关注为性少数青少年服务的医生准备不足和培训重点问题。
Perspectives on inadequate preparation and training priorities for physicians working with sexual minority youth.
机构信息
Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA.
Department of Anthropology, University of Central Florida, Orlando, Florida, USA.
出版信息
Int J Med Educ. 2021 Oct 27;12:186-194. doi: 10.5116/ijme.615c.25d3.
OBJECTIVES
To understand pediatric and family medicine residents' and practitioners' perceived ability to work with lesbian, gay, bisexual, and queer (LGBQ) youth, assessment of their prior educational experiences, and recommendations for medical training to better prepare physicians to provide quality care to this population.
METHODS
We conducted semi-structured individual interviews with 24 pediatric/family medicine residents (n=20) and practicing physicians (n=4) in the U.S. Recorded interviews were professionally transcribed. Data were analyzed using Grounded Theory and qualitative content analysis approaches.
RESULTS
Most physicians did not feel adequately prepared to provide quality care to LGBQ youth, and many who felt knowledgeable obtained their knowledge from on-the-job experiences of caring for LGBQ patients. Findings regarding physicians' recommendations for implementing a formal training program revealed three themes: (I) medical school training (implemented earlier in medical school within a structured program as part of the normal curriculum), (II) training content (LGBQ-specific health needs, self-awareness of implicit biases, interviewing techniques, and resources), and (III) training strategies (panels of LGBQ patients, role-playing/standardized patients, and online modules).
CONCLUSIONS
Understanding physicians' assessment of abilities and recommendations for training improvements based on their experiences is important for advancing the quality of healthcare for LGBQ youth. Guidance came mostly from residents who recently completed medical school. Thus, their perspectives are especially useful to improve medical education and, ultimately, the care provided to LGBQ youth. Findings suggest a multi-pronged approach that offers several training modalities encompassing individual, intrapersonal, and institutional/systemic/community levels can improve medical school curricula on caring for LGBQ youth.
目的
了解儿科和家庭医学住院医师和医生对与女同性恋、男同性恋、双性恋和酷儿（LGBQ）青年合作的能力的感知，评估他们之前的教育经验，并为医学培训提出建议，以更好地使医生为这一人群提供优质护理。
方法
我们在美国对 24 名儿科/家庭医学住院医师（n=20）和执业医师（n=4）进行了半结构化的个人访谈。记录的访谈由专业人员转录。使用扎根理论和定性内容分析方法进行数据分析。
结果
大多数医生觉得自己没有准备好为 LGBQ 青年提供优质护理，而许多自认为有知识的医生是从照顾 LGBQ 患者的工作经验中获得知识的。关于医生实施正式培训计划的建议的调查结果揭示了三个主题：（一）医学院培训（在医学院早期作为正常课程的一部分在结构化计划中实施）；（二）培训内容（LGBQ 特定的健康需求、对隐性偏见的自我意识、访谈技巧和资源）；（三）培训策略（LGBQ 患者小组、角色扮演/标准化患者和在线模块）。
结论
了解医生根据经验评估能力和培训改进建议对提高 LGBQ 青年医疗保健质量很重要。指导主要来自最近完成医学院学业的住院医师。因此，他们的观点对于改进医学教育以及最终为 LGBQ 青年提供的护理特别有用。调查结果表明，一种多管齐下的方法，提供几种培训模式，涵盖个人、人际和机构/系统/社区层面，可以改进医学院关于照顾 LGBQ 青年的课程。
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