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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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Ravi R, Cheng S, Hutter J, Ibbitson A, Ljubojevich E, Chan Z, Beavers L, Nixon S. A Call to Disrupt Heteronormativity and Cisnormativity in Physical Therapy: Perspectives of 2SLGBTQIPA+ Participants on Future Directions for PT Curricula. Physiother Can 2024; 76:188-196. [PMID: 38725597 PMCID: PMC11078244 DOI: 10.3138/ptc-2022-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/03/2022] [Accepted: 07/18/2022] [Indexed: 05/12/2024]
Abstract
Purpose To explore the perspectives of individuals with self-reported expertise and/or lived experiences regarding aspects of 2SLGBTQIPA+ health that should be included in pre-licensure physical therapy (PT) curricula across Canada, including how, when, and by whom this content should be delivered. Method We conducted a critical qualitative, cross-sectional study with semi-structured virtual interviews. We analyzed participants' perspectives thematically using the DEPICT method. Results Thirteen participants across Canada with a variety of gender identities and sexual orientations were interviewed. Participants described how transformative change on 2SLGBTQIPA+ issues in PT requires an approach that is based on interrupting heteronormativity and cisnormativity in PT curricula. Participants explained how this could be achieved by (1) emphasizing both historical inequities and present-day considerations for safe and inclusive practice, (2) introducing the content early and integrating it throughout the programme using a variety of large- and small-group sessions, and (3) including 2SLGBTQIPA+ individuals in content delivery and creation. Conclusions This study brings attention to the need for the PT profession to understand how the pervasive social structures of heteronormativity and cisnormativity shape education and practice, and offer strategies for disrupting complicity with these systems of inequality.
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Affiliation(s)
- Roshni Ravi
- From the:
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Sharon Cheng
- From the:
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Hutter
- From the:
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Aaron Ibbitson
- From the:
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Eric Ljubojevich
- From the:
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Zachary Chan
- From the:
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Beavers
- From the:
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Stephanie Nixon
- From the:
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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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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Prasad S, O'Malley CB, DeLeon R, Levy AS, Griffin DP. Inclusive LGBTQIA+ healthcare: An interprofessional case-based experience for cultural competency awareness. Front Public Health 2023; 10:993461. [PMID: 36684971 PMCID: PMC9846843 DOI: 10.3389/fpubh.2022.993461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/02/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Lesbian, Gay, Bi-sexual, Transgender, Questioning, Intersex, and Asexual (LGBTQIA+) patients report experiences of discrimination within healthcare settings due to a lack of provider knowledge and biases of healthcare workers. There is an identified need among all health professions to provide more culturally competent healthcare for this community. Early interventions during healthcare profession training programs may be effective to address this need. The overall goal of this study was to assess the educational impact of an active learning session that was specifically designed to enhance LGBTQIA+ cultural competency awareness using an interprofessional setting. Methods This 2-year study involved students from 16 healthcare professional programs joining virtually to form interprofessional teams. A small group case-based learning approach was used and included pre/post-activity surveys to measure the change in student attitude and confidence, as well as the change in perception of the importance of the activity. Results Results indicate an increase in perception of importance (p < 0.005) and in overall level of confidence (p < 0.001) with respect to LGBTQIA+ issues post-session. Key themes established through the session represent an overall recognition of the importance of interprofessional education and awareness of LGBTQIA+ healthcare needs. Discussion The results demonstrate the effectiveness of a case-based approach for enhancing cultural competency awareness across different healthcare professions programs. This session also provided an interprofessional learning environment to allow multiple healthcare professions program students to interact and share perspectives. The positive impact of this intervention in a highly collaborative virtual learning environment also highlights that this immersive active learning approach that can be adopted across different programs and institutions.
