Background

We identified that there is a lack of undergraduate education & training surrounding transgender issues in healthcare across multiple medical schools. As a result, medical students lack the confidence to interact with transgender patients, which can unfortunately persist as they graduate and become doctors. Moreover, a lack of confidence and hesitation could lead to transgender patients being improperly managed and/or reporting poorer hospital experiences and discrimination1 .

Objectives

The objective of this education intervention was as follows: • To establish the baseline knowledge of medical students on transgender issues and what teaching they currently receive on the topic. • To improve knowledge and understanding of transgender issues in healthcare through simulation training. • To improve confidence of students when interacting with this patient cohort, which we hope will subsequently improve the patient experience.

Design and Implementation

Pre-simulation questionnaires were given to 45 students to complete which explored the teaching they had received on the topic and the nature of this teaching. We designed a high fidelity simulation scenario for 4 th year medical students. This was then reviewed and edited with the help of: • Senior O&G and SH consultants • GWH PALS service • University educators who were working on similar projects • Our transgender actor The simulation session was run for 6 medical students in the simulation suite. The pre simulation discussion was on the following topics: • Definitions • Previous experience with transgender patients; and was it positive or negative • Their anxieties about consulting transgender patients • The barriers to transgender patients accessing care • The effect on accessing screening programmes Following this two students completed the simulation within the simulation suite with four students observing via a live audio visual feed. The four students were given observer tools to aid with their engagement and learning. It also provided topics of discussion during the debrief. The simulation ran for approximately 25 minutes. Following this all students, educators and actor de-briefed and assimilated learning points together. Students were sent a post simulation questionnaire following this.

 

Results

Pre simulation
Survey 45 students from the University of Bristol, University of Oxford and King’s College London completed the pre-simulation survey. 19 (42%) students reported they have never received any teaching on transgender issues in health care. All 26 (58%) students who reported receiving teaching of transgender care reported that they received didactic teaching. 37 (82%) of students expressed that they would like to receive more formal teaching on this issue.

Post simulation

Survey 5 out of 6 students completed the post simulation survey. Student reported learning is demonstrated in Image 2. 4 out of the 5 expressed that they will change their practice following this session.

Reflections

Things Which Went Well:

• Involved students from different medical schools.

• Sought active involvement from the transgender community.
• Students reported positive experience.

Future Learning Points:

• Create more scenarios.

• Recruiting transgender actors.

• Recruiting consultants to support teaching.

Conclusion

There is a gap in medical education regarding teaching and training on transgender issues in healthcare. Following further data collection, we demonstrated the usefulness and effectiveness of simulation as a tool to deliver hands-on teaching. This simulation gave the medical students some experience in communicating with transgender patients in a healthcare setting; all in a safe environment to facilitate further discussion. To take this forward we are looking to create and implement more scenarios. Additionally, we are looking at ways in which we can recruit more transgender actors to assist in this project and with other teaching which occurs within the undergraduate teaching department. References 1. James, S. and Colling Sylvester, H., 2018. Transgender health and its current omission from medical schoo