Standardized Patient Experience Research Articles

Standardized Patient Encounter to Enhance Care to LGBTQIA+ Patients

Context Athletic trainers provide care for a variety of patients with diverse backgrounds, including members of the lesbian, gay, bisexual, transgender, queer, intersex, other diverse sexualities, other gender identities, or other gender expressions (LGBTQIA+) community. Learners who gain experience with patients who identify as LBGTQIA+ should be better prepared clinicians. Objective The purpose of this paper is to describe a standardized patient (SP) experience for a patient who is gay and concerned about a sexually transmitted infection after a conversation with a previous partner. Background Patients who identify as LGBTQIA+ report substandard care and have poor health care experiences. Standardized patients are used in athletic training education as a method to teach and assess skills and can be used to improve the care that learners provide to patients who identify as gay. Educational Advantage Education drives clinical practice, and incorporating SP cases in which learners must provide care for a patient who is gay will help the learners provide better inclusive patient-centered care as a clinician. Conclusions Faculty may consider using a SP encounter to better prepare learners to provide care for a patient who is gay.

The Interprofessional Standardized Patient Experience: An Effective Interprofessional Education Activity for Prelicensure Health Professional Students.

For future success in the modern health care environment, health professions students require effective interprofessional education experiences to develop their perceptions of other professionals on the health care team. The Interprofessional Standardized Patient Experience (ISPE) is an interprofessional education activity for prelicensure health professional students in nursing, pharmacy, physical therapy, medicine, social work, and occupational therapy. The ISPE involved collaboration among students to conduct a subjective interview. Students from six health care professions individually interviewed a simulated patient while being observed by students from other professions. A structured faculty-guided debriefing session followed the comprehensive interview process. Students completed a voluntary pre- and post-ISPE survey with interprofessional questions and feedback on the activity. Descriptive statistics were used to analyze individual responses. Differences in student opinions by student profession and by the number of professions present were examined using chi-square tests. Over 4 consecutive academic years, 1,265 students completed the ISPE, and 1,028 completed the pre- and post-ISPE surveys. Analysis of the survey responses indicated that the ISPE enhanced student awareness of the functions of an interprofessional team and increased student knowledge of the roles of different health care professions. Students rated the ISPE as a valuable experience. Differences were noted in some of the measures by profession and group size. A single ISPE had a significant impact on prelicensure students' perceptions. The ISPE is a novel and effective approach to interprofessional education that students appreciate.

Systematic review of contemporary interventions for improving discharge support and transitions of care from the patient experience perspective.

To synthesize the impact of improvement interventions related to care coordination, discharge support and care transitions on patient experience measures. Systematic review. Searches were completed in six scientific databases, five specialty journals, and through snowballing. Eligibility included studies published in English (2015-2023) focused on improving care coordination, discharge support, or transitional care assessed by standardized patient experience measures as a primary outcome. Two independent reviewers made eligibility decisions and performed quality appraisals. Of 1240 papers initially screened, 16 were included. Seven studies focused on care coordination activities, including three randomized controlled trials [RCTs]. These studies used enhanced supports such as improvement coaching or tailoring for vulnerable populations within Patient-Centered Medical Homes or other primary care sites. Intervention effectiveness was mixed or neutral relative to standard or models of care or simpler supports (e.g., improvement tool). Eight studies, including three RCTs, focused on enhanced discharge support, including patient education (e.g., teach back) and telephone follow-up; mixed or neutral results on the patient experience were also found and with more substantive risks of bias. One pragmatic trial on a transitional care intervention, using a navigator support, found significant changes only for the subset of uninsured patients and in one patient experience outcome, and had challenges with implementation fidelity. Enhanced supports for improving care coordination, discharge education, and post-discharge follow-up had mixed or neutral effectiveness for improving the patient experience with care, compared to standard care or simpler improvement approaches. There is a need to advance the body of evidence on how to improve the patient experience with discharge support and transitional approaches.

