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. 2023 Jul 19;23(1):519.
doi: 10.1186/s12909-023-04499-4.

Knowledge, behaviours, and training related to 2SLGBTQIA+ health education amongst entry-level physiotherapy students in Canada: results of a nationwide, cross-sectional survey

Codie A Primeau  1   2   3   4 , Holly T Philpott  5   6   7 , Kyle Vader  8 , Janelle Unger  9   5 , Christina Y Le  10 , Trevor B Birmingham  9   5   6   7 , Joy C MacDermid  9   5   6
Affiliations

Knowledge, behaviours, and training related to 2SLGBTQIA+ health education amongst entry-level physiotherapy students in Canada: results of a nationwide, cross-sectional survey

Codie A Primeau et al. BMC Med Educ. .

Abstract

Background: Individuals who identify as 2SLGBTQIA+ report worse health outcomes than heterosexual/cisgender counterparts, in part due to poor experiences with healthcare professionals. This may stem from inadequate 2SLGBTQIA+ health and inclusiveness training in health professional student education. The purpose of the study was to evaluate knowledge, behaviours, and training related to 2SLGBTQIA+ health education and inclusiveness for entry-level physiotherapy students in Canada.

Methods: We conducted a nationwide, cross-sectional survey with physiotherapy students from accredited Canadian physiotherapy programs. We administered the survey through Qualtrics and recruited students through targeted recruitment emails and social media posts on Twitter and Instagram between August and December 2021. Survey responses are reported as frequencies (percentage). We also completed multivariable logistic regressions to evaluate associations among question responses related to working with 2SLGBTQIA+ individuals (i.e., communication, feeling prepared and assessment competency). Covariates included training hours (< 10/10 + hours) and 2SLGBTQIA+ identity (yes/no).

Results: A total of 150 students responded to the survey, with 35 (23%) identifying as 2SLGBTQIA+ . Many students felt confident in communicating effectively with clients who identify as 2SLGBTQIA+ (69%). However, only half (47%) felt comfortable assessing clients who identify as 2SLGBTQIA+ . Routine practice of inclusive behaviours such as using pronouns, considering identities are fluid and a patient's gender identity and/or sexual orientation may shift from one visit to the next, and considering trauma-informed care practices were reported from less than half of the students (< 45%). Around 29% of students reported no 2SLGBTQIA+ training in their physiotherapy program, while 47% reported 0-10 hours, and 24% reported 10 + hours of training. Students with 10 + hours of training had 92% higher odds of feeling competent in assessing 2SLGBTQIA+ clients, compared to those with < 10 hours of training.

Conclusions: Entry-level physiotherapy students in Canada show a lack of understanding and awareness for 2SLGBTQIA+ health and inclusive behaviours which can meaningfully impact patient experience. Students report feeling incompetent when working with 2SLGBTQIA+ patients, which may be associated with lack of 2SLGBTQIA+ training in their programs. Greater efforts and attention towards increasing 2SLGBTQIA+ health education and inclusivity in Canadian entry-level physiotherapy programs is critically needed.

Keywords: EDI; Education; Inclusiveness; LGBTQ +; LGBTQ + health; Physiotherapy; Survey.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Self-reported physiotherapy student (n = 150) knowledge and clinical preparedness related to working with clients who identify as 2SLGBTQIA+ in a physiotherapy setting
Fig. 2
Fig. 2
Distribution of survey responses from physiotherapy students (n = 150) for self-reported understanding of 2SLGBTQIA+ terms they could accurately describe
Fig. 3
Fig. 3
Self-reported physiotherapy student (n = 150) behaviours related to working with clients who identify as 2SLGBTQIA+ in a physiotherapy setting
See this image and copyright information in PMC

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  • Commentary on Ravi et al.1.
    Setchell J, Ross MH. Setchell J, et al. Physiother Can. 2024 May 8;76(2):197-198. doi: 10.3138/ptc-2022-0019-cc. eCollection 2024 May. Physiother Can. 2024. PMID: 38725592 Free PMC article. No abstract available.

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