Use of Simulation to Teach Obstetrics and Gynecology Residents How to Care for Transgender & Gender Diverse Patients

Abstract

Abstract Purpose of Review Lesbian, gay, bisexual, transgender, queer, and other gender diverse (LGBTQ+) individuals face barriers in access to healthcare and face poorer healthcare outcomes than the cisgender population. Gynecologists provide routine health maintenance and primary care for LGBTQ + patients. Lack of physician knowledge of the unique healthcare considerations of LGBTQ+ patients heightens barriers to care. Healthcare simulation can serve to provide Ob/Gyn residents with practice implementing and strengthening their communication skills and cultural competence with LGBTQ+ patients. There are various simulation modalities, including standardized patients, virtual reality, and high-fidelity manikins, which can be implemented for LGBTQ+ simulation. This article will review implementation of simulation-based training, creating a safe learning environment, and strategies for debriefing and feedback. Recent Findings Various governing bodies of medical education list education on LGBTQ+ care within key learning objectives for medical students and obstetric and gynecologic (Ob/Gyn) residents. However, program directors and residents have identified LGBTQ+ healthcare as a gap in their education, often citing lack of curriculum as an educational barrier. Among Ob/Gyn residents who have participated in healthcare simulation on LGBTQ+ care, there has been a qualitative improvement in comfort with and knowledge of medical care (Ruud et al. in J Midwifery Womens Health 2021;66(6):778–86), (Kreines  et al. in J Assist Reprod Genet 2022;39(12):2755–66). Summary Healthcare simulation should be implemented within medical training to improve the care and medical outcomes of LGBTQ+ patients. While some qualitative studies have shown resident self-reported improvement after healthcare simulation with LGBTQ+ patients, longitudinal studies need to be done to assess long-term impact. Additionally, educational grants for simulation equipment and curricula can improve access to healthcare simulation.