Enhancing the sustainability of a Dedicated Education Unit: Overcoming obstacles and strengthening partnerships.

BACKGROUND: Dedicated Education Units are innovative teaching models that involve collaboration between nurse educators and clinical institutions to provide effective clinical learning. An essential requisite for Dedication Education Units is an effective academic-practice partnership. Following the initiation of a Dedicated Education Unit, partnerships can fade and lines of communication can deteriorate, resulting in dissatisfaction or termination of the partnership. PROBLEM: The ongoing sustainability of a Dedicated Education Unit was questioned due to personnel turnover, communication challenges, and infrequent provision of training for nurses. APPROACH: A redesign project was implemented with the goal to improve academic-practice collaboration, confirm mutual benefit, and envision long-term sustainability. Focus groups were conducted with key stakeholders to identify and evaluate program revisions following three semesters of student rotations on the redesigned Dedicated Education Unit. OUTCOMES: The redesigned Dedicated Education Unit elements received overwhelmingly positive feedback from nurses, students, and faculty. Participants reported increased collaboration between the academic and practice partners, improved communication between faculty and nurses, increased student satisfaction, and improved role preparation for nurses. CONCLUSION: This project demonstrated that Dedicated Education Units can provide mutual benefits to academic and practice partners; however, ongoing collaboration from all members of the partnership is essential for ongoing sustainability.

Best Practices in Transgender Health: A Clinician's Guide.

Providing culturally competent and medically knowledgeable care to the transgender community is increasingly falling within the realms of practice for primary care providers. The purpose of this article is to provide an overview of best practices as they relate to transgender care. This article is by no means a comprehensive guide, but rather a starting point for clinicians as they provide high-quality care to their transgender patients.

Factors Modifying Burnout in Osteopathic Medical Students.

OBJECTIVE: The purposes of the current study are to examine factors modifying burnout and identify which of these factors place osteopathic medical students at risk for developing burnout. METHODS: The current study used a cross-sectional study design and an anonymous, web-based survey to assess burnout and depression in osteopathic medical students. The survey included Maslach Burnout Inventory, the Patient Health Questionnaire, the Stressors and their impact scale, students' sleeping and studying habits, and students' extracurricular involvement. RESULTS: In total, 1294 osteopathic medical students completed the survey. Burnout was present in 516 (39.9%) osteopathic medical students, and 1006 (77.0%) met criteria for depression. Females were 1.5 times more likely to be burned out in comparison to males. For the burnout subscales, males had lower emotional exhaustion, slightly higher depersonalization, and lower personal accomplishment. Lesbian/gay/bisexual/asexual students were 2.62 times more likely to be burned out compared with heterosexual students. Depression and academic, personal, and family stressors were all strongly linked to overall burnout. Finally, for modifiable factors, average hours of sleep, average hours spent studying, and club involvement appeared to be linked to burnout. CONCLUSIONS: The current study suggested that a variety of factors, including non-modifiable, situational, and modifiable, impact burnout in osteopathic medical students. Future research is necessary since burnout in physicians affects the quality of care provided to patients.

American sign language and deaf culture competency of osteopathic medical students.

The study examined the effectiveness of a workshop on Deaf culture and basic medical American Sign Language for increasing osteopathic student physicians' confidence and knowledge when interacting with ASL-using patients. Students completed a pretest in which they provided basic demographic information, rated their confidence levels, took a video quiz on basic medical signs, and experienced a practical standardized encounter with a Deaf patient. They then attended a 4-hour workshop and, 2 weeks later, completed a posttest. Thirty-three students completed the pretest; 29 attended the workshop; 26 completed the posttest. Video quiz scores increased significantly from pretest to posttest, as did scores for the standardized patient encounter after completion of the workshop. Students also reported increased levels of confidence in interactions with the Deaf community. The results suggest that a single workshop was effective in increasing both confidence and short-term knowledge in interactions with Deaf patients.

Acceptance of lesbian, gay, bisexual, and transgender patients, attitudes about their treatment, and related medical knowledge among osteopathic medical students.

