scholarly journals Improving Residents’ Competency in Caring for Transgender Individuals Through Development of a Curriculum

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A799-A799
Author(s):  
Michele Gortakowski ◽  
Chelsea Gordner
Keyword(s):  
Health Care ◽  
Medical School ◽  
Medical Training ◽  
Panel Discussion ◽  
Role Playing ◽  
Baseline Survey ◽  
Free Text ◽  
Formal Curriculum ◽  
Residency Programs ◽  
Transgender Health

Abstract Objectives: Several recent publications have described the lack of education in transgender health care among providers across all levels of medical training. Here we describe a QI project that developed and implemented a transgender health care curriculum for the University of Massachusetts Medical School-Baystate Medical Center (UMass-Baystate) pediatric and combined internal medicine-pediatrics residency programs. Methods: We designed a curriculum for the UMass-Baystate pediatric (9 residents/yr) and med-peds (8 residents/yr) residency programs. The curriculum included grand rounds presentations on transgender health care, didactic sessions integrated into the residents’ protected educational time throughout the academic year, and a panel discussion with non-binary and transgender individuals from the community. The didactic sessions included a mixture of lectures, role- playing, and case-based discussion. The curriculum development was guided by a curriculum design specialist and adapted each year based on feedback. Residents’ self- reported comfort and competency level were assessed through a survey at baseline and at the end of each year. Results: Ninety-eight percent (42/43) completed the baseline survey. Forty percent (17/42) had received no formal training in medical school, and 21% (9/42) had never taken care of a transgender patient. At baseline, 62% felt a little less comfortable and 50% felt somewhat competent, 2.4% very competent caring for transgender individuals compared to cisgender individuals. After three years, 25% felt a little less comfortable and 44% felt somewhat competent, 19% felt very competent caring for transgender individuals compared ot cisgender individuals. The community panel was very well received. Free text comments regarding the curriculum included “very helpful,” “loved the panel,” “clinically relevant.” Conclusions: This QI initiative served as the groundwork for the development of a formal curriculum to enhance medical education among residents in caring for transgender individuals. After three years, residents felt more comfortable and competent in caring for transgender individuals as compared to the baseline survey. We will continue to adapt the curriculum as it continues. The curriculum has expanded to include the pediatric nurses and the UMass medical students.

scholarly journals Transgender Health Care Curriculum Development: A Dual-Site Medical School Campus Pilot

Health Equity ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 102-113 ◽  
Author(s):  
Anna J. Najor ◽  
Juliana M. Kling ◽  
Reese L. Imhof ◽  
Jon D. Sussman ◽  
Todd B. Nippoldt ◽  
...  
Keyword(s):  
Health Care ◽  
Curriculum Development ◽  
Medical School ◽  
Transgender Health ◽  
Dual Site

scholarly journals Resetting the compass: exploring the implicit messages of orientation to a community-engaged medical school

2017 ◽  
Vol 8 (1) ◽  
pp. e88-100
Author(s):  
Rachel Helen Ellaway ◽  
Tim Dubé ◽  
Gerry Cooper ◽  
Lisa Graves
Keyword(s):  
Medical School ◽  
Hidden Curriculum ◽  
Medical Training ◽  
Free Text ◽  
Community Members ◽  
Future Health ◽  
Northern Ontario ◽  
Social Mission ◽  
Orientation Week ◽  
Survey Responses

Background: Although students’ transition into medical school is a critical step in their professional journey, orientation has been relatively under-researched, particularly with regard to its intersections with schools’ social missions. This paper reports on a study looking at the implicit messages of orientation to the Northern Ontario School of Medicine’s undergraduate program.Methods: An extended mixed methods study was conducted to look at different aspects of the School’s Orientation Week. The term “hidden curriculum” was used to shape inquiry, both in its broad sense of implicit educational experiences and messages and in its more specific sense of the educational messages sent by a medical school’s culture and activities. Data were collected using participant surveys, focus groups, and interviews. Transcripts and free-text survey responses were analyzed to identify underlying themes.Results: Orientation Week was generally well received and was generally perceived by different stakeholders (such as students, school leaders, and community members) as a positive and necessary undertaking. However, there were points of contention and confusion that created a hidden curriculum with respect to participants’ identities, both as students and as future health professionals.Conclusion: Orientation to undergraduate medical training can be successfully linked to a school’s social mission, but in doing so it can send complex and unintended messages to the participants that may be perceived quite differently based on their circumstances and expectations.

scholarly journals A Transgender Health Care Panel Discussion in a Required Diversity Course

