Can a student-led teaching intervention improve student and staff understanding of LGBTQ+ identities and health-related issues in undergraduate medicine?
Problem
LGBTQ+ people face health inequalities that culminate in a 12-year lower life expectancy in areas of high anti-LGBTQ+ prejudice (Hatzenbuehler et al, 2017) and 1 in 4 LGBTQ+ people have witnessed healthcare staff make negative remarks about LGBTQ+ people (Stonewall, 2018). Furthermore, 70% of NHS staff have had negative experiences in the last two years related to their sexual orientation (BMA & GLADD, 2016). Despite these statistics, 85% of medical students want more teaching in this area (Arthur et al, 2021). Indeed, in a cross-sectional survey of UK medical schools, half of respondents said their institution "could do better" with respect to LGBTQ+ material in curriculum (Tollemache et al, 2021). Given this, medical education must include relevant teaching to enable current and future healthcare staff to provide LGBTQ+ inclusive care.
Approach
Members of the University of Glasgow Medical Students LGBTQIA+ Society created a pre-recorded lecture, titled 'Gender, Sex and Sexuality: Getting the Basics Right', which was sign-posted to pre-clinical medical students (n ≈ 600), and some of their tutors, via an online learning environment. Viewers were invited to complete an online questionnaire, to evaluate the resource’s impact.
Findings
Despite a small sample size of responses (N=33), some key learning points were noted. Students reported increased confidence using relevant terminology, comfort in their ability to consult with LGBTQ+ patients, and recognised a need for knowledge of the LGBTQ+ community and LGBTQ+ issues as a healthcare issue. Initial qualitative analysis of written feedback identified several themes, including increased self-affirmation of own identity, acknowledgement of own areas of weakness, and improved awareness of the importance of LGBTQ+ healthcare. Where discomfort or lack of confidence existed, a majority reported this related to use of pronouns, in introductions and/or consultations. However, there was a keenness to see this incorporated into communication skills teaching. Ideally, this pilot would be repeated with a longer follow up, and expanded to include staff in the sample. Future lectures could be enhanced based on feedback. Importantly, these topics must be integrated into core curricula.
Consequences
Preliminary feedback suggests student-led teaching can increase awareness and understanding of LGBTQ+ identities and health-related issues. These methods may be transferable to other neglected areas of health and marginalised identities. Changing the current status quo of LGBTQ+ healthcare, must start within education, to provide students and staff with the knowledge they need for inclusive and effective care within a diverse population.