Teaching Note—The Dynamic Duo: Use of Standardized Clients Across the Social Work Practice and Field Curricula

ABSTRACT This reflection from one department of social work showcases the use of simulation as an integrated tool of practice-based education and assessment for social work education within generalist and specialized practice classes. We show several ways we are using simulation as both a learning and assessment tool for social work practice skills. This includes in-class simulations using paid standardized patient as clients, the use of objective standard clinical examination as an assessment tool in the standardized patient suite within the university, the use of field instructors as feedback mechanisms for standardized patient experiences, and translating and linking student skills in the classroom to real-world field experiences. Challenges, lessons learned, and opportunities for future exploration are discussed.

Dental students' perceptions of standardized patient experiences using Zoom: Dyadic factors.

The COVID-19 pandemic required a rapid transition to online education, including simulations. The current study identified students' perceptions of communicating with standardized patients in a virtual setting. This qualitative study thematically analyzed 485 reflections submitted by 248 students between Spring 2020 and Spring 2022. Statements describing both the virtual medium and dyadic interactions between students and patients were coded for emergent themes and also coded as positive (facilitative) or negative (critical). Four themes emerged from the data related to the virtual medium: impact on nonverbal communication, patient engagement/rapport, presentation aids, and listening. Within these broad themes, 13 subthemes were identified, nine of which were negative/critical. Technology problems were specifically identified as compromising both engagement and listening. Even when technology worked well, students noted that it reduced the number of message cues received from the patient and complicated the process of sending cues (e.g., by requiring students to look away from a patient's face to make "eye contact" through a camera). Overall, students were critical of Zoom's impact on dyadic factors with standardized patients. However, they did acknowledge some positive aspects regarding the technology. These findings provide a foundation to consider when teaching students how to communicate effectively via teledentistry.

Student empathy in standardized patient experiences: Applying concepts from a critical thinking emulation model.

Clinician empathy can improve patient outcomes, but the literature is scant on patient-based, student-led experiences to demonstrate the projection of empathy in patient interactions. (1) Develop a learning guide for observable behaviors communicating emotional and cognitive empathy and (2) determine whether the learning guide can be used as a rubric for assessing empathy in a standardized patient experience. Eleven standardized patients assessed 80 D3 students using a 4-point interval scale on 19 behavioral criteria in four domains: Initiation (four criteria); Health History and Caries Risk (four criteria); Treatment Planning (six criteria); and Communication Skills (five criteria). Standardized patients also provided qualitative feedback. Standardized patients completed all 1520 interval scales on the rubric and 94% of 320 open-ended entries. Students performed well. Of the 1520 criterion interval scales, 1242 (81.7%) were rated "excellent." Wilcoxon signed-rank tests revealed Initiation scores (Mean [M]=3.82, Standard deviation [SD]=0.28) and Treatment Planning scores (M=3.82, SD=0.36) were significantly higher than Health History Scores (M=3.75, SD=0.34; p<0.05). Qualitative feedback also was overwhelmingly positive for Treatment Planning and more equivocal for Health History. The emulation model for students to demonstrate observable aspects of empathy is viable as both a learning guide and evaluation rubric in a standardized patient format. The next steps include the development of a succinct skillset for reinforcement in the patient setting and continued discussion on what best captures core observable aspects of empathy.

Measuring acute effects of subanesthetic ketamine on cerebrovascular hemodynamics in humans using TD-fNIRS

Quantifying neural activity in natural conditions (i.e. conditions comparable to the standard clinical patient experience) during the administration of psychedelics may further our scientific understanding of the effects and mechanisms of action. This data may facilitate the discovery of novel biomarkers enabling more personalized treatments and improved patient outcomes. In this single-blind, placebo-controlled study with a non-randomized design, we use time-domain functional near-infrared spectroscopy (TD-fNIRS) to measure acute brain dynamics after intramuscular subanesthetic ketamine (0.75 mg/kg) and placebo (saline) administration in healthy participants (n = 15, 8 females, 7 males, age 32.4 ± 7.5 years) in a clinical setting. We found that the ketamine administration caused an altered state of consciousness and changes in systemic physiology (e.g. increase in pulse rate and electrodermal activity). Furthermore, ketamine led to a brain-wide reduction in the fractional amplitude of low frequency fluctuations, and a decrease in the global brain connectivity of the prefrontal region. Lastly, we provide preliminary evidence that a combination of neural and physiological metrics may serve as predictors of subjective mystical experiences and reductions in depressive symptomatology. Overall, our study demonstrated the successful application of fNIRS neuroimaging to study the physiological effects of the psychoactive substance ketamine in humans, and can be regarded as an important step toward larger scale clinical fNIRS studies that can quantify the impact of psychedelics on the brain in standard clinical settings.