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Affiliation(s)
- Samiksha Prasad
- Dr. Kiran C. Patel College of Allopathic Medicine, Department of Medical Education, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Chasity B. O'Malley
- Dr. Kiran C. Patel College of Allopathic Medicine, Department of Medical Education, Nova Southeastern University, Fort Lauderdale, FL, United States
- Boonshoft School of Medicine, Wright State University, Dayton, OH, United States
| | - Rolando DeLeon
- Dr. Kiran C. Patel College of Allopathic Medicine, Department of Medical Education, Nova Southeastern University, Fort Lauderdale, FL, United States
- Division of Obstetrics and Gynecology, HCA Florida Mercy Hospital, Miami, FL, United States
| | - Arkene S. Levy
- Dr. Kiran C. Patel College of Allopathic Medicine, Department of Medical Education, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Daniel P. Griffin
- Dr. Kiran C. Patel College of Allopathic Medicine, Department of Medical Education, Nova Southeastern University, Fort Lauderdale, FL, United States
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Perrin H, Shannon K, Lowik AJ, Rich A, Baral S, Braschel M, Deering K. Access to and quality of care for sexual and gender minority women living with HIV in Metro Vancouver, Canada: Results from a longitudinal cohort study. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231205677. [PMID: 38116643 PMCID: PMC10676058 DOI: 10.1177/17455057231205677] [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: 10/20/2022] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND While scarce, literature suggests that women at the intersection of HIV status and gender and/or sexual minority identities experience heightened social and health disparities within health care systems. OBJECTIVES This study examines the association between sexual and/or gender minority identities and: (1) experiences of poor treatment by health professionals and (2) being unable to access health services among a cohort of women living with HIV in Metro Vancouver, Canada. DESIGN Data were drawn from a longitudinal community-based cohort of women living with HIV (Sexual Health and HIV/AIDS Women's Longitudinal Needs Assessment). METHODS We examined associations between sexual and/or gender minority identities and the two outcomes. We drew on explanatory variables to measure sexual minority and gender minority identities independently and a combined variable measuring sexual and/or gender minority identities. The associations between each of these three variables and each outcome were analysed using bivariate and multivariable logistic regression models with generalized estimating equations for repeated measures over time. Adjusted odds ratios and 95% confidence intervals are reported. RESULTS The study sample included 1460 observations on 315 participants over 4.5 years (September 2014 to February 2019). Overall, 125 (39.7%) reported poor treatment by health professionals and 102 (32.4%) reported being unable to access health care services when needed at least once over the study period. A total of 110 (34.9%) of participants reported sexual and/or gender minority identities, 106 (33.7%) reporting sexual minority identities, with 29 (9.2%) reporting gender minority identities. In multivariable analysis, adjusting for confounders, sexual minority identities, and combined sexual and/or gender minority identities were significantly associated with increased odds of experiencing poor treatment by health professionals (sexual minority adjusted odds ratio = 1.39 (0.94-2.05); sexual and/or gender minority adjusted odds ratio = 1.48 (1.00-2.18)) and being unable to access health services (sexual minority adjusted odds ratio = 1.89 (1.20-2.97); sexual and/or gender minority adjusted odds ratio = 1.91 (1.23-2.98)). In multivariable analysis, gender minority identities were not significantly associated with increased odds of experiencing poor treatment by health professionals (gender minority adjusted odds ratio = 1.38; 95% CI = 0.76-2.52) and being unable to access health services (gender minority adjusted odds ratio = 1.72; 95% CI = 0.89-3.31) possibly due to low sample size among women with gender minority identities. CONCLUSION Our findings suggest the need for access to inclusive, affirming, trauma-informed health care services tailored specifically for and by women living with HIV with sexual and/or gender minority identities.
