Building gender and sexual diversity into case-based learning
DOI:
https://doi.org/10.11157/fohpe.v25i4.806Keywords:
LGBT, medical education, case-based learning, experiential learning, curriculumAbstract
On a background of insufficient inclusion and calls for change, medical schools across Australia and Aotearoa New Zealand must work to build LGBTQIA+ health into their curricula. Due to the unique strengths of case-based learning (CBL)—including learning in the context of LGBTQIA+ individuals, providing a safe space to practice skills in inclusive care and reflect on biases and allowing for a focus on the structural and social determinants of health—we propose that CBL is an effective starting point for medical schools looking to maximise growth in students’ knowledge, skills and attitudes. We also discuss current LGBTQIA+ inclusion, strategies to integrate LGBTQIA+ health into the curriculum and CBL and the effects of such curricular interventions.
References
Alpert, A. B., CichoskiKelly, E. M., & Fox, A. D. (2017). What lesbian, gay, bisexual, transgender, queer, and intersex patients say doctors should know and do: A qualitative study. Journal of Homosexuality, 64(10), 1368–1389. https://doi.org/10.1080/00918369.2017.1321376
Australian Medical Council. (2023). Standards for assessment and accreditation of primary medical programs. https://www.amc.org.au/wp-content/uploads/2023/08/AMC-Medical_School_Standards-FINAL.pdf
Bidell, M. P. (2005). The sexual orientation counselor competency scale: Assessing attitudes, skills, and knowledge of counselors working with lesbian, gay, and bisexual clients. Counselor Education and Supervision, 44(4), 267–279. https://doi.org/10.1002/j.1556-6978.2005.tb01755.x
Bowden, S., Law, M., Kurabi, B., Naguib, M., Klostermann, N., Freeman, S., Berditchevskaia, I., Balbaa, A., Kirubarajan, A., & Lazor, J. (2021). Evaluating and implementing an opportunity for diversity and inclusion in case-based learning. Canadian Medical Education Journal, 12(4), 146–148. https://doi.org/10.36834/cmej.71412
Carman, M., Rosenberg, S., Bourne, A., & Parsons, M. (2020). Research matters: Why do we need LGBTIQ-inclusive services? Rainbow Health Victoria. https://www.rainbowhealthvic.org.au/media/pages/research-resources/research-matters-why-do-we-need-lgbtiq-inclusive-services/3898382955-1614819704/research-matters-lgbtq-inclusive-services.pdf
Carpenter, M. (2020). Intersex human rights, sexual orientation, gender identity, sex characteristics and the Yogyakarta Principles plus 10. Culture, Health & Sexuality, 23(4), 516–532. https://doi.org/10.1080/13691058.2020.1781262
Carroll, R., & Gray, L. (2021). Diversifying clinical education case studies. The Clinical Teacher, 18(5), 494–496. https://doi.org/10.1111/tct.13369
Carroll, R., Rose, S. B., Garrett, S. M., & Gray, L. (2023). Fifth year medical students’ education, confidence and learning needs related to healthcare provision for sexual and gender minority patients: A cross-sectional survey. Journal of Primary Health Care, 15(2), 122–127. https://doi.org/10.1071/HC22082
Cohen, D. A., Newman, L. R., & Fishman, L. N. (2017). Twelve tips on writing a discussion case that facilitates teaching and engages learners. Medical Teacher, 39(2), 147–152. https://doi.org/10.1080/0142159X.2017.1266315
Coopes, A. (2018). Glass closets and the hidden curriculum of medical school. O&G Magazine, 20(4), 45–46. https://www.ogmagazine.org.au/20/4-20/glass-closets-and-the-hidden-curriculum-of-medical-school/
Goodall, K. R., & Wofford, L. G. (2022). Pedagogical strategies of LGBTQIA+ education in pre-licensure nursing: An integrative review. Nurse Education Today, 199, Article 105547. https://doi.org/10.1016/j.nedt.2022.105547
Grant, R., Smith, A. K. J., Newett, L., Nash, M., Turner, R., & Owen, L. (2021). Tasmanian healthcare professionals’ & students’ capacity for LGBTI + inclusive care: A qualitative inquiry. Health & Social Care in the Community, 29(4), 957–966. https://doi.org/10.1111/hsc.13130
Halliwell, F. (2022, September 26). LGBTQIASB+ content in medical education: What lies ahead? InSight+, (37). https://insightplus.mja.com.au/2022/37/lgbtqiasb-content-in-medical-education-what-lies-ahead/
Higgins, A., Downes, C., Sheaf, G., Bus, E., Connell, S., Hafford-Letchfield, T., Jurček, A., Pezzella, A., Rabelink, I., Robotham, G., Urek, M., van der Vaart, N., & Keogh, B. (2019). Pedagogical principles and methods underpinning education of health and social care practitioners on experiences and needs of older LGBT+ people: Findings from a systematic review. Nurse Education in Practice, 40, Article 102625. https://doi.org/10.1016/j.nepr.2019.102625
