Nathan/Natalie Marquez: A Standardized Patient Case to Introduce Unique Needs of an LGBT patient

Abstract

Abstract Introduction This standardized patient case introduces the unique needs of lesbian, gay, bisexual, and transgendered (LGBT) youth during an outpatient visit. This workshop was developed by clinician educators as part of a small-group curriculum for preclinical medical students. This case was developed by an internal medicine physician and vetted through pediatricians and clinicians with an interest in LGBT health. The session is intended to be used with preclinical or early clinical learners to give students practice in obtaining a complete history while simultaneously recognizing the added psychosocial stressors on LGBT youth, and how these stressors may manifest as physical complaints. Methods The session was run in a small-group setting, with a faculty facilitator. Students interviewed standardized patients in their weekly small-group session (12 students and one facilitator per group). The case pertained to a 15− to 25-year-old patient with chief complaint of headache. In delving deeper into social history, the students encountered the scenario of a patient with conflicted views on his/her sexual orientation and family pressures. Results The case and session have been used to train about 560 medical students. A subset (n = 95) of students was randomly selected to evaluate the small-group session. Eighty-seven percent of students rated the session as excellent or good, 12% as fair, and 2% as poor. During the 2013-14 and 2014-15 academic years, 88% of facilitators (n = 17) agreed or strongly agreed that the “content of the session was at the appropriate level for the students' level of learning.” Additional comments were generally positive, including “content was excellent and ‘real’” and “students did a great job discussion LGBT content.” Areas for improvement included suggestions that “more time” be allowed for discussion and reflections stating that “addressing both adolescent and LBGT in one session was challenging.” Discussion This standardized patient case introduces the unique needs of an LGBT youth during an outpatient visit, and has been used to train medical students to recognize the unique needs for a patient-centered, compassionate environment when treating adolescents who self-identify as LGBT.

Keywords

• Small Group
• Standardized Patient
• Headache
• Sexual Orientation
• LGBT
• Medical Student