(043) Assessing Confidence in Caring for LGBTQ+ in Medicine and Teaching Acclimate Survey
Authors: Jones A , Williams E , Hamilton O , Campbell J 
Published: May 2023

Abstract

Introduction
Discrimination against LGBTQ+ individuals in West Virginia (WV) may compound the already poor health outcomes faced by all West Virginians. Medical students across the United States (US) report positive attitudes towards LGTBQ+ patients but do not feel adequately trained to provide proper care. Medical schools and residency programs in WV have begun to incorporate LGTBQ+ training in their curricula, but the effect on confidence is not known. We report preliminary survey results from WV resident physicians and medical students on their confidence caring for LGTBQ+ patients.

Objective
Use survey data to evaluate the quantity and quality of LGBTQ+ medical education of residents and medical students in WV and assess its impact on confidence and comfort in treating LGBTQ+ patients.

Methods
An anonymous survey was distributed via REDCap from February to June 2022 to residents and medical students at a major WV medical school and teaching hospital. The survey collected demographic information and exposure to LGTBQ+ undergraduate medical training, and assessed with a Likert Scale attitudes, comfort, and confidence in providing informed care; many questions were adapted from a validated survey. Data were analyzed with Fisher’s exact and Mann-Whitney tests. Significance was set at p&lt;0.05.

Results
Thirty-five students and 23 residents completed the survey. Students identified as male (37%), female (54%), non-binary (6%), and other (3%); residents identified as male (52%) or female (48%). Most students (77%) and residents (83%) were heterosexual; other sexual orientations included gay (6% of students, 4% of residents), lesbian (6% of students), bisexual (9% of students, 13% of residents). One student (3%) identified as “other.” Most students (67%) were from WV and most residents (57%) attended medical school in WV. Residents were from nine specialties; Internal Medicine (22%) and Surgery (22%) were most represented. Residents attended US (61%), International (35%), and Caribbean (4%) schools. Most residents did not have LGBTQ+ lectures (57%) or standardized patients (57%) in medical school (57%), but have had lectures in residency (55%). Students reported LGTBQ+ curriculum (67%) but not standardized patients (69%). Students felt more competent than residents with LGTBQ+ language (z=3.04, p&lt;0.00), and that physicians should ask patients their pronouns, gender identity (z=2.8, p=0.01). Among all respondents, those without LGTBQ+ curriculum in medical school felt less comfortable asking about gender identity (z=–2.24, p=0.03), sexual orientation (z=–2.207, p=0.03), sexual preferences (z=–2.705, p=0.01), and reported anxiety about their knowledge of LGTBQ+ healthcare (z=3.354, p&lt;0.00). Those without standardized patient experiences felt less competent (z=–4.127, p&lt;0.00) and more anxious (z=3.040, p&lt;0.00) performing a physical exam on a transgender patient. Most subjects reported appropriate awareness of disparities (64%), but not in linking patients to resources (52%); most would attend training (89%) and support mandatory LGTBQ+ education (93%).

Conclusions
Though preliminary results, medical learners want training in LGTBQ+ healthcare and do not feel adequately prepared to care for the unique needs of these patients.

Disclosure
No