Residency Training: The need for an integrated diversity curriculum for neurology residency

Rosendale, Nicole; Josephson, S. Andrew

doi:10.1212/wnl.0000000000004751

Cited by 20 publications

(13 citation statements)

References 8 publications

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“…The most commonly reported barrier related to the training interventions was lack of appropriate educational materials (Park & Safer, 2018 ; Rosendale & Josephson, 2017 ; Vance et al, 2020 , 2021 ). Facilitation-related barriers primarily centered around the lack of expertise or experience among faculty or instructors to facilitate the training (Berenson et al, 2020 ; Biro et al, 2021 ; Block et al, 2020 ; Click et al, 2019 , 2020 ; Greene et al, 2017 ; Marshall et al, 2017 ; McCave et al, 2019 ; Park & Safer, 2018 ; Rosendale & Josephson, 2017 ; Sawning et al, 2017 ; Sequeira et al, 2012 ; Stumbar et al, 2021 ; Thompson et al, 2020 ; Ufomata et al, 2020 ; Vance et al, 2018 ) and availability of transgender simulation patients (Berenson et al, 2020 ; Biro et al, 2021 ; Block et al, 2020 ; Click et al, 2019 , 2020 ; Greene et al, 2017 ; Marshall et al, 2017 ; McCave et al, 2019 ; Park & Safer, 2018 ; Rosendale & Josephson, 2017 ; Sawning et al, 2017 ; Sequeira et al, 2012 ; Stumbar et al, 2021 ; Thompson et al, 2020 ; Ufomata et al, 2020 ; Vance et al, 2018 ). Low participation rates among certain subgroups (e.g., male and cisgender people) was the most reported barrier related to the audience (Braun et al, 2017 ; Minturn et al, 2021 ; Pathoulas et al, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

“…Low participation rates among certain subgroups (e.g., male and cisgender people) was the most reported barrier related to the audience (Braun et al, 2017 ; Minturn et al, 2021 ; Pathoulas et al, 2021 ). Institutional/contextual barriers included time constraints in the majority of sources and costs associated with consultation, curriculum development, as well as recruiting and fairly compensating transgender simulation patients/guest speakers (Altneu et al, 2020 ; Bi et al, 2020 ; Biro et al, 2021 ; Braun et al, 2017 ; Click et al, 2019 ; Cooper et al, 2018 ; Kidd et al, 2016 ; Marshall et al, 2017 ; Minturn et al, 2021 ; Rosendale & Josephson, 2017 ; Roth et al, 2020 ; Salkind et al, 2019 ; Sawning et al, 2017 ; Stumbar et al, 2021 ; Ufomata et al, 2020 ; Underman et al, 2016 ; Vance et al, 2020 ; Ward-Gaines et al, 2021 ). Kidd and colleagues critiqued the limited effectiveness of ‘one-shot’ educational interventions, on which much of residency education relies, [which] may not necessarily result in sustained improvements” ( 2016 , p. 4).…”

Section: Resultsmentioning

confidence: 99%

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Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators

Heesewijk

Kent

Grift

et al. 2022

Adv in Health Sci Educ

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Health disparities faced by transgender people are partly explained by barriers to trans-inclusive healthcare, which in turn are linked to a lack of transgender health education in medical school curricula. We carried out a theory-driven systematic review with the aim to (1) provide an overview of key characteristics of training initiatives and pedagogical features, and (2) analyze barriers and facilitators to implementing this training in medical education. We used queer theory to contextualize our findings. We searched the PubMed/Ovid MEDLINE database (October 2009 to December 2021) for original studies that reported on transgender content within medical schools and residency programs (N = 46). We performed a thematic analysis to identify training characteristics, pedagogical features, barriers and facilitators. Most training consisted of single-session interventions, with varying modes of delivery. Most interventions were facilitated by instructors with a range of professional experience and half covered general LGBT+-content. Thematic analysis highlighted barriers including lack of educational materials, lack of faculty expertise, time/costs constraints, and challenges in recruiting and compensating transgender guest speakers. Facilitators included scaffolding learning throughout the curriculum, drawing on expertise of transgender people and engaging learners in skills-based training. Sustainable implementation of transgender-health objectives in medical education faces persistent institutional barriers. These barriers are rooted in normative biases inherent to biomedical knowledge production, and an understanding of categories of sex and gender as uncomplicated. Medical schools should facilitate trans-inclusive educational strategies to combat transgender-health inequities, which should include a critical stance toward binary conceptualizations of sex and gender throughout the curriculum.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators

Heesewijk

Kent

Grift

et al. 2022

Adv in Health Sci Educ

View full text Add to dashboard Cite

show abstract

“…However, a 30 to 40 % response rate is typical for surveys of similar cohorts. (8,9) And the proportion of adult and child neurology programs in our sample (70 % and 30 % respectively) is representative of the proportion of adult and child neurology programs in the United States (68% and 32 % respectively). Another limitation is the self-report nature of the data.…”

