Rural Perspectives on Health Services for Transgender and Gender Diverse Youth.

As the world grows more diverse, physicians and public health practitioners must become adept at providing care to everyone, including people who identify as transgender or gender diverse (TGD). Although this population is growing in all age demographics, there is a large increase in young TGD individuals who require pediatric health care providers to improve their practices. While a few comprehensive care clinics have been established to serve the TGD community, they are mostly located in urban areas. In addition to the unique barriers faced by rural TGD youth, providers must care for their patients with limited resources. In this commentary, we offer a set of recommendations to improve provider education, build connections between the health system and community, address the fragmentation of health services in rural areas and improve the transition from pediatric to adult health care.

Cross Talk: Evaluation of a Curriculum to Teach Medical Students How to Use Telephone Interpreter Services.

PURPOSE: Telephone interpretation and recent technology advances assist patients with more timely access to rare languages, but no one has examined the role of this technology in the medical setting and how medical students can be prepared for their use. We sought to determine if structured curriculum on interpretation would promote learners self-reported competency in these encounters and if proficiency would be demonstrated in actual patient encounters. METHODS: Training on the principles of interpreter use with a focus on communication technology was added to medical student education. The students later voluntarily completed a retrospective pre/post training competency self-assessment. A cohort of students rotating at a clinical site had a blinded review of their telephone interpretation encounters scored on a modified validated scale and compared to scored encounters with preintervention learners. Nested ANOVA models were used for audio file analysis. RESULTS: A total of 176 students who completed the training reported a statistically significant improvement in all 4 interpretation competency domains. Eighty-three audio files were analyzed from students before and after intervention. These scored encounters showed no statistical difference between the scores of the 2 groups. However, plotting the mean scores over time from each encounter suggests that those who received the curriculum started their rotation with higher scores and maintained those scores. CONCLUSIONS: In an evaluation of learners' ability to use interpreters in actual patient encounters, focused education led to earlier proficiency of using interpreters compared to peers who received no training.