LGBT-Competence in Social Work Education: The Relationship of School Contexts to Student Sexual Minority Competence

Embedding cultural competency and cultural humility in undergraduate pharmacist initial education and training: a qualitative exploration of pharmacy student perspectives

BACKGROUND

Emphasis has been placed upon embedding equity, diversity and inclusion within the initial education and training of healthcare professionals, like pharmacists. Yet, there remains limited understanding of how best to integrate cultural competency and cultural humility into undergraduate pharmacy student training.

AIM

This qualitative study explored the views of pharmacy students to understand perspectives on, and identify recommendations for, embedding cultural competency and cultural humility within pharmacy education and training.

METHOD

Undergraduate pharmacy students from one UK-based School of Pharmacy were invited to participate in an in-person, semi-structured interview to discuss cultural competency in the pharmacy curriculum. Interviews were conducted between November 2022 and February 2023 and were audio-recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes. QSR NVivo (Version 12) facilitated data management. Ethical approval was obtained from the Newcastle University Ethics Committee.

RESULTS

Twelve undergraduate pharmacist students, across all years of undergraduate training, were interviewed. Three themes were developed from the data, centring on: (1) recognising and reflecting on cultural competency and cultural humility; (2) gaining exposure and growing in confidence; and (3) thinking forward as a culturally competent pharmacist of the future.

CONCLUSION

These findings offer actionable recommendations to align with the updated Initial Education and Training standards from the United Kingdom (UK) pharmacy regulator, the General Pharmaceutical Council; specifically, how and when cultural competency teaching should be embedded within the undergraduate pharmacy curriculum. Future research should further explore teaching content, learning environments, and methods of assessing cultural competency.

Social Work Education & Support of Gender Expansive People: A Qualitative Analysis of MSW Student Experiences

This study examined Master of Social Work (MSW) student experiences with social work education related to support of transgender, nonbinary, queer or other gender expansive people. Sixty-seven students from a sample of thirty-four MSW programs in the United States provided brief qualitative reflections on their educational experiences related to gender identity or expression. Thematic content analysis of these data revealed five primary emergent themes related to; MSW program capacity, persistent bias/tension, safety issues, emotional and academic burden, and lived-experiences external to social work education. Findings suggest there remains a disconnect between the stated intent of social work to support gender expansive communities and the reality of social work education. Specifically, although most students appear to want more from their schools of social work regarding trans-affirming education, most programs reflect persistent discomfort with this domain, or a hesitance or inability to address the topic appropriately and consistently. Examples of how social work education might work to improve its capacity to reflect support of gender expansive people and communities are discussed.

Religious-based negative attitudes towards LGBTQ people among healthcare, social care and social work students and professionals: A review of the international literature

There is a dearth of research on how negative religious attitudes towards LGBTQ people inform professional practice. This paper reports on a scoping review of 70 selected studies from 25 different countries. It explores key issues and knowledge gaps regarding the delivery of services to LGBTQ adults by religious healthcare, social care and social work organisations and/or practitioners with faith-based objections to LGBTQ people and their lives. The review identified four main themes: (1) a close connection between religious affiliation and negative attitudes towards LGBTQ people, among both students and professionals; (2) a heightening effect of religiosity, particularly among Christian and Muslim practitioners/students; (3) educators' religious attitudes informing curriculum design and delivery, and some highly religious students resisting and/or feeling oppressed by LGBTQ-inclusivity, if present; (4) examples of practice concerns raised by professionals and lay LGBTQ people. The article considers the ethical, practical, educational and professional standards implications, highlighting the need for further research in this area.

Psychometric Validation of the Portuguese Version of the Modern Homonegativity Scale among Portuguese College Students

The studies focused on analysing attitudes toward homosexuality show that the manifestation of homonegativity has evolved into more modern forms. We therefore propose using instruments that capture subtle aspects in discrimination against gay and lesbian people. The objective of this study is twofold. First, we aim to adapt and validate the Portuguese version of the Modern Homonegativity Scale. Second, we set out to analyse the modern homonegativity shown by Portuguese university students. The scale includes two parallel subscales (MHS-Gay Men and MHS-Lesbian Women), each with 12 items. Six hundred and forty-one Portuguese college students between 18 and 27 years of age participated in the study (M_age = 21.23; SD = 1.88). The results demonstrate the unidimensionality of the scale and a high degree of internal consistency, along with satisfactory fit indices. Those people who identified as male and heterosexual showed greater modern homonegativity. We conclude that the Portuguese version of the MHS is valid and reliable for evaluating modern homonegativity in Portugal.

Promoting Sexual Health Knowledge through a Social Workers' Mentorship Programme: A Study of Gay Young Adults

Mentorship of counselling for men who have sex with other men and gay youths is understudied. The purpose of this study was to explore the effectiveness of how the Mentor Modelling Programme may increase the sexual health knowledge and practices of gay youths. As an expansion of a previous study with the application of the conceptual framework, this study mapped a sexual health promotion plan and the six-month-long Mentor Modelling Programme with the coordination of eight health and social care professionals and 40 gay youths. The researcher found positive and supportive feedback of how the Mentor Modelling Programme could increase sexual health knowledge, promote long-term relationships, and encourage referral of other vulnerable people. The results indicated two directions. The first solicited the perspectives of health and social care professionals and gay youths on how they would describe the relationship, application to, and experience of the Mentor Modelling Programme and second, assessed how this Mentor Modelling Programme influenced and changed the ideas and senses about counselling services and mentorship. This study reflected the current limited sexual promotion between traditional and inclusive sexual health materials. It further indicated the necessary concerns and areas of attention needed to upgrade the materials and host inclusive sexual health materials for both youths and adults in the communities.

