purpose of the study was to evaluate knowledge, behaviours, and training related to 2SLGBTQIA+ health education and inclusiveness for entry-level physiotherapy students in Canada. METHODS We conducted a nationwide, cross-sectional survey with physiotherapy students from accredited Canadian physiotherapy programs. We administered the survey through Qualtrics and recruited students through targeted recruitment emails and social media posts on Twitter and Instagram between August and December 2021. Survey responses are reported as frequencies (percentage). We also completed multivariable logistic regressions to evaluate associations among question responses related to working with 2SLGBTQIA+ individuals (i.e., communication, feeling prepared and assessment competency). Covariates included training hours (< 10/10 + hours) and 2SLGBTQIA+ identity (yes/no). RESULTS A total of 150 students responded to the survey, with 35 (23%) identifying as 2SLGBTQIA+ . Many students felt confident in communicating effectively with clients who identify as 2SLGBTQIA+ (69%). However, only half (47%) felt comfortable assessing clients who identify as 2SLGBTQIA+ . Routine practice of inclusive behaviours such as using pronouns, considering identities are fluid and a patient's gender identity and/or sexual orientation may shift from one visit to the next, and considering trauma-informed care practices were reported from less than half of the students (< 45%). Around 29% of students reported no 2SLGBTQIA+ training in their physiotherapy program, while 47% reported 0-10 hours, and 24% reported 10 + hours of training. Students with 10 + hours of training had 92% higher odds of feeling competent in assessing 2SLGBTQIA+ clients, compared to those with < 10 hours of training. CONCLUSIONS Entry-level physiotherapy students in Canada show a lack of understanding and awareness for 2SLGBTQIA+ health and inclusive behaviours which can meaningfully impact patient experience. Students report feeling incompetent when working with 2SLGBTQIA+ patients, which may be associated with lack of 2SLGBTQIA+ training in their programs. Greater efforts and attention towards increasing 2SLGBTQIA+ health education and inclusivity in Canadian entry-level physiotherapy programs is critically needed.
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Affiliation(s)
- Codie A Primeau
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.
- Bone and Joint Institute, Western University, London, ON, Canada.
- Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, N6A 3K7, Canada.
| | - Holly T Philpott
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
- Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, N6A 3K7, Canada
| | - Kyle Vader
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Janelle Unger
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Christina Y Le
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Trevor B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
- Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, N6A 3K7, Canada
| | - Joy C MacDermid
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
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Cheung C, MacCormick H, Munro A, George RB. Sexual and gender minorities curricular content in Canadian anesthesia residency programs. Can J Anaesth 2023; 70:1100-1102. [PMID: 37193864 DOI: 10.1007/s12630-023-02465-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/26/2022] [Accepted: 09/01/2022] [Indexed: 05/18/2023] Open
Affiliation(s)
- Christopher Cheung
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - Hilary MacCormick
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.
- Department of Women's and Obstetric Anesthesia, IWK Health Centre, Halifax, NS, Canada.
| | - Allana Munro
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
- Department of Women's and Obstetric Anesthesia, IWK Health Centre, Halifax, NS, Canada
| | - Ronald B George
- Department of Anesthesiology & Pain Medicine, University of Toronto, Toronto, ON, Canada
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Altmiller G, Wilson C, Jimenez FA, Perron T. Impact of a Virtual Patient Simulation on Nursing Students' Attitudes of Transgender Care. Nurse Educ 2023; 48:131-136. [PMID: 36383074 DOI: 10.1097/nne.0000000000001331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Transgender individuals experience considerable prejudice and bias, creating barriers to health care. PURPOSE The purpose of this study was to determine the effect of a virtual patient simulation scenario of caring for a transgender adult on nursing students' attitudes and beliefs about transgender people. METHODS A validated 29-item instrument developed to assess an individual's view of transgender identity was administered in a pre-/posttest nonequivalent-groups design to junior- and senior-level nursing students. RESULTS Statistically significant differences were found between the control and treatment groups for the subscale human value. CONCLUSIONS Findings support experiential learning in nursing as an effective tool in teaching cultural competence and sensitivity when caring for transgender patients. Attitudes and beliefs of senior nursing students and junior nursing students toward transgender individuals differed, with senior students being more receptive.
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Affiliation(s)
- Gerry Altmiller
- Professor (Drs Altmiller and Perron), The College of New Jersey, Ewing; and Director Education, Research and Design (Dr Wilson) and Psychometrician (Dr Jimenez), Elsevier, Shadow Health, Gainesville, Florida
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Yu H, Bauermeister JA, Flores DD. LGBTQ+ health education interventions for nursing students: A systematic review. NURSE EDUCATION TODAY 2023; 121:105661. [PMID: 36463790 DOI: 10.1016/j.nedt.2022.105661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Nurses are the largest segment of the American healthcare workforce, yet little is known about how American nursing students are educated about lesbian, gay, bisexual, transgender, queer, and other individuals' (LGBTQ+) health and the efficacy of these trainings. This systematic review assessed articles in English that quantitatively evaluated the effects of curricula and training for nursing students regarding LGBTQ+ health and examined their effects on students' outcomes. DESIGN Systematic review. DATA SOURCES Six electronic databases (PubMed, CINAHL, British Nursing Index, Embase, Scopus and PsycINFO). REVIEW METHODS Controlled vocabulary and/or keywords were used for each database. Of the initial 1766 citations, 26 articles met inclusion criteria. Data extracted included study design, sample characteristic/size, training topic, modality, duration, trainer, measurement tool, training target, effect size, and key finding. RESULTS Nearly 80 % of the reviewed studies were published between 2018 and 2021. All studies included were quasi-experimental: pretest-posttest with control (n = 3), without control (n = 20), and posttest only without control (n = 3). Training modalities were categorized into four groups: multimodal pedagogy with (n = 7) and without simulation (n = 6), single modality with simulation (n = 6) and with didactic lectures (n = 7). Eight studies employed LGBTQ+ people as trainers. Eight studies included interprofessional students; 18 studies engaged only nursing students. Interventions improved students' knowledge about LGBTQ+ health (n = 8), attitudes toward LGBTQ+ communities (n = 8), comfort level regarding interacting with LGBTQ+ individuals (n = 7), confidence in providing LGBTQ+ inclusive care in practice (n = 13) and LGBTQ+ cultural competence in nursing care (n = 2). CONCLUSIONS Educating and qualifying nursing students about LGBTQ+ health may improve their knowledge, attitudes, and skills when interacting with LGBTQ+ patients and may reduce health disparities for LGBTQ+ clients. Broad integration of content and competencies in LGBTQ+ health and well-being in nursing curricula should be prioritized. Future research should include rigorous, longitudinally designed evaluation of training curricula focusing on students' actual behavior changes. Evaluation should include comparison groups and validated measurement instruments about LGBTQ+ health education constructs specifically for nursing students.
