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Neish C, Ross MH. Physiotherapy students hold varying attitudes, beliefs and learning preferences regarding LGBTQIA+ healthcare: a mixed methods study. J Physiother 2024; 70:302-310. [PMID: 39327171 DOI: 10.1016/j.jphys.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 08/10/2024] [Accepted: 08/27/2024] [Indexed: 09/28/2024] Open
Abstract
QUESTIONS What are physiotherapy students' attitudes and beliefs towards providing care for lesbian, gay, bisexual, transgender, queer, intersex, asexual and other related identities (LGBTQIA+) individuals? What education have students received on LGBTQIA+ healthcare needs? What are students' preferences for receiving this content? DESIGN Mixed-methods design using a purpose-built online survey. PARTICIPANTS Australian undergraduate and postgraduate physiotherapy students. METHODS Participants were invited to complete an online survey. Data were collected on: personal, clinical, professional and educational exposure to LGBTQIA+ identities and topics; heteronormative attitudes and beliefs via the modified Heteronormative Attitudes and Beliefs Scale (mHABS); and perspectives about LGBTQIA+ care. Welch's t-test and analysis of variance were used to analyse differences in mHABS and subscale scores between groups based on personal, clinical, professional and educational exposure. Open text responses were analysed thematically. Quantitative and qualitative data were first analysed separately and then cross-validated for integration in the results. RESULTS The survey was completed by 324 eligible students. Cross-comparison of data generated four key themes pertaining to students' perspectives about working with the LGBTQIA+ community and education about LGBTQIA+ health: students with closer personal relationships to the LGBTQIA+ community demonstrated more inclusive attitudes and beliefs about LGBTQIA+ care and education; there are cis/heteronormativity and negative views towards LGBTQIA+ health; students who are ambivalent about LGBTQIA+ care hold egalitarian beliefs; and integrated education on LGTBQIA+ health delivered by members of the community is important. CONCLUSION Physiotherapy students' attitudes and beliefs about the LGBTQIA+ community were diverse, with cis/heteronormativity prevalent in respondents. Students with closer relationships to the LGBTQIA+ community demonstrated more inclusive attitudes and beliefs. The lack of understanding of LGBTQIA+ needs and relevance to physiotherapy highlights the need for improved LGBTQIA+ education in physiotherapy curricula.
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Affiliation(s)
- Calum Neish
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Megan H Ross
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
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Primeau CA, Philpott HT, Vader K, Unger J, Le CY, Birmingham TB, MacDermid JC. Knowledge, behaviours, and training related to 2SLGBTQIA+ health education amongst entry-level physiotherapy students in Canada: results of a nationwide, cross-sectional survey. BMC MEDICAL EDUCATION 2023; 23:519. [PMID: 37468895 DOI: 10.1186/s12909-023-04499-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 07/04/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Individuals who identify as 2SLGBTQIA+ report worse health outcomes than heterosexual/cisgender counterparts, in part due to poor experiences with healthcare professionals. This may stem from inadequate 2SLGBTQIA+ health and inclusiveness training in health professional student education. The purpose of the study was to evaluate knowledge, behaviours, and training related to 2SLGBTQIA+ health education and inclusiveness for entry-level physiotherapy students in Canada. METHODS We conducted a nationwide, cross-sectional survey with physiotherapy students from accredited Canadian physiotherapy programs. We administered the survey through Qualtrics and recruited students through targeted recruitment emails and social media posts on Twitter and Instagram between August and December 2021. Survey responses are reported as frequencies (percentage). We also completed multivariable logistic regressions to evaluate associations among question responses related to working with 2SLGBTQIA+ individuals (i.e., communication, feeling prepared and assessment competency). Covariates included training hours (< 10/10 + hours) and 2SLGBTQIA+ identity (yes/no). RESULTS A total of 150 students responded to the survey, with 35 (23%) identifying as 2SLGBTQIA+ . Many students felt confident in communicating effectively with clients who identify as 2SLGBTQIA+ (69%). However, only half (47%) felt comfortable assessing clients who identify as 2SLGBTQIA+ . Routine practice of inclusive behaviours such as using pronouns, considering identities are fluid and a patient's gender identity and/or sexual orientation may shift from one visit to the next, and considering trauma-informed care practices were reported from less than half of the students (< 45%). Around 29% of students reported no 2SLGBTQIA+ training in their physiotherapy program, while 47% reported 0-10 hours, and 24% reported 10 + hours of training. Students with 10 + hours of training had 92% higher odds of feeling competent in assessing 2SLGBTQIA+ clients, compared to those with < 10 hours of training. CONCLUSIONS Entry-level physiotherapy students in Canada show a lack of understanding and awareness for 2SLGBTQIA+ health and inclusive behaviours which can meaningfully impact patient experience. Students report feeling incompetent when working with 2SLGBTQIA+ patients, which may be associated with lack of 2SLGBTQIA+ training in their programs. Greater efforts and attention towards increasing 2SLGBTQIA+ health education and inclusivity in Canadian entry-level physiotherapy programs is critically needed.
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Affiliation(s)
- Codie A Primeau
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.
- Bone and Joint Institute, Western University, London, ON, Canada.
- Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, N6A 3K7, Canada.
| | - Holly T Philpott
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
- Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, N6A 3K7, Canada
| | - Kyle Vader
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Janelle Unger
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Christina Y Le
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Trevor B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
- Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, N6A 3K7, Canada
| | - Joy C MacDermid
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
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