scholarly journals An undergraduate medical curriculum framework for providing care to transgender and gender diverse patients: A modified Delphi study

2021 ◽  
Author(s):  
Rachel H. Ellaway ◽  
Nicole L. Thompson ◽  
Claire Temple-Oberle ◽  
Danièle Pacaud ◽  
Helena Frecker ◽  
...  
Keyword(s):  
Medical Students ◽  
Delphi Study ◽  
Medical Curriculum ◽  
Healthcare Services ◽  
Community Members ◽  
Modified Delphi ◽  
Healthcare Needs ◽  
Gender Diverse ◽  
Curriculum Framework ◽  
And Gender

Abstract Introduction The lack of attention to transgender and gender diverse (TGD) people in undergraduate medical education (UME) is a point of concern, particularly among medical students. A project was undertaken to develop a UME curriculum framework for teaching the healthcare needs of TGD people. Methods Using a modified Delphi methodology, four rounds of surveys were presented to an expert stakeholder group that included content experts, generalist physicians, UME teaching faculty, and medical students. Questions covered what content should be taught, who should teach the content, and how much time should be dedicated for this teaching. Once the Delphi process was complete, feedback on the provisional framework was sought from members of the TGD community to ensure it represented their needs and perspectives. Results 71 panel members and 56 community members participated in the study. Core values included the scope of the framework, and topics such as inclusivity, and safety in practice and in teaching. The framework included terminology, epidemiology, medical and surgical treatment, mental health, sexual and reproductive health, and routine primary care. There was also guidance on who should teach, time to be allocated, and the learning environment. Discussion There is a clear need to train tomorrow’s doctors to provide competent and respectful healthcare services to and for TGD patients. Although local factors will likely shape the way in which this framework will be implemented in different contexts, this paper outlines a core UME-level curriculum framework for Canada and, potentially, for use in other parts of the world.

scholarly journals Differential Diagnoses That Final-Year Medical Students Need to Consider: A Modified Delphi Study

2020 ◽  
Author(s):  
Yuka Urushibara-Miyachi ◽  
Makoto Kikukawa ◽  
Masatomi Ikusaka ◽  
Junji Otaki ◽  
Hiroshi Nishigori
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Clinical Reasoning ◽  
Delphi Study ◽  
Teaching And Learning ◽  
Core Curriculum ◽  
Medical Curriculum ◽  
Differential Diagnoses ◽  
Modified Delphi ◽  
Medical Disciplines

Abstract Background: Contrastive learning is known to be effective in teaching medical students how to generate diagnostic hypotheses in clinical reasoning. However, there is no consensus on comprehensive lists of differential diagnoses across different medical disciplines regarding the common symptoms that should be learned as part of the undergraduate medical curriculum. In Japan, the national model core curriculum for undergraduate medical education was revised in 2016, and lists of differential diagnoses for 37 common symptoms were introduced into the curriculum. This study aimed to validate the list of items based on expert consensus for use as a reference worldwide.Methods: The authors used a modified Delphi method to develop consensus among a panel of 23 expert physician-teachers in clinical reasoning from across Japan. The panel evaluated the items on a 5-point Likert scale, based on whether a disease should be hypothesized by final-year medical students considering a given symptom. They also added other diseases that should be hypothesized. A positive consensus was defined as both a 75% rate of panel agreement and a mean of 4 or higher with a standard deviation of less than 1 on the 5-point scale. The study was conducted between September 2017 and March 2018. Results: This modified Delphi study identified 275 essential and 67 supplemental items corresponding to the differential diagnoses for 37 common symptoms that Japanese medical students should master before graduation. Conclusions: The lists developed in the study can be useful for teaching and learning how to generate initial hypotheses by encouraging students’ contrastive learning. Although the lists may be specific to the Japanese context, the lists and process of validation are generalizable to other countries for building national consensus on the content of medical education curricula.

scholarly journals Lists of potential diagnoses that final-year medical students need to consider: a modified Delphi study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuka Urushibara-Miyachi ◽  
Makoto Kikukawa ◽  
Masatomi Ikusaka ◽  
Junji Otaki ◽  
Hiroshi Nishigori
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Clinical Reasoning ◽  
Delphi Study ◽  
Teaching And Learning ◽  
Core Curriculum ◽  
Medical Curriculum ◽  
Signs And Symptoms ◽  
International Consensus ◽  
Modified Delphi

