Lesbian, Gay, Bisexual, and Transgender-Related Content in Undergraduate Medical Education
Lesbian, Gay, Bisexual, and Transgender-Related Content in Undergraduate Medical Education
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DOI：
10.1001/jama.2011.1255
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发表时间：
2011-09-07
影响因子：
120.7
通讯作者：
Lunn, Mitchell R.
中科院分区：
文献类型：
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作者：
Obedin-Maliver, Juno;Goldsmith, Elizabeth S.;Lunn, Mitchell R.
背景女同性恋、男同性恋、双性恋和变性人（LGBT）个体经历健康和医疗保健差异，并有特定的医疗保健需求。医学教育组织已经呼吁对LGBT敏感的培训，但学校如何以及在何种程度上教育学生提供全面的LGBT病人护理是未知的。目的描述LGBT相关的医学课程和相关的课程开发实践，并确定院长对其机构的LGBT相关课程内容的评估。医学教育系主任（或同等学历）在加拿大和美国的176所对抗疗法或整骨疗法医学院进行了调查，以完成一个13个问题，2009年5月至2010年3月的基于网络的问卷调查。主要结果测量报告的LGBT相关课程内容的小时数。（85.2%）回答，132人（75.0%）完全完成问卷。在整个课程中，用于教授LGBT相关内容的中位报告时间为5小时（四分位距[IQR]，3-8小时）。在132名受访者中，9名（6.8%; 95% CI，2.5%-11.1%）报告在临床前年的教学时间为0小时，44名（33.3%; 95% CI，25.3%-41.4%）报告在临床年的教学时间为0小时。美国对抗疗法的中位临床时间与美国整骨疗法的中位临床时间存在显著差异（2小时[IQR，0-4小时] vs 0小时[IQR，0-2小时]; P= 0.008）。尽管128所学校（97.0%; 95% CI，94.0%-99.9%）教导学生在获得性史时询问患者是否“与男性、女性或两者发生性关系”，报告的必修课程中16个LGBT特定主题领域的教学频率较低：83所学校至少有8个主题（62.9%; 95% CI，54.6%-71.1%）和11所学校的所有主题（8.3%; 95% CI，3.6%-13.0%）。58所学校的LGBT内容被评为“公平”（43.9%; 95% CI，35.5%-52.4%）。建议的增加内容的成功战略包括在77所学校重点关注与男女同性恋、双性恋和变性者有关的健康和健康差距的课程材料（58.3%，95% CI，49.9%-66.7%），教师愿意并能够在67所学校教授LGBT相关课程内容（50.8%，95%CI，42.2%-59.3%）。结论在2009 - 2010年，美国和加拿大医学院报告的LGBT相关主题的时间中位数很小，但数量，涵盖的内容和感知的教学质量差异很大。JAMA. 2011;306（9）：971-977
Context Lesbian, gay, bisexual, and transgender (LGBT) individuals experience health and health care disparities and have specific health care needs. Medical education organizations have called for LGBT-sensitive training, but how and to what extent schools educate students to deliver comprehensive LGBT patient care is unknown.Objectives To characterize LGBT-related medical curricula and associated curricular development practices and to determine deans' assessments of their institutions' LGBT-related curricular content.Design, Setting, and Participants Deans of medical education (or equivalent) at 176 allopathic or osteopathic medical schools in Canada and the United States were surveyed to complete a 13-question, Web-based questionnaire between May 2009 and March 2010.Main Outcome Measure Reported hours of LGBT-related curricular content.Results Of 176 schools, 150 (85.2%) responded, and 132 (75.0%) fully completed the questionnaire. The median reported time dedicated to teaching LGBT-related content in the entire curriculum was 5 hours (interquartile range [IQR], 3-8 hours). Of the 132 respondents, 9 (6.8%; 95% CI, 2.5%-11.1%) reported 0 hours taught during preclinical years and 44 (33.3%; 95% CI, 25.3%-41.4%) reported 0 hours during clinical years. Median US allopathic clinical hours were significantly different from US osteopathic clinical hours (2 hours [IQR, 0-4 hours] vs 0 hours [IQR, 0-2 hours]; P=.008). Although 128 of the schools (97.0%; 95% CI, 94.0%-99.9%) taught students to ask patients if they "have sex with men, women, or both" when obtaining a sexual history, the reported teaching frequency of 16 LGBT-specific topic areas in the required curriculum was lower: at least 8 topics at 83 schools (62.9%; 95% CI, 54.6%-71.1%) and all topics at 11 schools (8.3%; 95% CI, 3.6%-13.0%). The institutions' LGBT content was rated as "fair" at 58 schools (43.9%; 95% CI, 35.5%-52.4%). Suggested successful strategies to increase content included curricular material focusing on LGBT-related health and health disparities at 77 schools (58.3%, 95% CI, 49.9%-66.7%) and faculty willing and able to teach LGBT-related curricular content at 67 schools (50.8%, 95% CI, 42.2%-59.3%).Conclusion The median reported time dedicated to LGBT-related topics in 20092010 was small across US and Canadian medical schools, but the quantity, content covered, and perceived quality of instruction varied substantially. JAMA. 2011;306(9):971-977