The Use of Mock Standardized/Simulated Patient Encounters in Facilitating Development of Clinical Competence in Medical Students.

Background Standardized patient (SP) encounters are used in medical school to mimic clinical practice by exposing students to possible clinical situations they may encounter in future practice. SP includes trained individuals who portray the roles of patients to help medical students practice recording medical histories, physical exam skills, communication skills, and typing a subjective, objective, assessment and plan (SOAP) note. The goal of SP is to prepare medical students adequately during their didactic years before beginning clerkships. SP encounters have becomestandard in medical school curriculums, but the option for a mock SP encounter has not. Methods In this study, a total of 34 participants completed an eight-question survey before a mock SP experience and after their graded SP encounters to assess the students' confidence levels and preparedness. Each question addressed a different aspect of the student's satisfaction and attitude regarding the SP encounters. The answers were measured on a Likert scale from 1 (not prepared) to 5 (very prepared). The central tendency (mean) was analyzed using a T-test with Welch's method. The standard deviation was analyzed using Bonett's test.A Cronbach's alpha was used to show the reliability of the survey used. Results The first four questions addressed the student's satisfaction with their mock SP experience. The mean student satisfaction with being able to ask questions to improve their knowledge and understanding improved, with a p-value of< 0.001. Student satisfaction with having the opportunity to record a patient's history improved, with a p-value of < 0.001. The overall satisfaction with having a chance to practice physical exam skills improved, with a p-value of < 0.001. Mean student satisfaction with practicing treatment and counseling of patients improved, with a p-value of <0.001. The final four questions addressed the students' attitudes regarding their experience. The mean confidence of students improved, with a p-value of <0.001. Students also reported an improved attitude towards the feedback they received, with a p-value of <0.001. The final two questions did not show a statistically significant difference in answers. Students rated the final two questions equally before and after the mock SP experience, with p-values > 0.05. These questions addressed whether mock SP encounters would be beneficial and asked if they wanted additional mock simulation opportunities built into the curriculum. Conclusions The students showed improved confidence, attitudes, and satisfaction surrounding standardized patient encounters. The results supported the hypothesis that there would be a difference between the responses before and after the SP encounter.The questionnaire showed that the students reported subjective changes in their competence following the encounter.

(043) Assessing Confidence in Caring for LGBTQ+ in Medicine and Teaching Acclimate Survey

