内科住院医师照顾女同性恋、男同性恋、双性恋、跨性别和酷儿/疑问患者的准备情况评估。
Assessment of Internal Medicine Resident Preparedness to Care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Patients.
机构信息
Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
出版信息
J Gen Intern Med. 2019 Jun;34(6):893-898. doi: 10.1007/s11606-019-04855-5. Epub 2019 Mar 7.
BACKGROUND
Recognizing the unique health needs of sexual and gender minorities (i.e., lesbian, gay, bisexual, transgender, queer/questioning individuals) is critical to providing competent and comprehensive healthcare.
OBJECTIVE
To assess resident knowledge of healthcare issues uniquely affecting sexual and gender minorities as well as the role of online case-based didactics to measure and improve knowledge in the diagnosis and treatment of these patients.
DESIGN
A multicenter online education intervention from December 2016 to April 2018.
PARTICIPANTS
The study population consisted of 833 PGY1-3 residents at 120 internal medicine residency programs in the USA who completed 1018 tests.
INTERVENTIONS
A 1-h online module addressing sexual and gender minority (SGM) health. The test evaluated each resident in four categories: (1) terminology relevant to SGM patients; (2) health disparities and preventive care issues affecting SGM patients; (3) substance use and mental health issues unique to SGM patients; and (4) common sexually transmitted illnesses affecting SGM populations.
MAIN MEASURES
Participants completed a pre-test assessing SGM health knowledge. A didactic module reviewing diagnosis and management of these diseases was then completed, followed by a post-test.
KEY RESULTS
Among 1018 resident respondents, there was no difference between post-graduate year pre-test performance (PGY-1 52%, PGY-2 50%, PGY-3 51%; p = 0.532) or post-test performance (PGY-1 80%, PGY-2 82%, PGY-3 82%; p = 0.285). Pre-test and post-test performance of an online didactic module was the same across test categories and patient populations for PGY-1 vs. PGY-2 vs. PGY-3. Residents demonstrated an improvement between pre- and post-test knowledge.
CONCLUSIONS
Baseline knowledge of health issues of sexual and gender minorities, as assessed by pre-test performance, did not change during residency training. An online didactic module introduced trainees to critical issues regarding the care of these vulnerable populations until such curricula are required in training. Health disparities in LGBTQ communities may improve with improved physician training on clinical care of LGBTQ patients and families.
背景
认识到性少数群体和性别少数群体（即女同性恋、男同性恋、双性恋、跨性别、酷儿/疑问者）的独特健康需求对于提供有能力和全面的医疗保健至关重要。
目的
评估住院医师对独特影响性少数群体和性别少数群体的医疗保健问题的了解，以及在线基于案例的教学在衡量和改善这些患者的诊断和治疗知识方面的作用。
设计
2016 年 12 月至 2018 年 4 月的一项多中心在线教育干预。
参与者
该研究人群包括美国 120 个内科住院医师培训计划中的 833 名 PGY1-3 住院医师，他们完成了 1018 次测试。
干预措施
一个 1 小时的在线模块，解决性少数群体和性别少数群体（SGM）的健康问题。该测试评估了每位住院医师在以下四个方面的知识：（1）与 SGM 患者相关的术语；（2）影响 SGM 患者的健康差距和预防保健问题；（3）SGM 患者特有的物质使用和心理健康问题；以及（4）影响 SGM 人群的常见性传播疾病。
主要测量
参与者完成了一项关于 SGM 健康知识的预测试。然后完成了一个关于这些疾病的诊断和管理的教学模块，接着是一个后测试。
主要结果
在 1018 名住院医师受访者中，研究生学习年限的预测试表现（PGY-1 为 52%，PGY-2 为 50%，PGY-3 为 51%；p=0.532）或后测试表现（PGY-1 为 80%，PGY-2 为 82%，PGY-3 为 82%；p=0.285）之间没有差异。PGY-1 与 PGY-2 与 PGY-3 相比，在线教学模块的预测试和后测试表现在测试类别和患者群体方面均相同。住院医师在预测试和后测试知识方面都有所提高。
结论
通过预测试表现评估，性少数群体和性别少数群体健康问题的基线知识在住院医师培训期间没有改变。在线教学模块向受训者介绍了有关这些弱势群体护理的关键问题，直到培训中需要此类课程。LGBTQ 社区的健康差距可能会随着对 LGBTQ 患者和家庭的临床护理的医生培训的改善而得到改善。
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