CONTEXT: Limited research exists on the health issues faced by lesbian, gay, bisexual, and transgender (LGBT) patients, as viewed in the context of osteopathic medical education. A full understanding of current medical students' acceptance of, attitudes toward, and knowledge of these issues could lead to the development and incorporation of curricula focusing on the care of LGBT patients into colleges of osteopathic medicine (COMs). OBJECTIVE: To determine among osteopathic medical students the levels of acceptance of LGBT patients, attitudes toward treating this population, and medically relevant knowledge about their distinct health-related issues. METHODS: In August 2012, students at 6 COMs were sent an e-mail invitation that contained basic information about the study and a link providing access to an anonymous Web-based survey. Standard scales used in previous studies were compiled and individualized into 130 items for the purposes of the present study. RESULTS: Of the 4112 osteopathic medical students contacted, 1698 (41.3%) entered the survey and 1335 (32.5%) completed it. Two hundred respondents (15%) self-identified as having a sexual orientation on the lesbian, gay, or bisexual (LGB) spectrum. Although respondents generally had favorable levels of acceptance of LGBT patients and positive attitudes toward treatment of this population, self-identified LGB students had even greater acceptance of LGBT patients (P<.001) and more positive attitudes toward their treatment (P<.001). When medically relevant knowledge of issues related to the health of LGBT patients was assessed, 125 respondents (12.9%) obtained a passing score of 7 or higher, with LGB students scoring significantly higher than students whose self-identified sexual orientation was heterosexual only (P=.01). Differences in the levels of acceptance of (P=.008), treatment attitudes toward (P=.001), and relevant medical knowledge (P=.05) pertaining to LGBT patients were noted between respondents from the 6 COMs. CONCLUSION: The results suggest that even though osteopathic medical students had mostly positive personal attitudes and treatment attitudes toward LGBT patients, some disparities were still present. Also, students lacked adequate knowledge of the unique medical issues faced by the LGBT population. In the future, students should be given more training to effectively treat LGBT patients and their health-related issues.

Still in the closet: the invisible minority in medical education.

BACKGROUND: To investigate the relationship between sexual orientation and gender identity in regard to levels of depression; levels of perceived social support; comfort with disclosure of orientation; and the lesbian, gay, bisexual, and transgender (LGBT) campus climate. METHODS: E-mail invitations to participate in the current cross-sectional questionnaire-based study were sent to all thirty US osteopathic medical schools in August 2012; six schools responded and disseminated the survey to their students. Participating students completed an anonymous web-based survey, and informed consent was obtained when they accessed the survey. The survey was designed specifically for the current study but contained scales used with permission from previously published research. Analysis procedures included nonparametric tests, one-way analysis of variance and Pearson's correlations. RESULTS: Of the 4112 students invited to participate in the survey, 1334 (32.4%) completed it. Approximately 85% of respondents self-identified as heterosexual only. No respondents identified as transgender. In general, LGB students indicated higher levels of depression (P < .001), slightly lower levels of perceived social support (P < .001), and more discomfort with disclosure of sexual orientation (P < .001). A majority of students rated their campus climate as noninclusive. CONCLUSIONS: Results of the current study indicated a relationship between sexual orientation and depression, perceived social support, comfort with disclosure of orientation, and the LGBT campus climate in osteopathic medical students. In the future, osteopathic medical schools should consider closely examining their campus culture in order to create a more positive and inclusive environment for all its students.

Forgive me Father for I have sinned: the role of a Christian upbringing on lesbian, gay, and bisexual identity development.

This study (n = 84) examined the extent to which a Christian upbringing may inhibit same-sex attracted individuals from accepting a lesbian, gay, and bisexual (LGB) identity. No significant differences were found between current and former Christians' positive or negative gay identities. Participants who had left Christianity were more liberal and viewed God as hostile. Participants' "outness" as LGB to their primary network was associated with a greater positive and lesser negative gay identity. Participants' LGB network size was not related to either their positive or negative gay identifications. Finally, the participants' sexual histories were not related to their negative identities, but were related to their positive identities.