Successful implementation of an LGBTQI health elective into a medical school curriculum: a tool to increase culturally-sensitive care in person-centered medicine
AbstractMost US medical schools do not yet include gender and sexual diversity in pre-clinical curricula and lack formal training in the medical care of Lesbian, Gay, Bisexual, Trans, Intersexed and Queer (LGBTIQ) patients. This paper describes the design, implementation and evaluation of a student-led pre-clinical elective to address such deficiencies at one institution. After formally assessing curricular gaps, two medical students designed a semester-long course consisting of eight lecture-discussion sessions taught by volunteer community physicians and activists, accompanied by reading and written assignments. In the inaugural year of the course, the response rate for written anonymous evaluations by student participants was 81.2% (n=29). Quantitative and qualitative evaluations of both individual sessions and the course were extremely positive. In spite of initial educational challenges and limitations that have since been addressed, including lecture overlap and a self-selected audience, the course has thus far proved sustainable. The curriculum intervention achieved its further goals of institutional recognition of the need for LGBTIQ education and providing a model to integrate elective material into the standard curriculum. This paper provides medical students, faculty and administrators with a medical education pre-clinical curriculum development template for addressing other curricular content gaps at their own institutions, particularly for medically under-served populations. As such, it is advanced as an important contribution to the advancement of culturally-sensitive clinical practice, a key component of person-centered medicine.
Dohrenwend, A. (2009). Perspective: A grand challenge to academic medicine: Speak out on gay rights. Academic Medicine 84, 788-792.
Obedin-Maliver, J., Goldsmith, E.S., Stewart, L., White, W., Tran, E., Brenman ,S., Wells,
M., Fetterman, D.M., Garcia, G. &Lunn, M.R. (2011).Lesbian, gay, bisexual, and transgender-related content in undergraduate medical education.Journal of the American Medical Association 306 (9), 971-977.
Brondani, M.A. & Paterson, R. (2011). Teaching lesbian, gay, bisexual, and transgender issues in dental education: A multipurpose method. Journal of Dental Education 75 (10), 1354-1361.
Sanchez, N.F., Rabatin, J. & Sanchez, J.P. (2006). Medical students' ability to care for lesbian, gay, bisexual, and transgendered patients. Family Medicine 38 (1), 21-27.
Wallick, M.M., Cambre, K.M. & Townsend, M.H. (1992). How the topic of homosexuality is taught at US medical schools. Academic Medicine 67 (9), 601-603.
McGarry, K.A., Clark, J.G., Cyr, M.G. &Lindau, C. (2002). Evaluating a lesbian and gay healthcare curriculum. Teaching and Learning in Medicine 14 (4), 244-248.
Council of Scientific Affairs, American Medical Association. (1996). Healthcare needs of gay men and lesbian women in the United States. Journal of the American Medical Association 275, 1254-1259.
Tesar, C.M. &Rovi, S.L. (1998). Survey of curriculum on homosexuality/bisexuality in departments of family medicine. Family Medicine 30 (4), 291-297.
Gay and Lesbian Medical Association (GLMA). “Creating A Safe Clinical Environment for Lesbian, Gay, Bisexual, Transgender and Intersexed (LGBTI) Patients.” Guidelines accessed October 21st, 2011.
Gay and Lesbian Medical Association (GLMA). “Healthy People 2010: Lesbian, Gay, Bisexual and Transgender Health.” www.glma.org accessed October 21st, 2011.IQ Solutions, Inc; 2010.
Lee, P.A., Houk, C.P., Ahmed, S.F., Hughes, I.A. et al. (2006). Consensus statement on management of intersex disorders. Pediatrics 118 (2), e488-e500.
Caro-Bruce, E., Schoenfield, E., Nothnagle, M. & Taylor, J. (2006). Addressing gaps in abortion education: a sexual health elective created by medical students.Medical Teacher 28 (3), 244-247.