Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2019


Doctor of Nursing Practice (DNP)

Primary Advisor

Laurie Posey, Ed.D.; Dana Hines, Ph.D., RN


Background: Negative healthcare experiences may lead to poor health outcomes for transgender individuals, but nursing curricula give little attention to transgender healthcare. This study engaged nursing students in a simulated clinical experience (SCE) which featured a young adult transgender male in an acute care setting to determine whether participation would have a significant impact on student nurses’ attitudes and beliefs about transgender individuals.

Methods: The convergent parallel mixed-methods design used a one group pretest-posttest and a post-case debriefing interview to examine undergraduate nursing student attitudes and beliefs toward transgender individuals. Participants (N=27) reported their feelings via the Transgender Attitudes and Beliefs Survey (TABS), a 29-item inventory with three subscales: interpersonal comfort, sex/gender beliefs, and human value.


Paired-samples t-tests compared scores before and after the SCE. There were significant differences in the total pre (M=161.55, SD=19.95) and post (M=167.48, SD=23.25) SCE scores, t(26)=2.70, p=.01 and the sex/gender beliefs pre (M=46.40, SD=7.66) and post (M=52.33, SD=12.26) SCE subscale, t(26)=3.30, p<.001. There were not significant differences for the interpersonal comfort and human value subscales. Four themes (discomfort recognition, avoidance rationalization, identity dismissal, and values divergence) emerged from the post-SCE debriefing interviews.

Conclusions: These findings suggest that participation in a SCE can have a positive impact on students’ overall attitudes and beliefs about transgender individuals, particularly when examining rigid attitudes and beliefs regarding sex and gender. Additional research with larger groups of nursing students in different academic settings using other transgender SCE cases is needed to determine whether these results are generalizable.

Open Access


Included in

Nursing Commons



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