Najor Anna J, Kling Juliana M, Imhof Reese L, Sussman Jon D, Nippoldt Todd B, Davidge-Pitts Caroline J
Mayo Clinic Alix School of Medicine, Rochester, Minnesota.
Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, Arizona.
Health Equity. 2020 Apr 2;4(1):102-113. doi: 10.1089/heq.2019.0106. eCollection 2020.
Lack of physician training contributes to health care disparities for transgender people. The limited generalizability and feasibility of published training approaches lessen their utility in lowering barriers for other institutions to adopt similar training. All first-year medical students at the Mayo Clinic Alix School of Medicine (MCASOM) in Minnesota and Arizona received a 1-h lecture introducing key concepts related to transgender people and their health disparities. Students completed a 21-question survey before and after the lecture, and 1 year later. Chi-square likelihood coefficients were used to compare responses between the three time points. Eighty-six of 100 students answered the prelecture survey (86% response rate); 70 the postlecture survey; and 44 the 1-year follow-up survey. Twenty-five (29%) students had prior education in any lesbian, gay, bisexual, and transgender (LGBT+) health disparities, but this did not correlate with more favorable attitudes or knowledge. LGBT+ students and those with close LGBT+ friends had the most favorable attitudes and knowledge. The proportion of students comfortable with caring for transgender people changed significantly (76% self-reported very comfortable prelecture vs. 91% postlecture, =0.0073) and remained at 89% 1 year later. The proportion of students comfortable with a transgender patient scenario significantly increased (67% self-reported very comfortable prelecture vs. 87% postlecture, =0.032) even when surveyed 1 year later (95% very comfortable, <0.0001). This study demonstrates that a 1-h lecture can increase the proportion of medical students who demonstrate positive attitudes and correct knowledge on transgender patient care for at least a year, and how a survey can gather essential information on student learning needs to guide training development.
医生培训的缺乏导致了跨性别者在医疗保健方面存在差异。已发表的培训方法普遍适用性和可行性有限,降低了其在降低其他机构采用类似培训的障碍方面的效用。明尼苏达州和亚利桑那州梅奥诊所阿里克斯医学院(MCASOM)的所有一年级医学生都参加了一场为时1小时的讲座,内容是介绍与跨性别者及其健康差异相关的关键概念。学生们在讲座前后以及1年后完成了一项包含21个问题的调查。卡方似然系数用于比较三个时间点的回答。100名学生中有86名回答了讲座前的调查(回复率86%);70名回答了讲座后的调查;44名回答了1年后的随访调查。25名(29%)学生此前接受过任何关于女同性恋、男同性恋、双性恋和跨性别者(LGBT+)健康差异的教育,但这与更积极的态度或知识并无关联。LGBT+学生以及有亲密LGBT+朋友的学生态度最积极,知识掌握得也最好。对为跨性别者提供护理感到自在的学生比例有显著变化(讲座前76%自称非常自在,讲座后为91%,P = 0.0073),1年后仍保持在89%。即使在1年后进行调查(95%非常自在,P < 0.0001),对跨性别患者场景感到自在的学生比例也显著增加(讲座前67%自称非常自在,讲座后为87%,P = 0.032)。这项研究表明,一场为时1小时的讲座能够提高医学生对跨性别患者护理表现出积极态度和正确知识的比例,且至少能持续一年,还表明调查如何能够收集有关学生学习需求的重要信息以指导培训发展。