Assessing the current status of and developing best practices in the delivery of sexual and gender minority content in PA education: a mixed methods approach

Abstract

Background: A strategy aimed at reducing the health disparities experienced by sexual and gender minority (SGM) populations is to ensure health care providers are well equipped to care for them. There is a gap in the health professions literature addressing best practices for delivering this content in training. This research aims to assess the current status of and to identify PA educator beliefs about best practices in the delivery of SGM content in PA education. Methods: This mixed methods study was guided by queer theory and curricular development practices. Quantitative data was obtained through a survey sent to all US PA programs in 2021. Questions addressed amount, delivery, and importance of lesbian, gay, bisexual, transgender, queer, (LGBTQ) content and how well students are prepared to care for LGBTQ patients. Data was analyzed with bivariate and multivariate methods. Qualitative data was obtained through 5 focus groups with expert PA educators exploring their perceptions about best practices in the delivery of SGM content in PA education. Focus groups were conducted from April to May 2024. Content analysis was completed by 2 coders using both inductive and deductive methods. A comparison of results from quantitative and qualitative analyses was conducted to evaluate for convergence. Results: The questionnaire had a 71.8% response rate (204 out of 284 responded) and showed that the majority of PA programs teach between 1 to 3 hours on each LGBTQ content area and integrate the content throughout their curricula. Multivariate analyses showed increased odds of having adequately or well-prepared students with knowledgeable faculty members (AOR=6.16; 95% CI 2.97, 12.78) and teaching more than 3 hours of LGBTQ+ content (AOR=5.20; 95% CI 95% 1.60, 16.82). Qualitative analyses revealed expert PA educator beliefs about best practices including topics to include in the curricula, ideal teaching approaches, necessary student competencies, and barriers and facilitators to inclusion of SGM content. Conclusion: Convergence of findings resulted in 8 consensus best practices for the inclusion of SGM content in PA education. PA education accreditation standards require the inclusion of SGM content in PA education and findings from this study may serve as a guide for evaluating and integrating content.