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耳鼻咽喉科住院医师培训项目中的性与性别少数群体课程

Sexual and Gender Minority Curriculum Within Otolaryngology Residency Programs.

作者信息

Goetz Teddy G, Nieman Carrie L, Chaiet Scott R, Morrison Shane D, Cabrera-Muffly Cristina, Lustig Lawrence R

机构信息

Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

出版信息

Transgend Health. 2021 Oct 4;6(5):267-274. doi: 10.1089/trgh.2020.0105. eCollection 2021 Oct.

Abstract

Otolaryngologists are uniquely situated to provide sexual and gender minority (SGM) care, including gender-affirmation (voice/communication, facial surgery) and HIV/AIDS-related conditions. Yet, no research has characterized otolaryngology residency program directors' attitudes toward SGM-related curricula, nor opportunities for supporting training in SGM-related care. An anonymous cross-sectional e-mail survey was disseminated to 116 otolaryngology residency program directors in July-September 2019. Information collected included current/future curriculum in and attitudes toward SGM care, and program demographics. Data were categorical and analysis utilized chi-square test. The 65 complete responses (56% rate) were nationally representative. Overall, 17% of programs include no SGM-related education. Subjective importance of SGM training ranged from not important at all (3%) to absolutely essential (11%), with mode of average importance (47%); this varied significantly by program geographic setting and population, and program size. The mean percentage of curriculum dedicated to SGM care was 1.0% for didactics and 0.7% for clinical. Curricula include HIV/AIDS-related conditions (58%), facial gender-affirming procedures (50%), culturally informed care (42%), changes with gender-affirming hormones (voice/communication: 48%, facial: 22%), and cancer in SGM patients (42%). Frequently reported barriers were insufficient experienced faculty (52%) and time (42%). Program directors deemed visiting expert lectures (66%), small-group discussion (39%), and online modules (27%) the best ways to incorporate SGM education. More than 80% of otolaryngology residency curricula in a representative national survey include SGM-related education, which represents a limited portion of total curriculum. These results highlight the opportunity for expert lectures and discussion-based and online tool development to facilitate standardized SGM education in otolaryngology residencies.

摘要

耳鼻喉科医生在提供性取向和性别认同少数群体(SGM)护理方面具有独特优势,包括性别肯定(嗓音/沟通、面部手术)以及与艾滋病毒/艾滋病相关的病症。然而,尚无研究描述耳鼻喉科住院医师培训项目主任对SGM相关课程的态度,也未涉及支持SGM相关护理培训的机会。2019年7月至9月,我们向116名耳鼻喉科住院医师培训项目主任开展了一项匿名横断面电子邮件调查。收集的信息包括当前/未来SGM护理课程及对其的态度,以及项目人口统计学数据。数据为分类数据,分析采用卡方检验。65份完整回复(回复率56%)具有全国代表性。总体而言,17%的项目未纳入任何与SGM相关的教育内容。SGM培训的主观重要性从完全不重要(3%)到绝对必要(11%)不等,平均重要性的众数为(47%);这因项目地理位置、人群及规模的不同而有显著差异。专门用于SGM护理的课程平均比例在理论教学方面为1.0%,临床方面为0.7%。课程包括与艾滋病毒/艾滋病相关的病症(58%)、面部性别肯定手术(50%)、文化相关护理(42%)、性别肯定激素变化(嗓音/沟通:48%,面部:22%)以及SGM患者的癌症(42%)。经常报告的障碍是经验丰富的教员不足(52%)和时间不够(42%)。项目主任认为客座专家讲座(66%)、小组讨论(39%)和在线模块(27%)是纳入SGM教育的最佳方式。在一项具有全国代表性的调查中,超过80%的耳鼻喉科住院医师课程纳入了与SGM相关的教育内容,但这在总课程中所占比例有限。这些结果凸显了开展专家讲座、基于讨论的教学以及开发在线工具以促进耳鼻喉科住院医师标准化SGM教育的机会。

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