Clinical Teacher最新文献

A universal understanding of the terms ‘equality, diversity and inclusion’ (EDI) are often taken for granted, especially within the field of health professions education. Often, when we think of inclusion, we think about those we bring into our community, not those we exclude. Our framing of diversity is often limited to increasing the visibility of one particular group of individuals, ignoring the multiple microsecting identities that individuals hold. This year, our Annual Scholarship Meeting (ASM) focussed on addressing these issues by celebrating diversity, by creating an inclusive community and by improving equity within our field and our association. This special issue provides an overview of our meeting, ‘Developing a Diverse Workforce’. We have collated the commentaries from our keynote speakers who delivered insightful presentations on intersecting issues pertaining to EDI.

The importance of the chosen focus on the theme of ‘developing a diverse workforce’ becomes evident when one considers a recent statistic from the World Health Organisation (WHO). Shockingly, according to WHO, no European member state has achieved full gender equity with regard to health outcomes. This is a healthcare issue, a workforce issue and a curricula issue. Our ASM, as led by our plenary speakers, considered EDI at the intersections between health, workforce and curricula. We focussed on equity and representation within the workforce based upon gender, disability, race, sexuality including LGBTQIA+, and social class. Our Gold Medal winner drew attention to the issues with representation in the global south and challenged us to consider what issues are facing healthcare educators, students and providers in different cultures that may not share the same views as the global north. Dr Holly Quinton has created infographics to summarise the salient points from each plenary.

As we go back to our daily lives, we need to take time to reflect on the messages from our ASM 2023. Developing a diverse workforce for the needs of a diverse society is not a single action. It needs planning, it requires cultural shifts, and above all else, commitment. EDI was not a one off theme at ASME; we have a commitment to improving, as evidenced in our strategy, in the themes of future meetings and the initiatives that we run. What we need now is a collective effort to improve, to nurture individuals and to include (Figure 1).

Duncan Shrewsbury

Department of Medical Education, Brighton and Sussex Medical School, University of Brighton, Brighton, UK

In the UK, where I am based, it is estimated that 2.8% adults identify as belonging to the lesbian, gay, or bisexual (LGB) community, with a further 0.5% identifying as transgender or gender diverse (TGD).¹ In some countries, however, it is important to remember that not only is this sort of information not gathered, but it remains illegal to be lesbian, gay, bisexual transgender or queer (LGBTQ). Different versions of acronyms to refer to this heterogenous community exist (box 1) and sometimes the term ‘queer’ is used as a celebratory and inclusive umbrella term to refer to folk who do not identify as heterosexual and/or cisgendered. This is an example of a ‘reclamation’ of a pejorative slur that will be familiar, and probably still hurtful, to many in the community, necessitating sensitivity in the use of the term.

Data suggest that those in the LGBTQIA+/queer community experience disproportionately higher rates of illness. This is overwhelmingly exemplified by rates of anxiety, depression and suicidality that are experienced at rates two to ten times that seen in the general population respectively.² Other health conditions are also seen to affect people within the LGBTQIA+ community disproportionately, such as asthma affecting lesbians and breast cancer affecting lesbian and bisexual women.³ Further research to elucidate these patterns is lacking. In additional to greater healthcare needs, however, the queer community seem to experience a number of barriers to accessing healthcare, such as prejudice and discrimination from healthcare staff.² Alarmingly, up to 1 in 6 people who experience sexual orientation or gender identity change efforts (e.g. so-called ‘conversion therapy’)—which are ineffectual, traumatic and damaging—believe their ‘treatment’ was overseen or delivered by a healthcare professional.⁴ Queer colleagues and friends in the healthcare profession experience similar prejudice and discrimination, with reports suggesting that not only is this a sizeable problem, but also sadly little has changed in recent years.^5,6 This represents a pervasive issue of culture in healthcare and health professions education that must be addressed in order to provide inclusive care to the diverse communities we serve.

Studies looking into teaching about LGBTQIA+ health in undergraduate medical education suggest that very few medical schools have adequate provision in this domain, but that learners who have greater exposure tend to be able to perform more holistic history-taking, and that learners generally desire more teaching on this subject to better prepare them for professional practice.^7,8 A challenge for educators is to ensure that LGBTQIA+ peoples are represented in teaching and assessment, and that