Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, United States of America.
University of Michigan Medical School, Ann Arbor, Michigan, United States of America.
PLoS One. 2020 Aug 13;15(8):e0237670. doi: 10.1371/journal.pone.0237670. eCollection 2020.
Efforts to characterize healthcare professional students' lesbian, gay, bisexual, and transgender (LGBT) cultural competency are necessary to recommend educational initiatives. Very few studies have evaluated LGBT cultural competency across multiple healthcare disciplines, and no known studies have included students of other healthcare disciplines such as occupational therapy, pharmacy, physical therapy, and physician assistant.
Healthcare professional students (N = 1701) at three universities across the United States completed a survey consisting of demographics, experiential variables (i.e., LGBT patients and LGBT curricular hours), and the 7-point Likert LGBT-Development of Clinical Skills Scale (LGBT-DOCSS). LGBT-DOCSS scores, annual LGBT patients, and annual LGBT curricular hours were compared across healthcare disciplines.
While students reported very high Attitudinal Awareness (M = 6.48, SD = 0.92), they endorsed moderate Basic Knowledge (M = 5.54, SD = 1.16) and low Clinical Preparedness (M = 3.78, SD = 1.28). After controlling for several demographic and experiential variables, there were significant differences among healthcare disciplines on LGBT-DOCSS scores, with social work students reporting the highest on all scores, and dental students reporting the lowest on all scores except Clinical Preparedness. There were also significant differences among healthcare disciplines on annual LGBT patients [mean range: 0.57 (dental) to 7.59 (physician assistant)] and annual LGBT curricular hours [mean range: 0.51 (occupational therapy) to 5.64 (social work)]. Experiential variables were significant predictors for Overall LGBT-DOCSS, Clinical Preparedness, and Basic Knowledge (all p < 0.001); LGBT patients was also a significant predictor for Attitudinal Awareness (p < 0.05).
Taken together, significant differences in LGBT cultural competency exist across healthcare disciplines, which may result from inadequate experiences with LGBT patients and LGBT curricular education. Future efforts should consider increasing LGBT patient contact hours and LGBT formal education hours to enhance healthcare students' LGBT cultural competency.
为了提出教育倡议，有必要对医疗专业学生的同性恋、双性恋、跨性别（LGBT）文化能力进行描述。很少有研究评估过多个医疗保健学科的 LGBT 文化能力，也没有已知的研究包括职业治疗、药学、物理治疗和医师助理等其他医疗保健学科的学生。
美国三所大学的医疗专业学生（N=1701）完成了一份包含人口统计学、体验变量（即 LGBT 患者和 LGBT 课程时间）和 7 点李克特 LGBT-临床技能发展量表（LGBT-DOCSS）的调查。比较了不同医疗保健学科之间的 LGBT-DOCSS 分数、每年 LGBT 患者和每年 LGBT 课程时间。
虽然学生报告的态度意识非常高（M=6.48，SD=0.92），但他们对基本知识的认可度适中（M=5.54，SD=1.16），对临床准备的认可度较低（M=3.78，SD=1.28）。在控制了几个人口统计学和体验变量后，不同医疗保健学科之间在 LGBT-DOCSS 分数上存在显著差异，社会工作学生在所有分数上的得分最高，而牙科学生在除临床准备外的所有分数上的得分最低。不同医疗保健学科之间在每年 LGBT 患者数量上也存在显著差异[平均范围：0.57（牙科）至 7.59（医师助理）]和每年 LGBT 课程时间[平均范围：0.51（职业治疗）至 5.64（社会工作）]。体验变量是 LGBT-DOCSS 总体、临床准备和基本知识的重要预测因素（均 p<0.001）；LGBT 患者也是态度意识的重要预测因素（p<0.05）。
总的来说，医疗保健学科之间存在显著的 LGBT 文化能力差异，这可能是由于与 LGBT 患者和 LGBT 课程教育的经验不足所致。未来的努力应考虑增加 LGBT 患者接触时间和 LGBT 正规教育时间，以提高医疗保健学生的 LGBT 文化能力。