Abstract Background Contrastive learning is known to be effective in teaching medical students how to generate diagnostic hypotheses in clinical reasoning. However, there is no international consensus on lists of diagnostic considerations across different medical disciplines regarding the common signs and symptoms that should be learned as part of the undergraduate medical curriculum. In Japan, the national model core curriculum for undergraduate medical education was revised in 2016, and lists of potential diagnoses for 37 common signs, symptoms, and pathophysiology were introduced into the curriculum. This study aimed to validate the list of items based on expert consensus. Methods The authors used a modified Delphi method to develop consensus among a panel of 23 expert physician-teachers in clinical reasoning from across Japan. The panel evaluated the items on a 5-point Likert scale, based on whether a disease should be hypothesized by final-year medical students considering given signs, symptoms, or pathophysiology. They also added other diseases that should be hypothesized. A positive consensus was defined as both a 75% rate of panel agreement and a mean of 4 or higher with a standard deviation of less than 1 on the 5-point scale. The study was conducted between September 2017 and March 2018. Results This modified Delphi study identified 275 basic and 67 essential other than basic items corresponding to the potential diagnoses for 37 common signs, symptoms, and pathophysiology that Japanese medical students should master before graduation. Conclusions The lists developed in the study can be useful for teaching and learning how to generate initial hypotheses by encouraging students’ contrastive learning. Although they were focused on the Japanese educational context, the lists and process of validation are generalizable to other countries for building national consensus on the content of medical education curricula.

scholarly journals Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

2019 ◽  
Vol 16 (24) ◽  
pp. 5088 ◽  
Author(s):  
Sav Zwickl ◽  
Alex Wong ◽  
Ingrid Bretherton ◽  
Max Rainier ◽  
Daria Chetcuti ◽  
...  
Keyword(s):  
Health Services ◽  
Best Practice ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Research Priorities ◽  
Health Service Delivery ◽  
Free Text ◽  
Healthcare Needs ◽  
Gender Diverse ◽  
And Gender

There is an increasing demand for trans and gender diverse (TGD) health services worldwide. Given the unique and diverse healthcare needs of the TGD community, best practice TGD health services should be community-led. We aimed to understand the healthcare needs of a broad group of TGD Australians, how health professionals could better support TGD people, and gain an understanding of TGD-related research priorities. An anonymous online survey received 928 eligible responses from TGD Australian adults. This paper focuses on three questions out of that survey that allowed for free-text responses. The data were qualitatively coded, and overarching themes were identified for each question. Better training for healthcare professionals and more accessible transgender healthcare were the most commonly reported healthcare needs of participants. Findings highlight a pressing need for better training for healthcare professionals in transgender healthcare. In order to meet the demand for TGD health services, more gender services are needed, and in time, mainstreaming health services in primary care will likely improve accessibility. Evaluation of training strategies and further research into optimal models of TGD care are needed; however, until further data is available, views of the TGD community should guide research priorities and the TGD health service delivery.

Healthcare Needs of and Access Barriers for Brazilian Transgender and Gender Diverse People

2016 ◽  
Vol 20 (1) ◽  
pp. 115-123 ◽  
Author(s):  
Angelo Brandelli Costa ◽  
Heitor Tome da Rosa Filho ◽  
Paola Fagundes Pase ◽  
Anna Martha Vaitses Fontanari ◽  
Ramiro Figueiredo Catelan ◽  
...  
Keyword(s):  
Access Barriers ◽  
Healthcare Needs ◽  
Gender Diverse ◽  
And Gender

scholarly journals Determining electrocardiography training priorities for medical students using a modified Delphi method

2020 ◽  
Author(s):  
Charle Andre Viljoen ◽  
Rob Scott Millar ◽  
Kathryn Manning ◽  
Vanessa Celeste Burch
Keyword(s):  
Medical Students ◽  
Delphi Method ◽  
Delphi Study ◽  
Delphi Technique ◽  
Expert Panel ◽  
Expert Consensus ◽  
Modified Delphi ◽  
Wide Range ◽  
Life Threatening ◽  
Curriculum Specialists

Abstract BackgroundAlthough electrocardiography is considered a core learning outcome for medical students, there is currently little curricular guidance for undergraduate ECG training. Owing to the absence of expert consensus on undergraduate ECG teaching, curricular content is subject to individual opinion. The aim of this modified Delphi study was to establish expert consensus amongst content and context experts on an ECG curriculum for medical students.MethodsThe Delphi technique, an established method of obtaining consensus, was used to develop an undergraduate ECG curriculum. Specialists involved in ECG teaching were invited to complete three rounds of online surveys. An undergraduate ECG curriculum was formulated from the topics of ECG instruction for which consensus (i.e. ≥75% agreement) was achieved. ResultsThe panellists (n=131) had a wide range of expertise (42.8% Internal Medicine, 22.9% Cardiology, 16% Family Medicine, 13.7% Emergency Medicine and 4.6% Health Professions Education). Topics that reached consensus to be included in the undergraduate ECG curriculum were classified under technical aspects of performing ECGs, basic ECG analysis, recognition of the normal ECG and abnormal rhythms and waveforms and using electrocardiography as part of a clinical diagnosis. This study emphasises that ECG teaching should be framed within the clinical context. Course conveners should not overload students with complex and voluminous content, but rather focus on commonly encountered and life-threatening conditions, where accurate diagnosis impacts on patient outcome. A list of 23 “must know” ECG diagnoses is therefore proposed.ConclusionA multidisciplinary expert panel reached consensus on the ECG training priorities for medical students.

