Religion and Sexual / Gender Minority ( SGM ) Case
BOX 1 : Sample Clinical Scenario with Discussion Questions
In the family medicine teaching clinic , a third-year medical student presents his first patient to you . He describes Lori who just turned 21 years old , and she is here today for her annual health supervision visit . Lori will be starting a nursing program and needs you to complete her immunization record . The student says that her immunizations are up-to-date , except she never received the HPV vaccine . During the presentation of the patent ’ s social history , the student mentions that Lori is in a monogamous relationship with her girlfriend . When you ask the student if he discussed the HPV vaccine with Lori , he replies , “ I didn ’ t think she needed it , because she ’ s gay .”
Discussion Questions
1 . What misconceptions / assumptions are the student making about Lori ?
2 . All patients should be offered appropriate immunizations . What potential health disparities can result from inadequate / inappropriate treatment of various populations of patents ? What are some health disparities in SGM patents reported in the medical literature ?
3 . How would you reply to one of your residents who asks to not take care of Lori as his religion believes homosexuality is a sin ? Does “ religious freedom ” allow a physician to avoid caring for various populations of patents ?
4 . How will you balance your religious beliefs and personal biases with your obligation to provide equitable health care to all patents ?
5 . What is an implicit bias test , and are you willing to take one ? If you take an implicit bias test , how can you use the results to make you a better health care provider ?
Legend : HPV = human papilloma virus
of course , any more than same-culture interactions always go splendidly , but , all other things being equal , they are certainly more likely to end badly .” 17 Cross-cultural patient-provider understanding and rapport is necessary in optimizing clinical encounters and health outcomes . For example , Eiser and Ellis describe African American cultural variations with regard to religion , use of natural remedies , and distrust in the health care system to underscore the role of cultural influences on health and health care encounters . 18
Learning events , such as described in our report , if inter-woven into curricula from day one of a student ’ s education , can raise awareness about health disparities and illuminate ways to eliminate cultural blunders that could negatively impact health care delivery and outcomes . Collaborative on-line engagement among dentists-and physicians-in-training for an educational session to examine the unique needs of diverse populations is a viable strategy to raise awareness about health disparities . Optimizing patient care is the ultimate goal of interprofessional education . 11 The on-line route made it possible for both dental students and medical students to participate , as there were no mutually available timeframes for an in-person collaborative session during an event-filled orientation week . Although the literature includes reports of successful implementation of on-line interprofessional didactic experiences between dental and medical students , the reports are limited and do not include the topics of caring for individuals from varied backgrounds and health disparities . In 2018 , Green et al reported that less than half of dental students , along with other health professional students , agreed that their training formally prepared them to care for patients who identify as sexual and gender minorities . 19 A need still exists to fill-in gaps in the teaching of health professional students to care for patients from diverse backgrounds . Students in the 21st century are technologically savvy and respond well to on-line assignments . Solomon et al reported that their participants in on-line events , including medical students and other health professional students , had positive perceptions about the use of web-based modules . 12 The authors emphasized the need to provide clear instruction and statement of deadlines when employing on-line assignments . 12 Care was taken to ensure the clarity of instruction and deadlines in the preparation of our on-line assignment with the inclusion of step-by-step directions . Blue et al reported successful use of on-line teaching modules for an interprofessional course that included dental and medical students , amongst other learners . 8 Although our learning event was fully web-based , Blue et al recommended also including an in-person component for optimal interprofessional collaboration . 8 However , strict time and geographical constraints may not always allow for the creation of a hybrid educational session . Our data supports the effectiveness of an educational session including dental and medical students that occurs strictly on-line to raise awareness about diversity and health disparities . In a meta-analysis by Cook and colleagues , it was suggested that the effectiveness of web-based learning was similar to traditional teaching methods for professional students , including those in dental and medical school . 20
Multiple limitations of our work have been considered . A primary statistical concern was that the data were not matched , although they contained most of the same respondents . This limits our within-group
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