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Mazzawi M, Maxwell A. Addressing the Healthcare Needs of Transgender Youth in the Emergency Department. Pediatr Emerg Care 2024; 40:486-491. [PMID: 38815145 DOI: 10.1097/pec.0000000000003194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
ABSTRACT Transgender is a term that refers to individuals who identify with a gender that is different from the sex assigned to them at birth. In addition to gender dysphoria, many transgender youth experience a number of challenges including homelessness, violence, and mental health problems such as suicidality. Although transgender people represent a growing subset of the population, most providers receive very little training specific to the unique healthcare needs of transgender patients. In this CME review article, we define relevant terminology then discuss best practices for clinical encounters involving transgender youth in the emergency department. Finally, we review gender-affirming care including behavioral modifications, hormones, and surgeries for transfeminine and transmasculine individuals.
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Affiliation(s)
- Malek Mazzawi
- From the Clinical Assistant Professor of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, CA
| | - Angela Maxwell
- Assistant Instructor Emergency Medicine and Pediatrics, Division of Emergency Medicine, Children's National Hospital, The George Washington School of Medicine and Health Sciences, Washington, DC
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Mohadeb J, Brueton-Campbell L, Doucet K, Reed A, Mitchell D, McColl T, Massarella C, Bigham B, Primiani N, Primavesi R, Kruse M, Souleymanov R, Klassen B, Brandt A, Dawson C, Gheorghica L, Prefontaine N, Crawford J, Kamabu S, Hrymak C, Leeies M. Development and evaluation of a clinical simulation-based educational innovation on sexual orientation and gender identity in emergency medicine. CAN J EMERG MED 2024; 26:413-423. [PMID: 38703266 DOI: 10.1007/s43678-024-00688-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/27/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Sexual orientation and gender identity (SOGI)-diverse patients are marginalized and poorly cared for in the emergency department, yet well-designed educational interventions to meet this gap are lacking. We developed, implemented, and assessed a novel multi-modal SOGI curriculum on health and cultural humility for emergency medicine physician trainees. METHODS We conducted a prospective, single-arm evaluation of our educational intervention. A convenience sample of emergency medicine resident physicians (n = 21) participated in the facilitated curriculum including didactic and clinical simulation components. Participants completed a pre- and post-curriculum evaluation that assessed clinical skills, preparedness, attitudinal awareness, and basic knowledge in caring for SOGI-diverse patients. The content of the module was based on a scoping literature review and national needs assessment of Canadian emergency physicians, educators, and trainees along with expert collaborator and input from patient/community partners. The curriculum included a facilitated pre-brief, didactic presentation, clinical simulation modules, and a structured de-brief. Participant clinical skills were evaluated before and after the educational intervention. Our primary outcome was change in clinical preparedness, attitudinal awareness, and basic knowledge in caring for SOGI-diverse patients pre- and post-intervention. RESULTS Our patient-centered, targeted emergency medicine SOGI health and cultural humility training resulted in a significant improvement in resident self-rated clinical preparedness, attitudes, and knowledge in caring for SOGI-diverse patients. This training was valued by participants. CONCLUSION We have designed an effective, patient-centered curriculum in health and cultural humility for SOGI-diverse patients in EM. Other programs can consider using this model and developed resources in their jurisdictions to enhance provider capacities to care for this marginalized group.
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Affiliation(s)
- Juan Mohadeb
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Kris Doucet
- Health Sciences Centre, Shared Health Manitoba, Winnipeg, MB, Canada
| | - Anna Reed
- Health Sciences Centre, Shared Health Manitoba, Winnipeg, MB, Canada
| | - Devon Mitchell
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tamara McColl
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Carys Massarella
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Blair Bigham
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Nadia Primiani
- Department of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - Robert Primavesi
- Department of Emergency Medicine, McGill University, Montreal, QC, Canada
| | - Michael Kruse
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Rusty Souleymanov
- Department of Social Work, University of Manitoba, Winnipeg, MB, Canada
| | - Ben Klassen
- Community-Based Research Centre, Vancouver, BC, Canada
| | - Adam Brandt
- Investigaytors, Village Lab, Winnipeg, MB, Canada
| | | | | | | | | | - Seth Kamabu
- Investigaytors, Village Lab, Winnipeg, MB, Canada
| | - Carmen Hrymak
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada
- Health Sciences Centre, Shared Health Manitoba, Winnipeg, MB, Canada
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Murdoch Leeies
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada.