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Affiliation(s)
- H Perrin
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - K Shannon
- Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada
- Division of Social Medicine, Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - AJ Lowik
- Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada
| | - A Rich
- Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada
- Department of Social Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M Braschel
- Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada
- Division of Social Medicine, Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - K Deering
- Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada
- Division of Social Medicine, Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
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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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Primeau CA, Vader K, Philpott HT, Xiong Y. A Need for Greater Emphasis on 2SLGBTQIA+ Health Among Physiotherapists in Canada. Physiother Can 2022; 74:117-120. [PMID: 37323717 PMCID: PMC10262744 DOI: 10.3138/ptc-2021-0107-gee] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 07/21/2023]
Affiliation(s)
- Codie A. Primeau
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Bone and Joint Institute, Western University, London, Ontario, Canada
| | - Kyle Vader
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Holly T. Philpott
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Bone and Joint Institute, Western University, London, Ontario, Canada
| | - Yijun Xiong
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
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Primeau CA, Vader K, Philpott HT, Xiong Y. La nécessité d’insister davantage sur la santé LGBTQI2SA+ chez les physiothérapeutes au Canada. Physiother Can 2022. [DOI: 10.3138/ptc-2021-0107-gef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Codie A. Primeau
- École de physiothérapie, faculté des sciences de la santé, Université Western, London, Ontario, Canada
- École des sciences de la santé et de la réadaptation, faculté des sciences de la santé, Université Western, London, Ontario, Canada
- Bone and Joint Institute, Université Western, London, Ontario, Canada
| | - Kyle Vader
- École de réadaptation, Université Queen’s, Kingston, Ontario, Canada
| | - Holly T. Philpott
- École des sciences de la santé et de la réadaptation, faculté des sciences de la santé, Université Western, London, Ontario, Canada
- Bone and Joint Institute, Université Western, London, Ontario, Canada
| | - Yijun Xiong
- École de physiothérapie, faculté des sciences de la santé, Université Western, London, Ontario, Canada
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Cooper RL, Ramesh A, Radix AE, Reuben JS, Juarez PD, Holder CL, Belton AS, Brown KY, Mena LA, Matthews-Juarez P. Affirming and Inclusive Care Training for Medical Students and Residents to Reducing Health Disparities Experienced by Sexual and Gender Minorities: A Systematic Review. Transgend Health 2022. [PMID: 37525832 PMCID: PMC10387161 DOI: 10.1089/trgh.2021.0148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose Providing inclusive and comprehensive gender-affirming care is critical to reducing health disparities (gaps in care) experienced by sexual and gender minorities (SGM). Currently, little is known about how medical students and residents are being trained to address the health needs of SGM persons or of the most effective methods. Methods We conducted a systematic review of the research literature from 2000 to 2020 on the effectiveness of teaching medical students and residents on knowledge, attitudes, and skills in addressing the health of SGM persons and the strength of the research sample, design, and methods used. Results We identified a total of 36 articles that assessed the impact of medical student and resident education on knowledge, comfort, attitudes, confidence, and skills in working with SGM patients. All studies utilized quasi-experimental designs, and found efficacious results. No study examined the impact of training on patient outcomes. Conclusion Future studies will need to be powered and designed to assess the impact of training on patient outcomes.
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Affiliation(s)
- Robert Lyle Cooper
- Department of Family and Community Medicine, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, Tennessee, USA
| | - Aramandla Ramesh
- Department of Biochemistry, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, Tennessee, USA
- National Center for Medical Education Development and Research, Meharry Medical College, Nashville, Tennessee, USA
| | - Asa E. Radix
- Callen-Lorde Community Health Center in New York, New York, New York, USA
| | - Jayne S. Reuben
- Department of Biomedical Sciences, Texas Agricultural and Mechanical University College of Dentistry, Dallas, Texas, USA
| | - Paul D. Juarez
- Department of Family and Community Medicine, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, Tennessee, USA
- National Center for Medical Education Development and Research, Meharry Medical College, Nashville, Tennessee, USA
| | - Cheryl L. Holder
- Department of Family Medicine at Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Allyson S. Belton
- Satcher Health Leadership Institute at Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Katherine Y. Brown
- Department of Family and Community Medicine, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, Tennessee, USA
- National Center for Medical Education Development and Research, Meharry Medical College, Nashville, Tennessee, USA
| | - Leandro A. Mena
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Patricia Matthews-Juarez
- Department of Family and Community Medicine, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, Tennessee, USA
- National Center for Medical Education Development and Research, Meharry Medical College, Nashville, Tennessee, USA
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O'Leary KB, Kunkel GH. Restructuring LGBTQ Curriculum in Medical Schools. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:487-490. [PMID: 33608846 DOI: 10.1007/s40596-021-01414-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Kerry B O'Leary
- University of Texas Medical Branch, Galveston, TX, USA. Kerry.o'
