Health disparities among transgender population continue to exist despite its increasing social acceptance in the US. Health disparities include increased rates of psychiatric disorders, substance abuse, suicide and HIV/DTDs (Healthy People 2020). It is important that nursing education incorporate into their curriculum the healthcare needs specific to this group as along with gender affirming care.
Introduction and Background: The aim of the study was to assess the knowledge and comfort levels of nurse practitioner students would have with transgender patients as well as evaluate the amount of education provided to them about transgender health care needs.
Method: Study participants Fifty-four (54) nurse practitioner students enrolled in a master’s of science program participated in the study. Nurse practitioner students in two courses were selected for the study. One course, Advance health assessment and a second course, Primary adult and geriatric care. The advanced health assessment course is one of the graduate APRN courses, which focuses on communication, history taking and assessment skills. The primary adult and geriatric care course focused on clinical decision-making, diagnosis and management of adult and geriatric medical/health problems.
Intervention: Students were informed during the fall 2016 semester they would be participating in an educational evaluation project on transgender care. Instructional materials on transgender care included readings, video, role-play and class discussions during one class session. Prior to providing the instructional materials, a pre-test “Assessing medial attitudes toward transgender care (Skukla, Dundas, Asp, Saltzman &Duggan, 2015) was administrated. Students were given two weeks to read the assigned transgender materials. After the class discussion, a posttest of the attitudes survey was administrated afterwards.
Findings: Overall, the mean age of the students was 33.7 years, 11.7 % males and 78.3% females with 23 AGNP and 31 FNP students. Forty-eight (48.3%) reported that they have not cared for a transgender patient while 41.7% had cared for a transgender patient. Prior to the transgender education activity, the students rated that they were between “very uncomfortable“ to “somewhat uncomfortable” when caring for a transgender patient with students reporting they received an average of 1.5 hours of education on transgender care and this increased to 3.4 hours after the education activity(P< .001) in the study. In relation to professional and comfort levels in providing transgender patient care, the T-test results also showed statistically significant differences between the pre and posttests with student’s comfort levels in the various aspects of transgender care. These areas include your education has prepared to care for transgender patients (p.00), providing mental health care to transgender patients(p.035), prescribing hormone therapy to achieve gender transition (p.030), and referring transgender patients for reassignment surgery (p.033). Students who reported that they had experience caring for transgender patients had felt more comfortable and competent with transgender care in more areas. It is reported that there is minimal content and time spent on the management of care for transgender patients in the advanced practice-nursing curriculum. Nurses with no experience and who have education on the care of transgender patients feel more comfortable and competent in providing care. In addition, nurses who have cared for transgender patients felt more comfortable and competent in more aspects in providing care to this population. Students reported they were less uncomfortable because of the education content on transgender care provided in the advanced health assessment and primary adult and geriatric courses. Increasing student’s comfort and knowledge on transgender care would improve communication and patient engagement. The results of the study also supported by Shukla et al, (2015) and Sanchez, Rabatin, Sanchez, Hubbard and Kalet (2006) who reported that education on transgender care increases comfort and competence to this population. Integrating transgender care content in graduate nursing curriculum needs to further be implemented to decrease the health disparity found among this group (Lim &Hs, 2016; IOM, 2011). Limitations to the study include the small sample size and are only generalizable to the nurse practitioner students located in this university.
Audience Take Away:
• Review the amount of formal education NP students have received about the transgender population.
• Expand knowledge in area of specific health needs of the transgender population.
• Evaluate the student’s awareness and comfort level on transgender.
• Promote increase awareness on personal sexual preference and care management of the transgender population among nurse practitioner students to decrease health care disparities.