907 - Transforming Transgender Care

Over the last 10 years, the number of transgender people in the United States has increased. The 2015 US Transgender Survey reported 222 transgender people in Arkansas alone. A key question we need to address is how competent do future nurses feel to care for the transgender population? This presentation will describe the integration of a transgender scenario into simulation for nursing students. We will discuss the development of the scenario, the implementation of the scenario, and the students experience of the scenario through experiential learning.

According to the 2015 US Transgender Survey, the number of transgender people is growing. The survey reported that, due to being transgender, 35% of the Arkansas respondents had at least one negative experience in healthcare, 29% did not see a healthcare provider for fear of being mistreated, and 40% did not see a healthcare provider because they were unable to afford it (U.S. Transgender Survey, 2017). Research shows that transgender people are at a higher risk than cisgender people for mental health disorders including mood, anxiety, trauma, eating and suicidal ideation (Pinna, et al. 2022). Due to this statistical data, and the current healthcare climate, nursing students need to be prepared to care for this type of client when entering the profession. Thus, a transgender mental health scenario was created and integrated into the curriculum. Thereby creating a safe environment for student exposure to competent care of the transgender client.

This scenario was implemented in 2022. After gathering quality improvement data the team identified that the feedback was reliable, but the content validity was too broad. Refocusing on the objectives yielded insight into how reducing the number of variables presented would produce a more targeted result. This study will be completed this summer for the transition to RN nursing students. The created scenario is about a transgender male client admitted for suicidal ideation. The client has a history of major depressive disorder and has no support for his transition. The objective is to gain trust and rapport with the client to complete an admission history. This will necessitate the students asking the client about the transition process and how it is affecting the client’s mental health. There will be 2-4 nursing students that complete the simulation at one time. Prior to the simulation, the students will complete a pre-survey including questions about previous experience caring for transgender clients, related terminology, proper use of pronouns, preparedness, and confidence of caring for a transgender client. After the scenario and debrief, the students will answer a post-survey answering questions similar to those of the pre-survey to evaluate the efficacy of the scenario.

The needs assessment completed for the scenario determined that a transgender simulation was needed for students to have exposure before entering the profession. The target audience will be the transition to RN group of students in the mental health nursing course. Once this data is collected and reviewed for these students, the team will determine if any modifications should be made to the study before continuing.

As the number of transgender clients in the U.S. increases, nursing students need exposure in a safe controlled environment to learn how to competently care for these clients. The implementation of a transgender scenario in simulation gives nursing students the opportunity to critically think and care for clients without punitive consequences. With experience, the students will feel more confident in caring for a transgender client when entering the nursing profession.