Hill, A. O., Bourne, A., McNair, R., Carman, M., & Lyons, A. (2020). Private Lives 3: The health and wellbeing of LGBTIQ people in Australia. Australian Research Centre in Sex, Health and Society. https://www.latrobe.edu.au/__data/assets/pdf_file/0009/1185885/Private-Lives-3.pdf
Hollenbach, A. D., Eckstrand, K. L., & Dreger, A. (2014). Implementing curricular and institutional climate changes to improve health care for individuals who are LGBT, gender nonconforming, or born with DSD. Association of American Medical Colleges. https://www.aamc.org/system/files/c/2/157460-implementing_curricular_climate_change_lgbt.pdf
Hopper, M. K. (2018). Alphabet soup of active learning: Comparison of PBL, CBL, and TBL. HAPS Educator, 22(2), 144–149. https://doi.org/10.21692/haps.2018.019
Jain, V., & Krishnan, L. (2024). Critical pedagogies in health professions education. AMA Journal of Ethics, 26(1), E3–E5. https://doi.org/10.1001/amajethics.2024.3
Katz-Wise, S. L., Jarvie, E., Potter, J., Keuroghlian, A. S., Gums, J. N., Kosciesza, A. J., Hanshaw, B. D., Ornelas, A., Mais, E., DeJesus, K., Ajegwu, R., Presswood, W., Guss, C. E., Phillips, R., Charlton, B. M., Kremen, J., Williams, K., & Dalrymple, J. L. (2023). Integrating LGBTQIA + community member perspectives into medical education. Teaching and Learning in Medicine, 35(4), 442–456. https://doi.org/10.1080/10401334.2022.2092112
Keuroghlian, A. S., Charlton, B. M., Katz-Wise, S. L., Williams, K., Jarvie, E., Phillips, R., Kremen, J., Guss, C. E., Dalrymple, J. L., & Potter, J. (2022). Harvard Medical School’s sexual and gender minority health equity initiative: Curricular and climate innovations in undergraduate medical education. Academic Medicine, 97(12), 1786–1793. https://doi.org/10.1097/ACM.0000000000004867
Kim, S., Phillips, W. R., Pinsky, L., Brock, D., Phillips, K., & Keary, J. (2006). A conceptual framework for developing teaching cases: A review and synthesis of the literature across disciplines. Medical Education, 40(9), 867–876. https://doi.org/10.1111/j.1365-2929.2006.02544.x
Krishnan, A., Rabinowitz, M., Ziminsky, A., Scott, S. M., & Chretien, K. C. (2019). Addressing race, culture, and structural inequality in medical education: A guide for revising teaching cases. Academic Medicine, 94(4), 550–555. https://doi.org/10.1097/ACM.0000000000002589
Levy, A., Prasad, S., Griffin, D. P., Ortega, M., & O’Malley, C. B. (2021). Attitudes and knowledge of medical students towards healthcare for lesbian, gay, bisexual, and transgender seniors: Impact of a case-based discussion with facilitators from the community. Cureus, 13(8), Article e17425. https://doi.org/10.7759/cureus.17425
McLean, S. F. (2016). Case-based learning and its application in medical and health-care fields: A review of worldwide literature. Journal of Medical Education and Curricular Development, 3. https://doi.org/10.4137/JMECD.S20377
Minturn, M. S., Martinez, E. I., Le, T., Nokoff, N., Fitch, L., Little, C. E., & Lee, R. S. (2021). Early intervention for LGBTQ health: A 10-hour curriculum for preclinical health professions students. MedEdPORTAL, 17, Article 11072. https://doi.org/10.15766/mep_2374-8265.11072
Murphy, M. (2016). Hiding in plain sight: The production of heteronormativity in medical education. Journal of Contemporary Ethnography, 45(3), 256–289. https://doi.org/10.1177/0891241614556345
Murray, J., Li, M., Dadoo, P., Xu, Y., Van de Luecht, M., Liu, J., & Xu, Y. (2021). Transgender health and access to care (2021). Australian Medical Students' Association. https://amsa.org.au/wp-content/uploads/2023/10/Transgender-Health-and-Access-to-Care-2021.pdf
Noonan, E. J., Sawning, S., Combs, R., Weingartner, L. A., Martin, L. J., Jones, V. F., & Holthouser, A. (2018). Engaging the transgender community to improve medical education and prioritize healthcare initiatives. Teaching and Learning in Medicine, 30(2), 119–132. https://doi.org/10.1080/10401334.2017.1365718
Parameshwaran, V., Cockbain, B. C., Hillyard, M., & Price, J. R. (2017). Is the lack of specific lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) health care education in medical school a cause for concern? Evidence from a survey of knowledge and practice among UK medical students. Journal of Homosexuality, 64(3), 367–381. https://doi.org/10.1080/00918369.2016.1190218
