Ben Hersh, MD
PGY-4 Family Medicine Resident
Oregon Health & Science University
Oregon Health & Science University
Rebecca Cantone, MD
Director of Student Education for Family Medicine
Oregon Health & Science University
Oregon Health & Science University
BACKGROUND:
Transgender individuals face significant marginalization in health care:
25% reported having to teach their practitioner about transgender people in order to receive appropriate care.
Only 50% had ever received hormone-based therapy though almost 80% desired it.
Only 16% of academic institutions self-identify as having comprehensive LGBT based training and over 50% as having none.
Institutions with transgender specific curriculum have noted improvement in learner’s knowledge, attitudes, and beliefs about transgender health.
PROJECT:
Goal: Address health disparities experienced by transgender individuals and improve deficiencies in training through the creation of an Objective Structured Clinical Examination (OSCE) for family medicine residents.
Learning Objectives: Improve confidence in evaluating eligibility for and prescribing gender affirming hormones.
Case Scenario: A healthy gender non-binary adult establishing care and seeking hormone affirmation therapy.
Curriculum Evaluation: Residents (n=19) and observing faculty (n=10) completed pre and post Surveys.
DATA ANALYSIS METHODS:
Differences between pre and post survey items were analyzed using the Wilcoxon Signed Rank Test. Since multiple hypotheses were tested, a Holm-Bonferroni correction was applied.
RESULTS:
Learners showed statistically significant improvement in confidence in their knowledge and awareness.
Faculty showed a statistically significant improvement in confidence in their knowledge in aggregate.
LESSONS:
When creating curriculum to address the needs of a diverse group, it is essential to have early and regular input from community stakeholders.
Faculty of all experience levels are able to participate and learn in this curriculum format.
Early identification of shared project goals with your institution can significantly help with buy-in and resource allocation.
100% fidelity between Standardized Patient (SP) familiarity/experience with the subject matter would be optimal, but may be hindered by resources. Hence, adequate training for SPs is critical.
Resident initiated projects and outreach can help drive higher faculty engagement