Abstract Introduction Discrimination against LGBTQ+ individuals in West Virginia (WV) may compound the already poor health outcomes faced by all West Virginians. Medical students across the United States (US) report positive attitudes towards LGTBQ+ patients but do not feel adequately trained to provide proper care. Medical schools and residency programs in WV have begun to incorporate LGTBQ+ training in their curricula, but the effect on confidence is not known. We report preliminary survey results from WV resident physicians and medical students on their confidence caring for LGTBQ+ patients. Objective Use survey data to evaluate the quantity and quality of LGBTQ+ medical education of residents and medical students in WV and assess its impact on confidence and comfort in treating LGBTQ+ patients. Methods An anonymous survey was distributed via REDCap from February to June 2022 to residents and medical students at a major WV medical school and teaching hospital. The survey collected demographic information and exposure to LGTBQ+ undergraduate medical training, and assessed with a Likert Scale attitudes, comfort, and confidence in providing informed care; many questions were adapted from a validated survey. Data were analyzed with Fisher’s exact and Mann-Whitney tests. Significance was set at p&amp;lt;0.05. Results Thirty-five students and 23 residents completed the survey. Students identified as male (37%), female (54%), non-binary (6%), and other (3%); residents identified as male (52%) or female (48%). Most students (77%) and residents (83%) were heterosexual; other sexual orientations included gay (6% of students, 4% of residents), lesbian (6% of students), bisexual (9% of students, 13% of residents). One student (3%) identified as “other.” Most students (67%) were from WV and most residents (57%) attended medical school in WV. Residents were from nine specialties; Internal Medicine (22%) and Surgery (22%) were most represented. Residents attended US (61%), International (35%), and Caribbean (4%) schools. Most residents did not have LGBTQ+ lectures (57%) or standardized patients (57%) in medical school (57%), but have had lectures in residency (55%). Students reported LGTBQ+ curriculum (67%) but not standardized patients (69%). Students felt more competent than residents with LGTBQ+ language (z=3.04, p&amp;lt;0.00), and that physicians should ask patients their pronouns, gender identity (z=2.8, p=0.01). Among all respondents, those without LGTBQ+ curriculum in medical school felt less comfortable asking about gender identity (z=–2.24, p=0.03), sexual orientation (z=–2.207, p=0.03), sexual preferences (z=–2.705, p=0.01), and reported anxiety about their knowledge of LGTBQ+ healthcare (z=3.354, p&amp;lt;0.00). Those without standardized patient experiences felt less competent (z=–4.127, p&amp;lt;0.00) and more anxious (z=3.040, p&amp;lt;0.00) performing a physical exam on a transgender patient. Most subjects reported appropriate awareness of disparities (64%), but not in linking patients to resources (52%); most would attend training (89%) and support mandatory LGTBQ+ education (93%). Conclusions Though preliminary results, medical learners want training in LGTBQ+ healthcare and do not feel adequately prepared to care for the unique needs of these patients. Disclosure No

Promoting Sexual and Gender Minority Health Clinical Skills Training for All Medical Students.

Despite societal, legal, and cultural improvements in their well-being, sexual and gender minority (SGM) people in the United States still face substantial physical and mental health disparities that are exacerbated by physician stigma and lack of training. Although there have been efforts at medical schools nationwide to address these disparities and interweave SGM health education into existing preclerkship courses, opportunities to practice related clinical skills during the clerkship years remain largely elective. Furthermore, national survey data from 2020 indicate that SGM Americans continue to delay or avoid medical care because of physician discrimination. By providing predominantly opt-in opportunities for hands-on SGM health clinical training, educators risk perpetuating existing structural inequities and widening health disparities. In this article, the authors advocate for required SGM health clinical training for all undergraduate medical students, regardless of intended specialty. They highlight 3 types of elective SGM health clinical training models currently in use at medical schools across the country, including student-run clinics, advanced electives, and longitudinal scholarly concentrations. Using these examples, the authors then outline ways that educators can interweave required SGM health clinical training into undergraduate medical education, including with the recruitment and retention of SGM faculty, staff, and students; required SGM standardized patient experiences; the integration of SGM clinical opportunities throughout the core clerkships; and partnerships with SGM health centers. Using these methods, medical schools can mobilize passionate students, faculty, and leaders to both counter the bigotry and hate faced by SGM populations and develop innovative strategies to improve SGM patient health outcomes and expand opportunities for SGM health scholarship.

Engaging Nursing Students in Mental Health Concepts Through Multiple Teaching Modalities

Utilizing multiple active learning strategies may facilitate knowledge, critical thinking, communication, and attitude regarding mental health concepts in nursing students. Faculty in an accelerated 12-month baccalaureate nursing program delivered mental health nursing concepts utilizing team-based learning (TBL), a video response assignment, faculty-led clinical in an inpatient psychiatric hospital, and a standardized patient simulation. Twenty-two nursing students (71%) voluntarily completed a faculty-derived instrument to evaluate the efficacy of each learning experience on knowledge, critical thinking, communication, and attitude. Students favored in-person clinical (73%-91%) and TBL (68%-77%) in terms of the perceived effectiveness to improve knowledge, critical thinking, communication, and attitude toward the mentally ill. Standardized patient experiences (45%-64%) were not rated as favorably but did fare better than video-response assignments (32%-45%). Research is needed to provide a formal evaluation of mental health teaching modalities. [J Nurs Educ. 2023;62(X):XXX-XXX.].

