Abdominal Pain in a Gender-Diverse Patient: A Standardized Patient Case for Second-Year Medical Students

Introduction With a growing emphasis on addressing the social determinants of health as a key component of patient-centered healthcare, holistically caring for marginalized groups such as the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) population is an essential skill for future physicians. Yet, training on this topic remains limited in the undergraduate medical curriculum. Using gender-diverse individuals for standardized patient (SP) encounters presents a unique opportunity for students to interact with members of gender-diverse communities while practicing their inclusive patient interviewing skills. Methods This session consisted of a 1.5-hour small group during which students interviewed a sex and gender minority (SGM) SP presenting with abdominal pain. The patient encounter was followed by a debriefing session, during which the SP provided feedback and shared their lived experiences, including those involving the health care system. Students completed optional, anonymous, online, pre- and post-session surveys to assess their knowledge, perceived impact of, and satisfaction with the session. Results Around 95 of 104 (91%) students responded to both surveys. Results showed statistically significant increases in the number of students who stated that they were confident in their ability to take a sexual history, use terminology that is inclusive of different gender identities, and elicit health concerns frequently experienced by SGM people. Additionally, between the pre- and post-survey, there was a statistically significant increase in students' identification of specific health disparities experienced by gender-diverse people. Discussion This case improved students' knowledge regarding health disparities of gender-diverse people and their perception of their skills related to caring for this population. Direct assessment of students' skills would allow for further assessment of the impact of this session. Conclusion This study demonstrates that a 1.5-hour faculty-facilitated small group SP encounter with a gender-diverse actor significantly improved second-year medical students' perceived confidence and competence in caring for SGM people. It also improved their understanding of health disparities. These outcomes are further reinforced by utilizing SGM individuals as SPs.