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Affiliation(s)
- Hyunmin Yu
- University of Pennsylvania School of Nursing, Philadelphia, PA 19104, United States of America.
| | | | - Dalmacio Dennis Flores
- University of Pennsylvania School of Nursing, Philadelphia, PA 19104, United States of America.
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Llayton C, Wagner TD, Anderson AN, Crawford AN, Donohoe KL, Matulewicz AT, Caldas LM. Introducing LGBTQIA+ Patient Care to Pharmacy Students Through Laboratory-Based Exercises. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8569. [PMID: 34697011 PMCID: PMC10159440 DOI: 10.5688/ajpe8569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 09/27/2021] [Indexed: 05/06/2023]
Abstract
Objective. To assess the impact of novel skills-based laboratory exercises on first-, second-, and third-year pharmacy students' confidence and knowledge regarding care for people identifying as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other (LGBTQIA+).Methods. An LGBTQIA+ lecture discussing pronouns, common terminology, health disparities, health screenings, and gender-affirming hormone therapy was presented to students. During laboratory sessions, students applied lecture topics via a learning level-specific activity. Students completed a pre- and post-activity survey assessing their knowledge, confidence, and activity experience.Results. Seventy-nine students (N=348) completed both the pre- and post-activity survey. Students' overall increase in knowledge scores was significant, with improvement in four out of six questions among each cohort. A significant increase was seen in students understanding of the role of the pharmacist, their confidence in caring for LGBTQIA+ patients, and their comfort with using appropriate terminology. Most students (92%) agreed or strongly agreed that learning about LGBTQIA+ patient care was a positive experience, while 74% agreed that additional education on LGBTQIA+ patients is needed within their pharmacy curriculum.Conclusion. After a brief skills-based laboratory course, students' knowledge and confidence in caring for LGBTQIA+ patients improved; however, students agreed that more exposure was necessary. Future studies will follow students as they progress through the curriculum to determine the impact of exposure to LGBTQIA+ content across all three didactic years.
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Affiliation(s)
- Chelsey Llayton
- University of Charleston School of Pharmacy, Charleston, West Virginia
| | - Tyler D Wagner
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | - Apryl N Anderson
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | - Alexis N Crawford
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | - Krista L Donohoe
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | | | - Lauren M Caldas
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
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Smallheer B, Chidume T, Spinks MK, Dawkins D, Pestano-Harte M. A Scoping Review of the Priority of Diversity, Inclusion, and Equity in Health Care Simulation. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Melton TC, Johnson WT, Tipton B, Aragon KG, Daniels CC, Renfro CP. Improving Pharmacy Students' Clinical Knowledge on Providing Care for Patients Belonging to the LGBTQ+ Community. PHARMACY 2022; 10:pharmacy10040070. [PMID: 35893708 PMCID: PMC9326589 DOI: 10.3390/pharmacy10040070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 02/01/2023] Open
Abstract
A 12-question survey instrument was developed, pilot-tested, and administered to 191 pharmacy students in their first professional year after engaging in a learning activity focusing on topics across five categories with clinical relevance to providing care to the LGBTQ+ community. A paired student t-test was performed on survey tool pre-test and post-test survey responses, with p < 0.05 considered significant. A total of 183 usable pre-test and post-test survey responses were received. Statistically significant differences between the pre-test and post-test correct responses were observed for scenarios involving proper pronoun use, hormone therapy (HT) counseling, immunization best practices, and communication hesitancy. The greatest knowledge change was reported in the categories of immunization best practices (48.9%), HT counseling (33.6%), and pronoun use (22.8%). Active learning assignments are effective teaching strategies to promote clinical knowledge in providing inclusive and culturally competent care to LGBTQ+ patients. Clinical topic areas including proper pronoun use, HT counseling, immunization best practices, privacy, risk awareness, and communication hesitancy are effective curricula additions for pharmacy colleges to advance inclusive curricula concerning providing care to the LGBTQ+ community.
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Affiliation(s)
- Tyler C. Melton
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN 38103, USA; (W.T.J.III); (B.T.); (C.P.R.)
- Correspondence:
| | - William T. Johnson
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN 38103, USA; (W.T.J.III); (B.T.); (C.P.R.)
| | - Brittany Tipton
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN 38103, USA; (W.T.J.III); (B.T.); (C.P.R.)
| | - Kelsea G. Aragon
- College of Pharmacy, University of New Mexico, Albuquerque, NM 87106, USA;
| | | | - Chelsea Phillips Renfro
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN 38103, USA; (W.T.J.III); (B.T.); (C.P.R.)
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Mikovits JC. "I don't feel like I'm a person": Nursing knowledge of transgender care through the lens of transgender people. J Adv Nurs 2022; 78:3012-3024. [PMID: 35642833 DOI: 10.1111/jan.15308] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/29/2022] [Accepted: 05/07/2022] [Indexed: 11/27/2022]
Abstract
AIMS One aim of this study was to discover and understand the perceptions of healthcare delivery for transgender people who have had interactions with nurses while receiving care. An additional purpose of this study was to identify if these perceptions of nursing knowledge have an influence on transgender individuals seeking future healthcare. DESIGN Qualitative, interpretive description. METHODS Recruitment of participants and interviews took place between September and November 2020. Confidentiality and protection of human participants was prioritized, and data analysis concluded in early 2021. RESULTS Ten participant interviews were completed until data saturation were determined. One overarching theme and five supporting themes were constructed from data. Based on participant experiences, these themes reflect transgender peoples' perceptions of nursing knowledge of transgender care and how these perceptions impact seeking future healthcare. CONCLUSION Experiences that shaped transgender peoples' perceptions of nursing knowledge of transgender care varied depending on the locations of these services and the experience and understanding of registered nurses. These findings highlight the perceptions that transgender people have of registered nurses' knowledge of transgender care and the influence that those perceptions have on them seeking future healthcare.
