LGBTQ+ Psychosocial Concerns in Nursing and Midwifery Education Programmes: Qualitative Findings from a Mixed-Methods Study

Undergraduate Nursing Faculty Knowledge, Beliefs, and Experiences with Teaching LGBTQ+ Content: A Scoping Review

BACKGROUND

Nursing education research about inclusion of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) health content in undergraduate nursing curricula primarily focuses on student learning outcomes. There is less research evidence about the experiences of nursing faculty with teaching LGBTQ+ health topics.

PURPOSE

The purpose of this scoping review was to identify current evidence about pre-licensure, undergraduate nursing faculty knowledge, beliefs, and experiences with teaching LGBTQ+ content.

METHODS

Six EBSCO databases were searched for manuscripts published between 2012 and 2023. Peer-reviewed articles, published in English, describing studies of pre-licensure, undergraduate nursing faculty knowledge, beliefs, and experiences with teaching LGBTQ+ health content were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was used to guide inclusion of studies for review.

RESULTS

The literature search yielded 612 results, of which 58 were selected for full text screening. Twelve total studies were retained for this scoping review.

CONCLUSIONS

Faculty knowledge related to LGBTQ+ health is framed by a "deficit narrative," emphasizing physical and mental health risks and negative outcomes. Faculty beliefs are often measured with instruments that reflect cisnormativity or heteronormativity. There is an ongoing need to research the experiences of inclusion of LGBTQ+ content by pre-licensure, undergraduate nursing faculty.

LGBTQIA+ healthcare content in pre-registration nursing and midwifery curricula: A cross-sectional study

BACKGROUND

Nurses and midwives are expected to provide inclusive care for LGBTQIA+ populations. However, there is a paucity of knowledge on how well-prepared nursing and midwifery graduates are for this aspect of their role.

AIM

To explore LGBTQIA+ content in pre-registration nursing and midwifery curricula in Australia.

DESIGN

Cross-sectional study.

SETTINGS

Australian higher education institutions offering 86 pre-registration nursing and midwifery programs.

SAMPLE

Publicly available pre-registration nursing and midwifery course programs in Australia as presented in the online course handbooks of 25 randomly selected educational institutions.

METHODS

A LGBTQIA+ terminology matrix was developed to guide data extraction from subject titles, synopses, and learning outcomes. Explicit terms were those strongly associated with LGBTQIA+. Implicit terms were those indirectly associated with LGBTQIA+. Explicit and implicit LGBTQIA+ terms were analyzed for frequencies. Poisson regression was used to compare counts of LGBTQIA+ terms by course, subject, and university.

RESULTS

Among the 1093 subjects, no subject titles included explicit terms and 6 (0.55 %) titles included implicit LGBTQIA+ terminology. Explicit LGBTQIA+ terminology was identified in 54 (4.9 %) subject synopses and implicit terminology was found in 323 (29.6 %) subject synopses. Explicit LGBTQIA+ terms were identified in 14 (1.3 %) learning outcomes while implicit terms were found in 323 (29.6 %) learning outcomes. Group of Eight universities were more likely to use explicit and implicit LGBTQIA+ terminology than non-Group of Eight universities (p < 0.001; p = 0.035). Undergraduate programs included more LGBTQIA+ terminology than postgraduate programs (p = 0.019; p < 0.001). Core subjects were more likely to include LGBTQIA+ content than elective subjects (p < 0.001).

CONCLUSION

Explicit LGBTQIA+ terminology was minimal indicating limited overall content. The study results alert nursing and midwifery educators to take a targeted approach to teaching and learning with a LGBTQIA+ focus to support future nurses and midwives with quality knowledge and skills and ensure equitable and safe care for LGBTQIA+ people.

Providing Inclusive Midwifery Care for 2SLGBTQQIA+ People: Supporting Inclusion in Ontario's Midwifery Education Program

INTRODUCTION

Research on how midwives in North America are trained to provide inclusive care to Two Spirited, Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersex, or Asexual (2SLGBTQQIA+) clients is limited. The objective of this study was to define 2SLGBTQQIA+ inclusive midwifery care in the Canadian context and to explore the experiences of graduates of Ontario's Midwifery Education Program (MEP) to determine how midwives are trained to provide inclusive care.

METHODS

Ethics approval was obtained for this qualitative study to perform semistructured interviews with graduates from the MEP hosted by McMaster, Toronto Metropolitan, and Laurentian University. Eleven midwives were recruited and were required to be (1) graduates of Ontario's MEP, (2) registered midwives under the College of Midwives of Ontario or elsewhere, (3) currently practicing or on leave, and (4) self-identified advocates for 2SLGBTQQIA+ individuals.

RESULTS

When defining 2SLGBTQQIA+ inclusive care, midwives described the following principles: using inclusive language, changing the clinical environment, amending documents and websites, and tailoring care for each client. Participants recognized recent efforts by Ontario's MEP to provide 2SLGBTQQIA+ inclusive education while highlighting the need to expand 2SLGBTQQIA+ content across all courses, practicing inclusive care during placement, and ensuring an inclusive environment in the program.

DISCUSSION

Midwives in this study helped conceptualize inclusive midwifery care for 2SLGBTQQIA+ clients and underlined remaining gaps in Ontario's MEP toward providing student midwives with this competency by graduation. This study helped to fill a gap in the literature on how Canadian midwives are trained to provide 2SLGBTQQIA+ inclusive care and generated recommendations for Ontario's MEP to support prelicensure education that trains inclusive midwives. Having demonstrated gaps in how birth workers are trained to provide 2SLGBTQQIA+ inclusive care, this study points to the need for other prelicensure health professional programs to evaluate their training and to support 2SLGBTQQIA+ inclusive practice.

The Power of a Story: Enhancing Students' Empathy for Transgender Pregnant Men

BACKGROUND

Transgender individuals continue to face stigma and discrimination within the health care system. Sharing the lived experience of transgender pregnant men can increase awareness, understanding, and empathy for this underrepresented population.

METHOD

A transgender man (and advocate) shared his pregnancy experiences with students enrolled in a maternity course. Students completed pre- and postpresentation surveys on their perceptions of working with transgender patients and the importance of providing transgender-affirming care.

RESULTS

Students reported the speaker's presentation increased their awareness of the experience of transgender patients. Many students reported increased interest and desire to provide trans-affirming care.

CONCLUSION

Nursing faculty can provide opportunities for students to meet and speak with transgender patients as a strategy to increase empathy and reduce discrimination toward transgender patients in health care. [J Nurs Educ. 2022;61(8):489-492.].