How Do OSCE Cases Activate Learners About Transgender Health?

Area of Science:

• Medical Education
• Transgender Health
• Simulation-Based Learning

Background:

• Medical residents often lack adequate training in gender-affirming care.
• Objective structured clinical examinations (OSCEs) can provide a safe space for skill development.
• Transgender health-related OSCE (THOSCE) cases aim to bridge this educational gap.

Purpose of the Study:

• To evaluate the impact of THOSCE case exposure on medical learners' activation in providing gender-affirming care.
• To identify the educational value and themes associated with THOSCE cases.

Main Methods:

• A modified grounded theory approach was employed.
• Focus groups were conducted with primary care internal medicine residents who participated in THOSCE cases (2018-2019).
• Transcripts were analyzed and coded to identify emergent themes.

Main Results:

• Eighteen residents participated, revealing themes related to gender-affirming care.
• Learner activation was conceptualized in four stages: role importance, confidence/knowledge, action-taking, and perseverance.
• Residents valued simulation for practicing transgender health skills, particularly psychosocial aspects.

Conclusions:

• THOSCE cases enhance learner comfort and skills in gender-affirming care, especially psychosocial elements.
• Residents expressed a need for more accessible biomedical training and outpatient experience.
• A staged, simulation-based approach is proposed to teach gender-affirming care skills effectively to all learners.