Developing health care provider knowledge, confidence, and cultural sensitivity through resident transgender training: a controlled educational study.

Abstract

Background: Transgender and gender-diverse (TGD) individuals face substantial health disparities as a result of discrimination and poor provider competence in understanding their health needs. Relatively little work has been done studying educational interventions targeted toward increasing residents' knowledge and ability to treat TGD individuals with sensitivity. We studied the effectiveness of implementing a lecture series on transgender health in preparing internal medicine residents to care for the TGD population.

Methods: Both study and control participants were recruited through their affiliated internal medicine residency programs. The study design was a pre-post controlled educational study. A lecture series was developed at Riverside University Health System as the educational intervention. We used a Transgender Assessment survey developed for the study to determine changes in the residents' knowledge, self-confidence, and knowledge of barriers to care during the study period from January to June 2022. The data were statistically analyzed to assess the differences between pre- and post- and study and control groups.

Results: Similar demographics were noted between the study and control groups. Compared with the control group, residents in the study group tended to have more exposure to transgender health education prior to the study. Residents in the study group demonstrated increased knowledge and self-confidence after completing the curriculum. The study group's average knowledge score increased from 4.8 to 6.1 post-intervention (p = 0.004). Self-confidence scores in providing gender-specific care rose from an average of 13.7 to 17.9 post-intervention (p < 0.001). The study group had higher post-intervention scores compared to the control group, particularly in knowledge of gender-affirming therapies (post 4.3 vs. pre 3.4, p = 0.01) and self-confidence in providing gender-specific care (post 17.9 vs. pre 12.3, p=0.004). No significant changes were observed in knowledge of barriers to care for both groups.

Conclusions: Our study demonstrates the effectiveness of a curriculum focused on TGD health in improving residents' knowledge and confidence. Further research is needed on the durability of these effects and the curriculum's impact on awareness of barriers to care. Implementing such curricula at other institutions could reinforce educational programs in medical schools to improve provider competence and address the healthcare needs of TGD individuals.