“I’ll take Gender Identity for 500”- Changing knowledge and comfort in the care of LGBTQ patients with a novel training approach

• Published in: Pediatrics (Evanston) Vol. 144; no. 2_MeetingAbstract; p. 580
• Main Authors: Lammert, Taylor R., Lupez, Emily
• Format: Journal Article
• Language: English
• Published: Evanston American Academy of Pediatrics 01-08-2019
• Subjects: Anxiety; Comfort; Curricula; Gender identity; Health care facilities; Health disparities; Jargon; Knowledge; Patients; Pediatrics; Polls & surveys; Socioeconomics; Statistical analysis; Terminology; Tobacco
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.144.2MA6.580

Introduction: Patients who identify as LGBTQ experience many health disparities, including higher rates of cancer, tobacco use, and anxiety/depression. Pediatric patients who identify as LGBTQ are also at risk of family rejection, which is linked with negative health outcomes in adulthood. These disparities have been linked to providers' insufficient knowledge of appropriate terminology and relevant health inequities in this patient population. We developed a student-run training program, Safe Zone in Medicine, to educate providers about LGBTQ terminology and health disparities. Our program utilizes application of material through a jeopardy-like game, role-play, patient narratives, and reflection on bias, privilege, and the intersection between LGBTQ identities, race, and socioeconomic status. This study assessed the efficacy of our training in changing comfort and knowledge surrounding the care of LGBTQ patients. Methods: A 2-hour training with pre/post-training surveys was conducted multiple times and was ultimately delivered to 229 students, residents, faculty, and staff at Wake Forest Baptist Medical Center. Surveys assessed self-reported comfort in caring for LGBTQ patients and knowledge of LGBTQ terminology; responses were scored on a 5 and 10 point scale respectively. Pre/post scores were compared across all participants and stratified by training-level using Wilcoxon-Mann-Whitney analysis and Kruskas Wallis analysis. The surveys also assessed stage of life when trainees became aware of others' LGBTQ identities. Results: After training, Wilcoxon-Mann-Whitney analysis demonstrated statistically significant changes in knowledge and comfort after training overall, and within stratified groups, except for comfort in faculty/staff (Table 1). Kruskas Wallis analysis showed statistically different pre-training knowledge scores between groups, but no difference between groups in post-training knowledge, pre-training comfort, nor post-training comfort scores (Table 1). There was a correlation between training-level and stage of life data regarding awareness of orientation and gender identity, and a correlation between stage of life and pre-training knowledge in only faculty (Table 1). There was no statistically significant correlation between pre, nor post training comfort and knowledge scores overall, or within training-level groups. Discussion: Our innovative curriculum led to significant increases in comfort and knowledge of LGBTQ patient care. Pre-training data suggests that earlier awareness of the LGBTQ community may influence pre-training knowledge, but analysis suggests our training was able to equilibrate knowledge and comfort across groups. The lack of correlation between comfort and knowledge suggests comfort arises from alternative sources such as clinical experience, which was simulated through our scenarios and discussions. Our approach effectively increased knowledge and comfort in participants regardless of training-level or past experience with LGBTQ patients, demonstrating its ability to be effective in multiple clinical environments that care for a variety of patients and across participants' levels of training.