In-Person or Online? Exploring Student Pharmacists’ Perceived Change in Interprofessional Skills between Two Delivery Formats

The COVID-19 pandemic drastically changed how education is delivered. Many academic programs quickly transformed their curriculum to online distance learning. This rapid transition may have compromised the rigor and fidelity of these activities. The Interprofessional Standardized Patient Experience (ISPE) is an interprofessional education activity (IPE) involving a team of students from six different healthcare professions that switched to an online delivery format. This manuscript compares pharmacy students' perceived change in interprofessional skills between the two formats. Following the ISPE, second-year pharmacy students completed the revised Interprofessional Collaborative Competencies Attainment Survey (ICCAS-R). The ICCAS-R assesses the change in interprofessional collaboration-related competencies in healthcare students before and after IPE training using a retrospective pre-post approach. For each ICCAS-R item and each delivery format (44 in-person and 51 online), paired Student's t-test on pre- and post-ISPE scores, and Cohen's d were calculated. Every item of the ICCAS-R was significant (p < 0.001), regardless of delivery format. Nearly all ICCAS-R items had a large effect size, and the remaining items had a medium effect size. The amount of change pre- and post-ISPE for each ICCAS-R item was calculated. Student's t-test was used to compare the magnitude of change in interprofessional skills between the two delivery formats. Only one difference was noted between the two delivery formats-ICCAS-R item 16, which measured actively listening to interprofessional team members (p = 0.0321). When switching to an online format, the high-fidelity dimension of the ISPE was retained. The ISPE is an effective IPE activity at increasing pharmacy students' self-perceived interprofessional collaboration skills regardless of delivery format. Even though students reported the ISPE increased their ability to actively listen to the perspectives of interprofessional team members in both formats, the magnitude of the benefit was more profound in the in-person group.

Creating opportunities for telehealth education, assessment, and care through Hotspotting (CO-TEACH): An interprofessional telehealth delivery curriculum and guide

Telehealth offers a healthcare solution when functional, social, or geographic barriers arise; however, many clinical education curricula are ill-equipped to prepare learners for effective, multidisciplinary telehealth consultations. The COVID-19 pandemic drastically expanded reliance on telehealth in clinical practice and highlighted the urgent need to educate students across health professions in telehealth delivery. To address this educational gap, student and faculty collaborators from Duke University and the University of North Carolina at Chapel Hill utilized a developmental evaluation approach to rapidly design and pilot a compact, five-session, virtual curriculum to train students from a broad range of health professions in telehealth delivery. Through focused readings, large group didactics, and small group discussion, the curriculum provided a general overview of telehealth, addressed specific issues in health equity and access in virtual care both locally and nationally, introduced skills for conducting telehealth visits, and employed a patient simulation for students to practice their newly learned skills. The curriculum was delivered virtually over eight weeks to 36 students from ten health professions programs (occupational therapy, social work, pharmacy, audiology, speech-language pathology, dentistry, medicine, nursing, physical therapy, and physician assistants) across two universities. End-of-course feedback surveys identified that students most valued the opportunity to work with learners from different professions, practical instruction for telehealth, and a standardized patient experience. On post-course surveys students reported high self-efficacy in their telehealth competencies and indicated very positive attitudes toward interprofessional education. Overall, the compact nature of this curriculum facilitates adaptability to other student-led groups.

Society for Education and the Advancement of Research in Connected Health SEARCH 2022 – The National Telehealth Research Symposium Abstracts Virtual Meeting November 16–18, 2022

Society for Education and the Advancement of Research in Connected Health SEARCH 2022 – The National Telehealth Research Symposium Abstracts Virtual Meeting November 16–18, 2022

Human Trafficking Education: A Pilot Study of Integration into Medical School Curriculum.

