Amidon Joel, Taylor Shannon Stark, Hinton Sarah
Prisma Health, University of South Carolina, School of Medicine Greenville, Department of Family Medicine, Greenville, SC.
Prisma Health, University of South Carolina, School of Medicine Greenville, Department of Family Medicine, Greenville, SC | Clemson University School of Health Research, Clemson, SC.
PRiMER. 2023 Jul 21;7:24. doi: 10.22454/PRiMER.2023.329607. eCollection 2023.
An increased focus on lesbian, gay, bisexual, transgender, queer (LGBTQ+) care in graduate medical education is needed to address health disparities in this patient population. This study assessed practice confidence and practice intentions of residents who rotated through an LGBTQ+ clinic during their residency.
Residents completed three to eight half-day sessions in a dedicated LGBTQ+ clinic focusing on primary care, pre-exposure prophylaxis (PrEP), and gender-affirming care from 2019 to 2022. Prior to this clinical experience, they were provided background reading materials, care guidelines, and clinical cases. Residents were electronically surveyed at two time points after completing this clinical experience to retrospectively assess their pre-and postcurricular confidence.
Seventeen out of 18 (94%) residents who completed the curricular experience responded to the initial survey, which showed statistically significant differences between reported pre- and postcurricular confidence in providing primary care, PrEP, and gender affirmation care. Eight-eight percent of residents reported that they planned to or have already incorporated this care into their practice. In a follow-up survey 1 year later, 15 out of 18 (83%) responded, reporting consistent skills confidence. Seventy-one percent of participants reported currently providing LGBTQ+ care. We noted no statistical difference between the initial postconfidence survey and the follow-up survey.
This study demonstrated positive associations between a focused curricular experience in LGBTQ+ care and both confidence providing LGBTQ+ care and planned and actual postgraduation practice patterns.
为解决这一患者群体的健康差异问题,研究生医学教育需要更加关注女同性恋、男同性恋、双性恋、跨性别、酷儿(LGBTQ+)群体的护理。本研究评估了在住院医师培训期间轮转至LGBTQ+诊所的住院医师的实践信心和实践意愿。
2019年至2022年期间,住院医师在专门的LGBTQ+诊所完成了三到八个半天的课程,内容侧重于初级保健、暴露前预防(PrEP)和性别肯定护理。在这段临床经验之前,他们获得了背景阅读材料、护理指南和临床病例。在完成这段临床经验后的两个时间点,对住院医师进行电子调查,以回顾性评估他们在课程前后的信心。
18名完成课程体验的住院医师中有17名(94%)回复了初始调查,结果显示在提供初级保健、PrEP和性别肯定护理方面,报告的课程前后信心存在统计学上的显著差异。88%的住院医师报告称,他们计划或将这种护理纳入自己的实践中。在一年后的后续调查中,18名中有15名(83%)回复,报告了一致的技能信心。71%的参与者报告目前正在提供LGBTQ+护理。我们注意到初始信心后调查与后续调查之间没有统计学差异。
本研究表明,LGBTQ+护理方面的重点课程体验与提供LGBTQ+护理的信心以及毕业后计划和实际的实践模式之间存在积极关联。