Lee Matthew, Tasa-Vinyals Elisabet, Gahagan Jacqueline
Gender and Health Promotion Studies Unit, School of Health and Human Performance, Dalhousie University, Nova Scotia, Canada.
Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Catalonia, Spain.
Can Med Educ J. 2021 Feb 26;12(1):e7-e20. doi: 10.36834/cmej.67870. eCollection 2021 Feb.
Lesbian, Gay, Bisexual, Trans, Queer, and Two-spirit (LGBTQ2S+) populations experience worse health outcomes compared to age-matched heterosexual and cisgender peers. Health professionals' deficient knowledge and negative attitudes can contribute to these inequities. Healthcare trainees report insufficient LGBTQS2+ cultural competence training.
In this prospective, mixed-methods pre-post design, Atlantic Canadian health students were tested on knowledge, attitudes and self-reported behaviours towards LGBTQ2S+ populations in healthcare settings. Assessment included psychometric measurements and clinical cases involving normative and non-normative fictional patients. Participants were randomised to intervention or control groups. The intervention consisted of three training sessions lead by LGBTQ2S+ experts and elders from the community. The control group continued with usual training. Full assessment was repeated after training. We also held focus group discussions with students and faculty.
The intervention group significantly improved attitudes toward and knowledge of LGBTQ2S+ populations and changed relevant aspects of their performance in the simulated clinical situations. Focus groups identified key gaps in current local training.
Integrating specific training related to LGBTQ2S+ health within health professions programs is an important step toward improving these populations' accessibility to a competent, exhaustive and nurturing healthcare. Additional research on innovative means to expand and broaden the scope of our training is warranted.
与年龄匹配的异性恋和顺性别同龄人相比，女同性恋、男同性恋、双性恋、跨性别、酷儿及双灵人群（LGBTQ2S+）的健康状况更差。卫生专业人员知识不足和态度消极会导致这些不平等现象。医疗保健实习生报告称，针对LGBTQ2S+文化能力的培训不足。
在这项前瞻性的混合方法前后设计研究中，对加拿大大西洋地区的健康专业学生在医疗环境中对LGBTQ2S+人群的知识、态度和自我报告行为进行了测试。评估包括心理测量和涉及规范及非规范虚构患者的临床病例。参与者被随机分为干预组或对照组。干预措施包括由LGBTQ2S+专家和社区长者主持的三次培训课程。对照组继续接受常规培训。培训后重复进行全面评估。我们还与学生和教师进行了焦点小组讨论。
干预组对LGBTQ2S+人群的态度和知识有了显著改善，并改变了他们在模拟临床情境中的相关表现。焦点小组确定了当前当地培训中的关键差距。
在卫生专业课程中纳入与LGBTQ2S+健康相关的特定培训，是朝着改善这些人群获得胜任、全面和关怀性医疗保健服务的机会迈出的重要一步。有必要对扩大和拓宽我们培训范围的创新方法进行更多研究。