2014 ◽  
Vol 78 (4) ◽  
pp. 81 ◽  
Author(s):  
Amy L. Parkhill ◽  
Jennifer L. Mathews ◽  
Scott Fearing ◽  
Jeanne Gainsburg
Keyword(s):  
Health Care ◽  
Panel Discussion ◽  
Diversity Course ◽  
Transgender Health

scholarly journals Teaching High-Value Care in Pediatrics: A National Survey of Current Practices and Guide for Future Curriculum Development

2017 ◽  
Vol 9 (6) ◽  
pp. 741-747 ◽  
Author(s):  
Michael J. Tchou ◽  
Alice Walz ◽  
Elizabeth Burgener ◽  
Alan Schroeder ◽  
Rebecca Blankenburg
Keyword(s):  
Medical Training ◽  
Health Care Expenditures ◽  
Program Directors ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Formal Curriculum ◽  
Residency Programs ◽  
Discussion Format ◽  
Case Based

ABSTRACT Background  Health care expenditures in the United States are increasing at an unsustainable pace. There have been calls to incorporate education on resource stewardship into medical training, yet the perceived need for and current use of high-value care (HVC) curricula in pediatrics residency programs is unknown. Objective  We described the current national landscape of HVC curricula in pediatrics residencies, including characterization of current programs, barriers to the practice of HVC, and clarification of preferred curricula types. Methods  Using a cross-sectional study design, we conducted a national, anonymous, web-based survey of pediatrics residency program directors and pediatrics chief residents in fall 2014. Results  We received responses from 85 of 199 (43%) pediatrics program directors and 74 of 199 (37%) pediatrics chief residents. Only 10% (8 of 80) of program directors and 12% (8 of 65) of chief residents reported having a formal curriculum on HVC. Respondents identified the largest barriers to HVC as a lack of cost transparency (program directors) and attending physicians having the final say in treatment decisions (chief residents). The majority of respondents (83%, 121 of 146) agreed their program needs a HVC curriculum, and 90% (131 of 145) reported they would use a curriculum if it was available. Respondents significantly preferred a case-based conference discussion format over other approaches. Conclusions  Most pediatrics residency programs responding to a survey lacked formal HVC curricula. There is a desire nationally for HVC education in pediatrics, particularly in a case-based discussion format.

scholarly journals Lactation challenges of resident physicians- results of a national survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Gabrielle W. Peters ◽  
Aleksandra Kuczmarska-Haas ◽  
Emma B. Holliday ◽  
Lindsay Puckett
Keyword(s):  
Response Rate ◽  
Medical Training ◽  
Free Text ◽  
Limited Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Tool ◽  
Residency Programs ◽  
Resident Physicians ◽  
Recent Graduates

Abstract Background There are unique challenges to parenting in residency and there is limited data to guide policy regarding lactation facilities and support for female physicians-in-training. We aimed to assess issues surrounding breast-feeding during graduate medical training for current residents or recent graduates from United States (US) residency programs. Methods A national cross-sectional survey was sent to current and recently graduated (2017 and later) female residents in June 2020. This questionnaire was administered using the Qualtrics Survey tool and was open to each participating woman’s organization for 4 weeks. Summary statistics were used to describe characteristics of all respondents and free-text responses were reviewed to identify common themes regarding avenues for improvement. Results Three hundred twelve women responded to the survey, representing a 15.6% response rate. The median duration of providing breastmilk was 9 months (IQR 6–12). 21% of residents reported access to usable lactation rooms within their training hospital, in which 12% reported a computer was present. 60% of lactating residents reported not having a place to store breast milk. 73% reported residency limited their ability to lactate, and 37% stopped prior to their desired goal. 40% reported their faculty and/or co-residents made them feel guilty for their decision to breastfeed, and 56% reported their difficulties with breastfeeding during residency impacted their mental health. Conclusion Residents who become mothers during training face significant obstacles to meeting their breastfeeding/pumping needs and goals. With these barriers defined, informed policy change can be instituted to improve the lactation experience for physicians-in-training.

scholarly journals BARRIERS TO TRANSGENDER HEALTH CARE IN PAKISTAN

2018 ◽  
Vol 16 (2) ◽  
pp. 33-34
Author(s):  
Munawar Hussain Soomro
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Federal Government ◽  
Binary Systems ◽  
Medical Training ◽  
Legal Protection ◽  
Mental Health Issue ◽  
Transgender People ◽  
Transgender Health ◽  
Transgender Persons