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A Systematic Review of Global Health Assessment for Education in Healthcare Professions. Ann Glob Health 2022; 88:1. [PMID: 35083127 PMCID: PMC8740639 DOI: 10.5334/aogh.3389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: Methods: Results: Conclusions:
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22
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Klein R, Elboim-Gabyzon M. Attitudes of registered physiotherapists in Israel toward people identifying as lesbian, gay, and bisexual: a cross-sectional survey. BMC MEDICAL EDUCATION 2021; 21:581. [PMID: 34789223 PMCID: PMC8597222 DOI: 10.1186/s12909-021-03018-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND This study aimed to explore the attitudes of registered physiotherapists (PTs) in Israel toward people identifying as lesbian, gay, or bisexual (LGB) and to identify background characteristics associated with their attitudes toward LGB individuals. METHODS This nationwide study in Israel employed an observational design. Participants completed an anonymous online questionnaire which included demographic characteristics (e.g., age, sex, gender, sexual orientation, religious affiliation, and religiousness) and questions regarding sources of knowledge about LGB individuals, and type of acquaintance with an LGB individual. In addition to two self-assessment questions regarding levels of homophobia (active engagement against LGB individuals) and heterosexism (holding negative opinions regarding LGB individuals) answered on a five point Likert scale (1 - not at all homophobic/ heterosexist, 5- very homophobic/ heterosexist) and the Hebrew version of the Attitudes Toward Homosexuality Scale (ATHS). Participants were recruited through professional organizations, social media, and word of mouth. RESULTS The data of 383 registered PTs practicing in Israel were analyzed. The median score regarding level of homophobia and heterosexism was one ("not at all"). ATHS scores ranged between 32 and 110 (out of 110), with a median score of 106 and 41% scoring below the median. Multivariant logistic regression indicated that identifying as men, heterosexual orientation, and religiousness were significantly associated with less positive attitudes toward LGB individuals. Only 2% of the participants reported having been introduced to issues regarding the LGB community during their professional physiotherapy education. CONCLUSIONS Registered PTs in Israel demonstrated favorable attitudes toward LGB individuals, as reflected both by ATHS scores and levels of self-reported homophobia and heterosexism. Based on the current results regarding sources of knowledge, updating the physiotherapy curriculum to include information regarding sexual orientation and health of the LGB community is suggested.
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Affiliation(s)
- Roei Klein
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, (Eshkol Bldg., Floor 9, room 910), Haifa, Israel
| | - Michal Elboim-Gabyzon
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, (Eshkol Bldg., Floor 9, room 910), Haifa, Israel.
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Bear MD, Mukherjee SM, Goldsmith CAW. Transgender health education for pharmacy students and its effect on student knowledge and attitudes. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1351-1357. [PMID: 34521531 DOI: 10.1016/j.cptl.2021.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/28/2021] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND PURPOSE Increased student pharmacist education on health issues and concerns of the underserved Lesbian, gay, bisexual, transgender, and queer (LGBTQ) population is needed. We incorporated pharmacy-specific, transgender-focused education into the curriculum and sought to identify whether pharmacy students' knowledge and attitudes towards LGBTQ individuals were affected by: (1) required online module or in-class lecture and (2) student demographics. Educational activity and setting: Pharmacy student attitudes and perceptions towards transgender individuals and the LGBTQ population were assessed before and after online (video) and in-person education using a modification of the Attitudes towards Lesbian Gay Bisexual Transgender Patients Scale. Wilcoxon test for non-parametric paired data was used to test for statistically significant changes between the pre- and post-education surveys, while two-way analysis of variance was used to analyze correlations between student demographics and responses. FINDINGS Changes in students' knowledge and attitudes were observed after exposure to either online or in-person education. Increases in students' perceived competence to provide care to patients identifying as LGBTQ were associated with both teaching methods. Significant demographic associations were seen with specific attitudes; female students and students who knew a transgender person were more likely to strongly disagree that discussing sexual behavior with LGBTQ patients is challenging. SUMMARY Delivery of transgender-focused education produced observable changes in student pharmacist perceptions and attitudes towards working with the LGBTQ patient population. Demographic characteristics, such as being female or knowing a transgender individual, positively correlated with student pharmacists' feeling more comfortable discussing sexual behavior with LGBTQ persons.
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Affiliation(s)
- Michael D Bear
- Pharmacy Practice, MCPHS University, School of Pharmacy-Worcester/Manchester, 40 Foster Street, Worcester, MA 01698, United States.
| | - S Mimi Mukherjee
- Pharmacy Practice, MCPHS University, School of Pharmacy-Worcester/Manchester, 40 Foster Street, Worcester, MA 01698, United States.
| | - Carroll-Ann W Goldsmith
- Pharmaceutical Sciences, MCPHS University, School of Pharmacy-Worcester/Manchester, 1260 Elm Street, Manchester, NH 03101, United States.
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Pedersen S, Corcoran L. Implementation of transgender and gender diverse curriculum in medical imaging programs: A review of the literature. J Med Imaging Radiat Sci 2021; 52:S110-S116. [PMID: 34303645 DOI: 10.1016/j.jmir.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/10/2021] [Accepted: 06/16/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Sexual and gender minority patients experience significant inequities when accessing health care. Transgender and non-binary patients are at an even greater risk of experiencing health disparities due to their specialized health care needs. In the discipline of medical imaging, limited cultural competence, social stigma, and cis-heteronormative environments are barriers for these patients. There is an urgent need to improve medical imaging care for transgender and non-binary people; inclusion of sexual and gender minority content in medical imaging curriculum is one strategy to begin to address this need. METHOD A review of the literature was undertaken to explore implementation of sexual and gender minority content in the curricula of medical imaging programs. RESULTS/DISCUSSION Three main themes were identified: 1) educators' acknowledgement of the importance and value of adding sexual and gender minority content to healthcare curriculum; 2) educators' lack of a sense of preparedness, experience, and knowledge to adequately teach this content: and 3) lack of resources and institutional support to help develop curriculum. CONCLUSION Including content in the curriculum related to the needs of transgender and non-binary patients will help ensure entry-to-practice Medical Radiation Technologists are better prepared to provide inclusive care.
