A pioneering training program at Rush has equipped more than 4,000 staff and students with tools to deliver respectful and supportive care to LGBTQ+ patients.
Rush’s T4 “train the trainer” program was developed to help staff and students improve patient care for LGBTQ+ people, who face widespread bias and discrimination when seeking health care, according to studies. Training is crucial to achieving the mission of Affirm: The Rush Center for Gender, Sexuality, and Reproductive Health.
An initial effort to offer training proved useful but limited in its reach.
“When Affirm launched, a few expert trainers had offered dozens of trainings in gender-affirming care to a few hundred employees at Rush. But to make the training accessible to everyone at Rush, we needed a new approach,” said psychologist Jay Behel, PhD, who leads education efforts at Affirm. “So, we developed a ‘train-the-trainer’ curriculum and a process for certifying and monitoring the new trainers.”
The success of T4 was showcased in a New England Journal of Medicine series of case studies about initiatives that address discrimination in health care, with the goal of inspiring other health systems and health care providers.
The need for affirming care
The Affirm center was launched in 2020 to help LGBTQ+ patients navigate care that is supportive and affirming. Affirm’s goal is to make training available to any of Rush University System for Health’s more than 12,000 employees who want it, said Sanjeev Singh, program manager of Affirm.
Since its start in February 2022, T4 has trained 52 trainers, who, in turn, have led over 180 sessions, training for more than 4,000 members of the Rush community in affirming care, Singh said.
Faculty, staff, and students from across Rush were invited to apply to be trainers. The application focused on prior commitment to gender-affirming care, connection to the LGBTQ+ community, and the degree of interest in sustaining this important work.
Simple, practical training
The curriculum for T4, which continues today, consists of one half-day of reviewing training content, learning and practicing presentation tactics and mastering how to answer frequently asked questions. To be certified, trainees must observe at least one training session and then be observed delivering one or more training sessions.
“With trainers distributed throughout the health system, we can often deploy trainers who have established their credibility in the clinic or area to which training is being delivered,” Behel and Singh wrote in the case study for NEJM.
T4’s top challenge is recruiting and training replacement trainers to address turnover. “In a large health system, attrition among trainers is inevitable,” they wrote.
Rush provides affirming care training to employees throughout the system, including new clinical employees, and in various college programs. The next goals are to reach community groups and to assess the training’s impact more thoroughly, they said.
