Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug 30;19(1):325.
doi: 10.1186/s12909-019-1727-3.

Training to Reduce LGBTQ-related Bias Among Medical, Nursing, and Dental Students and Providers: A Systematic Review

Free PMC article

Training to Reduce LGBTQ-related Bias Among Medical, Nursing, and Dental Students and Providers: A Systematic Review

Matthew Morris et al. BMC Med Educ. .
Free PMC article


Background: Lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals experience higher rates of health disparities. These disparities may be driven, in part, by biases of medical providers encountered in health care settings. Little is known about how medical, nursing, or dental students are trained to identify and reduce the effects of their own biases toward LGBTQ individuals. Therefore, a systematic review was conducted to determine the effectiveness of programs to reduce health care student or provider bias towards these LGBTQ patients.

Methods: The authors performed searches of online databases (MEDLINE/PubMed, PsycINFO, Web of Science, Scopus, Ingenta, Science Direct, and Google Scholar) for original articles, published in English, between March 2005 and February 2017, describing intervention studies focused on reducing health care student or provider bias towards LGBTQ individuals. Data extracted included sample characteristics (i.e., medical, nursing, or dental students or providers), study design (i.e., pre-post intervention tests, qualitative), program format, program target (i.e., knowledge, comfort level, attitudes, implicit bias), and relevant outcomes. Study quality was assessed using a five-point scale.

Results: The search identified 639 abstracts addressing bias among medical, nursing, and dental students or providers; from these abstracts, 60 articles were identified as medical education programs to reduce bias; of these articles, 13 described programs to reduce bias towards LGBTQ patients. Bias-focused educational interventions were effective at increasing knowledge of LGBTQ health care issues. Experiential learning interventions were effective at increasing comfort levels working with LGBTQ patients. Intergroup contact was effective at promoting more tolerant attitudes toward LGBTQ patients. Despite promising support for bias education in increasing knowledge and comfort levels among medical, nursing, and dental students or providers towards LGBTQ persons, this systematic review did not identify any interventions that assessed changes in implicit bias among students or providers.

Conclusions: Strategies for assessing and mitigating implicit bias towards LGBTQ patients are discussed and recommendations for medical, nursing, and dental school curricula are presented.

Keywords: Cultural competence; Implicit bias; LGBTQ; Medical education.

Conflict of interest statement

The authors declare that they have no competing interests.


Fig. 1
Fig. 1
Example of search strategy applied in MEDLINE/PubMed
Fig. 2
Fig. 2
Flowchart of study selection

Similar articles

See all similar articles


    1. Waisel DB. Vulnerable populations in healthcare. Curr Opin Anesthesiol. 2013;26(2):186–192. doi: 10.1097/ACO.0b013e32835e8c17. - DOI - PubMed
    1. Freid VM, Bernstein AB, Bush MA. Multiple chronic conditions among adults aged 45 and over: Trends over the past 10 years. NCHS Data Brief. 2012;2012(100):1–8. - PubMed
    1. Institute of Medicine . Collecting sexual orientation and gender identity data in electronic health records: workshop summary. Washington DC: National Academy of Sciences; 2013.
    1. Quinn GP, Sanchez JA, Sutton SK, Vadaparampil ST, Nguyen GT, Green BL, et al. Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. CA-Cancer J Clin. 2015;65(5):384–400. doi: 10.3322/caac.21288. - DOI - PMC - PubMed
    1. Conron KJ, Mimiaga MJ, Landers SJ. A population-based study of sexual orientation identity and gender differences in adult health. Am J Public Health. 2010;100(10):1953–1960. doi: 10.2105/AJPH.2009.174169. - DOI - PMC - PubMed

Publication types

MeSH terms