- Health Sciences Centre, Shared Health Manitoba, Winnipeg, MB, Canada.
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada.
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Kruse MI, Bigham BL, Phillips SP. A novel online training program for sexual and gender minority health increases allyship in cisgender, heterosexual paramedics. AEM EDUCATION AND TRAINING 2024; 8:e10958. [PMID: 38516255 PMCID: PMC10951873 DOI: 10.1002/aet2.10958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 01/02/2024] [Accepted: 01/18/2024] [Indexed: 03/23/2024]
Abstract
Introduction Sexual and gender minorities (SGM) make up 4% of the Canadian population. Due to existing barriers to care in the community, SGM patients may seek more help and be sicker at presentation to hospital. Paramedics occupy a unique role and can remove or decrease these barriers. There are no existing evaluations of training programs in SGM health for prehospital providers. A training program to develop better allyship in paramedics toward SGM populations was developed and assessed. Methods A 70- to 90-min mandatory, asynchronous, online training module in SGM health in the prehospital environment was developed and delivered via the emergency medical service (EMS) system's learning management system. A before-and-after study of cisgender, heterosexual, frontline paramedics was performed to measure the impact of the training module on the care of SGM patients. The validated Ally Identity Measure (AIM) tool was used to identify success of training and includes subscales of knowledge and skills, openness and support, and oppression awareness. Demographics and satisfaction scores were collected in the posttraining survey. Matched and unmatched pairs of surveys and demographic associations were analyzed using nonparametric statistics. Results Of 609 paramedics, 571 completed the training, and 239 surveys were completed before and 105 (n = 344) surveys after the training; 60 surveys were paired. Overall AIM scores of matched pairs (n = 60) improved by 12% (p < 0.001), with knowledge and skills accounting for most of the increase (21%, p < 0.001). Unmatched pairs (n = 344) were similar in demographics and scores. Rural paramedics also had significantly lower pretraining oppression awareness scores and had lower posttraining AIM scores compared to suburban paramedics (6% difference). Satisfaction scores rated the training as relevant and applicable (87% and 82%, respectively). Conclusions A novel prehospital training program in the care of SGM patients resulted in a statistically significant increase in allyship in cisgender, heterosexual-identified frontline paramedics.
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Affiliation(s)
- Michael I. Kruse
- Department of Family MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Blair L. Bigham
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Susan P. Phillips
- Department of Family MedicineQueen's UniversityKingstonOntarioCanada
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Leeies M, Kruse M, Weston B, Smith S, Primavesi R, Klassen B, Draenos C, Primiani N. Sexual orientation and gender identity advocacy in emergency medicine: a Canadian Association of Emergency Physicians position statement. CAN J EMERG MED 2024; 26:78-81. [PMID: 38240958 DOI: 10.1007/s43678-023-00644-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024]
Affiliation(s)
| | | | - Brock Weston
- University of Saskatchewan, Saskatoon, SK, Canada
| | - Sheila Smith
- University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Ben Klassen
- Community Based Research Centre, Vancouver, BC, Canada
| | - Chris Draenos
- Community Based Research Centre, Vancouver, BC, Canada
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Leeies M, Caslake E, Massarella C. Just the facts: transgender and gender diverse identities in emergency medicine. CAN J EMERG MED 2024; 26:10-14. [PMID: 37721696 DOI: 10.1007/s43678-023-00583-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023]
Affiliation(s)
- Murdoch Leeies
- Department of Emergency Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Ellie Caslake
- Department of Equity, Access & Participation, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Carys Massarella
