Teaching health professionals how to tailor gender-affirming medicine protocols: A design thinking project.

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Kinnon R MacKinnon, Lori E Ross, David Rojas Gualdron, Stella L Ng

Author Information

Kinnon R MacKinnon: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. k.mackinnon@mail.utoronto.ca.
Lori E Ross: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
David Rojas Gualdron: The Wilson Centre, Faculty of Medicine at University Health Network, University of Toronto, Toronto, Ontario, Canada.
Stella L Ng: The Wilson Centre, Faculty of Medicine at University Health Network, University of Toronto, Toronto, Ontario, Canada.

PMID: 32301051 DOI: 10.1007/s40037-020-00581-5

BACKGROUND: Content knowledge surrounding transgender (trans) medicine is currently lacking in the formal medical education curricula. Evidence indicates that the main protocols used to assess and refer trans patients for gender-affirming medicine are misunderstood by health professionals, and require flexible adaptation to achieve health equity and patient-centred care.
APPROACH: A free online educational tool for gender-affirming medicine, The Path to patient-Centred Care, was developed to teach learners how to adapt assessment protocols. Resource creation was supported by a knowledge translation grant that endorsed design thinking, a human-centred and solutions-focused framework recommended for use in curriculum development.
EVALUATION: The Path to patient-Centred Care provides learners with information related to key principles of patient-centred care in gender-affirming medicine, including a guide on how to adapt the main assessment protocols to achieve equitable care. The curriculum also includes narratives from trans patients and health professionals that focus on health equity, and a clinical vignette about a complex case, designed to foster critical thinking on medical ethics. Project future directions involve an implementation and evaluation pilot study with a diverse group of continuing professional development medical learners using a mixed-methods program evaluation design.
REFLECTION: The use of design thinking to develop this resource exemplifies a novel approach to curriculum development. By using pedagogical strategies that foster critical reflection, this innovative online education tool strives to teach self-directed learners how to provide care that emphasizes trans people's self-determination and autonomy in medical decision-making.

Continuing education Design thinking Gender-affirming medicine Protocols

Tomita T, Testa RJ, Balsam KF. Gender-affirming medical interventions and mental health in transgender adults. Psychol Sex Orientat Gend Divers. 2018; https://doi.org/10.1037/sgd0000316 . [DOI: 10.1037/sgd0000316]
Coutin A, Wright S, Li C, Fung R. Missed opportunities: are residents prepared to care for transgender patients? A study of family medicine, psychiatry, endocrinology, and urology residents. Can Med Educ J. 2018;9:e41��e55. [DOI: 10.36834/cmej.42906]
Korpaisarn S, Safer JD. Gaps in transgender medical education among healthcare providers: A major barrier to care for transgender persons. Rev Endocr Metab Disord. 2018;19:271��5. [DOI: 10.1007/s11154-018-9452-5]
Dubin SN, Nolan IT, Streed CG, Greene RE, Radix AA, Morrison SD. Transgender health care: improving medical students�� and residents�� training and awareness. Adv Med Educ Pract. 2018;9:377��91. [DOI: 10.2147/AMEP.S147183]
Bauer GR, Scheim AI, Pyne J, Travers R, Hammond R. Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada. BMC Public Health. 2015;15:525. https://doi.org/10.1186/2Fs12889-015-1867-2 . [DOI: 10.1186/2Fs12889-015-1867-2]
Coleman E, Bockting W, Botzer M, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgend. 2012;13:165��232. [DOI: 10.1080/15532739.2011.700873]
MacKinnon KR, Ng SL, Grace D, Sicchia SR, Ross LE. Protocols as curriculum? Learning health advocacy skills by working with transgender patients in the context of gender-affirming medicine. Adv Health Sci Educ Theory Pract. 2019; https://doi.org/10.1007/s10459-019-09899-0 . [DOI: 10.1007/s10459-019-09899-0]
Dewey JM. Challenges of implementing collaborative models of decision making with trans-identified patients. Health Expect. 2013;18:1508��18. [DOI: 10.1111/hex.12133]
MacKinnon KR, Grace D, Ng SL, Sicchia SR, Ross LE. ��I don��t think they thought I was ready:�� how pre-transition assessments create care inequities for trans people with complex mental health in Canada. Int J Ment Health. 2020; https://doi.org/10.1080/00207411.2019.1711328 . [DOI: 10.1080/00207411.2019.1711328]
Shuster SM. Uncertain expertise and the limitations of clinical guidelines in transgender healthcare. J Health Soc Behav. 2016;57:319��32. [DOI: 10.1177/0022146516660343]
Davy Z, Sorlie A, Suess Schwend A. Democratising diagnoses? The role of the depathologisation perspective in constructing corporeal trans citizenship. Crit Soc Policy. 2018; https://doi.org/10.1177/0261018317731716 . [DOI: 10.1177/0261018317731716]
MacKinnon KR, Ross LE. The path to patient-centred care. 2019. www.patient-centred.ca . Accessed April 3, 2020.
McLaughlin JE, Wolcott MD, Hubbard D, Umstead K, Rider TR. A qualitative review of the design thinking framework in health professions education. BMC Med Educ. 2019; https://doi.org/10.1186/s12909-019-1528-8 . [DOI: 10.1186/s12909-019-1528-8]
Ng SL, Wright SR, Kuper A. The divergence and convergence of critical reflection and critical reflexivity: implications for health professions education. Acad Med. 2019;94:1122��8. [DOI: 10.1097/ACM.0000000000002724]
Johnson BH. Promoting patient- and family-centered care through personal stories. Acad Med. 2016;91:297��300. [DOI: 10.1097/ACM.0000000000001086]
Cavanaugh T, Hopwood R, Lambert C. Informed consent in the medical care of transgender and gender-nonconforming patients. AMA J Ethics. 2016;18:1147��55. [DOI: 10.1001/journalofethics.2016.18.11.sect1-1611]
Baker L, Wright S, Mylopoulos M, Kulasegaram M, Ng S. Aligning and applying the paradigms and practices of education. Acad Med. 2019;94:1060. [DOI: 10.1097/ACM.0000000000002693]

/CIHR

Culturally Competent Care

Education, Medical

Humans

Patient-Centered Care

Transgender Persons

Male

Female

Journal Article Research Support, Non-U.S. Gov't

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