Improving Care For LGBTIQ+ Patients
As educators and advocates, Matthew Kesterke* and Faizan Kabani feel obligated to address health disparities for those who identify as lesbian, gay, bisexual, transgender, intersex or questioning/queer, plus (LGBTIQ+) in the classroom, community and beyond.
Kabani and Kesterke — both professors at the Texas A&M University College of Dentistry — joined forces in 2018 to research and advocate for a new interprofessional LGBTIQ+ health curriculum, which would be a first in Texas. The change would better equip professional health care students with the skills needed in everyday practice to better serve LGBTIQ+ patients.
To begin, they opened a dialogue with faculty members and students from all Texas A&M Health professional schools — the colleges of dentistry, medicine, nursing, pharmacy and the School of Public Health — as well as the College of Education & Human Development and the Clinical Learning Resource Center. The response reaffirmed that their mission was needed, and the interprofessional group has been meeting virtually since March 2019. That same year, the group was recognized by Texas A&M Health with the Teaching Award for Interprofessional Excellence.
“Literature suggests that LGBTIQ+ communities experience a disproportionate amount of health inequalities, including negative experiences with some health care providers, inadequate health insurance benefits, social violence and bullying, higher psychological distress and more,” Kabani said.
In clinic at the dental school, Kabani said he noticed firsthand how uncomfortable some students were in caring for LGBTIQ+ patients. He saw teachable moments and an opportunity to provide “meaningful conversations on cultural sensitivity and compassion,” Kabani said.
“At first it was disheartening to observe this gap. However, I quickly realized that more organized efforts were needed to help improve the climate at the dental school,” said Kabani, who was named 2020 Dental Hygiene Teacher of the Year by the Caruth School of Dental Hygiene class of 2020 student body.
“One thing I’m really excited about is we have a number of students involved now, including master’s students, Ph.D. students and medical students,” Kesterke said. “Getting students involved on ground-level research is very important and it means a lot. All of these colleges are working together.”
Many professional organizations, including the American Dental Education Association, agree that better research and education is needed on the issue, Kabani said.
A 2018 study underscores that professional health care students are on the same page. Survey results from about 1,000 medical, dental and nursing students revealed a general consensus that they believed there is a lack of needed training to address health issues in these populations. Although roughly 70 percent agreed they felt comfortable treating LGBTIQ+ patients, less than half believed they were given the formal training needed.
Another study found that related health care curriculum varied widely from one professional school to the next, both in content covered and time invested. In “Lesbian, Gay, Bisexual, and Transgender-Related Content in Undergraduate Medical Education,” deans at 132 U.S. and Canadian medical schools reported time dedicated to such training was minimal.
Kesterke and Kabani are working to change that, starting with the Texas A&M community. Their first research project included a survey of Texas A&M Health educators to identify gaps in LGBTIQ+ health care education. A second survey will gauge how students have been affected, how well they are taught and their familiarity with LGBTIQ+ issues. With the results, they hope to coordinate the first interprofessional LGBTIQ+ health curriculum at Texas A&M, with a goal to expand it across Texas.
“The ultimate goal is to establish the first-ever Texas A&M center for LGBTIQ+ health education,” Kesterke said.
Kabani and Kesterke presented their thoughts on interprofessional LGBTIQ+ education at a Project ECHO (Extension for Community Healthcare Outcomes) virtual meeting earlier this summer. They received a warm reception and post-meeting outreach from representatives at major universities across numerous states. Many wanted to know how they could use the Texas A&M research to effect change in their own states.
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