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Stanford KA, Macias-Konstantopoulos W, Linden J, Agrawal P, Cortes E, Barron RJ, Stoklosa H, Dekker AM, Paxton J, Knack S, Sharp WW. SAEM Response to the National Institutes of Health request for information: Future directions in violence against women research. Acad Emerg Med 2023; 30:1161-1167. [PMID: 37423251 DOI: 10.1111/acem.14775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Affiliation(s)
- Kimberly A Stanford
- Section of Emergency Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | | | - Judith Linden
- Department of Emergency Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Pooja Agrawal
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Emma Cortes
- Department of Emergency Medicine, Jefferson Health Northeast, Philadelphia, Pennsylvania, USA
| | - Rebecca J Barron
- Department of Emergency Medicine, UMass Chan Medical School-Baystate, Springfield, Massachusetts, USA
| | - Hanni Stoklosa
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- HEAL Trafficking, Long Beach, California, USA
| | - Annette M Dekker
- Department of Emergency Medicine, UCLA, Los Angeles, California, USA
| | - James Paxton
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan, USA
| | - Sarah Knack
- Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
| | - Willard W Sharp
- Section of Emergency Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
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Burcheri A, Coutin A, Bigham BL, Kruse MI, Lien K, Lim R, MacCormick H, Morris J, Ng V, Primiani N, Odorizzi S, Poirier V, Upadhye S, Primavesi R. Exploring a case for education about sexual and gender minorities in postgraduate emergency medicine training: forming recommendations for change. Postgrad Med 2023; 135:623-632. [PMID: 37310186 DOI: 10.1080/00325481.2023.2225329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/12/2023] [Indexed: 06/14/2023]
Abstract
Social medicine and health advocacy curricula are known to be uncommon in postgraduate medical education. As justice movements work to unveil the systemic barriers experienced by sexual and gender minority (SGM) populations, it is imperative that the emergency medicine (EM) community progress in its efforts to provide equitable, accessible, and competent care for these vulnerable groups. Given the paucity of literature on this subject in the context of EM in Canada, this commentary borrows evidence from other specialties across North America. Trainees across specialties and of all stages are caring for an increasing number of SGM patients. Lack of education at all levels of training is identified as a significant barrier to adequately caring for these populations, thereby precipitating significant health disparities. Cultural competency is often mistakenly attributed to a willingness to treat rather than the provision of quality care. However, positive attitudes do not necessarily correlate with trainee knowledge. Barriers to creating and implementing culturally competent curricula are plentiful, yet facilitating policies and resources are rare. While international bodies continuously publish position statements and calls to action, concrete change is seldom made. The scarcity of SGM curricula can be attributed to the universal absence of formal acknowledgment of SGM health as a required competency by accreditation boards and professional membership associations. This commentary synthesizes hand-picked literature in an attempt to inform healthcare professionals on their journey toward developing culturally competent postgraduate medical education. By thematically organizing evidence into a stepwise approach, the goal of this article is to borrow ideas across medical and surgical specialties to inform the creation of recommendations and make a case for an SGM curriculum for EM programs in Canada.
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Affiliation(s)
- Adam Burcheri
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Alexandre Coutin
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Blair L Bigham
- Department of Emergency Medicine, McMaster University, Hamilton, ON, Canada
| | - Michael I Kruse
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | - Kelly Lien
- Departments of Emergency Medicine and Family Medicine, Western University, London, ON, Canada
| | - Rodrick Lim
- Department of Pediatrics and Medicine, Western University, London, ON, Canada
| | - Hilary MacCormick
- Departments of Anesthesia, Pain Management, & Perioperative Medicine, Women's & Obstetric Anesthesia, IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | - Judy Morris
- Departments of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, QC, Canada