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11
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Minturn MS, Martinez EI, Le T, Nokoff N, Fitch L, Little CE, Lee RS. Early Intervention for LGBTQ Health: A 10-Hour Curriculum for Preclinical Health Professions Students. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2021; 17:11072. [PMID: 33473382 PMCID: PMC7809930 DOI: 10.15766/mep_2374-8265.11072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
INTRODUCTION Individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) face significant health disparities and barriers to accessing care. Patients have reported provider lack of knowledge as one of the key barriers to culturally responsive, clinically competent care. Many US and Canadian medical schools still offer few curricular hours dedicated to LGBTQ-related topics, and medical students continue to feel unprepared to care for LGBTQ patients. METHODS We developed a 10-hour LGBTQ health curriculum for preclinical medical and physician assistant students. The curriculum included lectures and case-based small-group discussions covering LGBTQ terminology, inclusive sexual history taking, primary care and health maintenance, and transition-related care. It also included a panel discussion with LGBTQ community members and a small-group practice session with standardized patients. Students were surveyed before and after completing the curriculum to assess for increases in confidence and knowledge related to LGBTQ-specific care. RESULTS Forty first- and second-year medical students completed the sessions and provided valid responses on pre- and postcourse surveys. Nearly all students initially felt unprepared to sensitively elicit information, summarize special health needs and primary care recommendations, and identify community resources for LGBTQ individuals. There was significant improvement in students' confidence in meeting these objectives after completion of the five sessions. Knowledge of LGBTQ health issues increased minimally, but there was a significant increase in knowledge of LGBTQ-related terminology. DISCUSSION Our 10-hour LGBTQ health curriculum was effective at improving medical students' self-confidence in working with LGBTQ patients but was less effective at increasing LGBTQ-related medical knowledge.
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Affiliation(s)
- Matthew S. Minturn
- Resident, Department of Medicine, University of Colorado School of Medicine
- Corresponding author:
| | - Erica I. Martinez
- Resident, Department of Obstetrics and Gynecology, Stanford University School of Medicine
| | - Thien Le
- Resident, Department of Anesthesiology, Emory University School of Medicine
| | - Natalie Nokoff
- Assistant Professor, Department of Pediatrics, University of Colorado School of Medicine; Assistant Professor, Section of Pediatric Endocrinology, Children's Hospital Colorado
| | - Louis Fitch
- Second-Year Medical Student, University of Colorado School of Medicine
| | - Carley E. Little
- Fourth-Year Medical Student, University of Colorado School of Medicine
| | - Rita S. Lee
- Associate Professor, Department of Medicine, University of Colorado School of Medicine
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12
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Nguyen TV. Update on Medical Education, Insurance Coverage, and Health Care Policy for Lesbian, Gay, Bisexual, Transgender, Questioning, Intersexual, and Asexual Patients. Dermatol Clin 2020; 38:201-207. [PMID: 32115129 DOI: 10.1016/j.det.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There are important gaps in LGBTQIA knowledge, clinical competency, and cultural sensitivity, as well as attitudes among health care professionals, medical educators, and those in the public and insurance policy sectors. These are not only professional deficiencies but also perpetuate discrimination, limit access to health care, and lead to poor health outcomes. Research supports the notion that acquiring skills and knowledge through dedicated training programs leads to more compassionate and competent care for LGBTQIA patients.
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Affiliation(s)
- Tien Viet Nguyen
- Bellevue Dermatology Clinic, 1810 116th Avenue Northeast #100, Bellevue, WA 98004, USA.
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13
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Deliz JR, Fears FF, Jones KE, Tobat J, Char D, Ross WR. Cultural Competency Interventions During Medical School: a Scoping Review and Narrative Synthesis. J Gen Intern Med 2020; 35:568-577. [PMID: 31705475 PMCID: PMC7018865 DOI: 10.1007/s11606-019-05417-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/15/2019] [Accepted: 09/16/2019] [Indexed: 02/04/2023]
Abstract
Many medical accreditation bodies agree that medical students should be trained to care for diverse patient populations. However, the teaching methods that medical schools employ to accomplish this goal vary widely. The purpose of this work is to summarize current cultural competency teaching for medical students and their evaluation methods. A scoping review was completed by searching the databases PubMed, Scopus, MedEdPORTAL, and MEDLINE for the search terms "medical education" and "cultural competency" or "cultural competence." Results were summarized using a narrative synthesis technique. One hundred fifty-four articles on cultural competency interventions for medical students were systematically identified from the literature and categorized by teaching methods, length of intervention, and content. Fifty-six articles had a general focus, and ninety-eight articles were focused on specific populations including race/ethnicity, global health, socioeconomic status, language, immigration status, disability, spirituality at the end of life, rurality, and lesbian, gay, bisexual, transgender, and queer. About 54% of interventions used lectures as a teaching modality, 45% of the interventions described were mandatory, and 9.7% of interventions were not formally evaluated. The authors advocate for expansion and more rigorous analysis of teaching methods, teaching philosophies, and outcome evaluations with randomized controlled trials that compare the relative effectiveness of general and population-specific cultural competency interventions.
