Objective

Despite known health disparities, there is limited training in lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) health, particularly in pediatric graduate medical education (GME). We aimed to develop a longitudinal LGBTQ curriculum for a pediatrics residency program tailored to the needs and interests of our trainees.

Methods

We developed a year-long curriculum based on a formal needs assessment and evaluated changes in provider knowledge, comfort, and self-reported clinical impact through pre- and postsurveys.

Results

The needs assessment was completed by 78 out of 110 providers (70.9% response rate); 60 (54.5%) and 70 (63.6%) completed the pre- and postcurriculum surveys, respectively. Postcurriculum implementation, there was an increase in mean comfort level asking about sexual orientation (4.1–4.5, P < .01), gender identity (3.5–3.8, P = .02), and sexual practices (3.4–3.8, P < .01), psychosocial screening (3.2–4.2, P < .01), applying medical/preventive screening guidelines (2.4–3.6, P < .01), and medically managing transgender patients (1.9–3.1, P < .01). Knowledge-based assessments increased from 25.2% correct to 38.5% (P = .01). Faculty felt significantly more comfortable teaching this material to trainees (21.7–70.0%, P < .01). Providers reported high scores regarding impact on clinical practice (4.0 of 5), intent to change practice (4.5 of 5), importance of (4.8 of 5) and satisfaction with (4.5 of 5) the curriculum.

Conclusions

There is a need to incorporate formal LGBTQ health training in GME. Our curriculum improved provider knowledge, comfort, self-reported clinical practice, and faculty preparedness to teach this material. It can serve as a framework for other pediatric programs to develop their own curricula.

中文翻译：

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弥合研究生医学教育的差距：纵向小儿女同性恋、男同性恋、双性恋、跨性别、酷儿/质疑健康课程

客观的

尽管存在已知的健康差异，但在女同性恋、男同性恋、双性恋、跨性别、酷儿/质疑 (LGBTQ) 健康方面的培训有限，尤其是在儿科研究生医学教育 (GME) 方面。我们的目标是为儿科住院医师计划开发一个纵向 LGBTQ 课程，以满足我们学员的需求和兴趣。

方法

我们根据正式的需求评估制定了为期一年的课程，并通过事前和事后调查评估了提供者知识、舒适度和自我报告的临床影响方面的变化。

结果

110 家供应商中有 78 家完成了需求评估（响应率 70.9%）；60 (54.5%) 和 70 (63.6%) 分别完成了课前和课后调查。课程实施后，询问性取向（4.1-4.5，P < .01）、性别认同（3.5-3.8，P  = .02）和性行为（3.4-3.8，P < .01）的平均舒适度有所增加。 01)、社会心理筛查 (3.2–4.2, P < .01)、应用医学/预防性筛查指南 (2.4–3.6, P < .01) 和医学管理跨性别患者 (1.9–3.1, P < .01)。基于知识的评估从 25.2% 的正确率增加到 38.5% ( P = .01）。教员们对向学员教授这些材料感到更加自在（21.7-70.0%，P < .01）。提供者在对临床实践的影响（5 分中的 4.0）、改变实践的意图（5 分中的 4.5 分）、重要性（5 分中的 4.8 分）和课程满意度（4.5 分，共 5 分）方面报告了高分。

结论

有必要将正式的 LGBTQ 健康培训纳入 GME。我们的课程提高了提供者的知识、舒适度、自我报告的临床实践以及教员教授这些材料的准备。它可以作为其他儿科项目开发自己课程的框架。