Experience with an LGBT Health Curriculum for Second Year Medical Students

1. Experience with an LGBT Health Curriculum for Second Year Medical Students Ellen Haller, M.D.; Shane Snowdon; Megan Swanson, MS3; Genevieve Peer, MD; Robert Daroff, MD Sample anonymous comments about the small group sessions: “I really liked how Dr. X was very flexible and had us spend more time talking about our LBGT related issues/concerns/questions rather than concentrating on going through the cases. I was also really touched by how well she expressed her story and feelings about issues that pertain to LGBT health. It made me proud to be learning medicine here.” “This was one of the best small group sessions yet. Dr. Y was amazing to share her story with us—what a wonderful way to break down traditional boundaries and just interact with and learn from each other as people.” Sample anonymous comments about the lecture/panel discussion: “What an incredible panel! We are so fortunate to have this session in our formal curriculum.” “The panel presented the key points in an organized and sensitive manner.” Purpose An annual two hour LGBT learning module designed to combat bias, raise awareness, and impart knowledge about LGBT health was introduced into the required UCSF second year medical school curriculum in 2004. The 2008 module was expanded to three hours and updated to include advances in LGBT health sciences and process changes informed by adult learning theory. This poster reviews the content and quality of the revised LGBT curriculum and plans for future development. Methods and Materials • Faculty interviews, a systematic literature review, national teaching guides and handbooks, student surveys, and previous UCSF syllabus chapters were used to create a revised, definitive, coordinated, and sustainable product. • Products included: • a comprehensive LGBT curriculum roadmap to promote longitudinal coordination of related content from across all MS1-2 courses • didactic lecture materials, extensive references • interactive, case-based small group content • Syllabus chapters included: • Primary Care Issues including Mental Health • Gynecological Health Issues for Lesbians and Bisexual Women • Sexual Health Issues for Men Who Have Sex with Men • Health Care Issues for Transgender People • Steps Clinicians Can Take to Become More LGBT-friendly Background • Numerous reports have indicated a need for greater attention to the health of lesbian, gay, bisexual, and transgender (LGBT) communities. • Studies have indicated that in addition to having the same basic health needs as the general population, LGBT people face systematic health disparities related to their sexual orientation and/or gender identity. • While the majority of health needs of LGBT people are identical to those of the general population, there are a few specific issues - many of which are related to living in a historically biased society - about which physicians must familiarize themselves. • UCSF introduced an LGBT learning module in 2004 to address these health disparities. An earlier report examining the effects of the module (Kelly, 2008) noted significant increased knowledge about access to health care and LGBT relationships, increased willingness to treat patients with gender identity issues, and enhanced awareness that sexual practices and identity are clinically relevant. • ----------------------------------------------------------------------References: Kelly L, Chou C, et al. Teaching and Learning in Medicine, 2008. • Current curriculum available from authors Conclusions Prior data supported the effect of a two hour module on LGBT health of improving knowledge and attitudes among UCSF MS-2’s. This initial examination of the effect of expanding the session to three hours and significantly revising the syllabus suggests that the module continues to be well received and useful. Descriptive comments suggest that the most powerful component for students may be out LGBT faculty facilitating small groups and including their personal experiences in the discussion. The three hour module included an introductory lecture and panel discussion for 90 minutes covering syllabus chapters described above, followed by 80 minute small groups, each led by an out LGBT faculty. Results Anonymous electronic evaluations were solicited from all students in attendance. Approximately 138 students attended the panel and lecture and 28 of those students submitted evaluations for a response rate of 20%. The response rate for evaluations of small groups was 82%. Numerical ratings are presented below and compared to ratings of similar activities. No other objective assessments were measured for this intervention. (Scale: 3=good; 4=very good; 5=excellent.) Additional research is needed to assess the best methods for addressing health disparities and bias faced by LGBT people in health care settings. UCSF’s module may address some of these issues through comprehensive education and exposure. Other schools are welcome to copy and implement it. The authors would like to give special acknowledgement to the UCSF Chancellor’s Advisory Committee on GLBT Issues and to the UCSF LGBT Resource Center. University of California, San Francisco School of Medicine