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Affiliation(s)
- Sidsel Pedersen
- Faculty of Health Disciplines, Athabasca University, Alberta, Canada.
| | - Lynn Corcoran
- Faculty of Health Disciplines, Athabasca University, Alberta, Canada
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A Latent Class Analysis of Chronic Health Conditions Among HIV-Positive Transgender Women of Color. AIDS Behav 2021; 25:52-63. [PMID: 31144132 DOI: 10.1007/s10461-019-02543-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Research on the health of transgender people has focused on the risk for and health consequences of HIV and other sexually transmitted infections with little known about the prevalence of a broader range of medical conditions experienced by transgender people. This study used latent class (LC) analysis to examine a range of chronic medical conditions among 223 HIV-positive transgender women of color receiving primary care and psychosocial services in Chicago. The best-fitting model had 2 classes: low and moderate/high multimorbidity with 26% of participants classified in the moderate/high multimorbidity LC. Age group (i.e., under 35 vs 35 and older; AOR 13.8, p < 0.001), ever having AIDS (AOR 4.0, p < 0.05) and psychological distress (AOR 5.1, p < 0.05) were associated with increased probability of moderate/high multimorbidity class membership. The results suggest focusing on HIV-related care or hormonal treatment and potential cardiovascular issues could result in sub-optimal treatment for a population dis-engaged from primary care but which has a broad spectrum of largely untreated medical conditions.
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Lee M, Tasa-Vinyals E, Gahagan J. Improving the LGBTQ2S+ cultural competency of healthcare trainees: advancing health professional education. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:e7-e20. [PMID: 33680227 PMCID: PMC7931472 DOI: 10.36834/cmej.67870] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Lesbian, Gay, Bisexual, Trans, Queer, and Two-spirit (LGBTQ2S+) populations experience worse health outcomes compared to age-matched heterosexual and cisgender peers. Health professionals' deficient knowledge and negative attitudes can contribute to these inequities. Healthcare trainees report insufficient LGBTQS2+ cultural competence training. METHODS In this prospective, mixed-methods pre-post design, Atlantic Canadian health students were tested on knowledge, attitudes and self-reported behaviours towards LGBTQ2S+ populations in healthcare settings. Assessment included psychometric measurements and clinical cases involving normative and non-normative fictional patients. Participants were randomised to intervention or control groups. The intervention consisted of three training sessions lead by LGBTQ2S+ experts and elders from the community. The control group continued with usual training. Full assessment was repeated after training. We also held focus group discussions with students and faculty. RESULTS The intervention group significantly improved attitudes toward and knowledge of LGBTQ2S+ populations and changed relevant aspects of their performance in the simulated clinical situations. Focus groups identified key gaps in current local training. CONCLUSIONS Integrating specific training related to LGBTQ2S+ health within health professions programs is an important step toward improving these populations' accessibility to a competent, exhaustive and nurturing healthcare. Additional research on innovative means to expand and broaden the scope of our training is warranted.
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Affiliation(s)
- Matthew Lee
- Gender and Health Promotion Studies Unit, School of Health and Human Performance, Dalhousie University, Nova Scotia, Canada
| | - Elisabet Tasa-Vinyals
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Jacqueline Gahagan
- Gender and Health Promotion Studies Unit, School of Health and Human Performance, Dalhousie University, Nova Scotia, Canada
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García-Acosta JM, Castro-Peraza ME, Perestelo-Pérez L, Rivero-Santana A, Arias-Rodríguez Á, Lorenzo-Rocha ND. Measuring Explicit Prejudice and Transphobia in Nursing Students and Professionals. NURSING REPORTS 2020; 10:48-55. [PMID: 34968349 PMCID: PMC8608125 DOI: 10.3390/nursrep10020008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/03/2020] [Accepted: 10/12/2020] [Indexed: 11/16/2022] Open
Abstract
Trans* people frequently report attitudes of prejudice/transphobia in health professionals. Conversely, health professionals indicate the lack of adequate training to care for these people and its impact on the quality of care provided. OBJECTIVE Our objective was to evaluate the explicit prejudices/transphobia of health students and professionals and compare them with the general population in Tenerife. METHODS A descriptive cross-sectional study was carried out with the Genderism and Transphobia Scale (GTS) and the Negative Attitude towards Trans* people Scale (EANT) with a total of 602 participants. RESULTS We found a low mean level of explicit prejudice/transphobia, with little/no differences between occupation groups. Explicit transphobia was correlated with being a man, less educated, and heterosexual, and not personally knowing a trans* person. Men and women were less transphobic about trans* people whose identities coincided with their own. CONCLUSION All participants showed a low mean level of explicit transphobia. This result is not incompatible with unconscious prejudice, which may translate to discriminatory behaviors. Interventions to change negative attitudes are still needed, since even a small percentage of transphobic health professionals could exert a considerable negative impact on health care. In professionals without transphobic attitudes, the barriers identified by trans* people might be a problem due to the lack of specific training.
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Affiliation(s)
- Jesús Manuel García-Acosta
- Canary Islands Public Health Service, Tenerife, 38071 Canary Islands, Spain; (J.M.G.-A.); (N.D.L.-R.)
- Department of Nursing, University of La Laguna, Tenerife, 38010 Canary Islands, Spain
| | - María Elisa Castro-Peraza
- Canary Islands Public Health Service, Tenerife, 38071 Canary Islands, Spain; (J.M.G.-A.); (N.D.L.-R.)
- Department of Nursing, University of La Laguna, Tenerife, 38010 Canary Islands, Spain
| | - Lilisbeth Perestelo-Pérez
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain;
- Health Services Research on Chronic Patients Network (REDISSEC), 38109 Tenerife, Spain;
- Institute of Biomedical Technologies, University of La Laguna, 38200 San Cristóbal de La Laguna, Spain
| | - Amado Rivero-Santana
- Health Services Research on Chronic Patients Network (REDISSEC), 38109 Tenerife, Spain;
- Institute of Biomedical Technologies, University of La Laguna, 38200 San Cristóbal de La Laguna, Spain
- Canary Islands Foundation of Health Research (FUNCANIS), 38320 San Cristóbal de La Laguna, Spain
| | | | - Nieves Doria Lorenzo-Rocha
- Canary Islands Public Health Service, Tenerife, 38071 Canary Islands, Spain; (J.M.G.-A.); (N.D.L.-R.)
