The Prevalence of Lesbian, Gay, Bisexual, and Transgender Health Education and Training in Emergency Medicine Residency Programs: What Do We Know?

BackgroundThe Institute of Medicine, The Joint Commission, and the U.S. Department of Health and Human Services all have recently highlighted the need for cultural competency and provider education on lesbian, gay, bisexual, and transgender (LGBT) health. Forty percent of LGBT patients cite lack of provider education as a barrier to care. Only a fewhours of medical school curriculum are devoted to LGBT education, and little is known about LGBT graduate medical education. ObjectivesThe objective of this study was to perform a needs assessment to determine to what degree LGBT health is taught in emergency medicine (EM) residency programs and to determine whether program demographics affect inclusion of LGBT health topics. MethodsAn anonymous survey link was sent to EM residency program directors (PDs) via the Council of Emergency Medicine Residency Directors listserv. The 12-item descriptive survey asked the number of actual and desiredhours of instruction on LGBT health in the past year. Perceived barriers to LGBT health education and program demographics were also sought. ResultsThere were 124 responses to the survey out of a potential response from 160 programs (response rate of 78%). Twenty-six percent of the respondents reported that they have ever presented a specific LGBT lecture, and 33% have incorporated topics affecting LGBT health in the didactic curriculum. EM programs presented anywhere from 0 to 8hours on LGBT health, averaging 45 minutes of instruction in the past year (median= 0 minutes, interquartile range [IQR]= 0 to 60 minutes), and PDs support inclusion of anywhere from 0 to 10hours of dedicated time to LGBT health, with an average of 2.2hours (median= 2hours, IQR= 1 to 3.5hours) recommended. The majority of respondents have LGBT faculty (64.2%) and residents (56.2%) in their programs. The presence of LGBT faculty and previous LGBT education were associated with a greater number of desiredhours on LGBT health. ConclusionsThe majority of EM residency programs have not presented curricula specific to LGBT health, although PDs desire inclusion of these topics. Further curriculum development is needed to better serve LGBT patients. Resumen IntroduccionEl Institute of Medicine, la Joint Commission y el Department of Health and Human Services han subrayado recientemente la necesidad en la competencia cultural y la educacion sanitaria de los profesionales sanitarios sobre lesbianas, gays, bisexuales y transexuales (LGBT). El 40% de los pacientes LGBT reconoce una falta de formacion de los sanitarios como una barrera en la atencion medica. Solo unas pocas horas del programa universitario de medicina esta dedicada a la formacion en LGBT, y se sabe poco sobre la formacion medica de postgrado sobre LGBT. ObjetivosEl objetivo de este estudio fue evaluar que grado de formacion sanitaria sobre LGBT se ensena en los programas de residencia de Medicina de Urgencias y Emergencias (MUE) y determinar si las caracteristicas de las personas que realizan el programa afectan a la inclusion de temas sanitarios sobre LGBT. MetodologiaSe envio un enlace de encuesta anonima a los directores del programa de residencia de la MUE a traves de la lista del servidor del Council of Emergency Medicine Residency Directors. La encuesta descriptiva de 12 items pregunto el numero de horas reales y deseadas de formacion saniataria sobre LGBT en el pasado ano. Tambien se buscaron las barreras percibidas para la educacion sanitaria sobre LGBT y la demografia del programa. ResultadosHubo 124 respuestas a la encuesta de una respuesta potencial de 160 programas (porcentaje de respuesta del 78%). Un 26% de los encuestados contest que nunca habia presentado una clase especifica sobre LGBT, y un 33% ha incorporado temas que afectan a la salud de LGBT en el plan de estudios. Los programas de MUE presentaron en cualquier lugar de 0-8 horas de formacion sanitaria sobre LGBT, con un promedio de 45 minutos de formacion en el pasado ano (mediana de 0 minutos, RIC 0 a 60 minutos), y los directores del programa apoyan la inclusion en cualquier lugar de 0 a 10 horas de tiempo dedicado a la formacion sanitaria sobre LGBT, con un promedio recomendado de 2,2 horas (mediana 2, RIC de 1 a 3,5 horas). La mayoria de los encuestados tienen profesores (64,2%) y residentes (56,2%) LGBT en sus programas. La presencia de profesores LGBT y la formacion sanitaria previa sobre LGBT se asociaron con un mayor numero de horas deseadas sobre formacion sanitaria sobre LGBT. ConclusionesLa mayoria de los programas de residencia en MUE no ha presentado un plan de estudios especifico para formacion sanitaria sobre LGBT, aunque los directores del programa desean la inclusion de estos temas. Es necesario el desarrollo de un programa futuro para atender mejor a los pacientes LGBT.