SAT402 A Multimodal Curriculum To Improve Medical Student Gender-affirming Communication Skills

Abstract

Abstract Disclosure: R.B. Jones: None. C. Maskart: None. J.M. Radway: None. A. Amaro: None. S. Cardillo: None. Introduction: Transgender and gender-diverse (TGD) people, whose gender identities and/or expression(s) exist outside the gender binary, are marginalized in healthcare. They often meet medical providers who do not have the skills or experience to address issues relevant to TGD persons. This can lead to suboptimal care and in some situations, micro- or macroaggressions. Physicians can help create a welcoming environment for gender-diverse people by addressing them in a respectful and affirming way. Physicians and trainees, however, rarely receive formal instruction or simulated training to practice providing gender-affirming care. Objective: The goal of the session was to give medical students an opportunity to observe, practice, and debrief medical encounters with gender-diverse patients. We collaborated with TGD standardized patients (SPs) and the standardized patient program to design a multimodal communication skills session: - 20-minute didactic lecture reviewing health care disparities affecting gender-diverse individuals and examples of gender-affirming language - 15-minute video encounter showing a provider misgendering a TGD SP then recovering, followed by a provider not misgendering the patient - 45-minute small group session where students take a history for a patient beginning hormone treatment to facilitate gender transition. Students receive feedback from the SP and preceptor. Notable design characteristics include TGD SPs involved in the curriculum and case scenario creation, piloting of the session, and recruitment of only faculty preceptors with clinical experience in gender-affirming hormone treatment (GAHT) to facilitate sessions. Results/Conclusions: 124 students completed the curriculum. Prior to and one week after the curriculum, students completed a 5-point self-assessment survey measuring six items: pronoun use, recovery from misgendering, communication skills with TGD knowledge, ability to take a targeted history, mental health effects of GAHT, and how to assess for treatment goals, skills, and attitudes with respect to gender-diverse healthcare. 85 students completed the pre-survey and 32 students completed the post-survey. When results were dichotomized to low (1-3 on scale) and high (4-5) comfort or ability, over 50% of students who completed the post-survey changed from low to high in their self-rated ability to take a targeted history, knowledge of the mental health effects of GAHT and how to assess for treatment goals. Qualitatively, SPs thought preceptors were particularly knowledgeable and affirming in the topic. Student feedback suggested the need for smaller group sizes which will be adapted for future iterations. Presentation: Saturday, June 17, 2023