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An estimated 4.5% of the US population identifies as LGBTQ+, and significant health disparities exist due to discrimination. Despite high prevalence, there is limited training in medical schools in LGBTQ+ healthcare. To address this educational gap, a curriculum, which was previously piloted with volunteer students (N=29), was integrated into the second year clinical skills course in order to increase knowledge of LGBTQ+ health issues and improve comfort with taking an inclusive sexual history. This study examines the impact of the now mandatory curriculum on the students’ knowledge, attitude, and perspective regarding the LGBTQ+ population.
The required curriculum included implicit bias testing, one hour lecture, standardized patient encounters with feedback, and a debrief session with faculty. Medical students participating in this experience were recruited for an evaluation of the program via voluntary survey. Data were collected anonymously via surveys pre- and post-curriculum, and participants were assigned a unique identifier to measure the individual effect. Demographic data including year of training, age, race/ethnicity, gender identity, and sexual orientation were collected. Student comfort discussing sexual orientation and gender identity and perceived preparation for taking an inclusive sexual history and providing care for LGBTQ+ patients was assessed via Likert scale (scale 1 [strongly disagree] through 5 [strongly agree]). Additional data were collected on student’s perception of the curriculum meeting learning objectives such as learning strategies for creating a safe space and understanding the spectra of gender identity and sexual orientation. Descriptive feedback was also collected on the educational intervention. This data was subsequently analyzed using SPSS version 24. This project was approved by the institutional IRB and was supported by a grant through the University of Oklahoma College of Medicine Academy of Teaching Scholars.
78 second year medical students completed both pre- and post-surveys. Statistical improvements in student scores post-curriculum were observed with all p-values <0.001 including comfort in: discussing sexual orientation (pre 3.47, post 4.26), discussing gender identity (pre 3.22, post 4.23), and collecting an inclusive sexual history (pre 2.92, post 4.21). Students felt that the learning goals and objectives were met, with mean scores for each objective greater than 4.0. Students reported a high overall satisfaction with the curriculum (mean 4.42, SD 0.57).
This now mandatory curriculum successfully improved student comfort levels in collecting an inclusive sexual history, and there was high student satisfaction with the curriculum.
Sources of Support
This project was supported by a grant through the University of Oklahoma College of Medicine Academy of Teaching Scholars.