Improving Knowledge and Competency in Gender-Affirming Patient Care Among New Nurses in Sexual and Reproductive Health Care

Abstract

Objective: To improve knowledge and competency in providing gender-affirming patient care among newly licensed registered nurses (RNs) working in sexual and reproductive health (SRH).

Design: Pilot, pretest/posttest, descriptive design.

Setting and participants: Participating RNs were employed at a large academic health center in the southeastern United States. All RNs were providing SRH nursing and participating in the health center's new nurse residency program.

Methods and intervention: Participants completed an online synchronous training that introduced topics such as sex versus gender, gender dysphoria, and health disparities. This education was followed by in-person training, where an unfolding case study applied concepts to theoretical patient scenarios specific to reproductive health. Participants completed a 20-item survey with a single assessment retrospective pre-post design to measure change in knowledge and competency.

Results: Twelve RNs participated in this pilot study. Fewer than half had previously received instruction on providing care to trans∗ persons. Seven self-perceived knowledge and competency areas were evaluated with paired retrospective pre-post design questions. All areas measured showed increases from pretraining to posttraining. Participants also had the opportunity to respond to open-ended questions. Common themes identified in these responses include participants planning to maintain a greater awareness and intentionality with language and abandoning cisgender assumptions. Several participants also described health care-specific systemic barriers that could prevent a trans∗ patient from feeling comfortable.

Conclusion: Providing new graduate nurses with education specific to trans∗ patients may help them to feel more knowledgeable and competent when caring for these individuals in SRH settings.

Keywords: clinical competence; gender affirming; gender expansive; gender identity; gender nonconforming; nurse education; nurses; reproductive health; transgender; trans∗.