King Callie K, Ryan Amanda M, Chase Tess
Psychologist, Center for Behavioral Health, Johns Hopkins All Children's Hospital.
Third-Year Resident, Department of Obstetrics and Gynecology, Bayfront Orlando Health.
MedEdPORTAL. 2025 Apr 1;21:11511. doi: 10.15766/mep_2374-8265.11511. eCollection 2025.
LGBTQ+ patients have decreased access to culturally competent gynecologic care, which contributes to health care inequity. We designed an interdisciplinary educational initiative for improving gender and sexually diverse gynecologic care among OB/GYN residents.
Residents were given optional American College of Obstetricians and Gynecologists Modules on Transgender Care, a lecture about LGBTQ+ health issues, and a standardized patient simulation followed by a debrief. The case of a 25-year-old assigned female at birth (AFAB), nonbinary, pansexual patient (played by an AFAB nonbinary, pansexual individual) presented for menstrual suppression. Due to known provider discomfort in this setting, learners were assessed with postintervention surveys, rather than during the simulation, to help foster psychological safety.
Pre- and postsurveys assessing LGBTQ+ competence and perceived helpfulness of the training were administered to 11 residents. Statistically significant increases ( < .05) were observed in comfort working with LGBTQ+ patients, knowledge regarding health needs for LGBTQ+ patients, comfort discussing sexual health practices with transgender/gender diverse patients, and confidence in ability to provide resources for LGBTQ+ patients. There were positive trends in reducing assumptions of a patient's gender identity and sexual orientation ( = .05), confidence asking a patient's name and pronouns ( = .06), supervising trainees caring for gender and sexually diverse patients ( = .07), and comfort using inclusive language ( = .08).
Interdisciplinary education, including simulation, can increase resident confidence in providing gynecologic care for gender and sexually diverse patients, enhance cultural competence of providers, and help reduce inequities in LGBTQ+ gynecologic care.
LGBTQ+患者获得具有文化胜任力的妇科护理的机会减少，这加剧了医疗保健的不平等。我们设计了一项跨学科教育倡议，以改善妇产科住院医师对性别和性取向多样化患者的妇科护理。
为住院医师提供了美国妇产科医师学会关于跨性别护理的模块、一场关于LGBTQ+健康问题的讲座，以及一次标准化患者模拟，随后进行总结汇报。案例为一名25岁出生时被指定为女性（AFAB）、非二元性别、泛性恋的患者（由一名AFAB非二元性别、泛性恋个体扮演）前来寻求月经抑制治疗。由于已知在此场景中医疗服务提供者会感到不适，因此通过干预后的调查对学习者进行评估，而非在模拟过程中，以帮助营造心理安全感。
对11名住院医师进行了评估LGBTQ+能力和培训感知帮助性的前后调查。在与LGBTQ+患者合作的舒适度、对LGBTQ+患者健康需求的了解、与跨性别/性别多样化患者讨论性健康实践的舒适度以及为LGBTQ+患者提供资源的能力信心方面，观察到有统计学意义的增加（<.05）。在减少对患者性别认同和性取向的假设（=.05）、询问患者姓名和代词的信心（=.06）、监督照顾性别和性取向多样化患者的实习生（=.07）以及使用包容性语言的舒适度（=.08）方面有积极趋势。
包括模拟在内的跨学科教育可以提高住院医师为性别和性取向多样化患者提供妇科护理的信心，增强医疗服务提供者的文化胜任力，并有助于减少LGBTQ+妇科护理中的不平等现象。
