Bridging the Gap in Graduate Medical Education: A Longitudinal Pediatric Lesbian, Gay, Bisexual, Transgender, Queer/Questioning Health Curriculum.

Abstract

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. 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. 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. 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.