Association of Lesbian, Gay, Bisexual, and Transgender (LGBT) Cultural Competency Training With Provider Practice Characteristics and Perceptions of Patient Care

Abstract

BACKGROUND While issues related to lesbian, gay, bisexual, and transgender (LGBT) health are increasingly incorporated into medical training, there remains limited guidance and opportunities for continuing medical education in LGBT health. It is unclear how participation in LGBT-specific training is distributed across physician specialties and practice regions. Additionally, national data assessing cultural competency training for physicians are scarce and do not delineate LGBT-specific training or training completed prior to, during, or after graduate medical education. METHODS Using data from the 2016 National Culturally and Linguistically Appropriate Services Physician Survey, this study evaluated patterns of post-residency cultural competency training, as well as associations between LGBT-specific training and provider perceptions of patient care outcomes. RESULTS Provider specialty, practice region, and receiving cultural competency training as a trainee were associated with post-residency LGBT-specific training. Surgical providers (odds ratio [OR]: 0.42; confidence interval [CI] 0.25–0.73; p = .002) and those practicing in the South (OR: 0.49; CI: 0.26–0.92; p = .025) had lower odds of completing LGBT-specific cultural competency training while in independent practice. Post-residency LGBT-specific training was associated with provider agreement that cultural competency training improves the quality of care (OR: 2.76; CI: 1.44–5.28; p = .002), patient satisfaction (OR: 2.55; CI: 1.32–4.93; p = .005), and patient comprehension (OR: 2.03; CI: 1.05–3.90; p = .034). CONCLUSIONS Our findings provide disaggregated analyses that nuance the assessment of cultural competency interventions and support a broader effort to increase attention to LGBT health in continuing medical education.