Addressing Bias in LGBTQIA+ Undergraduate Medical Education: An Innovative and Community Based Approach to Curriculum Reform

Abstract

Background: Individuals who are LGBTQIA+ or gender nonconforming have specific health needs and face health disparities that are exacerbated by a lack of training and cultural sensitivity among health professionals. This study was initiated by a second year University of Massachusetts School of Medicine student in response to the lack of LGBTQIA+ health content in the first year Doctoring & Clinical Skills (DCS1) course. The DCS1 session on collecting a sexual history was selected as the primary focus for revision. Community-Based Participatory Research, because of its emphasis on joining with a community of interest as full and equal partners in all phases of the research process, served as an ideal model for the novel application to curriculum development to address this gap in training in undergraduate medical education. Methods: A sample of 13 LGBTQIA+ community members from Worcester were recruited to form a curriculum advisory committee. The committee convened for two focus-group style meetings where they reviewed the curriculum and had the opportunity to provide their feedback, which was used to rewrite the session. Additionally, the community members had the opportunity to participate in a storytelling video where they discussed their experiences in healthcare as LGBTQIA+ patients. A pre-test post-test design was used to survey the UMMS SOM students in order to evaluate the new version of the DCS1 session. Results: The percentage of M1 students reporting they had the necessary skills to treat LGBTQIA+ patients increased from pre-session to post-session (26.2% (n=130), 63.2% (n=76), p = < 0.001). Compared to current M2 students who completed the course last year (n=65), more MS1 students (n=76) rated the overall quality of the DCS1 session as excellent or good (23.1%, 77.6%, p= < 0.0001. Conclusion: CBPR serves as an efficacious model for the creation of curriculum inclusive of LGBTQIA+ health.