he term “transgender” refers to a spectrum of individuals who express gender in ways that deviate from the gender binary. It includes transsexuals, crossdressers and others.1,2 In Pakistan, the state of being a transgender presents a serious challenge to the traditionally established binary systems of nature/culture, man/woman, masculinity/ femininity and sex/gender. Even transgender community were given their identity as citizens of Pakistan in year 2009.3 Whereas the transgender persons suffer significant health disparities.4,5 Real or perceived stigma and discrimination within biomedicine and the health care provision in general may impact transgender people’s desire and ability to access appropriate care. The situation of the community is worse because they are left ignored and isolated without the survival facilities, education, employment opportunities, identity crisis or even the conformity from the dominant social class.3 National health services of Pakistan should include rigorous determination in the health care system to provide adequate care for transgender in the country. There is need to know the mechanism through the knowledge and biases of medical work force across the spectrum of medical training with regard to transgender health care. With these studies we can validate and propose potential solutions to address the identified gaps. Whereas the situation in other developing countries including those belonging to African and Asian regions is not good. In developed countries the situation is found to be much better. However, reported data shows that transgender people even in developed world face various kinds of discrimination especially in health care situations. The federal government of USA does not have laws specifically for protecting transgender people from discrimination in employment, housing, healthcare, and adoption. U.S. President Barack Obama had issued an executive order prohibiting discrimination against transgender people in employment by the federal government and its contractors. While in Pakistan there was no specific law for the transgender, however, a Senate committee had approved a bill in December 2017 for full legal protection to transgender people. It will provide a relief to transgender people for their health care and other facilities. Further, National Assembly of Pakistan approved the final Bill as Act called the Transgender Person (Protection of Rights) Act, 2018 on 18 May 2018.6 There is need to assess the perceptions and knowledge of the heath care provider workforce to provide medical care to transgender. Barriers may include fear of stigma associated with providing transgender medical care. Barriers may also include bias in the structure of clinics, forms, and electronic medical record systems in addition to gaps in knowledge and bias among support staff. Identification of solutions to the gaps is needed, which are not solely a lack of knowledge. The degree to which third party payer policy impedes access needs to be determined. Determination of change needed to overcome the financial barrier to care is also required. It is necessary to evaluate other barriers including societal stigma, mental health issue among patients, and socioeconomic issues. Finally evaluation of strategies to overcome these barriers is a must to address the matter.

A Letter to Future Physicians: One Dozen Important Things You Might Not Learn Enough about During Medical Training—But Should

2010 ◽  
Vol 19 (4) ◽  
pp. 522-526
Author(s):  
STEVE HEILIG ◽  
PHILIP R. LEE
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Medical Training ◽  
Medical Knowledge ◽  
Formal Curriculum

Medical training is intense by design. Starting with medical school, for 4 years most of the time in the formal curriculum is filled with numerous essential topics, and, as scientific and medical knowledge increases, it is increasingly difficult to “triage” what must be learned. Efforts to insert new topics are often fraught with obstacles and resistance. Thus, it is problematic to suggest that even more be taught in those finite years of formal medical education. However, that is exactly what we propose to do here.

The effect of rural placements on future rural general practice

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Alexandra Louise MacDonald ◽  
Kerith Duncanson
Keyword(s):  
Health Care ◽  
General Practice ◽  
General Practitioner ◽  
Medical School ◽  
Junior Doctor ◽  
Medical Training ◽  
Internship And Residency ◽  
Rural Practice ◽  
Inclusion Criteria ◽  
Practitioner Training

Background: Providing health care to rural populations is a major issue in Australia. Disease burdenand health risk factorsincrease with remoteness, but the access to appropriate service decrease. The introduction of Rural Clinical Schools, rural locations for internship and residency, and decentralisation of the Australian General Practitioner Training Programaim to address this disparity. This systematic review aimed at determining if rural placements throughout medical training are associated with future rural general practice in Australia.Methods: Medline (Ovid), Pubmed, CINAHL and Science Direct were searched for the period January 2000 to July 2019. Included studies related specifically to rural general practitioners in Australia and studies were excluded if they reported only on intention to practice rurally. Evidence was assessed using the Standards for Quality Improvement Reporting Excellence Guidelines.Results: Eleven articles met the inclusion criteria. Three studies examined the effect of rural placements in medical school on future rural general practice. Three studies looked at placements as a junior doctor on future rural general practice. Four studies looked at the effect of rural general practitioner training on future rural general practice. One study reported on the effect of rural placements during both medical school and junior doctor years on future rural general practice. The studies supported an association between rural placements and future rural general practice, particularly for Australian born doctors, Australian graduates and individuals from rural backgrounds.Discussion: This review suggests that rural placements during medical training increase the likelihood of future rural general practice. The interplay of personal and professional life influence whether rural intention is sufficient to result in rural practice. Addressing human factors that influence rural practice will contribute to achieving equitable rural health care.

Sign in / Sign up

Export Citation Format

Share Document