- Department of Nursing, University of La Laguna, Tenerife, 38010 Canary Islands, Spain
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Grundmann O, Segal R, Pullo J, Davis L, Felix-Irizarry Y, Da Silva L, Holets T. The Pharmacist as an LGBTQ Ally. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:ajpe7835. [PMID: 32773835 PMCID: PMC7405310 DOI: 10.5688/ajpe7835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 12/22/2019] [Indexed: 05/30/2023]
Abstract
An ally is defined as one who is associated with another as a helper that provides support and assistance in an ongoing struggle or effort. Pharmacists should be allies to their patients by ensuring optimal health outcomes and by helping their patients achieve therapeutic objectives and goals. However, most colleges of pharmacy are currently not well equipped to train future pharmacists to counsel lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) patients. This commentary explores reasons for discrepancies in health care access for LGBTQ patients and how efforts can be advanced to meet the needs of this minority group. Pharmacists require adequate training to provide optimal care for a more diverse patient population and to be both an ally in health and a reassuring supporter for members of the LGBTQ community.
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Affiliation(s)
- Oliver Grundmann
- University of Florida, College of Pharmacy, Gainesville, Florida
| | - Richard Segal
- University of Florida, College of Pharmacy, Gainesville, Florida
| | - Joshua Pullo
- University of Florida, College of Pharmacy, Gainesville, Florida
| | - Laura Davis
- University of Florida, College of Pharmacy, Gainesville, Florida
| | | | - Lais Da Silva
- University of Florida, College of Pharmacy, Gainesville, Florida
| | - Tyler Holets
- University of Florida, College of Pharmacy, Gainesville, Florida
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Pratt-Chapman ML. Implementation of sexual and gender minority health curricula in health care professional schools: a qualitative study. BMC MEDICAL EDUCATION 2020; 20:138. [PMID: 32375760 PMCID: PMC7201690 DOI: 10.1186/s12909-020-02045-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/20/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, queer, and intersex people-inclusively termed "sexual and gender minorities"-have unique health and health care needs that are not being met by most healthcare providers due to lack of training in health care professional schools. The purpose of this qualitative study was to examine implementation factors for advancing sexual and gender minority health professional student curricula in academic settings. METHODS Semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR) were conducted with sixteen curricular champions to identify factors relevant to curricular adoption, integration, and sustainment. Themes were coded using a hybrid of deductive and inductive approaches and reported using major CFIR domains. RESULTS Facilitators supporting implementation of sexual and gender minority health curricula included collaboration among multiple stakeholders, alignment of formal and hidden curricula, fostering an organizational culture that valued inclusion and diversity, engagement with external subject matter experts or faculty with content expertise, and thoughtful and inclusive planning. CONCLUSION This study contributes to health care professional education research as well as to implementation science. Facilitators that were identified in this study can be used to increase the adoption, integration, and sustainment of sexual and gender minority health curricula in diverse academic settings.
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Affiliation(s)
- Mandi L Pratt-Chapman
- The George Washington University, GW Cancer Center, 2600 Virginia Ave, #324, Washington, DC, 20037, USA.
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Siller H, Tauber G, Hochleitner M. Does diversity go beyond sex and gender? Gender as social category of diversity training in health profession education - a scoping review. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc25. [PMID: 32328527 PMCID: PMC7171361 DOI: 10.3205/zma001318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/09/2019] [Accepted: 05/28/2019] [Indexed: 05/03/2023]
Abstract
Background: Sex and gender are social categories of diversity. Diversity can be perceived with an intersectional framework as it demonstrates the intersecting categories that might contribute to oppression, inequality, power and privilege. This article focused on what aspects were considered in diversity training programmes for health professions and the role of sex/gender in this context. Method: This scoping review focuses on the social categories mentioned in diversity education of health professionals. Articles on diversity training for health professionals were searched for in the Web of Science database using the keywords gender, diversity, training, education and health professions. Twelve articles were finally included in this review. Thematic analysis was employed to summarise information deduced from articles. Findings: Gaps in the aspects included in diversity training were identified. Findings show that culture was mostly discussed, whereas sex/gender and lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) were focused on only to a minor extent. Cultural diversity training includes self-reflection on one's own culture, whereas a comparable tool for sex/gender and LGBTQI is missing. Additionally, other social categories of diversity, such as disability or age, are largely absent. Conclusion: Diversity should be incorporated in its full breadth in health profession education and not fragmented. Additionally, other social categories such as gender might benefit from including self-reflection on these categories in addition to reflecting on the role of power and privilege in order to increase self-awareness for diversity. In this way, othering of the population might be prevented and healthcare can be improved for all.
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Affiliation(s)
- Heidi Siller
- Medical University of Innsbruck, Gender Medicine Unit, Innsbruck, Austria
- *To whom correspondence should be addressed: Heidi Siller, Medical University of Innsbruck, Gender Medicine Unit, Innrain 66, A-6020 Innsbruck, Austria, phone: +43 (0)512 504 25714, Fax: +43 (0)512 504 25719, E-mail:
| | - Gloria Tauber
- Medical University of Innsbruck, Gender Medicine Unit, Innsbruck, Austria
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Nolan IT, Blasdel G, Dubin SN, Goetz LG, Greene RE, Morrison SD. Current State of Transgender Medical Education in the United States and Canada: Update to a Scoping Review. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120520934813. [PMID: 32637641 PMCID: PMC7315660 DOI: 10.1177/2382120520934813] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/19/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND The published literature on education about transgender health within health professions curricula was previously found to be sporadic and fragmented. Recently, more inclusive and holistic approaches have been adopted. We summarize advances in transgender health education. METHODS A 5-stage scoping review framework was followed, including a literature search for articles relevant to transgender health care interventions in 5 databases (Education Source, LGBT Source, MedEd Portal, PsycInfo, PubMed) from January 2017 to September 2019. Search results were screened to include original articles reporting outcomes of educational interventions with a transgender health component that included MD/DO students in the United States and Canada. A gray literature search identified continuing medical education (CME) courses from 12 health professional associations with significant transgender-related content. RESULTS Our literature search identified 966 unique publications published in the 2 years since our prior review, of which 10 met inclusion criteria. Novel educational formats included interdisciplinary interventions, post-residency training including CME courses, and online web modules, all of which were effective in improving competencies related to transgender health care. Gray literature search resulted 15 CME courses with learning objectives appropriate to the 7 professional organizations who published them. CONCLUSIONS Current transgender health curricula include an expanding variety of educational intervention formats driven by their respective educational context, learning objectives, and placement in the health professional curriculum. Notable limitations include paucity of objective educational intervention outcomes measurements, absence of long-term follow-up data, and varied nature of intervention types. A clear best practice for transgender curricular development has not yet been identified in the literature.