Struggles With Sex and Gender. Perspectives of First Year Medical Students: A Focus Group Study

2021 ◽  
Vol 7 (1) ◽  
pp. 216
Author(s):  
Theodora Teunissen ◽  
Joni Scholte ◽  
Fransica Van der Meulen ◽  
Antoinette Lagro-Janssen ◽  
Cornelia Fluit
Keyword(s):  
Gender Differences ◽  
Medical Students ◽  
Medical Training ◽  
Medical Curriculum ◽  
First Year ◽  
Sex And Gender ◽  
Focus Group Study ◽  
And Gender ◽  
First Year Medical Students ◽  
Sex And Gender Differences

Sex and gender are important determinants of healthcare that need to be taken into account for medical teaching. Education is more effective if tailored to students’ subjectively-perceived needs and connected to their prior knowledge and opinions. This study explored first-year medical students thoughts about sex and gender differences in general and in specifically in healthcare, and what their educational preferences are in learning about these concepts during their medical training. Therefore six focus groups were conducted with 26 first-year medical students, 7 male and 19 female students, within one Dutch medical faculty. The discussions were audio-recorded and transcribed verbatim. After that a thematic analysis was performed which included descriptive coding, interpretative coding, and definition of overarching themes.  Three major themes were identified. (1) Students’ self-perception of concepts sex and gender, including three major domains: (a) The unavoidable allocation of individuals to groups, (b) The role of stereotypes, and (c) The effect of sex/gender on career choice options. (2) Students’ goal orientedness in learning about sex/gender. (3) Students’ struggles between the binary system of medicine and the complexity of reality. Continuous reflection during medical school might help medical students to acquire sex- and gender-sensitive competencies that can be applied in their future work. To increase awareness about the influence of sex and gender differences in healthcare and on career choices, we recommend addressing these themes explicitly early on in the medical curriculum.

690 HIV-related healthcare needs and access barriers for Brazilian transgender and gender diverse people

2018 ◽  
Vol 15 (7) ◽  
pp. S395
Author(s):  
A.B. Costa ◽  
A.M. Vaitses Fontanari ◽  
R.F. Catelan ◽  
K. Schwarz ◽  
J.L. Stucky ◽  
...  
Keyword(s):  
Access Barriers ◽  
Healthcare Needs ◽  
Gender Diverse ◽  
And Gender

scholarly journals Curriculum Development on the Human Rights of People with Disabilities for Future Medical Education: Using a modified Delphi

2021 ◽  
Author(s):  
Bomyee Lee ◽  
So-Youn Park
Keyword(s):  
Medical Education ◽  
Healthcare Workers ◽  
Medical Curriculum ◽  
People With Disabilities ◽  
Healthcare Services ◽  
Educational Content ◽  
Negative Attitudes ◽  
Introductory Course ◽  
Modified Delphi ◽  
Health Rights

Abstract Background Healthcare workers’ negative attitudes towards people with disabilities and limited understanding of disability characteristics create barriers for people with disabilities to access healthcare services. Healthcare workers untrained in treating patients with disabilities may exhibit negative attitudes, such as a doctor’s unilateral decisions or insufficient respect for patients’ experiences and opinions. This study aimed to develop a systematic medical education curriculum for increasing understanding of people with disabilities and treating patients with disabilities. Methods The authors conducted a systematic literature review to develop and verify the basic framework of the educational content and curriculum. Two surveys were also developed using the Delphi method to evaluate the adequacy and necessity of educational topics. Items with a content validity ratio equal to or greater than the minimum value were considered valid. Survey panels comprised academic experts and healthcare practitioners who were working with people with disabilities. We conducted two surveys, one for a basic and the other for an advanced course, in which 13 to 16 respondents took part. Results The authors selected 13 topics for the ‘Basic Introductory Course’ and included general educational content on the health rights of people with disabilities focused on improving students’ knowledge of disabilities. The authors also selected 12 topics for the ‘Care and Communication for Patients with Disabilities Course’ designed to improve students’ understanding of interviewing and communicating with patients with disabilities. Conclusions In Korea, disability has received little attention in the medical curriculum to date. The curriculum developed in this study provides preliminary data for guiding future directions in medical education and developing specific support plans for education that promotes people with disabilities’ health rights.

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