“一张人脸和声音”：跨性别患者教育者和医学生对性别多样性教学的观点。

'A human face and voice': transgender patient-educator and medical student perspectives on gender-diversity teaching.

机构信息

Medical School, Australian National University, Canberra, ACT 2600, Australia.

School of Medicine and Psychology, Australian National University, Canberra, ACT 2600, Australia.

出版信息

BMC Med Educ. 2023 Sep 1;23(1):621. doi: 10.1186/s12909-023-04591-9.

DOI:10.1186/s12909-023-04591-9

PMID:37658319

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10472656/

Abstract

BACKGROUND

Transgender and gender diverse (TGD) people face many obstacles in accessing health care, including discrimination, institutional bias, and clinician knowledge deficits. We developed a clinical skills and education module on gender-affirming care for pre-clinical medical students, in collaboration with a TGD-led civil society organisation. The module consisted of an educational session followed by preceptor-facilitated small group tutorials, led by TGD patient-educators (n = 22) who used their lived experience to explore medical history-taking and broader issues related to TGD healthcare with students (n = 199). This study aimed to explore the views of students and TGD patient-educators on the structure, delivery and impact of the module.

METHODS

Analysis of responses of TGD patient-educators and students to the module (2020 and 2021), in post-intervention surveys using open-ended questions for TGD patient-educators (18 responses from 22 educators) and free text comments as part of a quantitative survey for medical students (89 responses).

RESULTS

Responses from students and patient-educators to the session were highly positive. Students and patient-educators emphasised that the teaching session succeeded through elevating the centrality of shared experience and creating a safe space for learning and teaching. Safety was experienced by patient-educators through the recognition of their own expertise in a medical environment, while students reported a non-judgemental teaching space which allowed them to explore and redress recognised limitations in knowledge and skill. Patient-educators described their motivation to teach as being driven by a sense of responsibility to their community. Preceptor attitudes may function as a barrier to the effectiveness of this teaching, and further attention should be paid to supporting the education of clinical facilitators in TGD health.

CONCLUSION

The experiences of TGD patient-educators and medical students in this study suggest that this model of teaching could serve as a transferable template for TGD health and the inclusion of other historically marginalised groups in medical education.

摘要

背景

跨性别和性别多样化（TGD）人群在获得医疗保健方面面临许多障碍，包括歧视、制度偏见和临床医生知识不足。我们与 TGD 领导的民间社会组织合作，为医预学生开发了一个关于性别肯定护理的临床技能和教育模块。该模块由一个教育环节和随后的导师指导的小组辅导组成，由 TGD 患者教育者（n=22）领导，他们利用自己的生活经验与学生（n=199）探讨医学问诊和与 TGD 医疗保健相关的更广泛问题。本研究旨在探讨学生和 TGD 患者教育者对该模块的结构、交付和影响的看法。

方法

对 TGD 患者教育者和学生对该模块（2020 年和 2021 年）的反应进行分析，使用开放式问题对 TGD 患者教育者（22 名教育者中的 18 名）进行干预后调查，对医学生进行定量调查时使用自由文本评论作为其中的一部分（89 名学生的 89 条回复）。

结果

学生和患者教育者对该课程的反应非常积极。学生和患者教育者强调，教学课程通过提升共同经验的中心地位和创造一个学习和教学的安全空间而取得成功。患者教育者通过在医疗环境中认可自己的专业知识而感到安全，而学生则报告说，他们处于一个非评判性的教学空间，让他们能够探索和纠正知识和技能方面公认的局限性。患者教育者表示，他们的教学动机是出于对社区的责任感。导师的态度可能成为这种教学有效性的障碍，应进一步关注支持 TGD 健康和其他历史上被边缘化群体的医学教育。