Implementation of Transgender/Gender Nonbinary Care in a Family Medicine Teaching Practice

Ulrich, Irene Park; Harless, Chase; Seamon, Gwen; Kim, Annie; Sullivan, L; Caldwell, J.; Reed, Lisa; Knöll, H

doi:10.3122/jabfm.2022.02.210182

Cited by 8 publications

(4 citation statements)

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“…Stimulation based learning would be particularly helpful in providing exposure to complex situations and increasing confidence in rare situations [ 60 ]. In addition, culturally competent education can be implemented for equity-deserving populations [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Are early career family physicians prepared for practice in Canada? A qualitative study

Aggarwal

Abdelhalim

2023

BMC Med Educ

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Background In Canada, the College of Family Physicians of Canada (CFPC) introduced Competency Based Medical Education to prepare and train family medicine residents to be competent to enter and adapt to the independent practice of comprehensive family medicine. Despite its implementation, the scope of practice is narrowing. This study aims to understand the degree to which early career Family Physicians (FPs) are prepared for independent practice. Method A qualitative design was used for this study. A survey and focus groups were conducted with early-career FPs who completed residency training in Canada. The survey and focus groups examined the degree of preparedness of early career FPs in relation to 37 core professional activities identified by the CFPC’s Residency Training Profile. Descriptive statistics and qualitative content analysis were conducted. Results Seventy-five participants from across Canada participated in the survey, and 59 participated in the focus groups. Early career FPs reported being well prepared to provide continuous and coordinated care for patients with common presentations and deliver various services to different populations. FPs were also well prepared to manage the electronic medical record, participate in team-based care, provide regular and after-hours coverage, and assume leadership and teaching roles. However, FPs reported being less prepared for virtual care, business management, providing culturally safe care, delivering specific services in emergency care hospitals, obstetrics, self-care, engaging with the local communities, and conducting research activities. Conclusions Early career FPs do not feel fully prepared for practice in all 37 core activities in the Residency Training Profile. As part of the introduction of the three-year program by the CFPC, the postgraduate family medicine training should consider providing more exposure to learning opportunities and developing curricula in the areas where FPs are unprepared for practice. These changes could facilitate the production of a FP workforce better prepared to manage the dynamic and complex challenges and dilemmas faced in independent practice.

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Section: Discussionmentioning

confidence: 99%

Are early career family physicians prepared for practice in Canada? A qualitative study

Aggarwal

Abdelhalim

2023

BMC Med Educ

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“…9 To that end, a 2022 study at a family medicine residency used retrospective chart review to assess providers' adherence to GAC guidelines during clinical encounters with TGNB patients. 11 This technique enabled the authors not only to assess GAC as a clinical competency but also to measure the effectiveness of their intervention.…”

Section: Introductionmentioning

confidence: 99%

“…This discrepancy presents a critical opportunity to pilot and assess a multimodal educational intervention for improving provision of GAC among family medicine residents. Building on the work of Urlich et al, 11 we developed a novel pre-and postintervention chart review rubric to directly evaluate our intervention's impact on quality of care and documentation within resident-led GAC encounters.…”

Section: Introductionmentioning

confidence: 99%

Improving Family Medicine Residents’ Provision of Gender-Affirming Care

Smith,

Kaplan

2024

Fam Med

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Background and Objectives: Family physicians are uniquely poised to provide gender-affirming care (GAC) to transgender and nonbinary patients, but current undergraduate and graduate medical education in this field is lacking. Little is known about the impact of various GAC curricula on the clinical care provided by resident physicians. We aimed to assess the efficacy of a multimodal educational framework on the quality of GAC provided by residents at a large academic family medicine program. Methods: This pilot study used chart review to assess the impact of a multifaceted educational intervention around GAC in an academic family medicine practice. Components included faculty-specific didactics, resident feedback and didactics, standardized note templates, and compiled resources. We completed pre- and postintervention analysis of resident-led GAC encounters using a novel rubric based on standards of care and compared these results using descriptive statistics. Results: Following a multimodal educational intervention, residents demonstrated improvement in multiple domains of gender-affirming care, including documenting informed consent, counseling on pregnancy and contraception, and laboratory monitoring for patients initiating gender-affirming hormone therapy. Conclusions: This widespread improvement suggested that a multimodal approach to resident and faculty education may help enhance the quality of GAC provided by family medicine residents. Chart review offers a feasible and effective method for identifying gaps in resident knowledge and documentation in GAC. Further research should specifically explore faculty development in this area and expanded patient-centered quality metrics and outcomes that encompass GAC.

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“…Healthcare request by trans people is increasing but what we would like to highlight in this context is that despite recent progress there are still many barriers for access to genderaffirming care or general healthcare. 3 The unique anatomy of transgender people and taking GAHT may increase the susceptibility of diseases such as venous thromboembolism, cardiovascular diseases and osteoporosis and, in this context, clinicians should learn how to engage with these patients and inclusive systems of care should be provided. 4 Knowledge about the precise effects of GAHT on laboratory test results is limited as with many other aspects of trans health.…”

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confidence: 99%