College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
College of Humanities and Social Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
PLoS One. 2022 Jul 7;17(7):e0270862. doi: 10.1371/journal.pone.0270862. eCollection 2022.
Integrating training on health equity of sexual and gender minorities (SGM) in medical education has been challenging globally despite emphasis on the need for medical students to develop competence to provide adequate care for diverse patient groups. This study elicits Taiwanese medical students' perceptions of their values and preparedness to care for Lesbian, Gay, Bisexual, or Transgender (LGBT) patients using a qualitative approach that considers broader societal changes, and more focused topics such as the provision of relevant training in medical education.
Eighty-nine medical students/trainees from two southern Taiwanese medical schools (one public and one private) participated in focus groups (n = 70) and individual interviews (n = 19). Qualitative analysis was conducted using inductive thematic analysis.
Participants (i) expressed wide social acceptance and openness toward LGBT individuals, but were unsure of ways to communicate with LGBT patients; (ii) confirmed that stigmatization and biases might be developed during their training; (iii) recognized gender stereotypes could have negative impacts on clinical reasoning; (iv) considered themselves prepared to care for LGBT patients, yet equated non-discriminatory attitudes to preparedness; (v) acknowledged a lack of relevant professional skills; (vi) implicated curriculum did not address LGBT issues systematically and explicitly.
This study has identified the insufficiencies of current medical training and inadequate preparedness of medical students/trainees to provide better care for LGBT patients. It provides insights for medical educators to design and implement effective medical curriculum and training, and faculty development programs to equip medical students/trainees with self-awareness and competencies to more readily provide holistic care for SGM, in keeping up with social progress, and promote health equity for a more diverse patient population.
尽管强调医学生需要发展为不同患者群体提供充分护理的能力,但在医学教育中纳入性少数群体(SGM)健康公平方面的培训在全球范围内一直具有挑战性。本研究采用定性方法,从更广泛的社会变化以及更集中的主题(如在医学教育中提供相关培训)出发,探讨了台湾医学生对自己的价值观和为同性恋、双性恋、跨性别(LGBT)患者提供护理的准备情况的看法。
来自台湾南部两所医学院(一所公立和一所私立)的 89 名医学生/实习生(70 名参加焦点小组,19 名参加个人访谈)参与了本研究。使用归纳主题分析进行定性分析。
参与者(i)表示对 LGBT 个体的广泛社会接受度和开放度,但不确定如何与 LGBT 患者沟通;(ii)确认在培训过程中可能会产生污名化和偏见;(iii)认识到性别刻板印象可能对临床推理产生负面影响;(iv)认为自己准备好照顾 LGBT 患者,但将非歧视态度等同于准备;(v)承认缺乏相关专业技能;(vi)暗示课程没有系统地明确地解决 LGBT 问题。
本研究确定了当前医学培训的不足,以及医学生/实习生为更好地为 LGBT 患者提供护理而准备不足的情况。它为医学教育工作者提供了设计和实施有效的医学课程和培训以及教师发展计划的见解,以帮助医学生/实习生提高自我意识和能力,更轻松地为 SGM 提供全面护理,跟上社会进步的步伐,并为更多样化的患者群体促进健康公平。