Purpose: Graduate medical education curricula that provide training on LGBT healthcare are limited. The purpose of this study was to create and evaluate an LGBT curriculum for internal medicine (IM) residents.
Methods: The implicit association test (IAT) measuring implicit bias toward gay individuals was administered as part of a needs assessment. The curriculum was developed by a multidisciplinary team, with objectives derived from the Association of American Medical Colleges' curricular recommendations and the Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health. Surveys assessed residents' perceptions of the importance of primary care for LGBT patients, and their knowledge of and confidence in providing primary care to LGBT patients. Faculty also rated the usability of the curricular materials.
Results: The IAT showed a slight preference for straight people compared with gay people, with an average "D score" of 0.27 ± 0.42. The importance of receiving education about the primary care of LGB patients was rated as high across the pre- to postsurveys. Knowledge improved with participation in the curriculum (average overall score: 42% pre- vs. 66% postsurvey, p < 0.0001). Participants' confidence in their ability to provide information to LGBT patients about resources for community engagement and to implement gender-neutral practices in their clinics increased significantly (p < 0.05).
Conclusion: This curriculum pilot demonstrated an improvement in IM residents' knowledge of and confidence in providing care to LGBT patients. Our results suggest that curricular materials can be developed by experts in LGBT health and utilized effectively by nonexpert faculty to increase residents' knowledge and confidence regarding LGBT healthcare.
Keywords: LGBT health; cultural competency; curriculum/program evaluation; graduate medical education; primary care.