Comprehensive Internal Medicine Residency Curriculum on Primary Care of Patients Who Identify as LGBT

Eloho O. Ufomata · Kristen Eckstrand · Peggy B. Hasley · Kwonho Jeong · Doris McGartland Rubio · Carla L. Spagnoletti

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LGBTQ Health, Identity, and Policy Innovations in Medical Education Diversity and Career in Medicine

Abstract

PURPOSE: Graduate medical education curricula that provide training on LGBT healthcare are limited. The purpose of this study was to create and evaluate an LGBT curriculum for internal medicine (IM) residents. METHODS: The implicit association test (IAT) measuring implicit bias toward gay individuals was administered as part of a needs assessment. The curriculum was developed by a multidisciplinary team, with objectives derived from the Association of American Medical Colleges' curricular recommendations and the Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health. Surveys assessed residents' perceptions of the importance of primary care for LGBT patients, and their knowledge of and confidence in providing primary care to LGBT patients. Faculty also rated the usability of the curricular materials. RESULTS: The IAT showed a slight preference for straight people compared with gay people, with an average "D score" of 0.27 ± 0.42. The importance of receiving education about the primary care of LGB patients was rated as high across the pre- to postsurveys. Knowledge improved with participation in the curriculum (average overall score: 42% pre- vs. 66% postsurvey, p < 0.0001). Participants' confidence in their ability to provide information to LGBT patients about resources for community engagement and to implement gender-neutral practices in their clinics increased significantly (p < 0.05). CONCLUSION: This curriculum pilot demonstrated an improvement in IM residents' knowledge of and confidence in providing care to LGBT patients. Our results suggest that curricular materials can be developed by experts in LGBT health and utilized effectively by nonexpert faculty to increase residents' knowledge and confidence regarding LGBT healthcare.

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1998Measuring individual differences in implicit cognition: The implicit association test.1998Measuring individual differences in implicit cognition: The implicit association test.2003Understanding and using the Implicit Association Test: I. An improved scoring algorithm.2011Lesbian, Gay, Bisexual, and Transgender–Related Content in Undergraduate Medical Education 2015Health Care Providers’ Implicit and Explicit Attitudes Toward Lesbian Women and Gay Men 2016Implicit Racial Bias in Medical School Admissions 2015Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians 2014The Prevalence of Lesbian, Gay, Bisexual, and Transgender Health Education and Training in Emergency Medicine Residency Programs: What Do We Know?

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