Few medical schools incorporate formal education on human trafficking (HT) and sex trafficking (ST) into their curriculum. Our objective was to develop, implement, and evaluate education on HT and ST in the first-year medical student curriculum. The curriculum included a standardized patient (SP) experience and lecture. As part of their mandatory sexual health course, students interviewed an SP who presented with red flags for ST and then participated in a discussion led by a physician-facilitator in an observed small group setting. A multiple-choice survey to assess knowledge about HT and ST was developed and administered to students before and after the SP interview. Of the 50 first-year medical students, 29 (58%) participated in the survey. Compared with the students' baseline scores (according to the percentage of correct responses), scores after the educational intervention showed a significant increase in percentage correct on questions related to trafficking definition and scope (elder care, P = .01; landscaping, P = .03); victim identification (P < .001); referral to services (P < .001); legal issues (P = .01); and security (P < .001). On the basis of the feedback, a 2-hour lecture, which was adapted from the American Medical Women's Association-Physicians Against the Trafficking of Humans "Learn to Identify and Fight Trafficking" training, was presented the next year to all first-year medical students as part of their longitudinal clinical skills course and before the SP case. Curriculum objectives included learning trafficking definitions, victim/survivor identification, intersections with health care, the local impact of HT, and available resources. This curriculum fulfills course objectives and could be replicated at other institutions. Further evaluation of this pilot curriculum is necessary to evaluate its effectiveness.

A Telemedicine Standardized Patient Experience: Enhancing the Virtual Classroom and Preparing for Alternative Modalities of Care.

This pilot study explored the use of standardized patients in the virtual classroom in efforts to increase family nurse practitioner preparedness to engage in telemedicine care delivery. Using a mixed-methods approach, we determined this innovation significantly increased students' confidence in their ability to perform a telemedicine visit while also improving their satisfaction with the virtual classroom.

An interprofessional education approach to pain management through a standardized patient encounter

Interprofessional education and collaborative practice requirements of professional health programs have resulted in collaborative learning programming in nearly all health professions. Due to recent initiatives for contemporary education of health professionals on pain science education, an academic health science center at a large public southeastern university created a focused interprofessional learning activity on pain science education within its curriculum. The learning objectives for this session aligned with both the core competencies from the Interprofessional Education Collaborative and the International Association for the Study of Pain. In a two-year period, nearly 750 students participated in this interprofessional pain science education session from medicine, nursing, pharmacy, physical therapy, and behavioral health. The session involved a standardized patient encounter for a patient presenting with chronic pain. Both faculty observers and the standardized patients assessed student teams on their interprofessional competencies during the activity, who then discussed findings prior to faculty-student debriefings. Faculty and standardized patient raters agreed that student groups demonstrated very strong skills in communication, information sharing, and solicitation of patient/client input during the event. Other skills were met with some level of disagreement. This session identifies the potential impact of interprofessional learning that can transpire through a standardized patient experience with modeling of activities in association with contemporary pain science education competencies. Future models of this program should include further assessment of interprofessional learning from students of all health care disciplines as well as continued solicitation of input from the patient or standardized patients.

Outpatient visit modality and parallel patient satisfaction: A multi-site cohort analysis of telemedicine and in-person visits during the COVID-19 pandemic

Telemedicine approaches provide many benefits to patients across both primary and specialty care. Patient acceptance is imperative to successful telemedicine implementation. As telemedicine utilization continues to surge, it is imperative that healthcare organizations have a method for evaluating the patient experience with these types of visits. Previous studies on experience with telemedicine have focused on smaller patient populations with narrow inclusion criteria and limited geographical reach. This research described how patients’ satisfaction with video telemedicine-based visits varied based on patient characteristics and how they compare with in-person visits. We obtained and analyzed results from standardized patient experience surveys to compare telemedicine and in-person clinic visits during the COVID-19 pandemic (between July 1, 2020, and June 30, 2021) across a diverse patient population. During the study timeframe, surveys were sent to 1,521,398 patients with a response rate of 20% (307,185). Our organization’s unique structure, size, and geographic spread allowed for a deeper and more comprehensive examination of telemedicine participants. Though a few trends emerged in the results, there were no significant differences in patient ratings of telemedicine visits and in-person clinic visits during the same period (p=0.672). This study demonstrated that patient satisfaction with telemedicine visits was non-inferior to in-person outpatient visits during the study timeframe.

