Curricular Inclusion of Sexual and Gender Minority Primary Healthcare Needs for Physician Assistant Trainees: A Literature Review.

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.