Abstract
Background The lesbian, gay, bisexual, and transgender (LGBT) community is a diverse, underserved, and often stigmatized group that faces many barriers to accessing quality healthcare. Not only are few practicing physicians knowledgeable about and sensitive to the needs of LGBT patients, but medical school curricula include limited LGBT-related content. Our goals were to use LGBT-related educational sessions to gauge undergraduate medical students' interest and their perceptions of relevance and to eventually incorporate this topic into the curriculum.
Methods We provided 4 educational sessions to preclinical medical students at the Tulane University School of Medicine: 3 optional, 1-hour didactic sessions and 1 standardized patient encounter. Following sessions 1-3, students completed electronic feedback forms; we then analyzed their responses thematically.
Results The thematic analysis of student responses identified key themes: a current lack of exposure to LGBT content, agreement that LGBT material is applicable to students' work as future physicians, and the relevance of including such information in the medical school curriculum.
Conclusion The study validated the underlying assumption that LGBT educational sessions are meaningful to and valued by medical students.
INTRODUCTION
The lesbian, gay, bisexual, and transgender (LGBT) community is a diverse, underserved, and often stigmatized group that faces various barriers to accessing quality healthcare. The Institute of Medicine recognizes that few practicing physicians are knowledgeable about and sensitive to the needs of LGBT patients.1 A recent survey of medical school deans found that medical school curricula devote a median of 5 hours covering LGBT-related content across the 4-year curriculum.2 The same group indicated that improving access to curricular material would be the best way to increase the amount of content presented on this subject. Our objective was to present 4 LGBT educational sessions to medical students to gauge their interest and their perceptions of the content's relevance. Our intent was to eventually incorporate this topic into the curriculum.
METHODS
We held 4 educational sessions for preclinical medical students at the Tulane University School of Medicine in New Orleans, LA. The first 3 were optional, 1-hour didactic sessions. The last was a standardized patient encounter used by all students that involved taking a sexual history of a lesbian patient. We identified gaps in the current curriculum and tailored the sessions to address them. Table 1 presents the details regarding each session. Following sessions 1-3, students completed an electronic feedback form, and we analyzed their responses thematically. We did not ask the students to complete an evaluation mechanism following session 4.
Session Details
RESULTS
Thirty-five students filled out the survey after session 1, 39 students after session 2, and 30 students after session 3. Table 2 shows sample responses that indicate ways in which students felt they could provide sensitive care for transgender patients.
Sample Student Responses From Session 1
Following session 2, 82% of respondents could clearly articulate how to inquire appropriately about the gender of a patient's sexual partners. Appropriate responses were those that gave the patient an opportunity to disclose his or her LGBT status. Table 3 presents an example of an appropriate and an inappropriate response.
Sample Student Responses From Session 2
The thematic analysis of student responses identified several key themes: (1) acknowledgement of a current lack of exposure to LGBT content, (2) agreement that this information is applicable to students' work as future physicians, and (3) understanding that the material is relevant enough to be incorporated in the required medical school curriculum (Table 4).
Session 3 Postsession Feedback
DISCUSSION
Because all future physicians will treat LGBT patients, we believe that institutions should work to include more LGBT-related health content. Educational sessions such as ours provide the groundwork for attaining effective knowledge and skills needed to create robust LGBT curricula. Such programs have universal appeal because they incorporate training in interpersonal and communication skills, medical knowledge, patient care, and cultural competency, all of which are critical to student and physician professional development.
This pilot study has several limitations. The first 3 sessions were optional, so the feedback may have had a bias toward those interested in the subject matter. We did not obtain feedback from every participant and are unsure of the exact number of participants at each session. Also, we did not use an evaluation tool for the standardized patient encounter because we were unsure about how best to evaluate the sessions. Students participated in a debriefing session in groups of 4 following their standardized patient session to reflect on their interview.
For the 2012-2013 school year, we will use Likert scale readiness assessments to determine how sessions 1-3 impact student knowledge, skills, and attitudes. We plan to move forward in trying to incorporate session 3 into the required Endocrine Pharmacology unit of the second-year curriculum. Eventually we hope to incorporate all sessions; session 3 is the only one we are trying to include in the 2012-2013 school year. We also would like to add a transgender patient to the standardized patient encounter as a way for students to practice interviewing skills and conduct a history with a patient who is transgender and use an effective evaluation method for this session. Lastly, we would like for this project to evolve into a transportable educational tool that could be used at other institutions.
CONCLUSION
Despite the limitations of our study, the results validated our initial assumption that this underrepresented content is meaningful to and valued by medical students.
Epitoma
Physicians lack knowledge of and sensitivity to the needs and challenges of lesbian, gay, bisexual, and transgender patients, and this content is underrepresented in medical school curricula. Although the authors acknowledge the limitations of this qualitative study of student satisfaction and perceived need for the course, they present a viable curriculum for improving the education of medical students with regard to this vulnerable patient group.
—Guest Editor Leonardo Seoane, MD
This article meets the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties Maintenance of Certification competencies for Patient Care, Interpersonal and Communication Skills, and Professionalism.
Footnotes
The authors have no financial or proprietary interest in the subject matter of this article.
- Academic Division of Ochsner Clinic Foundation
