TY - JOUR
T1 - Steps to Improving Sexual and Gender Diversity Curricula in Undergraduate Medical Education
AU - Lindberg, Briana M.
AU - Fulleborn, Stephanie T.
AU - Semelrath, Kevin M.
AU - Lee, Rachael C.
AU - Nguyen, Dana R.
N1 - Funding Information:
Knowledge and education have the potential to modify potential bias, fear, or uninformed medical care that may impede the quality of care of LGBT patients. Resource pools are growing to assist undergraduate medical institutions, graduate medical programs, hospital systems, and individual providers in providing competent LGBT care. The AAMC provides an excellent guideline for curriculum topics in undergraduate medical education. Additionally, the AAMC, with funding from the Josiah Macy Jr. Foundation, has launched a “Sexual Orientation, Gender Identity, and Sex Development Project” to collate educational materials on LGBT care and serve as a repository for national training. Many of these resources can be accessed on the AAMC’s website and could be used for training any level of medical provider. The Department of Defense has also recognized the importance of the topic of LGBT care as evidenced by DoD directives. At least one group initiated a “LGBT Healthcare Awareness Campaign” in 2015 with future goals to launch informational outreach to all DoD providers.18 However, recent administration transgender policies and the U.S. Department of Health and Human Services announcement affording religious protection to care providers may oppositely create new additional barriers to effective care for the LGBT patient population.
Publisher Copyright:
© 2018 Association of Military Surgeons of the United States. All rights reserved.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Introduction: Changes in DoD policy now allow further discussion of well-documented health care needs and disparities of lesbian, gay, bisexual, and transgender (LGBT) patients among military medical students. Previous studies of military health care providers indicate knowledge and comfort gaps in LGBT care exist. We performed a focused needs assessment of sexual and gender diversity education in the undergraduate medical curriculum. Methods: Twenty-four Uniformed Service University (USU) School of Medicine (SoM) faculty involved in curriculum leadership, development or oversight voluntarily responded to a six-item, electronic mail questionnaire and semistructured interview by a randomly assigned investigator to assess the faculty perception of how well USU teaches LGBT medical care concepts within its curriculum. Results were stratified according to time at USU, faculty role and discipline. Analysis of variance and Cronbach's alpha were used to evaluate survey data while qualitative thematic coding was performed for qualitative interview analysis. Results: Seven hours of the USU SoM published curriculum contain limited LGBT-related content. About 66% of curriculum leaders participated in a survey and interview regarding LGBT curriculum at USU. On average, faculty rated curricular content regarding terminology, history-taking skills, preventive medicine, transgender health, use of evidence-based medicine, and prevention of discrimination in the care of LGBT patients as "poor" to "adequate." Qualitative analysis of faculty interviews revealed common themes of suspected barriers to curricular change, protective factors encouraging curricular development and change, implementation strategies and available resources, vulnerabilities to change, and overall next steps. Conclusions: Published sexual and gender diversity curriculum in the USU SoM is at or below that of the national average. The investigators and participating faculty involved in curricular development independently identified curriculum gaps related to this topic. Several barriers, protective factors, ideas for implementation, and next steps were identified.
AB - Introduction: Changes in DoD policy now allow further discussion of well-documented health care needs and disparities of lesbian, gay, bisexual, and transgender (LGBT) patients among military medical students. Previous studies of military health care providers indicate knowledge and comfort gaps in LGBT care exist. We performed a focused needs assessment of sexual and gender diversity education in the undergraduate medical curriculum. Methods: Twenty-four Uniformed Service University (USU) School of Medicine (SoM) faculty involved in curriculum leadership, development or oversight voluntarily responded to a six-item, electronic mail questionnaire and semistructured interview by a randomly assigned investigator to assess the faculty perception of how well USU teaches LGBT medical care concepts within its curriculum. Results were stratified according to time at USU, faculty role and discipline. Analysis of variance and Cronbach's alpha were used to evaluate survey data while qualitative thematic coding was performed for qualitative interview analysis. Results: Seven hours of the USU SoM published curriculum contain limited LGBT-related content. About 66% of curriculum leaders participated in a survey and interview regarding LGBT curriculum at USU. On average, faculty rated curricular content regarding terminology, history-taking skills, preventive medicine, transgender health, use of evidence-based medicine, and prevention of discrimination in the care of LGBT patients as "poor" to "adequate." Qualitative analysis of faculty interviews revealed common themes of suspected barriers to curricular change, protective factors encouraging curricular development and change, implementation strategies and available resources, vulnerabilities to change, and overall next steps. Conclusions: Published sexual and gender diversity curriculum in the USU SoM is at or below that of the national average. The investigators and participating faculty involved in curricular development independently identified curriculum gaps related to this topic. Several barriers, protective factors, ideas for implementation, and next steps were identified.
KW - LGBT
KW - curriculum
KW - gender diversity
KW - sexual diversity
KW - undergraduate medical education
UR - http://www.scopus.com/inward/record.url?scp=85060581130&partnerID=8YFLogxK
U2 - 10.1093/milmed/usy190
DO - 10.1093/milmed/usy190
M3 - Article
C2 - 30137522
AN - SCOPUS:85060581130
SN - 0026-4075
VL - 184
SP - E190-E194
JO - Military Medicine
JF - Military Medicine
IS - 1-2
ER -