Introducing Lesbian, Gay, Bisexual, and Transgender (LGBT) and Gender Identity Issues in a Medical Humanities Module

Introducing Lesbian, Gay, Bisexual, and Transgender (LGBT) and Gender Identity Issues in a Medical Humanities Module

P. Ravi Shankar (Xavier University School of Medicine, Oranjestad, Aruba) and Christopher Rose (Xavier University School of Medicine, Oranjestad, Aruba)
Copyright: © 2015 |Pages: 11
DOI: 10.4018/IJUDH.2015070101
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Abstract

Lesbian, gay, bisexual and transgender (LGBT) are ways of referring to someone's sexual orientation/preferences; gaining a better understanding as to how best serve the needs of the LGBT community are becoming increasingly important in medical education. While nations (especially developing ones) are making efforts to become more pluralistic societies that uphold and honor the rights of all their citizenry, members of the LGBT community continue to face hostility and violence. These factors cause many members of the LGBT community to be wary about identifying their sexual orientation. Curricular interventions to address LGBT issues are becoming increasingly common. The LGBT community faces a number of challenges and disparities in accessing healthcare. The authors facilitate a medical humanities (MH) module at the Xavier University School of Medicine, Aruba.. Small group, activity-based learning strategies are widely used during the module. Literature, case scenarios, paintings and role-plays are used to explore different aspects of MH. In this manuscript role-plays serve as vehicles to introduce LGBT issues to medical students during the module. The process of debriefing the role-play including students' comments are briefly discussed. One scenario deals with a young girl forced to become a worker in the sex trade, another contends with a night club owner who is diagnosed as HIV positive, a third situation portrays a young woman with a same gender life partner suffering from terminal cancer, the fourth situation explores the difficulties a female student faces when she reveals a sexual attraction for a same sex classmate. The role-plays serve to introduce students to an initial understanding of some of the issues faced by members of the LGBT community and an opportunity to put themselves in the position of a LGBT individual.
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Educational Initiatives To Introduce Medical Students To Lgbt Issues

Recently there have been many initiatives to introduce medical students to issues faced by the LGBT community. A study conducted at a metropolitan medical school in the United States (US) showed that medical students with greater exposure to LGBT patients had better knowledge and more positive attitudes towards this population compared to students with little or no clinical exposure (Sanchez et al., 2006). At the University of California, San Francisco a LGBT curriculum was implemented and the authors concluded that their small curricular intervention had resulted in significant short-term increase in student knowledge as measured by a survey (Kelley et al., 2008). A study conducted among both nursing students and medical students at a university in Australia concluded that respondents’ knowledge and attitude about homosexuality showed a significant association with race, political voting behavior, religious beliefs and having a LGBT friend who had declared their orientation openly (Chapman et al., 2012). A study conducted at the University of Cape Town in South Africa aimed to determine the extent to which LGBT related health content is taught in the curriculum (Muller, 2013). The author concluded that LGBT issues were not adequately covered in the curriculum and teaching where it existed was largely discretionary, unsystematic and not incorporated into the overarching curricular structure. A study conducted among both allopathic and osteopathic medical schools in the US and Canada aimed to characterize LGBT content in the school curricula (Obedin-Maliver et al, 2011.). The median time devoted to teaching LGBT content was 5 hours and the quantity, content covered and the perceived quality of the information varied substantially among schools.

A recent paper acknowledges that understanding a patient’s sexual orientation is important; however, the time afforded and the richness of discussions on this topic varies significantly across North American medical schools (Shindel & Parish, 2013). The authors conclude that there is a tremendous opportunity to mold views of the next generation of healthcare providers regarding human sexuality and they recommend a comprehensive and uniform curriculum on human sexuality. At the Tulane University School of Medicine in New Orleans, four educational sessions related to LGBT issues were offered to undergraduate medical students (Sequeira et al., 2012). Following the sessions students completed electronic feedback forms. Thematic analysis of student responses identified a current lack of exposure to LGBT content, a consensus that LGBT issues are important in the students’ work as future physicians and the relevance of including such issues in the school curriculum. Previous research has suggested that medical students, doctors and other healthcare professionals may have negative attitudes towards LGBT patients and colleagues (McKelvey et al., 1999; Eliason et al., 2011). At the Leicester-Warwick medical school in the United Kingdom, human sexuality is included in the curriculum in the context of a module on human diversity (Dixon-Woods et al., 2002). The course uses a mixture of teaching methods and the authors concluded the course was effective in reducing students’ anxieties about human sexuality and their confidence in developing appropriate skills.

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