Transgender and gender diverse health education for future nurses: Students' knowledge and attitudes

Abstract

Background: Compared to cisgender peers, transgender and gender diverse (TGD) people experience significant health disparities associated with discrimination and limited access to appropriate care in healthcare settings. Nurses represent the largest segment of the United States (US) healthcare workforce; however, US nursing programs only dedicate approximately 2.12 h to Lesbian, Gay, Bisexual, and TGD (LGBT)-related content. Objectives/design/setting/participants: To fill the gap in TGD-related nursing education, the Transgender Curriculum Integration Project (TCIP) developed and integrated an evidence-based curriculum specific to TGD health into the pre-licensure accelerated Bachelor’s in Nursing Science (BSN) program at Johns Hopkins School of Nursing. The purpose of this study was to assess the preliminary efficacy and feasibility (i.e., attrition, engagement, acceptability) of the TCIP in improving the TGD-related health knowledge and attitudes among a sample of pre-licensure nursing students. Methods: TCIP utilized a self-administered online survey to assess students’ knowledge and attitudes about TGD health prior to (time point 1) and following (time points 2 and 3) the integration of TGD-specific content into five nursing pre-licensure courses. Rank-based nonparametric testing using Kruskal-Wallis H and Mann-Whitney U were conducted to determine if there were statistically significant differences in responses between the three time points. Thematic content analysis was used to determine themes present among short answers. Results: Findings indicate TGD-specific content improved student’s gender sensitivity overtime, with improvements in self-reported skills in providing care for TGD people and knowledge of additional TGD-specific resources. However, gender sensitivity remains low among student’s and students requested more TGD content suggesting room for further improvement. Conclusions: Findings support the efficacy of TCIP and highlight complexities of curricular change that can guide future curricular integration and evaluation in nursing programs nation-wide.

Attitudes of nursing students towards LGBT individuals and the affecting factors

“…In other studies, students stated that they did not have sufficient information and that they wanted to learn more about these individuals. (Güleç et al, 2018; Sherman et al, 2021). In a study conducted with nursing students, almost all the students stated that they had knowledge about LGBTI (lesbian, gay, bisexual, transsexual, and intersex) individuals (Küçükkaya & Kahyaoğlu Süt, 2018).…”

“…In a study conducted with nursing students, participants emphasized that it is their ethical responsibility to care for everyone regardless of their sexual orientation (Cornelius & Carrick, 2015). In some studies, it was stated that some of the nursing students were uncomfortable working with LGBT patients and they were not ready to care for these individuals (Carabez et al, 2015; Mitchell et al, 2016; Sherman et al, 2021). It is emphasized that adequate and detailed training should be provided in the education system for providing care for these individuals as a solution (Brown et al, 2020; Carabez et al, 2015; Elertson & McNiel, 2020; McCann & Brown, 2020; Sherman et al, 2021).…”

“…In some studies, it was stated that some of the nursing students were uncomfortable working with LGBT patients and they were not ready to care for these individuals (Carabez et al, 2015; Mitchell et al, 2016; Sherman et al, 2021). It is emphasized that adequate and detailed training should be provided in the education system for providing care for these individuals as a solution (Brown et al, 2020; Carabez et al, 2015; Elertson & McNiel, 2020; McCann & Brown, 2020; Sherman et al, 2021). In one study with nursing students, to minimize possible harm to patients, importance of not forgetting ethical values and being nonjudgmental while giving appropriate care to all patients was emphasized (Rowniak, 2015).…”

Healthcare Mistreatment, State-Level Policy Protections, and Healthcare Avoidance Among Gender Minority People

“…This variation between state policy-and community-level societal stigma may impact provider or clinician interactions with GM patients. Some healthcare facilities have implemented changes to address the healthcare needs of GM people (Klein & Nakhai, 2016;Wyckoff, 2019) and in the provision of healthcare education (Cooper et al, 2018;Mayfield et al, 2017;Sherman et al, 2020). However, little is known about whether these efforts are effective in improving the healthcare experiences of GM people.…”

A systematic mapping literature review of education around sexual and gender diversities

“…Health care Medical students 31 Bakhai et al, 2016;Underman et al, 2016;Bonvicini, 2017;Holthouser et al, 2017;Sanchez et al, 2017;Beck Dallaghan et al, 2018;Cooper et al, 2018;Dudar et al, 2018;Ufomata et al, 2018;Gavzy et al, 2019;Nowaskie and Patel, 2020;Minturn et al, 2021;Tollemache et al, 2021 Nursing students Eliason et al, 2011;Aaberg, 2016;Hickerson et al, 2018;McEwing, 2020;Ray King et al, 2021;Sherman et al, 2021b Pharmacy students Mandap et al, 2014;Nowaskie and Patel, 2021 Biomedical students Muntinga et al, 2016 Staff members Seaborne et al, 2015;Bristol et al, 2018;Higgins et al, 2019 Transgender care Johnson et al, 2018;Sherman et al, 2021a Framework for improvement Eckstrand et al, 2017;Altneu et al, 2020Contents McDowell et al, 2020Pratt-Chapman, 2020 People's experiences or point of views Bacon, 2013;Formby, 2015Formby, , 2017Magnus and Lundin, 2016;Santos et al, 2018;Geunis and Holz, 2020 Teachers 13 Neary, 2013;Francis and Reygan, 2016;Henderson, 2019;…”