Original Publication
Open Access

Nathan/Natalie Marquez: A Standardized Patient Case to Introduce Unique Needs of an LGBT patient

Published: December 4, 2015 | 10.15766/mep_2374-8265.10300

Included in this publication:

  • Marquez Instructor's Guide.docx
  • Faculty Development Guide for Marquez.docx
  • Health Equity for LGBT Module 1.pptx
  • Health Equity for LGBT Module 3.pptx
  • Marquez Case.docx
  • Marquez Instructions for Learners.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: This standardized patient case introduces the unique needs of lesbian, gay, bisexual, and transgendered (LGBT) youth during an outpatient visit. This workshop was developed by clinician educators as part of a small-group curriculum for preclinical medical students. This case was developed by an internal medicine physician and vetted through pediatricians and clinicians with an interest in LGBT health. The session is intended to be used with preclinical or early clinical learners to give students practice in obtaining a complete history while simultaneously recognizing the added psychosocial stressors on LGBT youth, and how these stressors may manifest as physical complaints. Methods: The session was run in a small-group setting, with a faculty facilitator. Students interviewed standardized patients in their weekly small-group session (12 students and one facilitator per group). The case pertained to a 15- to 25-year-old patient with chief complaint of headache. In delving deeper into social history, the students encountered the scenario of a patient with conflicted views on his/her sexual orientation and family pressures. Results: The case and session have been used to train about 560 medical students. A subset (n = 95) of students was randomly selected to evaluate the small-group session. Eighty-seven percent of students rated the session as excellent or good, 12% as fair, and 2% as poor. During the 2013-14 and 2014-15 academic years, 88% of facilitators (n = 17) agreed or strongly agreed that the “content of the session was at the appropriate level for the students' level of learning.” Additional comments were generally positive, including “content was excellent and ‘real’” and “students did a great job discussion LGBT content.” Areas for improvement included suggestions that “more time” be allowed for discussion and reflections stating that “addressing both adolescent and LBGT in one session was challenging.” Discussion: This standardized patient case introduces the unique needs of an LGBT youth during an outpatient visit, and has been used to train medical students to recognize the unique needs for a patient-centered, compassionate environment when treating adolescents who self-identify as LGBT.

Educational Objectives

By the end of this session, learners will be able to:

  1. Describe healthcare disparities experienced by lesbian, gay, bisexual, and transgendered (LGBT) individuals.
  2. Gather essential and accurate information about patients and their conditions through history taking in a patient-centered manner.
  3. Sensitively and effectively elicit relevant information about sexual behavior, sexual history, and sexual orientation from all patients in a developmentally appropriate manner.
  4. Utilize a patient-centered interviewing approach to explore a chief complaint and obtain a relevant history of headache in a patient.

Author Information

  • Camilla Curren, MD: Ohio State University College of Medicine
  • Laura Thompson, MD: Ohio State University College of Medicine
  • Eric Altneu: Ohio State University College of Medicine
  • Kimberly Tartaglia, MD: Ohio State University College of Medicine
  • John Davis, PhD, MD: Ohio State University College of Medicine

None to report.

None to report.


  1. Makadon HJ. Improving health care for the lesbian and gay communities. N Engl J Med. 2006;354(9):895-897. http://dx.doi.org/10.1056/NEJMp058259
  2. Obedin-Maliver J, Goldsmith ES, Stewart L, et al.  Lesbian, gay, bisexual, and transgender–related content in undergraduate medical education. JAMA. 2011;306(9):971-977. http://dx.doi.org/10.1001/jama.2011.1255
  3. Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics. 2009;123(1):346-352. http://dx.doi.org/10.1542/peds.2007-3524


Curren C, Thompson L, Altneu E, Tartaglia K, Davis J. Nathan/Natalie Marquez: a standardized patient case to introduce unique needs of an LGBT patient. MedEdPORTAL. 2015;11:10300. https://doi.org/10.15766/mep_2374-8265.10300