Perales, F. (2019). The health and wellbeing of Australian lesbian, gay and bisexual people: A systematic assessment using a longitudinal national sample. Australian and New Zealand Journal of Public Health, 43(3), 281–287. https://doi.org/10.1111/1753-6405.12855
Prasad, S., O’Malley, C. B., DeLeon, R., Levy, A. S., & Griffin, D. P. (2023). Inclusive LGBTQIA+ healthcare: An interprofessional case-based experience for cultural competency awareness. Frontiers in Public Health, 10, Article 993461. https://doi.org/10.3389/fpubh.2022.993461
Pratt-Chapman, M. L. (2020). Implementation of sexual and gender minority health curricula in health care professional schools: A qualitative study. BMC Medical Education, 20, Article 138. https://doi.org/10.1186/s12909-020-02045-0
Rice, D. R., Hudson, S. T. J., & Noll, N. E. (2022). Gay = STIs? Exploring gay and lesbian sexual health stereotypes and their implications for prejudice and discrimination. European Journal of Social Psychology, 52(2), 326–341. https://doi.org/10.1002/ejsp.2793
Robertson, W. J. (2017). The irrelevance narrative: Queer (in)visibility in medical education and practice. Medical Anthropology Quarterly, 31(2), 159–176. https://doi.org/10.1111/maq.12289
Sanchez, A. A., Southgate, E., Rogers, G., & Duvivier, R. J. (2017). Inclusion of lesbian, gay, bisexual, transgender, queer, and intersex health in Australian and New Zealand medical education. LGBT Health, 4(4), 295–303. https://doi.org/10.1089/lgbt.2016.0209
Sharma, G., Jackson, E., Coret, A., & Han, A. (n.d.). A faculty primer: Portraying social identities in medical curriculum [Infographic]. University of Toronto. https://dfcm.utoronto.ca/sites/default/files/inline-files/Faculty%20Development%20Resource%20-%20Portraying%20Social%20Identities.pdf
Solotke, M., Sitkin, N. A., Schwartz, M. L., & Encandela, J. A. (2019). Twelve tips for incorporating and teaching sexual and gender minority health in medical school curricula. Medical Teacher, 41(2), 141–146. https://doi.org/10.1080/0142159X.2017.1407867
Thomas-Reid, M. (2018). Queer pedagogy. In Oxford Research Encyclopedia of Education. https://doi.org/10.1093/acrefore/9780190264093.013.405
Thompson, H., Coleman, J. A., Iyengar, R. M., Phillips, S., Kent, P. M., & Sheth, N. (2020). Evaluation of a gender-affirming healthcare curriculum for second-year medical students. Postgraduate Medical Journal, 96(1139), 515–519. https://doi.org/10.1136/postgradmedj-2019-136683
Treharne, G. J., Blakey, A. G., Graham, K., Carrington, S. D., McLachlan, L. A., Withey-Rila, C., Pearman-Beres, L., & Anderson, L. (2021). Perspectives on expertise in teaching about transgender healthcare: A focus group study with health professional programme teaching staff and transgender community members. International Journal of Transgender Health, 23(3), 334–354. https://doi.org/10.1080/26895269.2020.1870189
Ufomata, E., Eckstrand, K. L., Hasley, P., Jeong, K., Rubio, D., & Spagnoletti, C. (2018). Comprehensive internal medicine residency curriculum on primary care of patients who identify as LGBT. LGBT Health, 5(6), 375–380. https://doi.org/10.1089/lgbt.2017.0173
van Heesewijk, J., Kent, A., van de Grift, T. C., Harleman, A., & Muntinga, M. (2022). Transgender health content in medical education: A theory-guided systematic review of current training practices and implementation barriers & facilitators. Advances in Health Sciences Education, 27(3), 817–846. https://doi.org/10.1007/s10459-022-10112-y
Walker, K., Arbour, M., & Waryold, J. (2016). Educational strategies to help students provide respectful sexual and reproductive health care for lesbian, gay, bisexual, and transgender persons. Journal of Midwifery & Women’s Health, 61(6), 737–743. https://doi.org/10.1111/jmwh.12506
Wilby, K. J., Cox, D., Whelan, A. M., Arya, V., Framp, H., & Mansour, S. (2022). Representation of diversity within written patient cases: Exploring the presence of a “hidden curriculum”. Journal of the American College of Clinical Pharmacy, 5(8), 837–843. https://doi.org/10.1002/jac5.1628
Yang, H.-C. (2021). Teaching LGBT+ health and gender education to future doctors: Implementation of case-based teaching. International Journal of Environmental Research and Public Health, 18(16), Article 8429. https://doi.org/10.3390/ijerph18168429
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Focus on Health Professional Education: A Multi-Professional Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
On acceptance for publication in FoHPE the copyright of the manuscript is signed over to ANZAHPE, the publisher of FoHPE.
