Beyond Sensitivity. LGBT Healthcare Training in U.S. Medical Schools: A Review of the Literature

Utamsingh, Pooja Dushyant; Kenya, Sonjia; Lebron, Cynthia; Carrasquillo, Olveen

doi:10.1080/15546128.2017.1298070

Cited by 27 publications

(25 citation statements)

References 46 publications

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“…A review of LGBTQ educational interventions found that the average intervention consisted of only one to two lectures and roughly half had a component involving patient interaction. 46 Because these were broad LGBTQ interventions, even less time was likely devoted to transgender topics. Structural setbacks to intervention assessments included that as many as a half were optional (resulting in potential for selection bias), response bias, short-term nature of assessments, and lack of research that evaluates the comparability of scales used in different intervention assessments.…”

Section: Resultsmentioning

confidence: 99%

Transgender health care: improving medical students' and residents' training and awareness

Dubin¹,

Nolan²,

Streed³

et al. 2018

AMEP

251

221

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BackgroundA growing body of research continues to elucidate health inequities experienced by transgender individuals and further underscores the need for medical providers to be appropriately trained to deliver care to this population. Medical education in transgender health can empower physicians to identify and change the systemic barriers to care that cause transgender health inequities as well as improve knowledge about transgender-specific care.MethodsWe conducted structured searches of five databases to identify literature related to medical education and transgender health. Of the 1272 papers reviewed, 119 papers were deemed relevant to predefined criteria, medical education, and transgender health topics. Citation tracking was conducted on the 119 papers using Scopus to identify an additional 12 relevant citations (a total of 131 papers). Searches were completed on October 15, 2017 and updated on December 11, 2017.ResultsTransgender health has yet to gain widespread curricular exposure, but efforts toward incorporating transgender health into both undergraduate and graduate medical educations are nascent. There is no consensus on the exact educational interventions that should be used to address transgender health. Barriers to increased transgender health exposure include limited curricular time, lack of topic-specific competency among faculty, and underwhelming institutional support. All published interventions proved effective in improving attitudes, knowledge, and/or skills necessary to achieve clinical competency with transgender patients.ConclusionTransgender populations experience health inequities in part due to the exclusion of transgender-specific health needs from medical school and residency curricula. Currently, transgender medical education is largely composed of one-time attitude and awareness-based interventions that show significant short-term improvements but suffer methodologically. Consensus in the existing literature supports educational efforts to shift toward pedagogical interventions that are longitudinally integrated and clinical skills based, and we include a series of recommendations to affirm and guide such an undertaking.

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Section: Resultsmentioning

confidence: 99%

Transgender health care: improving medical students' and residents' training and awareness

Dubin¹,

Nolan²,

Streed³

et al. 2018

AMEP

251

221

View full text Add to dashboard Cite

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“…Overall, training regarding the unique needs of LGBT patients is lacking among physicians across all disciplines, despite strong recommendations from medical organizations including the Institute of Medicine (IOM), the American Association of Medical Colleges, the National Institutes of Health, the American Society of Clinical Oncology (ASCO), the Joint Commission, and the Agency for HealthCare Quality . Moreover, LGBT health education is sparse among postgraduate physician training programs . Although cultural competency is required by the Accreditation Council for Graduate Medical Education (ACGME), many medical specialties fall short of the goal, including oncology, general surgery, internal medicine, and preventative medicine .…”

Section: Introductionmentioning

confidence: 99%

“…LGBT health education is sparse among postgraduate physician training programs. 24 Although cultural competency is required by the Accreditation Council for Graduate Medical Education (ACGME), many medical specialties fall short of the goal, including oncology, general surgery, internal medicine, and preventative medicine. [25][26][27] These findings suggest that a large number of residency-trained physicians are graduating with little to no education regarding LGBT health care needs.…”

Section: Introductionmentioning

confidence: 99%

Web‐based LGBT cultural competency training intervention for oncologists: Pilot study results