The Clinical Reasoning Assessment Tool for Learning from Standardized Patient Experiences: A Pilot Study

Purpose: Clinical reasoning (CR) is the ability to integrate the knowledge of diagnoses with the use of supporting theories to create effective, client-centered interventions. One means of teaching CR to rehabilitation students is using standardized patient (SP) experiences. The relationship between faculty and student CR ratings after SP experiences has not been researched. The purpose of the study was to determine if there would be correlations between physical therapy (PT) and occupational therapy (OT) student and faculty ratings of CR skills after an SP experience. Method: The Clinical Reasoning Assessment Tool (CRAT) was used by students to self-reflect on their CR performance after an SP experience and compared to their respective faculty ratings. The CRAT includes three subsections: content knowledge, procedural knowledge, and conceptual reasoning, each with a visual analog scale. Correlations between students’ self-assessment of CR and faculty reviews were analyzed using Spearman’s rho correlations. Results: Seventeen PT and seventeen OT students participated. Spearman’s rho correlation coefficients for the PT students and their faculty were: content knowledge (r=.180; p=.488), procedural knowledge (r=.697; p=.002), and conceptual reasoning (r=.258; p=.317). Spearman’s rho correlation coefficients for the OT students and their faculty were: content knowledge (r=.103; p=.693), procedural knowledge (r=.676; p=.003), and conceptual reasoning (r=.505; p=.039). Conclusions: Neither PT nor OT student ratings was a statistically significant correlation in content knowledge ratings in relation to respective faculty ratings. Both PT and OT student procedural knowledge rating correlations with faculty were strong and statistically significant. PT student and faculty ratings were not significantly correlated in conceptual reasoning compared to faculty; however, OT students and faculty ratings were strong, had positive correlations, and were statistically significant. Further research is needed to assess students’ CR development longitudinally across curricula.

Harvard Medical School's Sexual and Gender Minority Health Equity Initiative: Curricular and Climate Innovations in Undergraduate Medical Education.

Sexual and gender minority (SGM) populations face numerous health disparities. Medical school curricula lack adequate educational content preparing students for serving SGM patients, and medical students typically do not experience welcoming, inclusive educational environments conducive to learning about SGM health care. In 2018, Harvard Medical School (HMS) launched the 3-year Sexual and Gender Minority Health Equity Initiative to integrate SGM health content throughout the longitudinal core medical curriculum and cultivate an educational climate conducive for engaging students and faculty in SGM health education. The initiative employed innovative strategies to comprehensively review existing SGM health curricular content and climate; integrate content across courses and clerkships; lead with LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and all sexual and gender minorities) community engagement; adopt an intersectional approach that centers racial equity; cultivate safe, affirming educational environments for LGBTQIA+ and non-LGBTQIA+ students and staff; ensure all graduating students are prepared to care for SGM patients; enhance faculty knowledge, skills, attitudes, and confidence teaching SGM health; evaluate effectiveness and impact of SGM health curricular innovations; prioritize sustainability of curricular innovations; and publicly share and disseminate SGM health curricular products and tools. Key outcomes of the initiative focused on 5 areas: development of 9 SGM health competencies, stakeholder engagement (HMS students and faculty, national SGM health experts, and LGBTQIA+ community members), student life and educational climate (increased LGBTQIA+ student matriculants, enhanced mentorship and support), curriculum development (authentic LGBTQIA+ standardized patient experiences, clerkship toolkit design), and faculty development (multimedia curriculum on content and process to teach SGM health). In addition to refining curricular integration, evaluating interventions, and implementing comprehensive antiracist and gender-affirming educational policies, the next phase will involve dissemination by translating best practices into feasible approaches that any school can adopt to meet local needs with available resources.