Improving Transgender Competency with a Short Single-Session Training Program
Delivering competent care to transgender patients becomes especially critical as plastic surgeons continue to pioneer transgender surgery. When transgender patients access care, effective communication rooted in correct pronouns, terminology, and vocabulary ensures a safe environment by healthcare staff and establishes an understanding of transgender patients healthcare needs. This study’s aim is to explore the feasibility of improving knowledge of transgender-related care and increasing comfort and competence for health care providers with the use of a short, efficient, single-session training program.
Methods/Technique
:We delivered training to professionals involved in post-op care for trans surgical patients and to medical students. The training sessions were given over one hour in one session. The format of the training was didactic with practice-based examples. To measure self-perceived ability and ease in providing care to transgender patients we measured outcomes before training and after training to determine self-perceived comfort and competence ranging from not competent/comfortable to very competent/comfortable To measure objective competence, we used a 6 item multiple-choice questionnaire. For analysis to determine the change on subjective and objective comfort/competence after training, two cohorts were established of surveyors consisting of high comfort/competence and low comfort/competence. We conducted McNemar's test to analyze paired proportions with a significance of p<.05. To determine if baseline comfort or competence predicted any positive change in objective competence after training, Pearson’s Chi-Squared Test with a critical value of .05 was conducted. Analyses were conducted using JMP Pro, Version 15 ( SAS Institute, Inc., Cary, NC, 1989-2019).
Results/Complications
:96 healthcare providers completed our training and submitted pre-training evaluations and post-training surveys. Subjectively, the training increased the percentage of providers that self-reported as very comfortable ( 73%, 95%, p<.05) and very competent ( 41%, 93%, p<.05) in caring for transgender patients. In subjects who reported high competence before training, our workshop increased the percentage of providers ( pre-training=83%, post-training=92%, p<.05) who received at least an 80% in the objective questionnaire. Self-perceived low comfort providers at baseline showed a greater increase in the percentage of providers who objectively got a higher score after training compared to self-perceived high comfort providers. ( low comfort=42%, high comfort] 35%, p=.55). Self-perceived low competence providers at baseline showed a greater increase in the percentage of providers who objectively got a higher score after training compared to self-perceived high competence providers ( low competence=40%, high competence= 30%, p=.05).
Conclusion
:Our short, single-session training session improved the comfort and competence of providers even in providers who reported subjective high competency at baseline. Providers who reported low comfort and low competence had better improvements in objective competence after our training session. The implementation of a short, interactive seminar like our workshop can be used to improve how care is delivered to transgender patients with improved provider knowledge of gender identity, gender expression, goals of care, sexual orientation, and transgender barriers. A nurturing provider-patient relationship built on trust is essential for the success of transgender surgical interventions that require patient compliance with invasive regimens preoperatively and postoperatively.