| | - Victor Ng
- Division of Emergency Medicine, Western University, London, ON, Canada
| | - Nadia Primiani
- Department of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - Scott Odorizzi
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Vincent Poirier
- Department of Emergency Medicine, McGill University, Montreal, QC, Canada
| | - Suneel Upadhye
- Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Robert Primavesi
- Department of Emergency Medicine, McGill University, Montreal, QC, Canada
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Leeies M, Collister D, Ho J, Trachtenberg A, Gruber J, Weiss MJ, Chandler JA, Mooney O, Carta T, Klassen B, Draenos C, Sutha K, Randell S, Strang M, Partain B, Whitley CT, Cuvelier S, MacKenzie LJ, Shemie SD, Hrymak C. Inequities in organ and tissue donation and transplantation for sexual orientation and gender identity diverse people: A scoping review. Am J Transplant 2023:S1600-6135(23)00359-3. [PMID: 36997028 DOI: 10.1016/j.ajt.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 03/31/2023]
Abstract
Sexual orientation and gender identity (SOGI) diverse populations experience discrimination in organ and tissue donation and transplantation (OTDT) systems globally. We assembled a multidisciplinary group of clinical experts as well as SOGI-diverse patient and public partners and conducted a scoping review including citations on the experiences of SOGI-diverse persons in OTDT systems globally to identify and explore the inequities that exist with regards to living and deceased OTDT. Using scoping review methods, we conducted a systematic literature search of relevant electronic databases from 1970-2021 including a grey literature search. We identified and screened 2402 references and included 87 unique publications. Two researchers independently coded data in included publications in duplicate. We conducted a best-fit framework synthesis paired with an inductive thematic analysis to identify synthesized benefits, harms, inequities, justification of inequities, recommendations to mitigate inequities, laws and regulations, as well as knowledge and implementation gaps regarding SOGI-diverse identities in OTDT systems. We identified numerous harms and inequities for SOGI-diverse populations in OTDT systems. There were no published benefits of SOGI-diverse identities in OTDT systems. We summarized recommendations for the promotion of equity for SOGI-diverse populations and identified gaps that can serve as targets for action moving forward.
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Brown C, Marnie C, Peters MDJ. Barriers and enablers to culturally safe care for trans and gender-diverse people in hospital emergency departments: a scoping review protocol. JBI Evid Synth 2023:02174543-990000000-00132. [PMID: 36735278 DOI: 10.11124/jbies-22-00262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective of this review is to identify barriers and enablers to the provision and accessibility of culturally safe care to trans and gender-diverse patients in the emergency department. INTRODUCTION Emergency departments have a unique role in creating patient experiences that influence positive or negative health outcomes. It is vital that emergency departments provide equitable experiences for all patients regardless of gender. Culturally safe care aims to support inclusive, effective, and appropriate care for trans and gender-diverse patients. Identifying the reported barriers and enablers to culturally safe care for trans and gender-diverse people in emergency departments will support knowledge users to advocate for and implement improvements to care. INCLUSION CRITERIA This review will consider studies that describe barriers and enablers of accessing culturally safe care in emergency departments reported by trans and gender-diverse people, their families/loved ones, as well as health care workers involved in the provision of care. English-language published and gray literature sources from January 1, 2000, to the present from all countries will be eligible. METHODS The review will follow the JBI methodology for scoping reviews and be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Database searches of MEDLINE, Emcare, Embase, ScienceDirect, PsycINFO, Web of Science, Scopus, Google Scholar, and ProQuest will be undertaken. Data will be presented in tabular format or graphs, with an accompanying narrative summary.
