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Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review.
BMC Med Educ. 2019 Aug 30; 19(1):325.BM

Abstract

BACKGROUND

Lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals experience higher rates of health disparities. These disparities may be driven, in part, by biases of medical providers encountered in health care settings. Little is known about how medical, nursing, or dental students are trained to identify and reduce the effects of their own biases toward LGBTQ individuals. Therefore, a systematic review was conducted to determine the effectiveness of programs to reduce health care student or provider bias towards these LGBTQ patients.

METHODS

The authors performed searches of online databases (MEDLINE/PubMed, PsycINFO, Web of Science, Scopus, Ingenta, Science Direct, and Google Scholar) for original articles, published in English, between March 2005 and February 2017, describing intervention studies focused on reducing health care student or provider bias towards LGBTQ individuals. Data extracted included sample characteristics (i.e., medical, nursing, or dental students or providers), study design (i.e., pre-post intervention tests, qualitative), program format, program target (i.e., knowledge, comfort level, attitudes, implicit bias), and relevant outcomes. Study quality was assessed using a five-point scale.

RESULTS

The search identified 639 abstracts addressing bias among medical, nursing, and dental students or providers; from these abstracts, 60 articles were identified as medical education programs to reduce bias; of these articles, 13 described programs to reduce bias towards LGBTQ patients. Bias-focused educational interventions were effective at increasing knowledge of LGBTQ health care issues. Experiential learning interventions were effective at increasing comfort levels working with LGBTQ patients. Intergroup contact was effective at promoting more tolerant attitudes toward LGBTQ patients. Despite promising support for bias education in increasing knowledge and comfort levels among medical, nursing, and dental students or providers towards LGBTQ persons, this systematic review did not identify any interventions that assessed changes in implicit bias among students or providers.

CONCLUSIONS

Strategies for assessing and mitigating implicit bias towards LGBTQ patients are discussed and recommendations for medical, nursing, and dental school curricula are presented.

Authors+Show Affiliations

Department of Family and Community Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN, 37208, USA. mmorris5@umc.edu.Department of Family and Community Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN, 37208, USA.Department of Biochemistry Cancer Biology Neuroscience & Pharmacology, Meharry Medical College, Nashville, TN, USA.School of Graduate Studies and Research, Meharry Medical College, Nashville, TN, USA.Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.Department of Human and Organizational Development, Vanderbilt University, Nashville, TN, USA.Department of Family and Community Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN, 37208, USA.Department of Family and Community Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN, 37208, USA.Department of Family and Community Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN, 37208, USA.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

31470837

Citation

Morris, Matthew, et al. "Training to Reduce LGBTQ-related Bias Among Medical, Nursing, and Dental Students and Providers: a Systematic Review." BMC Medical Education, vol. 19, no. 1, 2019, p. 325.
Morris M, Cooper RL, Ramesh A, et al. Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review. BMC Med Educ. 2019;19(1):325.
Morris, M., Cooper, R. L., Ramesh, A., Tabatabai, M., Arcury, T. A., Shinn, M., Im, W., Juarez, P., & Matthews-Juarez, P. (2019). Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review. BMC Medical Education, 19(1), 325. https://doi.org/10.1186/s12909-019-1727-3
Morris M, et al. Training to Reduce LGBTQ-related Bias Among Medical, Nursing, and Dental Students and Providers: a Systematic Review. BMC Med Educ. 2019 Aug 30;19(1):325. PubMed PMID: 31470837.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review. AU - Morris,Matthew, AU - Cooper,Robert Lyle, AU - Ramesh,Aramandla, AU - Tabatabai,Mohammad, AU - Arcury,Thomas A, AU - Shinn,Marybeth, AU - Im,Wansoo, AU - Juarez,Paul, AU - Matthews-Juarez,Patricia, Y1 - 2019/08/30/ PY - 2018/05/23/received PY - 2019/07/24/accepted PY - 2019/9/1/entrez PY - 2019/9/1/pubmed PY - 2020/2/25/medline KW - Cultural competence KW - Implicit bias KW - LGBTQ KW - Medical education SP - 325 EP - 325 JF - BMC medical education JO - BMC Med Educ VL - 19 IS - 1 N2 - BACKGROUND: Lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals experience higher rates of health disparities. These disparities may be driven, in part, by biases of medical providers encountered in health care settings. Little is known about how medical, nursing, or dental students are trained to identify and reduce the effects of their own biases toward LGBTQ individuals. Therefore, a systematic review was conducted to determine the effectiveness of programs to reduce health care student or provider bias towards these LGBTQ patients. METHODS: The authors performed searches of online databases (MEDLINE/PubMed, PsycINFO, Web of Science, Scopus, Ingenta, Science Direct, and Google Scholar) for original articles, published in English, between March 2005 and February 2017, describing intervention studies focused on reducing health care student or provider bias towards LGBTQ individuals. Data extracted included sample characteristics (i.e., medical, nursing, or dental students or providers), study design (i.e., pre-post intervention tests, qualitative), program format, program target (i.e., knowledge, comfort level, attitudes, implicit bias), and relevant outcomes. Study quality was assessed using a five-point scale. RESULTS: The search identified 639 abstracts addressing bias among medical, nursing, and dental students or providers; from these abstracts, 60 articles were identified as medical education programs to reduce bias; of these articles, 13 described programs to reduce bias towards LGBTQ patients. Bias-focused educational interventions were effective at increasing knowledge of LGBTQ health care issues. Experiential learning interventions were effective at increasing comfort levels working with LGBTQ patients. Intergroup contact was effective at promoting more tolerant attitudes toward LGBTQ patients. Despite promising support for bias education in increasing knowledge and comfort levels among medical, nursing, and dental students or providers towards LGBTQ persons, this systematic review did not identify any interventions that assessed changes in implicit bias among students or providers. CONCLUSIONS: Strategies for assessing and mitigating implicit bias towards LGBTQ patients are discussed and recommendations for medical, nursing, and dental school curricula are presented. SN - 1472-6920 UR - https://www.unboundmedicine.com/medline/citation/31470837/Training_to_reduce_LGBTQ_related_bias_among_medical_nursing_and_dental_students_and_providers:_a_systematic_review_ L2 - https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-019-1727-3 DB - PRIME DP - Unbound Medicine ER -