Comprehensive Curriculum for Internal Medicine Residents on Primary Care of Patients Identifying as Lesbian, Gay, Bisexual, or Transgender
Eloho Ufomata,
Kristen L. Eckstrand,
Carla Spagnoletti,
Clark Veet,
Thomas J. Walk,
Camille Webb,
Elena Jiménez Gutiérrez,
Christina Imming,
Emily Guhl,
Kwonho Jeong,
Doris Rubio,
Peggy Hasley
Affiliations
Eloho Ufomata
Assistant Professor of Medicine, Division of General Internal Medicine, University of Pittsburgh School of Medicine
Kristen L. Eckstrand
Psychiatry Fellow, Department of Psychiatry, UPMC Western Psychiatric Institute and Clinic
Carla Spagnoletti
Professor of Medicine, Division of General Internal Medicine, University of Pittsburgh School of Medicine
Clark Veet
General Internal Medicine Fellow, Division of General Internal Medicine, University of Pittsburgh School of Medicine; Clinical Instructor of Medicine, Division of General Internal Medicine, University of Pittsburgh School of Medicine
Thomas J. Walk
Clinical Instructor of Medicine, Division of General Internal Medicine, University of Pittsburgh School of Medicine; Clinical Instructor of Medicine, Division of General Internal Medicine, VA Pittsburgh Healthcare System
Camille Webb
Clinical Instructor of Medicine, Division of Infectious Diseases, University of Texas Medical Branch School of Medicine
Elena Jiménez Gutiérrez
Assistant Professor, Division of General and Hospital Medicine, University of Texas Health Science Center at San Antonio School of Medicine
Christina Imming
Pediatric Hospitalist, UPMC Children's Hospital of Pittsburgh; Primary Care Provider, Complex Care Center, UPMC Children's Hospital of Pittsburgh
Emily Guhl
Cardiology Fellow, University of Pittsburgh Medical Center
Kwonho Jeong
Statistician, Data Center, Center for Research on Health Care, University of Pittsburgh School of Medicine
Doris Rubio
Professor of Medicine, Biostatistics, Nursing, and Clinical and Translational Science, Division of General Internal Medicine, University of Pittsburgh School of Medicine
Peggy Hasley
Professor of Medicine, Division of General Internal Medicine, University of Pittsburgh School of Medicine
Introduction Significant gaps remain in the training of health professionals regarding the care of individuals who identify as lesbian, gay, bisexual, and transgender (LGBT). Although curricula have been developed at the undergraduate medical education level, few materials address the education of graduate medical trainees. The purpose of this curriculum was to develop case-based modules targeting internal medicine residents to address LGBT primary health care. Methods We designed and implemented a four-module, case-based, interactive curriculum at one university's internal medicine residency program. The modules contained facilitator and learner guides and addressed four main content areas: understanding gender and sexuality; performing a sensitive history and physical examination; health promotion and disease prevention; and mental health, violence, and reproductive health. Knowledge, perceived importance, and confidence were assessed before and after each module to assess curricular effectiveness and acceptability. General medicine faculty delivered these modules. Results Perceived importance of LGBT topics was high at baseline and remained high after the curricular intervention. Confidence significantly increased in many areas, including being able to provide resources to patients and to institute gender-affirming practices (p < .05). Knowledge improved significantly on almost all topics (p < .0001). Faculty felt the materials gave enough preparation to teach, and residents perceived that the faculty were knowledgeable. Discussion This resource provides an effective curriculum for training internal medicine residents to better understand and feel confident addressing LGBT primary health care needs. Despite limitations, this is an easily transferable curriculum that can be adapted in a variety of curricular settings.