Seay

Hicks

Markham

et al. 2019

Cancer

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Background Lesbian, gay, bisexual, and transgender (LGBT) cancer patients experience substantial health disparities, including poorer overall health and lower satisfaction with their cancer care than their heterosexual and cisgender counterparts, which may be due in part to a lack of culturally competent providers. To address these disparities, a web‐based LGBT cultural competency training tailored to oncologists was developed by an interdisciplinary team of scientists, LGBT cancer survivors, cultural competency experts, oncologists, a web designer, and an instructional designer. Methods Oncologists (n = 44) were recruited from 3 academic cancer centers in Florida. Participants were administered the LGBT cultural competency training Curriculum for Oncologists on LGBT populations to Optimize Relevance and Skills (COLORS) and completed pre‐ and posttraining measures regarding LGBT‐related knowledge, attitudes (including general negative attitudes and health care–related attitudes), and clinical practices. After the training, participants completed training acceptability measures. Results Of the 44 participants, 33 (75%) completed the COLORS training. Participants were 55% non‐Hispanic white, 63% male, and had a mean age of 47 years. Participants demonstrated significant improvements in LGBT‐related knowledge (t = −4.9, P < .001), attitudes (Z = −3.0, P = .002; t = −2.5, P = .019), and clinical practices (Z = −3.5, P < .001) after completing the COLORS training (Wilcoxon signed rank tests were used for nonnormally distributed variables). Moreover, training acceptability was high, with 82% of participants rating the training as high quality, and 97% being willing to recommend the training to a colleague. Conclusion The COLORS training is both feasible to administer and acceptable for use with oncologists, and may improve oncologists' LGBT‐related knowledge, attitudes, and clinical practices. Larger trials are needed to examine the training's effectiveness in reducing LGBT cancer disparities, as well as its applicability to other types of care providers.

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“…Similarly, with regards to medical education, medical students trained in overly simplistic approaches to diversity may devalue a patient's multiple identities and miss opportunities to improve rapport with their patients [27]. Although cultural competency is encouraged and medical student training is improving, cultural sensitivity is still lacking with regards to LGBTQ patients which may require additional training, such as differences between behaviour and identity, among other aspects of LGBTQ care [42][43]. For example, one study found that LGBTQ health is briefly taught in medical schools (median of 5 hours) and with no standardization in content covered [42].…”

Section: Discussionmentioning

confidence: 99%

“…For example, one study found that LGBTQ health is briefly taught in medical schools (median of 5 hours) and with no standardization in content covered [42]. Another review of LGBTQ healthcare training in U.S. Medical Schools found significant variability in training methods, on many occasions limited to a single lecture [43]. Similar issues of inadequate medical education on LGBTQ health has been echoed in Canada [44].…”

Section: Discussionmentioning

confidence: 99%

In Our Own Words: A Qualitative Exploration of Complex Patient-Provider Interactions in an LGBTQ Population

et al. 2019

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While sexual and gender minorities are at increased risk for poor health outcomes, there is limited data regarding patient-provider interactions. In this study, we explored the perspectives of LGBTQ patients and their encounters with physicians in order to improve our understanding of patient-physician experiences. Using purposive selection of self-identified LGBTQ patients, we performed fourteen in-depth semi-structured interviews on topics of sexual orientation and gender identity, as well as their perceived role in the patient-provider relationship. Coding using a modified grounded theory approach was performed to generate themes. We identified three major themes that demonstrate the complexity of LGBTQ patient experiences. The first, Lacking trust, identifies mistrust and loss of the physician-patient relationship resulting from physicians’ poor or judgmental communication, or from physicians making assumptions about gender, using incorrect pronouns, and not recognizing heterogeneity within the transgender community. A second theme, Being vulnerable, describes the challenges and fears related to comfort of patients with disclosing their sexual orientation and/or gender identity. A final theme, Navigating discrimination, outlines racial or ethnic discrimination which creates an additional burden on top of illness and stigmatized identity. Our results reveal the complex needs of individuals with multiple stigmatized identities when developing relationships with providers. By using an intersectional perspective that appreciates the plurality of patients’ identities, providers can help to improve their relationships with LGBTQ patients. Incorporating intersectional training for medical students and residents could greatly benefit both LGBTQ patients and their physicians.

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Beyond Sensitivity. LGBT Healthcare Training in U.S. Medical Schools: A Review of the Literature

Cited by 27 publications

References 46 publications

Transgender health care: improving medical students' and residents' training and awareness

Transgender health care: improving medical students' and residents' training and awareness

Web‐based LGBT cultural competency training intervention for oncologists: Pilot study results

In Our Own Words: A Qualitative Exploration of Complex Patient-Provider Interactions in an LGBTQ Population

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Beyond Sensitivity. LGBT Healthcare Training in U.S. Medical Schools: A Review of the Literature

Cited by 27 publications

References 46 publications

Transgender health care: improving medical students&#39; and residents&#39; training and awareness

Transgender health care: improving medical students&#39; and residents&#39; training and awareness

Web‐based LGBT cultural competency training intervention for oncologists: Pilot study results

In Our Own Words: A Qualitative Exploration of Complex Patient-Provider Interactions in an LGBTQ Population

Contact Info

Product

Resources

About

Transgender health care: improving medical students' and residents' training and awareness

Transgender health care: improving medical students' and residents' training and awareness