Elsevier

Nurse Education Today

Volume 64, May 2018, Pages 204-214
Nurse Education Today

Review
The inclusion of LGBT+ health issues within undergraduate healthcare education and professional training programmes: A systematic review

https://doi.org/10.1016/j.nedt.2018.02.028Get rights and content

Abstract

Background

An inclusive health curriculum within undergraduate and continuing professional development programmes (CPD) should include issues related to people whom identify as LGBT+.

Objectives

The aim of this systematic review was to examine the education and training requirements of undergraduate students and health professionals regarding the inclusion of LGBT+ health issues.

Design

A systematic review of the available published empirical studies.

Data sources

A systematic literature search was undertaken of the following databases: CINAHL, PubMed, PsycINFO, Embase and Sociological Abstracts. All papers reviewed were from the years 2007 to 2017 and written in English.

Review methods

Three research questions informing the literature review were: (i) What are the education and training requirements of undergraduate students and health professionals regarding the health needs of LGBT+ people? (ii) What are the approaches utilized in the education and training of undergraduate students and health professionals regarding the health needs of LGBT+ people? (iii) What are the best practice examples of the education and training of undergraduate students and health professionals? Following the application of definitive criteria, 22 papers were included in the review. Quality appraisal and data extraction was undertaken by the two authors.

Results

The 22 papers were reviewed in detail in the final data analysis and synthesis where four main themes were identified: (1) Cultural competence and inclusivity. (2) Existing knowledge of LGBT+ health-related issues. (3) Curriculum developments and outcomes. (4) Evidence of best practice in education delivery.

Conclusion

The review highlights the importance of the inclusion of LGBT+ health-related issues within the health curriculum and continuing professional development programmes and the implications for education and training, clinical practice and research.

Introduction

To be more fully inclusive of the range of sexual and gender identities, including groups such as asexual, intersex, questioning and queer, the contemporary umbrella term LGBT+ is now being more widely adopted (Formby, 2017; Fredriksen-Goldsen, 2016). This is the term used throughout this paper.

There is a global interest in providing access to adequate healthcare for all (Australian Human Rights Commission, 2014; Department of Health, 2013; Ontario Human Rights Commission, 2014), and to specific groups such as people whom identify as lesbian, gay, bisexual (Institute of Medicine, 2011; Royal College of Nursing, 2016; Royal College of Nursing, 2017; World Health Organisation, 2013). However, while this is laudable, there remains significant gaps, in for example, the research evidence-base focusing on the distinct needs of people who are transgender and intersex. This is despite the existing concerns around social inclusion, human rights, discrimination and marginalisation (McCann and Brown, 2017) and the challenges and negative attitudes faced by LGBT+ people when accessing and using health services (Dearing and Hequembourg, 2014; Mayock et al., 2008; Stewart and O'Reilly, 2017).

Section snippets

Background

There is clear evidence of the distinct health needs and service requirements of people whom identify as LGBT+. Physical health needs include sexually transmitted infections (STIs) including Human immuno-deficiency virus (HIV), hepatitis (Cahill and Makadon, 2013; The Royal College of General Practitioners (Northern Ireland), 2015). Mental health conditions are also prevalent such as anxiety, depression, self-harm, suicidal ideation, attempted suicide and drug and alcohol use (King et al., 2008

Aim

The aim of this systematic review was to identify the educational needs of undergraduate students and health professionals and the approaches used in their education in relation to people who identify as LGBT+. The review questions were:

  • 1.

    What are the education and training requirements of undergraduate students and health professionals regarding the needs of LGBT+ people?

  • 2.

    What are the approaches utilized in the education and training of undergraduate students and health professionals regarding

Findings

The aim of this systematic review was to consider the literature around the education of undergraduate students and the training of health professionals in relation to people whom identify as LGBT+. Following analysis of the included studies, four main themes emerged from the data: (1) Cultural competence and inclusivity. (2) Existing knowledge of LGBT+ health-related issues. (3) Curriculum developments and outcomes. (4) Evidence of best practice in education delivery and evaluation. Each theme

Discussion

In many countries across the world there have been major legislative developments that have recognised and strengthened the position of LGBT+ people (World Health Organisation, 2013). These advancements have enshrined within legislation the fundamental human rights and equality directives necessary to tackle discrimination, marginalisation and social exclusion. The positive legislative developments include human rights, civil partnership, marriage equality, adoption and fostering (Henry and

Strengths and Limitations

This systematic review has identified important issues that need to be addressed to ensure that undergraduate students and health practitioners possess the appropriate knowledge, skills, attitudes and values necessary to meet the distinct health needs of LGBT+ people. Tools have been developed to assist educators, undergraduate students and practitioners to identify areas related to LGBT+ health where further development is required. The identification of areas of best practice about LGBT+

Conclusion

There are examples of the inclusion and integration of LGBT+ health needs and concerns within undergraduate health curriculum and CPD programmes for practitioners. This is encouraging and necessary given the significant health inequalities and distinct needs experienced by this population. There are examples of best practice in the delivery and evaluation of LGBT+ health within education programmes that offer a helpful starting point to guide developments more widely. It is also apparent from

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author Contributions

EM and MB designed the review, conducted searches, critical appraisal and analysis of the data. Both authors reviewed drafts and prepared and finalised the review for publication.

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