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Affiliation(s)
- Juan R Deliz
- Washington University School of Medicine, 660 S Euclid Ave, CB 8126, St. Louis, MO, 63110, USA.
| | - Fayola F Fears
- Washington University School of Medicine, 660 S Euclid Ave, CB 8126, St. Louis, MO, 63110, USA
| | - Kai E Jones
- Washington University School of Medicine, 660 S Euclid Ave, CB 8126, St. Louis, MO, 63110, USA
| | - Jenny Tobat
- Washington University School of Medicine, 660 S Euclid Ave, CB 8126, St. Louis, MO, 63110, USA
| | - Douglas Char
- Department of Emergency Medicine, Washington University School of Medicine, Campus Box 8072, 660 South Euclid Ave, St. Louis, MO, USA
| | - Will R Ross
- Division of Nephrology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
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14
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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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15
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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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16
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Christensen JA, Hunt T, Elsesser SA, Jerpbak C. Medical Student Perspectives on LGBTQ Health. PRIMER : PEER-REVIEW REPORTS IN MEDICAL EDUCATION RESEARCH 2019; 3:27. [PMID: 32537598 DOI: 10.22454/primer.2019.288724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction Lesbian, gay, bisexual, transgender, and queer (LGBTQ) community members experience adverse health outcomes at higher rates than non-LGBTQ individuals. We examined the impact of student demographics as well as gender and sexuality didactic instruction on the attitudes of first-year medical students toward LGBTQ patients. Methods In January 2017, 255 first-year students at an urban allopathic medical school participated in a gender and sexuality health curriculum. We assessed student attitudes regarding LGBTQ patients using anonymous pre- and postintervention surveys. Each item was measured on a 5-point Likert scale. Results Of 255 possible respondents, we received 244 responses to the preintervention survey (95.7% response rate) and 253 to the postintervention survey (99.2% response rate). Participants were predominantly white (66.8%), heterosexual (94.7%), and cisgender (100%). Respondents who identified as LGBQ were significantly (P<.05) more likely than heterosexual students to agree with the following preintervention statements, among others: (1) Discordance between birth sex and gender is a natural human phenomenon, (2) When meeting a patient for the first time, I feel comfortable asking what pronoun they use, (3) I am able to empathize with the life experience of an LGB/T patient, (4) I am motivated to seek out opportunities to learn more about LGBTQ-specific health care issues. Statistically significant changes in attitudes between time points are seen in 4 out of 15 items. Conclusion A focused gender and sexuality curriculum appears to impact medical student attitudes regarding LGBTQ patients. Furthermore, recruitment of LGBTQ-identifying medical students may translate into improved workforce motivation to provide health care for LGBTQ patients.
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Affiliation(s)
- Julie A Christensen
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, Rochester, MN
| | - Travis Hunt
- Department of Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Steven A Elsesser
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA
| | - Christine Jerpbak
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA
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Gavzy SJ, Berenson MG, Decker J, Domogauer J, Alexander A, Pulaski M, Soto-Greene M, Sánchez N, Sánchez JP. The Case of Ty Jackson: An Interactive Module on LGBT Health Employing Introspective Techniques and Video-Based Case Discussion. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2019; 15:10828. [PMID: 31259237 PMCID: PMC6571794 DOI: 10.15766/mep_2374-8265.10828] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 04/29/2019] [Indexed: 05/13/2023]
Abstract
Introduction The Institute of Medicine's 2011 report on lesbian, gay, bisexual, and transgender (LGBT) health and the legalization of same-sex marriage are just two of the numerous milestones that have hastened medical schools' efforts to prepare trainees to address the needs of LGBT community members. Early awareness of sexual diversity through self- and peer introspection and video-based education can help trainees build a foundation towards providing affirming care to LGBT patients. Methods The Kern model was used to develop, implement, and evaluate an interactive multimodal workshop to provide first-year medical students with a formative introduction to LGBT health. Learning objectives focused on comprehending the spectrum of human sexuality, health issues for LGBT patients, and better practices for promoting affirming care. The module consisted of a PowerPoint presentation, sexuality survey, videos of provider-patient encounters, and community-based resources. Results The workshop was implemented among 178 first-year medical students in September 2018, with 93% completing the pre-/postworkshop evaluations. Comparison of evaluations showed an increase in confidence in addressing each of the three learning objectives. Over 85% rated the PowerPoint and videos as very good or excellent. Discussion This workshop was effective in helping first-year medical students appreciate the spectrum of sexual diversity, health issues facing LGBT individuals, and better practices to promote affirming care. The real-time sexuality survey helped trainees appreciate sexual diversity through self-reflection and near-peer sharing. The videos and accompanying discussion provided real-life encounters, along with common pitfalls in and pearls for communicating with LGBT patients.
