Steps to Improving Sexual and Gender Diversity Curricula in Undergraduate Medical Education

Briana M. Lindberg, Stephanie T. Fulleborn, Kevin M. Semelrath, Rachael C. Lee, Dana R. Nguyen

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


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.

Original languageEnglish
Pages (from-to)E190-E194
JournalMilitary Medicine
Issue number1-2
StatePublished - 1 Jan 2019


  • LGBT
  • curriculum
  • gender diversity
  • sexual diversity
  • undergraduate medical education


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