TABLE 1 : Self-reported Preparedness for Addressing 16 LGBT Health Topics
Preclinical a Clinical b Total c
# % # % # % Sexual orientation * 29 63.05 % 35 77.78 % 64 70.33 % Human Immunodeficiency Virus ( HIV ) 22 47.83 % 38 84.44 % 60 65.93 % Sexually transmitted infections ( not HIV ) 23 50.00 % 33 73.33 % 56 61.54 % Gender identity * 24 52.17 % 29 64.45 % 53 58.24 % Coming out * 24 52.18 % 27 59.99 % 51 56.04 % Alcohol , tobacco , or other drug use 22 47.83 % 28 62.23 % 50 54.95 % Safer sex 20 43.48 % 29 64.45 % 49 53.85 % Mental health 21 45.66 % 26 57.78 % 47 51.65 % Barriers to accessing medical care 19 41.30 % 27 60.00 % 46 50.55 % Unhealthy relationships ( e . g ., IPV ) 17 36.96 % 24 53.33 % 41 45.05 % Disorders of Sex Development ( DSD ) / Intersex * 17 36.97 % 20 44.44 % 37 40.66 % Adolescent health 16 34.79 % 20 44.45 % 36 39.56 % Chronic disease risk 14 30.43 % 20 44.44 % 34 37.36 % Body image 15 32.62 % 15 33.33 % 30 32.97 % Transitioning * 10 21.75 % 11 24.44 % 21 23.08 % Sex reassignment surgery * ( SRS ) 9 19.57 % 8 17.78 % 17 18.68 %
Note : Values are percentage of students who answered “ prepared ,” “ well prepared ,” or “ extremely well prepared ” versus those who answered “ insufficiently prepared ” or “ not at all prepared .” n a = 46 , n b = 45 , n c = 91
* Definitions from questionnaire provided in Supplemental Table 1 .
patients . The data suggests that allopathic medical school curricula in the state of WV has increased student rated comfort and preparedness in providing medical care to LGBT patients . Additionally , the number of LGBT topics student felt prepared to address increased when comparing preclinical to clinical students . This further supports our inference that the medical school didactic and clinical curricula were responsible for that change . However , there were still 37.5 % of topics that less than 50 % of clinical students felt prepared to address . In addition , students rated 56.25 % of topics as having “ too little coverage .”
There is no single solution to the problem of LGBT discrimination . However , based on the results of our study , two-thirds of students reported receiving required pre-clinical instruction of LGBT health topics and 42.2 % reported required clinical training on the subject . Further , the schools facilitated education on LGBTrelated content by promoting interaction with different LGBT-identified faculty , patients , student groups , panel discussions , conferences and more . Therefore , these medical schools have shown that they are making an effort to educate their student clinicians both in the classroom and in the hospital about LGBT-specific needs .
Our study has several strengths . First , it adds to the limited body of knowledge about LGBT attitudes among Appalachian medical professionals . Although many studies have similar designs , our study focuses on a unique subset of the US population that is often overlooked and underrepresented on a national scale . It also points to specific topics that are not currently being covered in sufficient detail for students to feel prepared to address , especially with regards to care for transgender patients .
This study has three main limitations . The sample size is small and does not include participants from the one osteopathic school in the state ; and there is inherent response bias for students interested in LGBT health concerns . Because responses from both allopathic schools were combined , with nearly three-quarters of the responses came from one school , we cannot clearly evaluate the variation in curricula for the two medical schools . Additionally , the data could be skewed due to recall bias where students may not accurately remember their attitudes from years prior . The main take-away from our study is that responses to our questionnaire by students enrolled at the two allo pathic medical schools in WV provide evidence that students want curricula to be further enhanced to optimize care of patients who identify as belonging to the sexual and gender minority community .
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