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Affiliation(s)
- Ian T Nolan
- Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Gaines Blasdel
- Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Samuel N Dubin
- New York University Grossman School of Medicine, New York, NY, USA
| | - Laura G Goetz
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Richard E Greene
- Department of Internal Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Shane D Morrison
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA
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Llayton CK, Caldas LM. Strategies for inclusion of lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) education throughout pharmacy school curricula. Pharm Pract (Granada) 2020; 18:1862. [PMID: 32206144 PMCID: PMC7075428 DOI: 10.18549/pharmpract.2020.1.1862] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others (LGBTQIA+) patients face stigma and barriers to health care, including a lack of health care professionals' knowledge and confidence in treating this patient population. Pharmacists are in prime position to decrease this health disparity. United States pharmacy schools have limited LGBTQIA+ content, continuing the concern of recent graduates without knowledge and confidence. This commentary discusses potential barriers to introducing LGBTQIA+ content into school of pharmacy curricula and presents five strategies currently in use by nursing, medical, and pharmacy schools. Schools of Pharmacy should consider proactive incorporation of this content to graduate practitioners able to provide quality care to LGBTQIA+ patients.
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Affiliation(s)
- Chelsey K Llayton
- PharmD. School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Lauren M Caldas
- PharmD, BCACP. School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
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McCave EL, Aptaker D, Hartmann KD, Zucconi R. Promoting Affirmative Transgender Health Care Practice Within Hospitals: An IPE Standardized Patient Simulation for Graduate Health Care Learners. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2019; 15:10861. [PMID: 32051844 PMCID: PMC7010321 DOI: 10.15766/mep_2374-8265.10861] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/26/2019] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Transgender patients frequently experience discrimination within health care settings due to provider lack of knowledge and bias resulting in poor service delivery. Team-based interprofessional collaboration is becoming a best practice for health professionals to improve patient-centered care and address these health disparities. METHODS A team-based interprofessional education simulation activity was developed as a teaching activity at a university for graduate health care learners in medicine, nursing, occupational therapy, physical therapy, physician assistant, social work, and health care administration programs over 2 years (N = 494). The simulation focused on a transgender patient brought to the emergency department (ED) after a workplace assault. Students were placed in interprofessional teams and asked to critique the initial ED interaction with the patient and then complete a team huddle and discharge planning meeting with a standardized patient. Student preparedness to engage in the Interprofessional Education Collaborative (IPEC) competencies was assessed through a posttest measure. RESULTS Student learners reacted overwhelmingly positively to the activities of the workshop. The averaging of 2 years of data yielded students responses of strongly agree and agree at 90% or higher for all IPEC core competencies, as well as for educational objectives of the workshop. DISCUSSION Reducing the structural, interpersonal, and individual stigma experienced by transgender patients requires institutions to offer experiential learning opportunities for future health care providers. This interprofessional education simulation experience focusing on transgender patients calls attention to the negative impact of stigma while also promoting competency in interprofessional practice.
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Affiliation(s)
- Emily L. McCave
- Associate Professor, Department of Social Work, Quinnipiac University
- Assistant Director, Center for Interprofessional Healthcare Education, Quinnipiac University
| | - Dennis Aptaker
- Clinical Assistant Professor, Department of Occupational Therapy, Quinnipiac University
| | - Kimberly D. Hartmann
- Professor, Department of Occupational Therapy, Quinnipiac University
- Director, Center for Interprofessional Healthcare Education, Quinnipiac University
| | - Rebecca Zucconi
- Assistant Professor, Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University
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Jann MW, Penzak S, White A, Tatachar A. An Elective Course in Lesbian, Gay, Bisexual, and Transgender Health and Practice Issues. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2019; 83:6967. [PMID: 31831892 PMCID: PMC6900814 DOI: 10.5688/ajpe6967] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/29/2019] [Indexed: 05/22/2023]
Abstract
Objective. To design, implement and assess a lesbian, gay, bisexual, and transgender (LGBT) health and practice elective course for second- and third-year Doctor of Pharmacy (PharmD) students. Methods. The course focused on health promotion, health care barriers, disease prevention, and treatment throughout an LGBT person's lifespan. The course included topic discussions, reading assignments, various active-learning activities, an objective structured clinical examination (OSCE) with a transgender person, and guest speakers from the LGBT community. Five quizzes were administered during the course that were mapped to specific session learning objectives and course learning outcomes. Students completed an anonymous pre- and post-course survey on the seven course learning outcomes to assess their knowledge and skills regarding the health of LGBT people. Results. Students exhibited significant learning with improvement in the seven course learning outcomes. The two most improved course learning outcomes were the medications used for LGBT people and summarizing health care resources available to LGBT people. The content of student portfolios included general themes of discrimination, health care access problems, advocacy, inclusive pharmacy environments, and desire to be a better practitioner. More than 91% of the students actively engaged the guest speakers from the LGBT community. Student performance on quizzes and in the OSCE activity was excellent. The capstone presentations covered a variety of topics including LGBT in Islam. Conclusion. Students demonstrated knowledge of the unique health care issues among the LGBT community. This elective course provides a framework for other pharmacy programs to incorporate LGBT health topics into the curriculum and to engage with their local LGBT community.
