Program Director’s Corner – November 2019
Use of Standardized Patients to Teach Transgender Care in Endocrinology Fellowship Programs
Mary Stevenson, MD
Assistant Professor of Medicine
Emory University School of Medicine
One area of growing interest and attention in endocrinology fellowship programs is the necessity of providing training in the unique health care needs of transgender and gender non-conforming individuals. Endocrinology fellows have historically reported insufficient education and guidance in this field. A 2017 survey of second year endocrinology fellows found that only 58.9% had been provided dedicated training in transgender care1. Moreover, of those fellows who had reported instruction in the topic, 40% had received less than two hours of content per year1. To address these deficiencies, endocrinology programs have been implementing teaching strategies that include lectures, small group discussions, online modules/webinars, elective rotations, and direct patient care time2.
The endocrinology fellowship training program at Emory University has been using the Objective Structured Clinical Examination, or OSCE, for the past three years as a teaching tool to improve fellows’ comfort and knowledge in delivering transgender care. Case vignettes of both trans-feminine and trans-masculine standardized patients have been presented to fellows to assess components within the four out of six ACGME core competencies of medical knowledge, patient care, professionalism, and interpersonal and communication skills3. The standardized patient and faculty members provide feedback to the fellows immediately after the simulated encounter. Additionally, fellows have completed pre- and post-encounter surveys about their comfort and medical knowledge in providing transgender care that can provide valuable information to guide further educational opportunities. We believe the OSCE can be a valuable tool to aid in identifying areas of strengths as well as areas for improvement and growth for endocrinology fellows.
A detailed description of the methods and results of one trans-feminine standardized patient case conducted at Emory University during the 2016-2017 academic year will soon be published in the Journal of the Endocrine Society4. We would love to collaborate with other endocrinology fellowship programs interested in implementing OSCE cases to improve endocrinologists’ care for transgender and gender non-conforming patients. Please contact Mary Stevenson, MD at firstname.lastname@example.org or Vin Tangpricha, MD, PhD at email@example.com with any questions or for further information.
1. Davidge-Pitts CJ, Nippoldt TB, Natt N. ENDOCRINOLOGY FELLOWS’ PERCEPTION OF THEIR CONFIDENCE AND SKILL LEVEL IN PROVIDING TRANSGENDER HEALTHCARE. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol. 2018;24(12):1038-1042. doi:10.4158/EP-2018-0307
2. Davidge-Pitts C, Nippoldt TB, Danoff A, Radziejewski L, Natt N. Transgender Health in Endocrinology: Current Status of Endocrinology Fellowship Programs and Practicing Clinicians. J Clin Endocrinol Metab. 2017;102(4):1286-1290. doi:10.1210/jc.2016-3007
3. Swing SR. The ACGME outcome project: Retrospective and prospective. Med Teach. 2007;29(7):648-654. doi:10.1080/01421590701392903
4. Stevenson MO, Sineath RC, Haw JC, Tangpricha V. Use of Standardized Patients in Endocrinology Fellowship Programs to Teach Competent Transgender Care. Journal of the Endocrine Society. Accepted, in press.