Dep. of Physician Assistant, Seton Hall University, 123 Metro Blvd., Nutley, NJ 07110, USA. Tel 908-403-6180.
J Allied Health. 2022 Spring;51(1):52-58.
Curricular inclusion of sexual health, sexual history taking skills and diversity training in physician assistant (PA) education is historically lacking, with a median of 5 hours of instruction. Communities are increasingly more diverse with 4.5% of the U.S. population identifying as sexual and gender minorities (SGM), but most medical programs do not address specific SGM needs. Trainees are woefully underprepared to properly interview, evaluate, and provide targeted care for SGM patients. This leads to dangerous healthcare disparities in disease prevention, mental health, and substance abuse. Additionally, provider discrimination, biases, and general discomfort in treating this population create significant barriers to proper medical care. The goals of this literature review were to explore the evidence related to medical trainees' knowledge and training gaps within topics of sexual health and sexual history taking in order to make positive productive recommendations for future medical education curricula. The databases used in the search were OpenAthens, PubMed, and Google Scholar. Search terms included LGBT, sexual history taking, sexuality, medical education, medical student, physician assistant student, gay, lesbian, transgender, training, and curriculum. Support from administration, faculty and community members are vital to successful development and implementation of inclusive curricular diversity modifications. Faculty may require robust training prior to leading important SGM health discussions. Integration of sexual health issues throughout all applicable course content allows for broader assimilation into standard of care and can address aspects of trainee discrimination and biases by embodying instead of isolating content. While few, excellent outcome programmatic examples of SGM curricular instillations exist to emulate and enhance. Further research is needed on optimal depth and breadth material criterion, and most effective instructional techniques for quality outcomes.
在医师助理（PA）教育中，性健康、性病史采集技能和多样性培训的课程纳入一直以来都有所欠缺，平均只有 5 个小时的教学时间。随着美国人口中有 4.5%的人认同自己为性少数群体和性别少数群体（SGM），社区的多样性越来越大，但大多数医疗项目都没有解决特定的 SGM 需求。培训生在正确采访、评估和为 SGM 患者提供有针对性的护理方面准备不足。这导致在疾病预防、心理健康和药物滥用方面存在危险的医疗保健差距。此外，由于提供者的歧视、偏见以及在治疗该人群时的普遍不适，这也给适当的医疗保健带来了重大障碍。本文献综述的目的是探讨与医疗培训生在性健康和性病史采集主题方面的知识和培训差距相关的证据，以便为未来的医学教育课程提出积极的建设性建议。搜索中使用的数据库包括 OpenAthens、PubMed 和 Google Scholar。搜索词包括 LGBT、性病史采集、性行为、医学教育、医学生、医师助理学生、同性恋、女同性恋、跨性别、培训和课程。行政部门、教师和社区成员的支持对于成功开发和实施包容性课程多样性修改至关重要。在领导重要的 SGM 健康讨论之前，教师可能需要接受强化培训。将性健康问题纳入所有适用课程内容中，可以更广泛地纳入标准护理，并通过体现而不是孤立内容来解决培训生歧视和偏见的问题。虽然存在少数优秀的 SGM 课程实施的范例可以借鉴和加强，但仍需要进一步研究最佳深度和广度的材料标准，以及最有效的教学技术，以取得良好的效果。