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Affiliation(s)
- Chantal Brown
- Rosemary Bryant AO Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Casey Marnie
- Rosemary Bryant AO Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.,National Policy Research Unit, Australian Nursing and Midwifery Federation (Federal Office), Adelaide, SA, Australia
| | - Micah D J Peters
- Rosemary Bryant AO Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.,National Policy Research Unit, Australian Nursing and Midwifery Federation (Federal Office), Adelaide, SA, Australia.,Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.,The Centre for Evidence-based Practice South Australia (CEPSA): A JBI Centre of Excellence
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Chernick LS, Bugaighis M, Britton L, Cruz AT, Goyal MK, Mistry RD, Reed JL, Bakken S, Santelli JS, Dayan PS. Factors influencing the conduction of confidential conversations with adolescents in the emergency department: A multicenter, qualitative analysis. Acad Emerg Med 2023; 30:99-109. [PMID: 36478023 DOI: 10.1111/acem.14638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Health care providers (HCPs) in the emergency department (ED) frequently must decide whether to conduct or forego confidential conversations with adolescent patients about sensitive topics, such as those related to mental health, substance use, and sexual and reproductive health. The objective of this multicenter qualitative analysis was to identify factors that influence the conduct of confidential conversations with adolescent patients in the ED. METHODS In this qualitative study, we conducted semistructured interviews of ED HCPs from five academic, pediatric EDs in distinct geographic regions. We purposively sampled HCPs across gender, professional title, and professional experience. We used the Theoretical Domains Framework (TDF) to develop an interview guide to assess individual and system-level factors affecting HCP behavior regarding the conduct of confidential conversations with adolescents. Enrollment continued until we reached saturation. Interviews were recorded, transcribed, and coded by three investigators based on thematic analysis. We used the coded transcripts to collaboratively generate belief statements, which are first-person statements that reflect shared perspectives. RESULTS We conducted 38 interviews (18 physicians, 11 registered nurses, five nurse practitioners, and four physician assistants). We generated 17 belief statements across nine TDF domains. Predominant influences on having confidential conversations included self-efficacy in speaking with adolescents alone, wanting to address sexual health complaints, maintaining patient flow, experiencing parental resistance and limited space, and having inadequate resources to address patient concerns and personal preconceptions about patients. Perspectives divided between wanting to provide focused medical care related only to their chief complaint versus self-identifying as a holistic medical HCP. CONCLUSIONS The factors influencing the conduct of confidential conversations included multiple TDF domains, elucidating how numerous intersecting factors influence whether ED HCPs address sensitive adolescent health needs. These data suggest methods to enhance and facilitate confidential conversations when deemed appropriate in the care of adolescents in the ED.
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Affiliation(s)
- Lauren S Chernick
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA.,Department of Population and Family Health, Columbia University, New York, New York, USA
| | - Mona Bugaighis
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Laura Britton
- Department of Nursing, Columbia University Irving Medical Center, New York, New York, USA
| | - Andrea T Cruz
- Divisions of Emergency Medicine and Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Monika K Goyal
- Department of Pediatrics, Children's National Hospital, George Washington University, Washington, DC, USA
| | - Rakesh D Mistry
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jennifer L Reed
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Ohio, Cincinnati, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Ohio, Cincinnati, USA
| | - Suzanne Bakken
- Department of Nursing and Bioinformatics, Columbia University Irving Medical Center, New York, New York, USA
| | - John S Santelli
- Department of Population and Family Health, Columbia University, New York, New York, USA.,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Peter S Dayan
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA
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Education about sexual and gender minorities within Canadian emergency medicine residency programs. CAN J EMERG MED 2022; 24:135-143. [PMID: 34985648 DOI: 10.1007/s43678-021-00236-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 11/16/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVES The CAEP 2021 2SLGBTQIA +i panel sought whether a gap exists within Canadian emergency medicine training pertaining to sexual and gender minority communities. This panel aimed to generate practical recommendations on improving emergency medicine education about sexual and gender minorities, thereby improving access to equitable healthcare. METHODS From August 2020 to June 2021, a panel of emergency medicine practitioners, residents, students, and community representatives met monthly via videoconference. A literature review was undertaken, and three mixed methods surveys were distributed to the CAEP member list, CAEP Resident Section, College of Family Physicians of Canada (CFPC)iii Emergency Medicine Members Interest Group, and to emergency medicine residency program directors and their residents. Informed by the review and surveys, recommendations were drafted and refined by panel members before presentation at the 2021 CAEP Academic Symposium. A plenary was presented to symposium attendees composed of national emergency medicine community members, which reported the survey results and literature review. All attendees were divided into small groups to develop an action plan for each recommendation. CONCLUSIONS The panel outlines eight recommendations for closing the curricular gap. It identifies three perceived or real barriers to the inclusion of sexual and gender minority content in emergency medicine residency curricula. It acknowledges three enabling recommendations that are beyond the scope of individual emergency medicine programs or emergency departments (EDs), that if enacted would enable the implementation of the recommendations. Each recommendation is accompanied by two action items as a guide to implementation. Each of the three barriers is accompanied by two action items that offer specific solutions to overcome these obstacles. Each enabling recommendation suggests an action that would shift emergency medicine towards sociocultural competence nationally. These recommendations set the primary steps towards closing the educational gap.
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