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Affiliation(s)
- Samuel J. Gavzy
- Fourth-Year Medical Student, Rutgers New Jersey Medical School
| | | | - Jilyan Decker
- Resident, Obstetrics and Gynecology Department, Rutgers New Jersey Medical School
| | - Jason Domogauer
- Resident, Medicine Department, Rutgers New Jersey Medical School
| | - Andreia Alexander
- Assistant Professor of Emergency Medicine, Indiana University School of Medicine
| | - Matthew Pulaski
- Fourth-Year Medical Student, Rutgers New Jersey Medical School
| | | | - Nelson Sánchez
- Associate Professor of Medicine, Weill-Cornell Medical College
| | - John Paul Sánchez
- Associate Dean, Diversity and Inclusion, Rutgers New Jersey Medical School
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18
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Stumbar SE, Garba NA, Holder C. Let's Talk About Sex: The Social Determinants of Sexual and Reproductive Health for Second-Year Medical Students. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2018; 14:10772. [PMID: 30800972 PMCID: PMC6346481 DOI: 10.15766/mep_2374-8265.10772] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 10/04/2018] [Indexed: 06/09/2023]
Abstract
Introduction Sexual health is influenced by a myriad of social factors including health care access, social and cultural norms, insurance status, educational level and health literacy, economic status, sex, gender identity, and sexual orientation and behavior. It is pivotal to educate future physicians about these social determinants so that they can work to mitigate the resulting disparities and thereby improve the health of patients and their communities. Methods This 2-hour, large-group session for second-year medical students was first given in the fall of 2017. It included a 1-hour, case-based lecture followed by a patient panel. Panelists discussed their interactions with the medical system and how these related to their sex and gender identity. Ninety students (77.5% response rate) completed both pre- and postsurveys and an overall assessment of the session. Results Students reported high levels of satisfaction with the session. Eighty-seven percent felt they would benefit from more classes including a patient panel, and 93% reported specifically that the panel helped them to identify their own biases related to sexual orientation and gender. In the postsurvey, there was a significant (p < .05) increase in the number of students reporting increased comfort regarding various aspects of sexual history taking and interacting with patients of different sexual orientations and gender identities. Discussion This instructional format provided an effective way to teach medical students about the social determinants of sexual and reproductive health. Students both appreciated the session format and reported increased comfort and confidence related to the subject matter.
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Affiliation(s)
- Sarah E. Stumbar
- Assistant Professor, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine
| | - Nana Aisha Garba
- Assistant Professor, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine
| | - Cheryl Holder
- Associate Professor, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine
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19
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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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Leslie KF, Sawning S, Shaw MA, Martin LJ, Simpson RC, Stephens JE, Jones VF. Changes in medical student implicit attitudes following a health equity curricular intervention. MEDICAL TEACHER 2018; 40:372-378. [PMID: 29171321 DOI: 10.1080/0142159x.2017.1403014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE This study assessed the: (1) effect of an LGBTQI + health equity curriculum (eQuality) on implicit attitudes among first (M1) and second year (M2) medical students and (2) utility of dedicated time to explore implicit bias. METHOD Implicit biases were assessed at baseline using implicit association tests (IAT) for all M2s and a random sample of first years (M1A). These students were then debriefed on strategies to mitigate bias. Following eQuality, all M1 and M2s completed post-intervention IATs. The remaining first years (M1B) were then debriefed. Paired sample t-tests assessed differences between pre/post. Independent sample t-tests assessed differences in post-IATs between M1 groups. RESULTS IATs indicated preferences for "Straight," "White," and "Thin" at both pre and post. M2s demonstrated statistically significant improvements pre to post for sexuality (p = 0.01) and race (p = 0.03). There were significant differences in post-intervention IAT scores between M1As who received the IAT and debriefing prior to eQuality and M1Bs for sexuality (p = 0.002) and race (p = 0.046). There were no significant changes for weight. CONCLUSION eQuality reduced implicit preference for "Straight" and "White." Differences in M1 post-intervention IAT scores between groups suggest dedicating time to debrief implicit attitudes enhances bias mitigation.
