Improving Provider Education in the Care of the LGBTQ+ Patient to Reduce Health Disparities and Foster Inclusive Care

The Cleveland Clinic Cancer Institute launched its LGBTQ+ Cancer Outreach Program in 2018 after the American Society for Clinical Oncology (ASCO) highlighted healthcare disparities in sexual and gender minorities. Between 2020 and 2023, the Institute trained clinical teams on LGBTQ+ patient care, covering topics like electronic health record documentation of sexual orientation/gender identity, basic LGBTQ+ terminology, common health disparities, and inclusive communication skills. Initial feedback revealed differences in the reception of training between providers in urban and rural settings, and the team sought to provide more in-depth education to improve provider knowledge, comfort in treating LGBTQ+ patients, and improve the experience of the patients in our cancer center.

Educational materials were developed to enhance providers' understanding of the barriers to care faced by LGBTQ+ patients and to promote the delivery of compassionate, inclusive care. These materials aimed to clarify common terminology, identify various forms of discrimination, address social determinants of health, and foster a welcoming environment for all patients. The education program featured pre- and post-surveys, two live grand rounds speaker lectures, and three self-paced electronic modules based on the Welcoming Spaces training by the LGBT Cancer Network, modified with their permission and collaboration.

Of the 347 participants, 244 (71%) completed the training between July and October 2024. Post-survey results showed 92-95% found the course informative. The respondents suggested having dedicated Q&A or open dialogue sessions to improve programming, making the training mandatory rather than optional, and including clinical skills practice and discussions on challenging scenarios. The team plans to update the training as it may be more effective, focused on an even higher level of patient care and real dynamic case studies.

Positive reception to the training contributes to the continuing initiative to offer this training annually. Although overall feedback suggested the training was informative, the team plans to update the training to eliminate potential redundancies in live sessions and e-learning modules, provide additional education in regional and rural settings, and develop patient care case studies to help participants apply the information they have learned to real-life scenarios.