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eQuality: a Process Model to Develop an Integrated, Comprehensive Medical Education Curriculum for LGBT, Gender Nonconforming, and DSD Health

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Abstract

Patients who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming (GNC), or born with differences of sex development (DSD) face significant health disparities. Many of these disparities originate from discrimination and systemic biases that decrease access to care and from inadequate provider knowledge that contributes to unmet medical needs. Provider training to deliver equitable care for these populations is thus critical, but such training is deficient at most medical institutions. The authors developed an integrated educational model, eQuality, that sought to drive educational and system innovation by teaching and assessing the acquisition of attitudes, knowledge, and skills needed to provide competent care for LGBT/GNC/DSD individuals. This paper outlines the process of its implementation for other programs to model. With input from an LGBT/GNC community advisory panel, eQuality incorporated new teaching sessions and revised existing content in 50.5 h of required curriculum. This curriculum involved 23 teaching faculty and included direct student-LGBT/GNC/DSD patient interactions for 320 students. The program was piloted in the first and second years of medical school and is being expanded into medical school years 3 and 4 with clinical assessments to ensure that curriculum translates into improved patient care. eQuality demonstrates that promoting healthcare equity for LGBT/GNC/DSD populations through medical education is feasible. Forthcoming baseline data will also enable future longitudinal comparisons as eQuality cultivates exceptional insight into the evolution of LGBT/GNC/DSD health knowledge and awareness among both students and faculty.

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Acknowledgements

The authors would like to thank Dean Toni Ganzel, whose continued support has made our work possible; Dr. Mordean Taylor-Archer, whose legacy of LGBT advocacy at the University has engendered a welcoming climate in which to do this work; the staff of the LGBT Center, whose tireless efforts support the strong community involvement in this project; many University of Louisville faculty who have contributed to the development and implementation of this work; and the UME Medical Education Research Unit staff for providing substantial research support.

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Authors and Affiliations

  1. Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA

    Amy Holthouser, Susan Sawning, Emily J. Noonan, Leslee J. Martin, Laura A. Weingartner & M. Ann Shaw

  2. Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, USA

    Amy Holthouser & V. Faye Jones

  3. Health Sciences Center Office of Diversity and Inclusion, University of Louisville, Louisville, KY, USA

    Katie F. Leslie & V. Faye Jones

  4. LGBT Center Satellite Office at the Health Sciences Center, University of Louisville, Louisville, KY, USA

    Stacie Steinbock & Emily J. Noonan

  5. Department of Medicine, Harvard Medical School, Cambridge, MA, USA

    Jennifer Potter

  6. The Fenway Institute, Boston, MA, USA

    Jennifer Potter

  7. Department of Internal Medicine, The Ohio State University, Columbus, OH, USA

    John Davis

  8. Department of Psychiatry, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, PA, USA

    Kristen L. Eckstrand

Authors
  1. Amy Holthouser
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  2. Susan Sawning
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  3. Katie F. Leslie
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  4. V. Faye Jones
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  5. Stacie Steinbock
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  8. Laura A. Weingartner
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  9. Jennifer Potter
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  10. John Davis
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  11. Kristen L. Eckstrand
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  12. M. Ann Shaw
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Corresponding author

Correspondence to Amy Holthouser.

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Holthouser, A., Sawning, S., Leslie, K.F. et al. eQuality: a Process Model to Develop an Integrated, Comprehensive Medical Education Curriculum for LGBT, Gender Nonconforming, and DSD Health. Med.Sci.Educ. 27, 371–383 (2017). https://doi.org/10.1007/s40670-017-0393-5

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