Enhancing student nurses’ cultural competence in the care of transgender individuals: An integrative review of educational approaches

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.