Kruse Michael I, Bigham Blair L, Phillips Susan P
Department of Family Medicine McMaster University Hamilton Ontario Canada.
Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada.
AEM Educ Train. 2024 Mar 20;8(2):e10958. doi: 10.1002/aet2.10958. eCollection 2024 Apr.
Sexual and gender minorities (SGM) make up 4% of the Canadian population. Due to existing barriers to care in the community, SGM patients may seek more help and be sicker at presentation to hospital. Paramedics occupy a unique role and can remove or decrease these barriers. There are no existing evaluations of training programs in SGM health for prehospital providers. A training program to develop better allyship in paramedics toward SGM populations was developed and assessed.
A 70- to 90-min mandatory, asynchronous, online training module in SGM health in the prehospital environment was developed and delivered via the emergency medical service (EMS) system's learning management system. A before-and-after study of cisgender, heterosexual, frontline paramedics was performed to measure the impact of the training module on the care of SGM patients. The validated Ally Identity Measure (AIM) tool was used to identify success of training and includes subscales of knowledge and skills, openness and support, and oppression awareness. Demographics and satisfaction scores were collected in the posttraining survey. Matched and unmatched pairs of surveys and demographic associations were analyzed using nonparametric statistics.
Of 609 paramedics, 571 completed the training, and 239 surveys were completed before and 105 ( = 344) surveys after the training; 60 surveys were paired. Overall AIM scores of matched pairs ( = 60) improved by 12% ( < 0.001), with knowledge and skills accounting for most of the increase (21%, < 0.001). Unmatched pairs ( = 344) were similar in demographics and scores. Rural paramedics also had significantly lower pretraining oppression awareness scores and had lower posttraining AIM scores compared to suburban paramedics (6% difference). Satisfaction scores rated the training as relevant and applicable (87% and 82%, respectively).
A novel prehospital training program in the care of SGM patients resulted in a statistically significant increase in allyship in cisgender, heterosexual-identified frontline paramedics.
性少数群体和性别少数群体（SGM）占加拿大人口的4%。由于社区中存在医疗保健障碍，SGM患者在前往医院就诊时可能会寻求更多帮助且病情更严重。护理人员扮演着独特的角色，可以消除或减少这些障碍。目前尚无针对院前医疗服务提供者的SGM健康培训项目评估。我们开发并评估了一个培训项目，以培养护理人员对SGM群体更好的盟友关系。
通过紧急医疗服务（EMS）系统的学习管理系统，开发并提供了一个70至90分钟的强制性、异步在线院前环境中SGM健康培训模块。对顺性别、异性恋的一线护理人员进行了前后对照研究，以衡量培训模块对SGM患者护理的影响。使用经过验证的盟友身份测量（AIM）工具来确定培训的成效，该工具包括知识与技能、开放性与支持以及压迫意识等子量表。在培训后的调查中收集了人口统计学数据和满意度评分。使用非参数统计分析匹配和不匹配的调查对以及人口统计学关联。
在609名护理人员中，571人完成了培训，培训前完成了239份调查问卷，培训后完成了105份（共344份）调查问卷；60份调查问卷进行了配对。配对组（n = 60）的总体AIM评分提高了12%（P < 0.001），其中知识与技能的提高占了大部分（21%，P < 0.001）。不匹配组（n = 344）在人口统计学和评分方面相似。与郊区护理人员相比，农村护理人员培训前的压迫意识评分也显著较低，培训后的AIM评分也较低（相差6%）。满意度评分将该培训评为相关且适用（分别为87%和82%）。
一项针对SGM患者护理的新型院前培训项目使顺性别、异性恋身份的一线护理人员的盟友关系在统计学上显著增强。
