Research Brief| Volume 16, P2-5, March 2018

Sexual Orientation/Gender Identity Cultural Competence: A Simulation Pilot Study

Published:December 08, 2017DOI:


      • To bridge the gap in lesbian, gay, bisexual, and transgender nursing education, a simulation pilot program was created.
      • A simulation observer guide provides objectives and expected outcomes for students.
      • A simulation scenario with lesbian, gay, bisexual, and transgender actors increases students' confidence and competence.



      Gaps in educational preparation may prevent nurses from providing culturally competent care to all patients independent of their sexual orientation and gender identity. In particular, the specific needs of patients in the lesbian, gay, bisexual, and transgender (LGBT) community are inadequately addressed in the traditional nursing curriculum.


      To bridge the gap in LGBT nursing education, a simulation program based on standardized patients, small group instruction, and evaluation was created. This program was used by senior-level undergraduate baccalaureate and accelerated nursing students enrolled in the required Community and Public Health Nursing Course at The University of Pennsylvania School of Nursing (n = 230).


      This program was implemented in the summer of 2016. Student evaluation revealed increased confidence in assessment and care of LGBT patients.


      When nursing students receive less training about LGBT issues than they need, simulation may be the optimal means for bridging that gap.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Simulation In Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Brennan A.M.
        • Barnsteiner J.
        • Siantz M.L.
        • Cotter V.T.
        • Everett J.
        Lesbian, gay, bisexual, transgendered or intersexed content for nursing curricula.
        Journal of Professional Nursing. 2012; 28: 96-104
        • Eliason M.J.
        • Dibble S.
        • DeJoseph J.
        Nursing's silence on lesbian, gay, bisexual and transgender issues. The need for emancipatory efforts.
        Advances in Nursing Science. 2010; 33: 206-218
        2020 topics and objectives: Lesbian, gay, bisexual and transgender health.
        U.S. Department of Health and Human Services, Washington, DC2013 (Retrieved from)
        • Institute of Medicine (IOM)
        The health of lesbian, gay, bisexual and transgender people: Building a foundation for better understanding.
        National Academies, Washington, DC2011
        • Lim F.A.
        • Brown D.V.
        • Jones H.
        Lesbian, gay, bisexual and transgender (LGBT) health: Fundamentals for nursing education.
        Journal of Nursing Education. 2013; 52: 198-203
        • Lim F.A.
        • Johnson M.
        • Eliason M.
        A national survey of faculty knowledge, experience and readiness for teaching lesbian, gay, bisexual and transgender health in baccalaureate nursing programs.
        Nursing Education Perspectives. 2015; 36: 144-152
        • Ranji U.
        • Beamesderfer A.
        • Kates J.
        • Salganicoff A.
        Health and access to care and coverage for lesbian, gay, bisexual, and transgender individuals in the US.
        Henry J. Kaiser Family Foundation, 2014
        • Substance Abuse and Mental Health Services Administration (SAMHSA)
        Top health issues for LGBT populations information and resource kit.
        (In HHS Publication No. (SMA) 12–4684) Substance Abuse and Mental Health Services Administration, Rockville, MD2012
      1. Ward, B. W., Dahlhamer, J. M., Galinsky, A. M., & Joestl, S. S. (2014). Sexual orientation and health among US adults: National Health Interview Survey, 2013. Retrieved from