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Affiliation(s)
- Michael W. Jann
- University of North Texas System College of Pharmacy, Fort Worth, Texas
| | - Scott Penzak
- Auburn University Harrison School of Pharmacy, Auburn, Alabama
| | - Annesha White
- University of North Texas System College of Pharmacy, Fort Worth, Texas
| | - Amulya Tatachar
- University of North Texas System College of Pharmacy, Fort Worth, Texas
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Lampalzer U, Behrendt P, Dekker A, Briken P, Nieder TO. The Needs of LGBTI People Regarding Health Care Structures, Prevention Measures and Diagnostic and Treatment Procedures: A Qualitative Study in a German Metropolis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3547. [PMID: 31546719 PMCID: PMC6801863 DOI: 10.3390/ijerph16193547] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/12/2019] [Accepted: 09/16/2019] [Indexed: 12/12/2022]
Abstract
(1) Background: Studies indicate that lesbian, gay, bisexual, transgender and intersex (LGBTI) people constantly face challenges and disadvantages in the health care system that prevent them from getting the best possible patient-centered care. However, the present study is the first to focus on LGBTI-related health in a major German metropolis. It aimed to investigate health care structures, prevention measures and diagnostic as well as treatment procedures that LGBTI individuals need in order to receive appropriate patient-centered health care and health promotion. (2) Methods: Following a participatory approach, five expert interviews with LGBTI people with multiplier function, i.e., people who have a key role in a certain social milieu which makes them able to acquire and spread information in and about this milieu, and three focus groups with LGBTI people and/or health professionals were conducted. Qualitative data were analyzed according to the principles of content analysis. (3) Results: The specific needs of LGBTI individuals must be recognized as a matter of course in terms of depathologization, sensitization, inclusion, and awareness. Such an attitude requires both basic knowledge about LGBTI-related health issues, and specific expertise about sufficient health care services for each of the minorities in the context of sex, sexual orientation and gender identity. (4) Conclusions: For an appropriate approach to LGBTI-centered health care and health promotion, health professionals will need to adopt a better understanding of specific soft and hard skills.
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Affiliation(s)
- Ute Lampalzer
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Pia Behrendt
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Arne Dekker
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Timo O Nieder
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
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García-Acosta JM, Castro-Peraza ME, Arias Rodriguez Á, Perez-Cánovas ML, Sosa-Alvarez MI, Llabrés-Solé R, Perdomo-Hernández AM, Lorenzo-Rocha ND. Impact of a Formative Program on Transgender Healthcare for Nursing Students and Health Professionals. Quasi-Experimental Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3205. [PMID: 31480755 PMCID: PMC6747280 DOI: 10.3390/ijerph16173205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND The field of specific healthcare for transgender people has not been included in the official curriculum of professionals. This causes a lack of knowledge that can be presumed to become a barrier to healthcare. Currently, different methodologies are emerging to achieve meaningful learning for students and professionals. The objective of this study was to evaluate the increase in the level of knowledge of final-year nursing students, applying methodological strategies such as problem-based learning (PBL) and film-forum. METHODS 59 nursing students were randomly assigned to two intervention groups (G1 = 31 and G2 = 28), and another 57 were assigned to the control group (without specific classes or workshops on the subject of the study). The intervention consisted of a specific training course on transgender issues (TGSC&W, TransGender Specific Course and Workshop), where the type of meaningful learning strategy used depended on the group (G1 = film-forum and G2 = PBL). The study was carried out at the Faculty of Nursing Nuestra Señora de Candelaria of the Canary Islands Health Service. The randomization was done by blindly choosing a computer-generated code. RESULTS The main outcome was based on 116 participants, comparing their level of knowledge before and after the workshop. The comparison by pairs shows that there were statistically significant differences (p = 0.000) between those undergoing the methodological interventions and the control group. Statistical significance between film-forum and PBL was not obtained (p = 1.000): Both methodologies increased the level of knowledge, but there was no significant difference between them. The means for satisfaction with the learning methodology used did not show statistically significant differences. CONCLUSION The workshop carried out was highly effective and significant in terms of increasing knowledge. No significant differences were observed in the level of knowledge, or in the degree of satisfaction, between the two methodologies used (PBL and film-forum).
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Affiliation(s)
- Jesús Manuel García-Acosta
- Faculty of Nursing N. S. Candelaria, Canary Islands Public Health Service, University of La Laguna, 38200 Tenerife, Canary Islands, Spain
| | - Maria Elisa Castro-Peraza
- Faculty of Nursing N. S. Candelaria, Canary Islands Public Health Service, University of La Laguna, 38200 Tenerife, Canary Islands, Spain.
| | | | - María Luisa Perez-Cánovas
- Faculty of Nursing N. S. Candelaria, Canary Islands Public Health Service, University of La Laguna, 38200 Tenerife, Canary Islands, Spain
| | - Maria Inmaculada Sosa-Alvarez
- Faculty of Nursing N. S. Candelaria, Canary Islands Public Health Service, University of La Laguna, 38200 Tenerife, Canary Islands, Spain
| | - Rosa Llabrés-Solé
- Faculty of Nursing N. S. Candelaria, Canary Islands Public Health Service, University of La Laguna, 38200 Tenerife, Canary Islands, Spain
| | - Ana María Perdomo-Hernández
- Faculty of Nursing N. S. Candelaria, Canary Islands Public Health Service, University of La Laguna, 38200 Tenerife, Canary Islands, Spain
| | - Nieves Doria Lorenzo-Rocha
- Faculty of Nursing N. S. Candelaria, Canary Islands Public Health Service, University of La Laguna, 38200 Tenerife, Canary Islands, Spain
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Bunting SR, Saqueton R, Batteson TJ. A Guide for Designing Student-Led, Interprofessional Community Education Initiatives About HIV Risk and Pre-Exposure Prophylaxis. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2019; 15:10818. [PMID: 31139737 PMCID: PMC6507924 DOI: 10.15766/mep_2374-8265.10818] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
INTRODUCTION There is room for innovation in medical education regarding HIV and modern biomedical preventive strategies such as pre-exposure prophylaxis (PrEP). Previously described undergraduate medical curricular modules address care for HIV patients but do not include PrEP. A graduate medical curriculum concerning HIV has also been described but misses the opportunity for early introduction of HIV risk prevention, an element of primary preventive care. The guiding framework described here provides one mechanism to begin addressing this gap and fosters interprofessional collaboration among students through community engagement. METHODS We assembled a team of 11 first-year students (medical, physician assistant, podiatry, pharmacy, and health care psychology). The team collaborated to create a training module about HIV risk and PrEP access in Lake County, Illinois. A biopsychosocial perspective on HIV risk and PrEP was employed as the guiding framework. The student team presented the module to care teams at the Lake County Health Department and to the university campus through interactive workshops. RESULTS Participating students completed a self-reflection instrument. Responses were positive in terms of student enjoyment and attainment of new knowledge regarding HIV risk and PrEP. Students also self-reported competency in a selected group of Interprofessional Education Collaborative competencies. Narrative responses were analyzed for context. DISCUSSION Student responses suggest that this activity is effective in providing education about HIV risk and PrEP. The framework is novel in that it requires research and modification at each site of implementation. Furthermore, as an extracurricular element, its implementation is flexible.
