Abstract

1. Purpose/Method Abstract Perceived Barriers Analysis Straight Talk about LGBT Medical School Curriculum Content Rebecca L. Tamas MD, Karen Hughes Miller PhD, Ruth Greenberg PhD, and Leslee Martin, MAUniversity of Louisville, Louisville, KY Medical students must be prepared to communicate effectively with a diverse patient population. Most medical schools in the U.S. acknowledge this by including diversity in their undergraduate medical curriculum. But diversity is often interpreted as meaning ethnicity, gender, or race rather than the more subtle diversity of sexual orientation. There is very little research on how lesbian, gay, bisexual, and transgender (LGBT) healthcare issues are actually introduced into the medical curriculum. The two primary objectives of this study were to quantify how much instructional time is actually dedicated to teaching about LGBT healthcare and to identify faculty perceptions of barriers to including LGBT topics in the curriculum at our institution. The U of L SOM undergraduate curriculum now includes 7 hours (roughly one instructional day in a four year program) dedicated to LGBT issues. This was less than the 13.6 hours our faculty considered to be “ideal,” but was considerably more than the 3.5 hours reported as the U.S. average as found in the AMSA Plus One Initiative study. 1 1. American Medical Student Association (AMSA). Plus One Initiative. Available http://www.amsa.org/gender/plus_one.cfm Accessed 05/20/2009. A Spearman’s rank correlation coefficient revealed a significant negative relationship between the number of instructional hours devoted to LGBT topics in courses and clerkships and the number of barriers identified by respondents, rs = -0.45, p =.047. That is, course and clerkship directors who perceived more barriers to teaching LGBT topics devoted fewer hours to those topics in their curricula. Conclusions It was encouraging to find that almost half of course directors and almost half of clerkship directors believed their courses would be improved by adding LGBT issues to their content. The implication is that we may have willing learners for professional development in this area. We were not surprised to find the barrier cited most frequently (61%) was “lack of instructional time” because this barrier is most often mentioned when any new content is proposed to the medical curriculum. The barrier mentioned next most often (43%) was “lack of professional development on how to teach this topic.” This is good news for medical educators because it is much easier to address extrinsic issues such as lack of professional development on the topic than intrinsic issues such as lack of comfort with the topic. It was also of interest to find a statistically significant negative correlation between the number of course hours dedicated to LGBT issues and the number of perceived barriers to addressing this topic. In other words, the more difficulty faculty perceive in including this topic, the fewer hours they dedicate to the topic. This, combined with the finding that basic science faculty saw less relevance to their course content than did clinical faculty, will help medical educators focus the design of professional development on issues where it is most needed. While some courses are certainly more conducive to teaching about patient sexuality than others, the barrier “lack of relevance to my course content” might be more logically addressed by strategies to teach LGBT healthcare content using an interdisciplinary approach. This study was designed to determine how much instructional time (preclinical and clinical) at the University of Louisville School of Medicine is dedicated to teaching about LGBT healthcare, and what were the perceived barriers to including more content on LGBT issues. A questionnaire was designed and distributed to all of the course directors and clerkship directors.