THURS-062 - Addressing Health Disparities Among Transgender and Gender Diverse Patients with Digital Clinician Training Modules

Brief Abstract Summary: Explore how a self-paced digital training module can equip medical trainees to provide affirming care for transgender and gender diverse (TGD) patients with eating disorders (ED). With step-by-step guidance, learn how to identify actionable health disparities that can be addressed through further education using digital training modules. Then, learn how to outline and develop an interactive digital training module without computer science background or external funding. Discuss key considerations, such as instructional design, engagement strategies, and interactive questions, to align the module’s design with its objectives. Examine gaps in current medical training for working with TGD patients, and identify approaches to further promote health equity through educational interventions.

Detailed abstract description:

Background: Current medical training and curricula often overlook the specific health needs of transgender and gender diverse (TGD) patients, who experience elevated rates of various health problems, such as eating disorders (ED). To address this gap, we developed an hour-long self-paced digital training module teaching key clinical skills for treating TGD patients with ED in a culturally responsive manner. We piloted this module with a cohort of medical trainees to demonstrate the feasibility and efficacy of this intervention for improving attitudes, beliefs, and self-efficacy towards treating TGD patients.

Methods: A cohort of medical school students (n=87) completed the training module and pre- and post-intervention surveys, with matching 7-point Likert-scale subsections on beliefs, attitudes, and self-efficacy. The pre-intervention survey also collected demographic information, while the post-intervention survey evaluated participant satisfaction with the training module and collected qualitative feedback.

Findings: Prior to intervention, participants scored highly on favorable beliefs and attitudes but lower in self-efficacy. Following the intervention, scores in all subsections improved significantly, with the greatest improvements in self-efficacy. The largest gain was in identifying harm reduction strategies for gender dysphoria (2.39 points, p< 0.001), followed by recognizing symptoms of gender dysphoria (1.85, p< 0.001) and other treatment obstacles for TGD patients with EDs (1.84, p< 0.001). Average satisfaction was 6.18/7.00. Participants noted they especially benefited from case study practice questions and learning advanced medical considerations for TGD people.

Implications: Despite endorsing supportive attitudes and beliefs, participants did not perceive themselves as well-equipped to work with TGD patients in the clinical setting prior to intervention. This study demonstrates the feasibility of a low-tech, self-paced intervention for developing core clinical skills to treat TGD patients with ED, which resulted in significant improvements in trainees’ beliefs, attitudes, and self-efficacy towards treating these patients.

While helpful clinician training resources have been developed to instruct trainees and physicians to address health disparities impacting LGBTQIA+ populations, many clinician training resources cover basic cultural responsiveness strategies for working with LGBTQIA+ patients, rather than focusing on specific health problems or subgroups of LGBTQIA+ people. Clinician training resources that build upon introductory attitude- and awareness- based programs by focusing on tackling a specific health disparity, such as ED outcomes among TGD people, are essential for furthering TGD health equity.

Future studies should continue to develop and rigorously evaluate clinician training activities tailored for specific health disparities, which is critical for advancing equitable healthcare for LGBTQIA+ patients.