Section: Discussionmentioning

confidence: 94%

How Are Residents Trained in Neuropathology? A Survey of Neurology Program Directors in the United States

Rayi

Rajneesh

Punia

et al. 2020

Journal of Neuropathology &Amp; Experimental Neurology

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To understand the current state of neurology residents training in neuropathology, we electronically distributed a 16-item survey to 150 adult and 70 child neurology program directors (PDs). The survey inquired about their program characteristics, neuropathology curriculum and assessment methods, trainee performance, and attitudes. Descriptive analysis was used to summarize categorical variables as frequencies and percentages and continuous as means and standard deviations. We conducted a series of Mann-Whitney U and Fisher’s exact tests to evaluate differences between various program characteristics. Sixty-four (29%) PDs responded to the survey, including 45 (30%) adult and 19 (27%) child neurology PDs. Thirty-one programs required a dedicated neuropathology rotation. The majority (92%) used the Residency In-Service Training Examination (RITE) to assess trainee’s knowledge. Approximately 86% of the PDs agreed that neuropathology is essential and a defined curriculum is necessary during residency training. There was no difference in the RITE scores between programs. We conclude that a neuropathology rotation was felt to be essential even though the RITE scores did not differ between programs with and without a dedicated rotation. Alternative evaluation and training methods may need consideration. A future survey of all the stakeholders may be required to thoroughly understand and disseminate the neuropathology education well.

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“…Despite this, the majority of medical students in a 2017 study desired more education than they received on LGBTQ+ health, suggesting that the gap in LGBTQ+ education has not closed in undergraduate medical education 9 . More recent surveys from non‐EM residencies show that a substantial gap in actual versus preferred hours of LGBTQ+ education exists at the graduate medical education level 10‐16 . The 2019 Model of the Clinical Practice of Emergency Medicine has added gender identity, sexual orientation, and transgender care to the core content adopted by the American Board of Emergency Medicine 17 .…”

Section: Introductionmentioning

confidence: 99%

“…9 More recent surveys from non-EM residencies show that a substantial gap in actual versus preferred hours of LGBTQ+ education exists at the graduate medical education level. [10][11][12][13][14][15][16] The 2019 Model of the Clinical Practice of Emergency Medicine has added gender identity, sexual orientation, and transgender care to the core content adopted by the American Board of Emergency Medicine. 17 It is unclear if these developments have led EM residency programs to implement or expand LGBTQ+specific education in their curricula or if a gap in EM training remains.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of lesbian, gay, bisexual, and transgender health education and training in emergency medicine residency programs: Where are we now?

Moll

Vennard

Noto

et al. 2021

AEM Education and Training

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Background: Despite identified inequities and disparities in lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) health, past studies have shown little or no education at the medical school or residency level for emergency physicians. With increased focus on health inequities and disparities, we sought to reexamine the status of sexual and gender minority health education in U.S. emergency medicine (EM) residencies. Objectives: Our primary objective was to determine how many EM residencies offer education on LGBTQ+ health. Secondary objectives included the number of actual versus preferred hours of LGBTQ+ training, identification of barriers to providing education, and correlation of education with program demographics. Finally, we compared our current data with past results of our 2013 study. Methods: The initial survey that sought to examine LGBTQ+ training in 2013 was used and sent in 2020 via email to EM programs accredited by the American Council for Graduate Medical Education who had at least one full class of residents in 2019. Reminder emails and a reminder post on the Council of Residency Directors in Emergency Medicine listserv were used to increase participation. Results: A total of 229 programs were eligible, with a 49.3% response rate (113/229).The majority (75%) offered education content on LGBTQ+ health, for a median (IQR) of 2 (1-3) hours and a range of 0 to 22 hours. Respondents preferred more hours of education than offered (median desired hours = 4, IQR = 2-5 hours; p < 0.001). The largest barrier identified was lack of time in curriculum (63%). The majority of programs had known LGBTQ+ faculty and residents. Inclusion and amount of education hours positively correlated with presence of LGBTQ+ faculty or residents; university-and county-based programs were more likely to deliver education content than private groups (p = 0.03). Awareness of known LGBTQ+ residents but not faculty differed by region, but there was no significant difference in actual or preferred content by region. Conclusion:The majority of respondents offer education in sexual and gender minority health, although there remains a gap between actual and preferred hours. This is

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Residency Training: The need for an integrated diversity curriculum for neurology residency

Abstract: Background: Providing culturally responsive care to an increasingly multicultural population is

Cited by 20 publications

References 8 publications

Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators

Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators

How Are Residents Trained in Neuropathology? A Survey of Neurology Program Directors in the United States

The prevalence of lesbian, gay, bisexual, and transgender health education and training in emergency medicine residency programs: Where are we now?

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