How much is needed? Patient exposure and curricular education on medical students’ LGBT cultural competency

Abstract

Background For medical students, providing exposure to and education about the lesbian, gay, bisexual, and transgender (LGBT) patient population are effective methods to increase comfort, knowledge, and confidence in caring for LGBT people. However, specific recommendations on the number of patient exposures and educational hours that relate to high LGBT cultural competency are lacking. Methods Medical students (N = 940) at three universities across the United States completed a survey consisting of demographics, experiential variables (i.e., number of LGBT patients and LGBT hours), and the 7-point Likert LGBT-Development of Clinical Skills Scale (LGBT-DOCSS). LGBT-DOCSS scores were stratified by 1-point increments, and experiential variable means were computed per each stratification to characterize the mean LGBT patients and hours of medical students with higher scores and those with lower scores. Results Medical students reported caring for some LGBT patients annually (M = 6.02, SD = 20.33) and receiving a low number of annual LGBT curricular hours (M = 2.22, SD = 2.85) and moderate number of annual LGBT extracurricular hours (M = 6.93, SD = 24.97). They also reported very high attitudinal awareness (M = 6.54, SD = 0.86), moderate knowledge (M = 5.73, SD = 1.01), and low clinical preparedness (M = 3.82, SD = 1.25). Medical students who cared for 35 or more LGBT patients and received 35 or more LGBT total hours reported significantly higher preparedness and knowledge. Conclusions Medical students have shortcomings in LGBT cultural competency and limited LGBT patient exposure and education. To improve LGBT cultural competency, medical schools and accrediting bodies should consider providing medical students with at least a total of 35 LGBT patient contacts and 35 LGBT education hours (10 h of required curricular education and 25 h of supplemental education).

Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot

“…Notably, only four participants indicated having received any trans-specific training in a formal college/university-level course. This is consistent with a plethora of research documenting low hours of LGBTQ content in medical and allied health professional training [ 26 , 27 ]. Other studies have highlighted how medical power and authority sustain social and institutional stigma against trans people by excluding knowledge of their care from medical training [ 79 ], evidenced in the limited hours dedicated in medical schools to lesbian, gay, bisexual, trans, and queer (LGBTQ+) health issues [ 80 ].…”

“…Other studies have highlighted how medical power and authority sustain social and institutional stigma against trans people by excluding knowledge of their care from medical training [ 79 ], evidenced in the limited hours dedicated in medical schools to lesbian, gay, bisexual, trans, and queer (LGBTQ+) health issues [ 80 ]. Thus, to shift healthcare practices, such training should be incorporated in allied health professional education at a college and university levels and residency programs [ 81 , 82 ] with a higher number of hours [ 27 ].…”

Attitudes and Knowledge of Medical Students Towards Healthcare for Lesbian, Gay, Bisexual, and Transgender Seniors: Impact of a Case-Based Discussion With Facilitators From the Community

“…These issues and practices contribute to the health disparities and sub-optimal care experienced by senior LGBT individuals when compared to their cis-gendered counterparts [ 12 , 13 ]. One strategy to improve the cultural competency of future physicians is to provide targeted educational opportunities within medical school curricula for medical students to interact with the LGBT population through both simulated and actual scenarios [ 14 ]. These curricular interventions are effective at increasing the level of comfort, knowledge, and confidence that student doctors have for providing care to LGBT patients [ 14 - 16 ].…”

Development, Implementation, and Effectiveness of a Self-sustaining, Web-Based LGBTQ+ National Platform: A Framework for Centralizing Local Health Care Resources and Culturally Competent Providers

“…The organization employs a cyclic, multidimensional framework to conduct needs assessments, identify resources and providers, promote these efforts on the website, and educate the next generation of providers. For instance, needs assessments, such as evaluating LGBTQ+ patients’ satisfaction with medical care [ 25 ] and characterizing providers’ [ 13 , 26 , 27 ] and students’ [ 28 , 29 ] attitudes, practices, and knowledge, through self-reported surveys are conducted at local and national levels. At the same time, LGBTQ+ public health services are identified via the internet, email, and word of mouth and added to the Public Resource Database; culturally competent providers are recruited to the OutList directory via listservs, medical institutions, local organizations, and word of mouth; and mentors (who provide consultation on school, career, research, and/or other academic pursuits for students, staff, and/or faculty) are invited to the Mentorship Program by emailing OutList providers.…”