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Affiliation(s)
- Samuel R. Bunting
- Second-Year Medical Student, Chicago Medical School, Rosalind Franklin University of Medicine and Science
- Corresponding author:
| | - Robert Saqueton
- Assistant Professor, Department of Medicine, Chicago Medical School, Rosalind Franklin University of Medicine and Science
| | - Tamzin J. Batteson
- Research Specialist, DeWitt C. Baldwin Institute for Interprofessional Education, Rosalind Franklin University of Medicine and Science
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Abstract
Pharmacists are increasingly part of a multifaceted team providing health care to members of the often marginalized transgender (TG) community. Some pharmacists, however, may feel unprepared to care for and interact with TG individuals. By providing comprehensive, respectful, and gender-affirming support, improving physical pharmacy environments with policies and procedures, pharmacists can be trustworthy providers for TG patients. This review focuses primarily on the health issues of TG persons and the pharmacist's role in promoting health, identifying barriers to health care, and providing health care resources for TG persons. The evolution of psychiatric diagnostic criteria, access to health care, and inclusion of TG, lesbian, gay, and bisexual topics in the educational curriculum are presented. Cultural competency and diversity training that addresses gender identity and sexual orientation issues should be important interdisciplinary and interprofessional activities for all health care professional education programs. Pharmacists play a key role in the health care needs of TG persons that include appropriate laboratory monitoring, complex pharmacotherapeutic challenges, and providing unbiased gender-affirming interactions. The pharmacy's physical environment, staff training, and policies and procedures can offer unique services to TG persons.
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Affiliation(s)
- Jan S Redfern
- Department of Pharmacotherapy, University of North Texas System College of Pharmacy, Fort Worth, Texas.,Redfern Strategic Medical Communications, Inc., Springtown, Texas
| | - Michael W Jann
- Department of Pharmacotherapy, University of North Texas System College of Pharmacy, Fort Worth, Texas
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Rosa DF, Carvalho MVDF, Pereira NR, Rocha NT, Neves VR, Rosa ADS. Nursing Care for the transgender population: genders from the perspective of professional practice. Rev Bras Enferm 2019; 72:299-306. [DOI: 10.1590/0034-7167-2017-0644] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/12/2017] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To describe and analyze the national and international scientific production on Nursing care for the transgender or gender-variance population. Method: Integrative review of the literature, conducted throughout the Virtual Health Library, Cumulative Index to Nursing and Allied Health Literature, Public Medline and Web of Science databases, without pre-established periods of time and using the descriptors "Transgender AND ‘Nursing Assistance'" and "Transgender AND ‘Nursing care'". Results: We included 11 articles, published between 2005 and 2016, broadly North American with only one Brazilian, so categorized: I- Fragility in the care of transgender people; II - Health of the transgender population: general and specific demands; III- Public health policies for transgender people. Transgender people have not found yet answers to their health demands; they are victims of prejudices and violence in services and seek care in extreme cases of sickness. Final considerations: Understanding their needs is primordial to build knowledge and practices that support nursing care.
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DeVita T, Bishop C, Plankey M. Queering medical education: systematically assessing LGBTQI health competency and implementing reform. MEDICAL EDUCATION ONLINE 2018; 23:1510703. [PMID: 30157712 PMCID: PMC6116674 DOI: 10.1080/10872981.2018.1510703] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) individuals face well-established health disparities. American medical schools have been inconsistent in their training in the care of LGBTQI-identified patient, and many have not formally assessed their curriculums for content related to the care of LGBTQI-identified patients. From 2015 to 2016, the authors systematically evaluated Georgetown University School of Medicine's preclinical curriculum for its LGBTQI competency using video lecture capture, LGBTQI health competencies published by the American Association of Medical Colleges (AAMC) and learning objectives developed by Vanderbilt University. Based on the results of the curricular audit, the authors have created didactic content targeted at the identified curricular gaps that has been implemented throughout the preclinical curriculum at Georgetown. The curricular auditing process described here could be replicated at other medical schools, which would allow educators to develop targeted content to address unmet competencies. Abbreviations AAMC: Association of American Medical Colleges; LGBTQI: Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex.
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Affiliation(s)
- Timothy DeVita
- Department of Medicine, Georgetown University School of Medicine, Washington, DC, USA
| | - Casey Bishop
- Department of Medicine, Georgetown University School of Medicine, Washington, DC, USA
| | - Michael Plankey
- Department of Medicine, Georgetown University School of Medicine, Washington, DC, USA
- CONTACT Michael Plankey Georgetown University School of Medicine, Washington, DC, USA
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Improving Clinical Education and Training on Sexual and Gender Minority Health. CURRENT SEXUAL HEALTH REPORTS 2018. [DOI: 10.1007/s11930-018-0185-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kwong HJ, O'Rourke PD. On Becoming a Woman. Am J Med 2018; 131:1135-1136. [PMID: 29625081 DOI: 10.1016/j.amjmed.2018.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/17/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Helaine J Kwong
- The Johns Hopkins University School of Medicine, Baltimore, Md.
| | - Paul D O'Rourke
- The Johns Hopkins University School of Medicine, Baltimore, Md
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Should Dental Care Make a Transition? J Am Dent Assoc 2018; 149:79-80. [DOI: 10.1016/j.adaj.2017.11.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 11/28/2017] [Indexed: 11/19/2022]
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Nama N, MacPherson P, Sampson M, McMillan HJ. Medical students' perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study. MEDICAL EDUCATION ONLINE 2017; 22:1368850. [PMID: 28853327 PMCID: PMC5653936 DOI: 10.1080/10872981.2017.1368850] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. OBJECTIVE The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. DESIGN Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey. RESULTS Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p < 0.001) or anti-LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%). CONCLUSION Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients.
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Affiliation(s)
- Nassr Nama
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- CONTACT Nassr Nama BC Children’s Hospital, 4480 Oak St., Vancouver, BCV6H 3N1, Canada
| | - Paul MacPherson
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Division of Infectious Diseases, University of Ottawa, Ottawa, Canada
| | - Margaret Sampson
- Department of Volunteers, Communication and Information Resources, Children’s Hospital of Eastern Ontario, Ottawa, Canada
| | - Hugh J. McMillan
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
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