Objective: This integrative review aimed to synthesise and critically examine educational strategies in improving cultural competence among pre-registration student nurses when caring for transgender patients. It also sought to inform future educational development and identify gaps for further research.
Background: The 2021 UK Census identified at least 262,000 individuals (0.5 % of the population) as transgender, though this is likely underestimated due to stigma and underreporting. Despite evolving public attitudes, 16 % of respondents in a 2019 survey admitted prejudice towards transgender people. The Nursing and Midwifery Council (NMC, 2018) emphasises dignified, non-discriminatory care for all, yet many LGBTQ+ individuals report negative healthcare experiences. Research consistently highlights gaps in education for healthcare professionals, affecting their confidence and ability to provide competent care for transgender individuals.
Design: An integrative review design was adopted, enabling the synthesis of diverse evidence sources to explore educational strategies that enhance cultural competence in pre-registration nursing curricula.
Methods: Using Whittemore and Knafl's (2005) integrative review framework and Joanna Briggs Institute (2024) mixed-methods guidance, nine studies were synthesised. A constant comparison approach enabled integration of qualitative and quantitative findings.
Results: No single educational strategy emerged as most effective. However, multi-method approaches, especially those involving active learning were consistently linked to improvements in knowledge, attitudes and skills CONCLUSION: Findings highlight the need for a standardised, comprehensive approach to cultural competence education in nursing curricula. Integrating such content has the potential to improve care quality, reducing health disparities and ensuring equitable, person-centred care for transgender individuals.
Keywords: Cultural competence; Cultural humility; Education; Gender diverse; LGBTQ+; Student nurse; Transgender; Undergraduate nurse.
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