The effects of educational curricula and training on LGBT‐specific health issues for healthcare students and professionals: a mixed‐method systematic review

Abstract

Introduction: Poor access of lesbian, gay, bisexual and transgender (LGBT) people to healthcare providers with clinical and cultural competency contributes to health inequalities between heterosexual/cisgender and LGBT people. This systematic review assesses the effect of educational curricula and training for healthcare students and professionals on LGBT healthcare issues.Methods: Systematic review; the search terms, strategy and process as well as eligibility criteria were predefined and registered prospectively on PROSPERO. A systematic search of electronic databases was undertaken. Screening for eligible studies and data extraction were done in duplicate. All the eligible studies were assessed for risk of bias. The outcome of interest was a change in participants’ knowledge, attitude and or practice.Results: Out of 1171 papers identified, 16 publications reporting 15 studies were included in the review. Three were non-randomized controlled studies and 12 had a pre/post-design; two had qualitative components. Bias was reported in the selection of participants and confounding. Risk reported was moderate/mild. Most studies were from the USA, the topics revolved around key terms and terminology, stigma and discrimination, sexuality and sexual dysfunction, sexual history taking, LGBT-specific health and health disparities. Time allotted for training ranged from 1 to 42 hours, the involvement of LGBT people was minimal. The only intervention in sub-Saharan Africa focused exclusively on men who have sex with men. All the studies reported statistically significant improvement in knowledge, attitude and/or practice post-training. Two main themes were identified from the qualitative studies: the process of changing values and attitudes to be more LGBT inclusive, and the constraints to the application of new values in practice.Conclusions: Training of healthcare providers will provide information and improve skills of healthcare providers which may lead to improved quality of healthcare for LGBT people. This review reports short-term improvement in knowledge, attitudes and practice of healthcare students and professionals with regards to sexual and LGBT-specific healthcare. However, a unified conceptual model for training in-terms of duration, content and training methodology was lacking.

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

“…This includes training regarding using the correct name and pronouns, which has been shown to be vitally important in validating TGD experiences [10,[12][13][14]. It can be argued that training programs in transgender healthcare would not only improve knowledge and professionalism and reduce discrimination but would address in part, the issue of lack of access to health services and inability to find doctors to provide gender-affirming treatments [15,16].…”

Cultural Competence of Nursing Faculty of the LGBT Population

“…Similarly in the nursing curriculum, nursing faculty reported that they devoted only 2 ½ hours teaching on LGBT health [6]. A recent review of the literature reported that globally, time allotted for training on LGBT or LGBT-related issues ranged from one hour to 42 hours [8]. These findings clearly illustrate the lack of education and training on LGBT care among the future healthcare workforce.…”

Evaluation of the four national lesbian, gay, bisexual, transgender, and queer (LGBTQ)-competent provider directories in the United States

“…LGBTQ patients. Institutional endeavors such as increasing formal LGBTQ education and curricular reform have shown promising bene ts for provider preparedness, knowledge, and attitudinal awareness [18]; however, these educational initiatives, at this time, are locally concentrated and are not standardized nor universal. Such shortfall highlights the need for platforms that enable patients to nd LGBTQcompetent healthcare providers.…”