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Affiliation(s)
- Katie F Leslie
- a Health Sciences Center Office of Diversity and Inclusion , University of Louisville , Louisville , KY , USA
| | - Susan Sawning
- a Health Sciences Center Office of Diversity and Inclusion , University of Louisville , Louisville , KY , USA
| | - M Ann Shaw
- a Health Sciences Center Office of Diversity and Inclusion , University of Louisville , Louisville , KY , USA
| | - Leslee J Martin
- a Health Sciences Center Office of Diversity and Inclusion , University of Louisville , Louisville , KY , USA
| | - Ryan C Simpson
- a Health Sciences Center Office of Diversity and Inclusion , University of Louisville , Louisville , KY , USA
| | - Jennifer E Stephens
- a Health Sciences Center Office of Diversity and Inclusion , University of Louisville , Louisville , KY , USA
| | - V Faye Jones
- a Health Sciences Center Office of Diversity and Inclusion , University of Louisville , Louisville , KY , USA
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21
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Fitzgerald SN, Leslie KF, Simpson R, Jones VF, Barnes ET. Culturally Effective Care for Refugee Populations: Interprofessional, Interactive Case Studies. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2018; 14:10668. [PMID: 30800868 PMCID: PMC6342357 DOI: 10.15766/mep_2374-8265.10668] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 12/24/2017] [Indexed: 05/14/2023]
Abstract
Introduction Within health sciences education literature, the majority of reported student experiences with refugee populations are limited to traditional, professionally independent, elective courses and extracurricular volunteer opportunities. A simulated patient exercise is a learning opportunity that helps participants engage with material in real time in a realistic environment, demanding higher levels of learning. This session utilized a simulated patient facilitator in interprofessional small groups to explore common health needs and barriers to care among refugee populations. Methods Health professions students from nine degree programs participated in a refugee health session in interprofessional teams of nine to 10 students to explore patient cases. The session concluded with a debriefing discussing the outcomes of the student-patient interaction, best practices, and exemplary practice models as takeaways. The simulated patient facilitators completed an Observation Checklist to assess students' grasp of learning objectives. Results Five hundred twenty-four students participated in the refugee session, divided into 61 groups. Observation Checklists were completed for 58 groups (95%). Assessment of student engagement focused on general health needs common to refugee populations: barriers to health care, team and individual roles, bias, consequences of nontreatment, and social determinants of health. Most of the groups (95%) reported engagement between the simulated patient facilitator and the group of student providers. Qualitative data indicated student groups were knowledgeable in each of the overarching learning objectives. Discussion This session allowed health sciences students to focus on culturally effective patient care for refugee populations as a part of an interprofessional team.
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Affiliation(s)
- Shannon N. Fitzgerald
- Coordinator, Department of Dental Clinical Affairs, University of Louisville School of Dentistry
| | - Katie F. Leslie
- Program Manager, Office of Diversity and Inclusion, University of Louisville Health Sciences Center
| | - Ryan Simpson
- Assistant Director, Office of Diversity and Inclusion, University of Louisville Health Sciences Center
| | - V. Faye Jones
- Associate Vice President, Health Affairs/Diversity Initiatives, University of Louisville Health Sciences Center
- Professor, Department of Pediatrics, University of Louisville School of Medicine
| | - Elizabeth Tatum Barnes
- Research Associate for the Refugee Health Initiative, Department of Medicine, Division of Infectious Disease, University of Louisville School of Medicine
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