LGBTQ+ health education interventions for nursing students: A systematic review

Abstract

Objectives: Nurses are the largest segment of the American healthcare workforce, yet little is known about how American nursing students are educated about lesbian, gay, bisexual, transgender, queer, and other individuals' (LGBTQ+) health and the efficacy of these trainings. This systematic review assessed articles in English that quantitatively evaluated the effects of curricula and training for nursing students regarding LGBTQ+ health and examined their effects on students' outcomes.

Design: Systematic review.

Data sources: Six electronic databases (PubMed, CINAHL, British Nursing Index, Embase, Scopus and PsycINFO).

Review methods: Controlled vocabulary and/or keywords were used for each database. Of the initial 1766 citations, 26 articles met inclusion criteria. Data extracted included study design, sample characteristic/size, training topic, modality, duration, trainer, measurement tool, training target, effect size, and key finding.

Results: Nearly 80 % of the reviewed studies were published between 2018 and 2021. All studies included were quasi-experimental: pretest-posttest with control (n = 3), without control (n = 20), and posttest only without control (n = 3). Training modalities were categorized into four groups: multimodal pedagogy with (n = 7) and without simulation (n = 6), single modality with simulation (n = 6) and with didactic lectures (n = 7). Eight studies employed LGBTQ+ people as trainers. Eight studies included interprofessional students; 18 studies engaged only nursing students. Interventions improved students' knowledge about LGBTQ+ health (n = 8), attitudes toward LGBTQ+ communities (n = 8), comfort level regarding interacting with LGBTQ+ individuals (n = 7), confidence in providing LGBTQ+ inclusive care in practice (n = 13) and LGBTQ+ cultural competence in nursing care (n = 2).

Conclusions: Educating and qualifying nursing students about LGBTQ+ health may improve their knowledge, attitudes, and skills when interacting with LGBTQ+ patients and may reduce health disparities for LGBTQ+ clients. Broad integration of content and competencies in LGBTQ+ health and well-being in nursing curricula should be prioritized. Future research should include rigorous, longitudinally designed evaluation of training curricula focusing on students' actual behavior changes. Evaluation should include comparison groups and validated measurement instruments about LGBTQ+ health education constructs specifically for nursing students.

Keywords: LGBTQ+ health; Nursing education; Nursing students.