医师助理教育中的跨性别健康课程方法。

Curricular Approaches to Transgender Health in Physician Assistant Education.

机构信息

J. Rolls is assistant professor, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah; ORCID: https://orcid.org/0000-0002-4793-2310.

J. Davis is associate dean, Curriculum, and professor, Department of Medicine, University of California San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0002-0252-8402.

出版信息

Acad Med. 2020 Oct;95(10):1563-1569. doi: 10.1097/ACM.0000000000003464.

DOI:10.1097/ACM.0000000000003464

PMID:32349019

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7523571/

Abstract

PURPOSE

According to the Williams Institute, 1.4 million U.S. adults identify as transgender. Many experience health care disparities. Professional organizations call for medical education to improve transgender care, but what curricula are being delivered is unknown. The goal of this study was to conduct the first comprehensive, national survey of transgender health care curricula in physician assistant (PA) education.

METHOD

The authors sent a questionnaire to program directors (PDs) at all 236 U.S. PA programs in June 2018. They categorized programs as those that currently deliver at least 1 hour of transgender health content and those who do not (Teaching/Not Teaching). They examined differences between Teaching and Not Teaching programs using chi-square tests, and they evaluated comments for themes.

RESULTS

The response rate was 100%. Of the 236 programs, 202 (85.6%) teach transgender content and 34 (14.4%) do not. According to PDs, most transgender content was delivered in medical interviewing (44.1%) or women's health (31.4%) and the most common transgender health topics included differentiating between sex and gender and between behavior and identity (78.8%), followed by health disparities (77.5%) and barriers to care (75.0%). PDs most commonly cited a lack of time (51.3%) and faculty knowledge (35.6%) as barriers for teaching transgender health topics. Half of the PDs (50.4%) ranked transgender health as very or extremely important. The authors detected statistically significant differences between Teaching and Not Teaching programs based on geographic region (P = .01), perceived importance (P ≤ .001), and presence of knowledgeable faculty (P = .01). Presence of knowledgeable faculty was significantly associated with perceived importance (P = .01).

CONCLUSIONS

This is the first comprehensive, nationwide survey of transgender health education in U.S. PA programs. A key finding is that the presence of expert faculty is significantly associated with delivery and perceived importance of transgender health curricula.

摘要

目的

根据威廉姆斯研究所的数据，美国有 140 万成年人认同自己是跨性别者。许多人经历着医疗保健方面的不平等。专业组织呼吁加强医学教育，以改善跨性别者的护理，但目前提供的课程内容尚不清楚。本研究的目的是对美国医师助理（PA）教育中跨性别者保健课程进行首次全面的全国性调查。

方法

作者于 2018 年 6 月向美国所有 236 个 PA 项目的项目主任（PD）发送了一份问卷。他们将项目分为目前提供至少 1 小时跨性别健康内容的项目（教学/不教学）。他们使用卡方检验比较教学和非教学项目之间的差异，并对评论进行主题评估。

结果

回复率为 100%。在 236 个项目中，有 202 个（85.6%）教授跨性别内容，34 个（14.4%）不教授。根据 PD 的说法，大多数跨性别内容是在医学访谈（44.1%）或妇女健康（31.4%）中教授的，最常见的跨性别健康主题包括区分性别和性别认同以及行为和身份（78.8%），其次是健康差距（77.5%）和护理障碍（75.0%）。PD 最常提到缺乏时间（51.3%）和教师知识（35.6%）是教授跨性别健康主题的障碍。一半的 PDs（50.4%）认为跨性别健康非常重要或极其重要。作者根据地理位置（P=0.01）、感知重要性（P≤0.001）和知识渊博的教师的存在（P=0.01），检测到教学和非教学项目之间存在统计学上的显著差异。知识渊博的教师的存在与感知的重要性显著相关（P=0.01）。