Contesting Sexual Prejudice to Support Sexual Minorities: Views of Chinese Social Workers

Professional development has been recognized as one of the strategies to effectively combat sexual prejudice and negative attitudes against lesbian, gay, bisexual, questioning/queer (LGBQ+) individuals and sexual minorities. Nevertheless, studies related to LGBQ+-inclusive training are rarely found in the Chinese Hong Kong context, where sexual prejudice still prevails without the establishment of antidiscrimination law. Sociocultural considerations, such as religious and parental influences, are obstacles to discussing the reduction of sexual prejudices, both within wider society and social work organizations, without institutional support. This paper aims to understand social workers’ perspectives on prejudice reduction training themes and perceived cultural barriers through qualitative in-depth interviews with 67 social workers. Qualitative thematic analysis yielded the following themes: (1) understanding sexuality; (2) initiating training legitimately; (3) contesting religious and cultural assumptions; (4) resolving value and ethical dilemma; (5) selecting relevant knowledge; (6) implementing diverse training strategies. The study suggests that social workers and service providers need to understand how sexual prejudice is manifested in Hong Kong through unique cultural forces. LGBQ+-inclusive content, addressing updated concepts and prejudice-free language, should be incorporated into the training curriculum. Intergroup contact, professional reflection, and experiential learning are suggested as training strategies (190).

Transgender-Competence in Social Work Education: The Relationship of School Contexts to Student Affirmation of Gender Expansive People

This study examined the relationship between Master of Social Work program's (MSW) support of lesbian, gay, bisexual, and transgender people (LGBT-competence), and social work student's self-perceived competence to support transgender people (transgender-competence). Thirty-four accredited MSW programs in the United States provided a sample of program directors, faculty members, and students (N = 1385). Hierarchical linear models revealed an MSW program's LGBT-competence was associated with the transgender-competence of its students, and that significant differences exist between organizational LGBT-competence and individual transgender-competence within schools of social work. Specifically, programs with greater LGBT-competence also had students who felt more competent to work with gender minorities. These findings suggest schools of social work provide different levels of support for gender minorities, and that such programs can take substantive action at an organizational level to improve the professional competence of future social workers to serve transgender populations. Implications for social work education are discussed.

A multicenter, multidisciplinary evaluation of 1701 healthcare professional students' LGBT cultural competency: Comparisons between dental, medical, occupational therapy, pharmacy, physical therapy, physician assistant, and social work students

Background

Efforts to characterize healthcare professional students’ lesbian, gay, bisexual, and transgender (LGBT) cultural competency are necessary to recommend educational initiatives. Very few studies have evaluated LGBT cultural competency across multiple healthcare disciplines, and no known studies have included students of other healthcare disciplines such as occupational therapy, pharmacy, physical therapy, and physician assistant.

Methods

Healthcare professional students (N = 1701) at three universities across the United States completed a survey consisting of demographics, experiential variables (i.e., LGBT patients and LGBT curricular hours), and the 7-point Likert LGBT-Development of Clinical Skills Scale (LGBT-DOCSS). LGBT-DOCSS scores, annual LGBT patients, and annual LGBT curricular hours were compared across healthcare disciplines.

Results

While students reported very high Attitudinal Awareness (M = 6.48, SD = 0.92), they endorsed moderate Basic Knowledge (M = 5.54, SD = 1.16) and low Clinical Preparedness (M = 3.78, SD = 1.28). After controlling for several demographic and experiential variables, there were significant differences among healthcare disciplines on LGBT-DOCSS scores, with social work students reporting the highest on all scores, and dental students reporting the lowest on all scores except Clinical Preparedness. There were also significant differences among healthcare disciplines on annual LGBT patients [mean range: 0.57 (dental) to 7.59 (physician assistant)] and annual LGBT curricular hours [mean range: 0.51 (occupational therapy) to 5.64 (social work)]. Experiential variables were significant predictors for Overall LGBT-DOCSS, Clinical Preparedness, and Basic Knowledge (all p < 0.001); LGBT patients was also a significant predictor for Attitudinal Awareness (p < 0.05).

Conclusions

Taken together, significant differences in LGBT cultural competency exist across healthcare disciplines, which may result from inadequate experiences with LGBT patients and LGBT curricular education. Future efforts should consider increasing LGBT patient contact hours and LGBT formal education hours to enhance healthcare students’ LGBT cultural competency.

The needs of LGBTI+ people within student nurse education programmes: A new conceptualisation

There is a growing body of international research evidence highlighting concerns around social exclusion and discrimination, significant health inequalities and health needs, and barriers to accessing effective healthcare for LGBTI + people. However, ways in which the healthcare needs of LGBTI + people can be addressed in student nurse education programmes have yet to be fully explored. The aim of this discussion paper is to present the evidence to support the inclusion of LGBTI + health throughout the nursing curriculum. A new conceptualisation of the full and effective integration of LGBTI + health content across and within the nursing curriculum is proposed. This can be achieved by further developing theory, skills simulation and practice learning opportunities. There is a need to ensure that nursing students are positioned and adequately prepared to effectively address concerns of social justice, reducing health inequalities, and providing responsive person-centred care for LGBTI + health service users.

Self-assessment of clinical competence with LGBT patients at a pediatric hospital

Hospital social workers were asked to complete the LGBT-DOCSS, a validated self-assessment of clinical competence, attitudes, and knowledge about working with lesbian, gay, bisexual (LGB), and transgender patients. As a group, they held positive attitudes about LGBT patients (Mean 6.9/7, SD .22) but were less confident about their knowledge (Mean 5.9/7, SD 0.96) and clinical preparedness (Mean 5.0/7, SD 1.24). In addition, providers felt significantly less competent about working with transgender than LGB patients. Factors that affected domains of self-assessed competence including experience working with LGB or transgender patients and the year training was completed.