Education First: Promoting LGBT+ Friendly Healthcare with a Competency-Based Course and Game-Based Teaching

Abstract

How, apart from by conveying professional knowledge, can university medical education nurture and improve the gender competency of medical students and thereby create an LGBT+ friendly healthcare environment? This study explored the use of game-based teaching activities in competency-based teaching from the perspective of competency-based medical education (CBME) and employed a qualitative case-study methodology. We designed an LGBT+ Health and Medical Care course in a medical school. Feedback was collected from two teachers and 19 medical students using in-depth interviews and thematic analysis was used to analyze the collected data. The findings of this study were as follows: (1) Games encouraged student participation and benefited gender knowledge transmission and transformation through competency learning, and (2) games embodied the idea of assessment as learning. The enjoyable feeling of pressure from playing games motivated students to learn. Using games as both a teaching activity and an assessment tool provided the assessment and instant feedback required in the CBME learning process. Game-based teaching successfully guided medical students to learn about gender and achieve the learning goals of integrating knowledge, attitudes, and skills. To fully implement CBME using games as teaching methods, teaching activities, learning tasks, and assessment tools, teachers must improve their teaching competency. This study revealed that leading discussions and designing curricula are key in the implementation of gender competency-based education; in particular, the ability to lead discussions is the core factor. Game-based gender competency education for medical students can be facilitated with discussions that reinforce learning outcomes to achieve the objectives of gender equality education and LGBT+ friendly healthcare. The results of this study indicated that game-based CBME with specific teaching strategies was an effective method of nurturing the gender competency of medical students. The consequent integration of gender competency into medical education could achieve the goal of LGBT+ friendly healthcare.

Teaching LGBT+ Health and Gender Education to Future Doctors: Implementation of Case-Based Teaching

“…The case study method involves collecting and analyzing data for a specific individual, group, or event, in order to gain in-depth understanding of the specific case, including a greater understanding of the phenomenon or problem, and then finding a solution or new perspective. A good case study can help researchers grasp and present insights at the micro and macro level; in addition, it has the effect of echoing and improving theory or practice [8,48].…”

“…In Taiwan, medical education is divided into three phases: undergraduate medical education (basic medical education and clinical education), the postgraduate year program (PGY), and continued medical education (specialty development). In the 6-year undergraduate medical education program, basic medical education is provided in the first 4 years, and clinical education is provided in the final 2 years [8].…”

“…The two gender courses were based on competency-based learning, and knowledge, attitudes, and skills were used as the core components [8]. The contents and objectives of the LGBT+ HMC course were as follows: (1) to understand how social structures, culture, and other factors influence the lives of LGBT+ people; and (2) to understand how sexual orientation, gender identity, gender expression, and gender discrimination affect the physical and mental health of LGBT+ patients.…”

“…For the warm-up activities, the LGBT+ HMC course used a 3 × 3 square game consisting of nine questions. The game was both a warm-up activity and a learning assessment tool [8].…”

“…Psychiatrists should be equipped with gender competence to understand the potential mental distress related to gender and provide the appropriate health care and treatment to patients. Competence refers to an integral ability based on relevant knowledge, attitudes, and skills that learners acquire from education; they enable the handling of complex personal or social lives and challenges [8]. When exhibited in professional medical fields, gender competence, according to Yang and Yen's definition, results from the collective integration of learning gender knowledge, attitude, and skills that can enable a physician to apply appropriate clinical practices and professional actions to gender-friendly healthcare [9].…”