An Exploration of Factors of LGBT Cultural Competency Among Prospective Healthcare Professionals

Background: LGBT patients have experienced discrimination when attempting to receive healthcare services and cultural competency of health care providers is considered to influence their experience and health outcomes. This study aims to assess the level of LGBT CC (cultural competency) among prospective professionals who are expected to provide health care services and to explore factors that affect those attributes.

Methods: Using a cross-sectional online survey, data were collected from a convenient sample of 57 different healthcare students (social work, nursing, and speech and language) in a faith-based university. Multiple linear regressions were conducted to test the effect of the following factors of LGBT CC beliefs and behaviors (measured by gay affirmative practice (GAP) scale): postsecondary experience (such as having taken courses related to cultural competency), relations with LGBT individuals, and religiosity measured by the Duke University Religion Index (DUREL).

Results: The sample were mostly female (91%), Christian (91%), and white (65%). In regard to the assessment of the LGBT CC-belief, the respondents agreed that practitioners should have LGBT CC (M=4.53). They assessed their own behavioral competency (LGBT CC-behavior) somewhat lower than the expectation (M=3.64). For the regression of LGBT CC-belief, only one factor was significant: having close relations with LGBT, β=.367. For LGBT CC-behavior, three factors were significant: being female (β=.418), level of religiosity (β=-.357), and having close relations with LGBT (β=.260). Surprisingly, the number of culturally competent courses was not significant with any of the LGBT CC outcomes although social work students had taken LGBT related courses (M=.97) more than nursing students (M=.40) and speech and language (M=.35). Additional analyses show that social work students had a higher LGBT CC-belief (M=4.69) than the others (M=4.31). The difference in the LGBT CC-behavior between social work students (M=3.75) and the others (M=3.50) was not statistically different.

Conclusions and Implications: Findings suggested that factors for CC-behavior are different from those of CC-beliefs and it is challenging to connect beliefs to actions. Institutions need to engage students/employees in critical thinking to understand the impact of experiences and values on practice and social policy in regard to LGBT rights. Experiential learning approaches would be beneficial than traditional learning methods that focus on knowledge and beliefs. Social work educators in faith-based universities should be more intentional in creating an environment that allows students to have open discussion of how religious beliefs impact attitudes and actions in practice. It is also beneficial that religious institutions who are limiting on acceptance of certain minority groups give the option to interact with diverse groups where these students/employees have the opportunity to be trained appropriately. These specific interaction opportunities may also be supported by the finding: relations with LGBT individuals, that also contributes to diversity policies within institutions as it is important for diversity interactions to gain cultural competence. This study implies the further need for research. However, it brings awareness to universities, healthcare facilities, policy makers, and other professionals that impact the LGBT population and people that potentially interact with these LGBT individuals.