Improving Emergency Health Care Workers’ Knowledge, Competency, and Attitudes Toward Lesbian, Gay, Bisexual, and Transgender Patients Through Interdisciplinary Cultural Competency Training

Introduction: Emergency staff members have a unique role in providing episodic care to marginalized populations. The lesbian, gay, bisexual, and transgender (LGBT) community is a marginalized population that is routinely encountered by ED staff. Implicit prejudice may influence emergency staff interactions and contribute to distrust of health care providers by some members of the LGBT community. The purpose of our study is to evaluate aggregate ED health care team member's knowledge and attitudes toward lesbian, gay, bisexual, and transgender people pre- and post-cultural competency training education. Methods: A pre-/post-intervention design was used to assess the impact of LGBT cultural competency training. The Ally Identity Measure (AIM) was administered to an unmatched sample of ED nurses, nurse practitioners, unit secretaries, and physicians. Consisting of 3 domains— knowledge and skills, openness and support, and awareness of oppression experienced by the LGBT community (Cronbach's alphas of 0.76 to 0.88)—the AIM assessed for aggregate differences among our staff pre- and post-cultural competency training. Results: Pre-survey data revealed 85.3 % (n = 81) of staff had no previous LGBT education specific to the needs of the population. Post-survey data collected between 3 to 5 months after the education intervention demonstrated a total index mean increase of 8.8% (P < 0.001) in the areas of knowledge and skills, openness and support, and awareness of oppression regarding the LGBT community. Discussion: Status post-cultural competency training, the AIM results indicated that our team's collective knowledge about challenges facing the LGBT community increased, and the aggregate scores reflected more openness, support, and awareness of oppression by our staff. This elevated self-awareness and increased knowledge may aid in creating a more open, supportive patient experience for the LGBT community members seeking care at our facility.