Utilizing the Delphi Method to Develop Undergraduate Medical Education Learning Objectives to Address Medical Care of Gender and Sexually Diverse Individuals.

Introduction Gender and sexually diverse (GSD) individuals disproportionately experience worse outcomes, bias, discrimination, and inequities in their care. Many avoid seeking healthcare due to fear of discrimination and mistreatment. One method for improvement focuses on specific GSD medical care training for undergraduate medical education (UME) learners. Efforts to standardize GSD care in UME are present, as displayed by the competencies put forth by the Association of American Medical Colleges (AAMC); however, these attempts resulted in broad themes that can be challenging to implement. The need for specific and easily implementable learning objectives exists. Methods We aimed to create a set of learning objectives specific to GSD care by utilizing the Delphi Method to develop consensus. Three hundred and seventy-nine individuals were invited to participate in this study, which involved four iterative rounds of expert participation. In round one, the expert panel received an initial questionnaire comprising published learning competencies and items. The panel was requested to review and propose additional items. The research team then consolidated and structured these items into learning objectives. In round two, the expert panel was asked to review these objectives and edit language to reflect appropriate, inclusive language. In round three, the expert panel was asked to rate the importance of each learning objective using a 5-point Likert scale (1 =not at all important; 5 =extremely important). In round four, experts were given the overall panel's mean and mode rating for each objective, reminded of their rating, and asked to make a final rating. Learning objectives rated 4 or 5 ("very important" or "extremely important") by at least 80% of experts were determined to be at consensus. The researchers then further examined objectives that had 100% respondent rating of either 4 or 5, thus achieving universal consensus by our expert panel. Results Although 59 individuals agreed to participate in the study, 31 individuals engaged in at least one round of the iterative process as part of the expert panel. The initial questionnaire comprised 30 competencies published by the AAMC and 32 published overlapping learning items. After round two, 79 learning objectives were created. This process eliminated 28 objectives, resulting in 51 succinct objectives that used inclusive and patient-centered language. Conclusion These learning objectives can easily be integrated into existing curricular structures in UME. They can be utilized to improve curricular education for future health professionals, with the final goal of improving health equity for GSD individuals.