School of Medicine, University of California San Francisco, San Francisco, USA.
, 513 Parnassus Ave, S-221, San Francisco, CA, USA.
BMC Med Educ. 2022 Oct 5;22(1):706. doi: 10.1186/s12909-022-03766-0.
A lack of undergraduate medical curricula on providing healthcare to transgender and gender diverse (TGD) patients has contributed to significant health disparities for TGD communities. To address this gap, we designed and evaluated a novel curriculum to train Obstetrics and Gynecology (OB/GYN) clerkship students in caring for TGD patients.
Following Kern's 6-step method for curriculum development, we created a two-part curriculum on TGD healthcare topics - an online module on gender-affirming care, followed by a series of interactive cases on TGD-specific health topics. Undergraduate medical students completing their core OB/GYN clerkships at a university academic medical center (January-December 2021) were invited to complete this curriculum. Participants completed pre/post assessment surveys to assess their experience caring for TGD patients, as well as a scored knowledge assessment before and after completing the curriculum.
Sixty-five students participated in this curricular assessment. Prior to completing the module, 45% agreed that they had received adequate TGD health training. Following module completion, students reported increased comfort in caring for transgender patients (49.2% vs. 81.5%; p < .001) and endorsed an improved fund of knowledge of both healthcare maintenance for TGD patients (61.5% vs. 100%; p < .001) and gender affirming medical therapies (60.0% vs. 96.9%; p < .001). Knowledge scores increased from a mean of 9.65 (1.81) to 12.5 (2.20) out of 15 (p < .001). In post-assessment surveys, 95% of participants agreed that the module was helpful for their learning. Qualitatively, students suggested longitudinal integration of TGD-topics into the pre-clinical curriculum, and expanded opportunities to practice patient counseling.
The findings of this study support the need for student education on TGD health. Integration of interactive, case-based TGD-care curricula into clinical training may increase medical students' knowledge and comfort in caring for TGD patients. Ongoing efforts to integrate TGD health training into undergraduate medical student curricula are necessary.
由于缺乏本科医学课程来为跨性别和性别多样化(TGD)患者提供医疗保健,TGD 群体存在显著的健康差距。为了解决这一差距,我们设计并评估了一门新的课程,以培训妇产科(OB/GYN)实习学生照顾 TGD 患者。
我们遵循 Kern 的 6 步课程开发方法,为 TGD 医疗保健主题创建了两部分课程-关于性别肯定护理的在线模块,以及一系列关于 TGD 特定健康主题的互动案例。在一所大学学术医疗中心完成核心妇产科实习的医学生(2021 年 1 月至 12 月)被邀请参加这门课程。参与者完成了预/后评估调查,以评估他们照顾 TGD 患者的经验,以及在完成课程前后进行的评分知识评估。
65 名学生参加了这项课程评估。在完成模块之前,45%的学生同意他们接受了足够的 TGD 健康培训。在完成模块后,学生报告说在照顾跨性别患者方面更有信心(49.2%比 81.5%;p<0.001),并认可了对 TGD 患者的医疗保健维护以及性别肯定医疗疗法的知识基础的改善(61.5%比 100%;p<0.001)和性别肯定医疗疗法(60.0%比 96.9%;p<0.001)。知识得分从 15 分中的 9.65(1.81)增加到 12.5(2.20)(p<0.001)。在后期评估调查中,95%的参与者同意该模块对他们的学习有帮助。从定性上看,学生建议将 TGD 主题纳入临床前课程的长期整合,并扩大实践患者咨询的机会。
这项研究的结果支持学生接受 TGD 健康教育的必要性。将互动式、基于案例的 TGD 护理课程纳入临床培训可能会提高医学生照顾 TGD 患者的知识和舒适度。需要不断努力将 TGD 健康培训纳入本科医学生课程。