Beyond Men, Women, or Both: A Comprehensive, LGBTQ-Inclusive, Implicit-Bias-Aware, Standardized-Patient-Based Sexual History Taking Curriculum
Jacob J. Mayfield,
Emily M. Ball,
Kory A. Tillery,
Cameron Crandall,
Julia Dexter,
J. Michael Winer,
Zachary M. Bosshardt,
Jason H. Welch,
Ella Dolan,
Edward R. Fancovic,
Andrea I. Nañez,
Henning De May,
Esmé Finlay,
Staci M. Lee,
Carl G. Streed,
Khizer Ashraf
Affiliations
Jacob J. Mayfield
Intern, Internal Medicine Residency Program, University of California, San Francisco, School of Medicine; Recent Graduate, University of New Mexico School of Medicine
Emily M. Ball
Intern, Emergency Medicine Residency Program, Jackson Memorial Hospital; Recent Graduate, University of New Mexico School of Medicine
Kory A. Tillery
Medical Student, University of New Mexico School of Medicine
Cameron Crandall
Professor, Department of Emergency Medicine, University of New Mexico School of Medicine; Vice Chair for Research, Department of Emergency Medicine, University of New Mexico School of Medicine; Director of LGBTQ Diversity and Inclusion, University of New Mexico Health Science Center
Julia Dexter
Medical Student, University of New Mexico School of Medicine
J. Michael Winer
Medical Student, University of New Mexico School of Medicine
Zachary M. Bosshardt
Medical Student, University of New Mexico School of Medicine
Jason H. Welch
Medical Student, University of New Mexico School of Medicine
Ella Dolan
Medical Student, University of New Mexico School of Medicine
Edward R. Fancovic
Professor, Division of General Internal Medicine in the Department of Internal Medicine, University of New Mexico School of Medicine; Executive Director of Assessment and Learning, University of New Mexico School of Medicine
Andrea I. Nañez
Intern, Obstetrics & Gynecology Residency Program, Kaiser Permanente Medical Group (Northern California)/San Francisco; Recent Graduate, University of New Mexico School of Medicine
Henning De May
Student, MD/PhD Program, University of New Mexico School of Medicine
Esmé Finlay
Assistant Professor, Division of Palliative Medicine in the Department of Internal Medicine, University of New Mexico School of Medicine
Staci M. Lee
Assistant Professor, Division of Infectious Diseases in the Department of Internal Medicine, University of New Mexico School of Medicine; Adjunct Instructor, School of Education, Johns Hopkins University
Carl G. Streed
Fellow, Division of General Internal Medicine & Primary Care, Brigham and Women's Hospital
Khizer Ashraf
Occupational Therapy Student, University of New Mexico School of Medicine
Introduction This standardized-patient-based module prepares medical students to take inclusive, comprehensive sexual histories from patients of all sexual orientations and gender identities. Health disparities faced by lesbian, gay, bisexual, transgender, and queer (LGBTQ) people are at least partially the result of inadequate access to health care and insufficient provider training. This module incorporates implicit bias activities to emphasize the important role providers can play in mitigating these disparities through compassionate, competent care. Furthermore, two of the three included cases highlight the negative impact sexual dysfunction can have on emotional well-being. Methods Over 3 hours, students participate in a 30-minute large-group lecture and three 40-minute small-group standardized patient encounters with debrief. Prework consists of a short video on sexual history taking, assigned readings, and an implicit bias activity. These materials are included in this resource, along with lecture slides, facilitator guide, and standardized patient cases. Though the cases are adaptable to all levels of medical education, this module is designed for second-year and early third-year medical students. Results Qualitative student evaluations were positive, and postparticipation surveys revealed statistically significant improvement in comfort with their ability to take a sexual history in general, and take one from patients with a differing sexual orientation. Deployed in the second year of our Doctoring curriculum, this module continues to receive positive evaluations. Discussion Introducing these skills begins to address the curricular deficiencies seen across medical education and lays the foundation for a more competent health care workforce to address the needs of LGBTQ patients.
