Changes in medical student implicit attitudes following a health equity curricular intervention

Leslie, Katie F.; Sawning, Susan; Shaw, Monica; Martin, Leslee J.; Simpson, Ryan; Stephens, J.; Jones, V. Faye

doi:10.1080/0142159x.2017.1403014

Cited by 32 publications

(42 citation statements)

References 43 publications

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“…We did not find an association between social contact and professional exposure to transgender people and knowledge, which may be a result of the retrospective nature of our study and the fact that we did not assess the effects of a specific, educational encounter. In addition to formal curricula to address implicit bias in medical education, many have stressed the importance of addressing informal instruction (or ‘the hidden curriculum’, including institutional culture) in medicine in order to decrease implicit bias . Interventions that address norms, such as increasing medical student diversity, experiences that promote empathy and role modelling, have been suggested specifically in caring for stigmatised populations .…”

Section: Discussionmentioning

confidence: 99%

Transphobia rather than education predicts provider knowledge of transgender health care

et al. 2019

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Purpose Transgender and gender diverse (TGD) patients face significant hurdles in accessing affirming, knowledgeable care. Lack of provider knowledge presents a substantial barrier to both primary and transition‐related care and may deter patients from seeking health care. Little is known about factors that affect provider knowledge or whether exposure to TGD health content during training is associated with improved knowledge among providers. Using the TGD Healthcare Knowledge Scale, this study aimed to determine whether prior education on TGD health predicts clinicians’ current knowledge regarding health care for TGD patients. Methods An online survey examining exposure to TGD content and knowledge of TGD health care was distributed to all primary care providers in an integrated health care system in the Midwestern United States. Multivariable linear regression was used to predict provider knowledge, controlling for demographics, transphobia and other potential confounders. Results The response rate was 57.3% (n = 223). The mean knowledge score was 7.41 (SD = 1.31) on a 10‐point scale. Almost half (48.4%, n = 108) had no formal education on TGD health care, yet half (49.7%, n = 111) of providers reported previously caring for at least one transgender patient. In regression analysis, provider knowledge of TGD health care was associated with transphobia (β = −0.377, 95% CI = −0.559 to −0.194, p < 0.001), but not with hours of formal education (β = −0.027, 95% CI = −0.077 to 0.023, p = 0.292) or informal education (β = −0.012, 95% CI = −0.033 to 0.009, p = 0.259). Conclusions Increasing hours of education related to TGD health care may not be sufficient to improve providers’ competence in care for TGD individuals. Transphobia may be a barrier to learning that needs to be addressed. Broader efforts to address transphobia in society in general, and in medical education in particular, may be required to improve the quality of medical care for TGD patients.

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Section: Discussionmentioning

confidence: 99%

Transphobia rather than education predicts provider knowledge of transgender health care

et al. 2019

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“…Included [31,32]: Describes the innovation and outcomes of the innovation [30,34]; Components of the larger systemslevel work; [33] Formative work N/A [31] N/A [31] Yes [32] Yes [32] N/A [33] N/A [33] No [34] N o [ 34] University of Pennsylvania Perelman Schools of Medicine, Nursing, and Dentistry [2,35,36] Yes [2] N o [ 2] Individual [2] Included No [35] N/A [35] Systems [35] N/A [36] N/A [36] Systems [36] University of Pittsburg School of Medicine [37] No No Individual Included…”

Section: No Individual Includedmentioning

confidence: 99%

Implementation of sexual and gender minority health curricula in health care professional schools: a qualitative study

Pratt-Chapman

2020

BMC Med Educ

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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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“…Consequently, some healthcare programmes have introduced teaching on LGBT+ health. An example of a comprehensive teaching programme is that offered by the University of Louisville School of Medicine, who have introduced a 50.5 hour integrated programme including a patient panel, with encouraging initial outcomes in terms of reduced implicit bias based on sexuality [10]. A recent systematic review of 15 LGBT+ teaching programmes (seven of which were medical schools) found improvements in knowledge, attitudes and/or practice towards LGBT+ people, however they did not evaluate whether these translated into improvements in the care of LGBT+ patients.…”

Section: Introductionmentioning

confidence: 99%

LGBT+ Health Teaching within the Undergraduate Medical Curriculum

Salkind

Gishen

Drage

et al. 2019

IJERPH

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: Introduction: The lesbian, gay, bisexual, and transgender (LGBT+) population experience health and social inequalities, including discrimination within healthcare services. There is a growing international awareness of the importance of providing healthcare professionals and students with dedicated training on LGBT+ health. Methods: We introduced a compulsory teaching programme in a large London-based medical school, including a visit from a transgender patient. Feedback was collected across four years, before (n = 433) and after (n = 541) the session. Student confidence in using appropriate terminology and performing a clinical assessment on LGBT+ people was assessed with five-point Likert scales. Fisher exact tests were used to compare the proportion responding “agree” or “strongly agree”. Results: Of the students, 95% (CI 93–97%) found the teaching useful with 97% (96–99%) finding the visitor’s input helpful. Confidence using appropriate terminology to describe sexual orientation increased from 62% (58–67%) to 93% (91–95%) (Fisher p < 0.001) and gender identity from 41% (36–46%) to 91% (88–93%) (p < 0.001). Confidence in the clinical assessment of a lesbian, gay or bisexual patient increased from 75% (71–79%) to 93% (90–95%) (p < 0.001), and of a transgender patient from 35% (31–40%) to 84% (80–87%) (p < 0.001). Discussion: This teaching programme, written and delivered in collaboration with the LGBT+ community, increases students’ confidence in using appropriate language related to sexual orientation and gender identity, and in the clinical assessment of LGBT+ patients.

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Changes in medical student implicit attitudes following a health equity curricular intervention

Abstract: 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.

Cited by 32 publications

References 43 publications

Transphobia rather than education predicts provider knowledge of transgender health care

Transphobia rather than education predicts provider knowledge of transgender health care

Implementation of sexual and gender minority health curricula in health care professional schools: a qualitative study

LGBT+ Health Teaching within the Undergraduate Medical Curriculum

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