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Lesbian, Gay, Bisexual, and Transgender Health: a Survey of Attitudes, Knowledge, Preparedness, Campus Climate, and Student Recommendations for Change in Four Midwestern Medical Schools

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Abstract

Medical school curricula addressing the unique healthcare needs and disparities of lesbian, gay, bisexual, and transgender (LGBT) patients are insufficient. National organizations have recommended curricular and institutional climate changes to address this problem. This study examined students’ perceived attitudes and knowledge regarding LGBT patient care and campus climate at four Midwestern US allopathic medical schools. During 2013, all medical students at the four institutions were invited to participate in the online anonymous survey. We used descriptive statistics for survey item results and qualitative methods to analyze responses to open-ended questions about curricular changes. Survey results were obtained from 34.6% of students and demonstrated that attitudes, knowledge, preparedness, and campus climate across all institutions were generally positive for LGBT patients and students. A negative correlation was found between overall campus climate and discrimination practices. Four themes emerged from students’ recommendations to improve their training, which included more clinical experiences with LGBT patients, more formal curricula on LGBT topics, establishment of safe learning environments, and addition of specific topics related to LGBT health. Due to the low prevalence of LGBT populations, reluctance to disclose sexual orientation or gender identity, and lack of LGBT-specific clinics, required experiences with LGBT patients during clinics or clerkship rotations may be more difficult in smaller urban communities in which some Midwestern medical schools are located. Potential alternatives include using multiple teaching modalities in the pre-clerkship years to expose students to LGBT-identified patients in clinical simulations and settings.

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Acknowledgements

The authors wish to thank Jenenne Geske, PhD, Associate Professor in the Department of Family Medicine, College of Medicine, University of Nebraska Medical Center, for assistance with statistical analyses and editorial review and support.

Funding

This study was funded by a Collaborative Grant from the Central Group on Educational Affairs (CGEA) of the Association of American Medical Colleges (AAMC).

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Authors and Affiliations

  1. Office of Medical Education, College of Medicine, University of Nebraska Medical Center, 985525 Nebraska Medical Center, Omaha, NE, 68198-5525, USA

    Gary L. Beck Dallaghan

  2. Family Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Jim Medder

  3. Psychiatry Residency, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Jeffrey Zabinski

  4. Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA

    Sabrina M. Neeley

  5. Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA

    Brenda Roman

  6. Pre-Clinical Curriculum, Carver College of Medicine, University of Iowa, Iowa City, IA, USA

    Jeffrey L. Emrich

  7. Pediatrics, University of Mississippi School of Medicine, Jackson, MS, USA

    Nicole Borges

  8. Student Affairs/Diversity, Office of Measurement and Evaluation, Pediatric-Medical Education, Medical College of Wisconsin, Milwaukee, WI, USA

    Dawn Bragg

Authors
  1. Gary L. Beck Dallaghan
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  2. Jim Medder
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  3. Jeffrey Zabinski
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  4. Sabrina M. Neeley
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  5. Brenda Roman
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  6. Jeffrey L. Emrich
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Corresponding author

Correspondence to Gary L. Beck Dallaghan.

Ethics declarations

The study protocol was approved by the institutional review boards of all participating institutions and was granted an exempt status at all schools.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Beck Dallaghan, G.L., Medder, J., Zabinski, J. et al. Lesbian, Gay, Bisexual, and Transgender Health: a Survey of Attitudes, Knowledge, Preparedness, Campus Climate, and Student Recommendations for Change in Four Midwestern Medical Schools. Med.Sci.Educ. 28, 181–189 (2018). https://doi.org/10.1007/s40670-018-0536-3

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  • DOI: https://doi.org/10.1007/s40670-018-0536-3

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