Nowaskie Dustin Z, Patel Anuj U
Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th St, #2364, Indianapolis, IN, 46202, USA.
University of Michigan Medical School, Ann Arbor, MI, USA.
BMC Med Educ. 2020 Dec 4;20(1):490. doi: 10.1186/s12909-020-02381-1.
For medical students, providing exposure to and education about the lesbian, gay, bisexual, and transgender (LGBT) patient population are effective methods to increase comfort, knowledge, and confidence in caring for LGBT people. However, specific recommendations on the number of patient exposures and educational hours that relate to high LGBT cultural competency are lacking.
Medical students (N = 940) at three universities across the United States completed a survey consisting of demographics, experiential variables (i.e., number of LGBT patients and LGBT hours), and the 7-point Likert LGBT-Development of Clinical Skills Scale (LGBT-DOCSS). LGBT-DOCSS scores were stratified by 1-point increments, and experiential variable means were computed per each stratification to characterize the mean LGBT patients and hours of medical students with higher scores and those with lower scores.
Medical students reported caring for some LGBT patients annually (M = 6.02, SD = 20.33) and receiving a low number of annual LGBT curricular hours (M = 2.22, SD = 2.85) and moderate number of annual LGBT extracurricular hours (M = 6.93, SD = 24.97). They also reported very high attitudinal awareness (M = 6.54, SD = 0.86), moderate knowledge (M = 5.73, SD = 1.01), and low clinical preparedness (M = 3.82, SD = 1.25). Medical students who cared for 35 or more LGBT patients and received 35 or more LGBT total hours reported significantly higher preparedness and knowledge.
Medical students have shortcomings in LGBT cultural competency and limited LGBT patient exposure and education. To improve LGBT cultural competency, medical schools and accrediting bodies should consider providing medical students with at least a total of 35 LGBT patient contacts and 35 LGBT education hours (10 h of required curricular education and 25 h of supplemental education).
对于医学生而言,让他们接触女同性恋、男同性恋、双性恋和跨性别(LGBT)患者群体并接受相关教育,是提高照顾LGBT人群时的舒适度、知识水平和信心的有效方法。然而,目前缺乏关于与高LGBT文化能力相关的患者接触次数和教育时长的具体建议。
美国三所大学的940名医学生完成了一项调查,内容包括人口统计学信息、经验变量(即LGBT患者数量和LGBT相关时长)以及7点李克特LGBT临床技能发展量表(LGBT-DOCSS)。LGBT-DOCSS分数以1分的增量进行分层,并计算每个分层的经验变量均值,以描述分数较高和较低的医学生的平均LGBT患者数量和时长。
医学生报告称每年照顾一些LGBT患者(M = 6.02,标准差 = 20.33),每年接受的LGBT课程时长较少(M = 2.22,标准差 = 2.85),每年接受的LGBT课外时长适中(M = 6.93,标准差 = 24.97)。他们还报告称态度意识非常高(M = 6.54,标准差 = 0.86),知识水平中等(M = 5.73,标准差 = 1.01),临床准备程度较低(M = 3.82,标准差 = 1.25)。照顾35名或更多LGBT患者且LGBT总时长达到35小时或更长时间的医学生报告的准备程度和知识水平明显更高。
医学生在LGBT文化能力方面存在不足,接触LGBT患者和接受相关教育的机会有限。为提高LGBT文化能力,医学院校和认证机构应考虑为医学生提供至少总共35次LGBT患者接触机会和35小时LGBT教育时长(10小时必修课程教育和25小时补充教育)。