MON-015 A Novel Internet-Based Program to Assess Educational Needs and Improve Care Delivery to Transgender People at the Resident Level

Abstract

BACKGROUND: One of the most significant barriers in providing care for transgender (TG) people is the lack of access to medical providers with knowledge and experience in TG health care. This care gap continues as transgender health remains the least-represented LGBT health topic in medical school education. To close this deficit, we developed an innovative IT-based education program to assess and improve residents’ knowledge, confidence and comfort with transgender health principles throughout their clinical training. METHODS: Our project targeted residents within our affiliated internal and family medicine programs and consisted of two phases. A pre-education phase, to determine current/perceived knowledge and comfort/attitudes towards caring for transgender patients using validated surveys, was enacted through our education platform using Google Forms. After assessing the gaps in comfort and knowledge, our student team developed an education program comprising the interventional phase in 2018. The program consists of three one-hour online modules and two one-hour live sessions featuring a lecture and interactions with transgender patients, covering topics such as: transgender health 101, medical therapies, and appropriate behavioral/medical evaluations. The residents will then complete the same assessment as a post-test both one month after program completion as well as at the end of each remaining year of residency to track longitudinal improvements in knowledge and comfort. RESULTS: On average, resident participants achieved a pre-test 74.4% accuracy in items assessing ‘knowledge,’ but only revealed self-assessed knowledgeability 40.0% of the time in items assessing ‘knowledge perception.’ Residents self-reported comfort counseling and treating transgender patients 81.9% of the time in response to items assessing ‘comfort with transgender care.’ Using chi-squared analysis, actual knowledge and comfort were similar (p = .064), but self-perceived knowledgeability significantly trailed behind both knowledge (-34.38%, p < .0001) and comfort (41.89%, p < .00001). CONCLUSION: Our initial results indicate that our novel approach was both feasible and aligned with residents’ self-education preferences. They demonstrate that a promising proportion of residents did imply comfort with transgender care, though perhaps culturally more generalizable to Southern California than residents nationwide. However, when comparing knowledge perception to actual knowledge and comfort, a discrepancy reveals that while these residents are generally comfortable and willing to treat transgender patients, they lack the knowledge base and confidence to do so. This finding clearly supports the need for the second-phase educational program and increases our optimism in its effectiveness in providing residents the tools to become thoughtful and effective providers.