Health History Skills for Interprofessional Learners in Transgender and Nonbinary Populations

Maria N. Ruud, Jennifer M. Demma, Anne Woll, Joseph M. Miller, Samantha Hoffman, Melissa D. Avery

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Introduction: Transgender and nonbinary peoplehave been identified as vulnerable and clinically underserved and experience health disparities. Lack of health care provider knowledge about transgender and gender diverse populations is a barrier to care, impacting health outcomes. The aim of this project was to develop, implement, and evaluate a simulation learning activity for midwifery and women's health nurse practitioner students and obstetrics and gynecology residents to interact with transgender and nonbinary individuals, with the goal of enhancing health history taking comfort and skills. Methods: A partnership was formed among University faculty and simulation educators, a community clinic providing gender-affirming care, and members of transgender and gender diverse populations who served as patient-teachers. Two cases frequently encountered in clinics providing care to transgender individuals were developed for the simulation. Learners were divided into interprofessional groups of 3 and completed one of 2 case scenarios with a patient-teacher. Learners and patient-teachers debriefed after the simulation to discuss and reflect on the experience. Results: Thirty-three learners participated in the simulation, 12 midwifery students, 16 women's health nurse practitioner students and 5 obstetrics and gynecology residents. Significant differences were observed for all comfort and skills questions, showing increased perceived comfort and skills from pre- to postsimulation. There were no significant differences in attitude responses. Discussion: We successfully created and implemented a new sexual and reproductive history taking skills simulation in partnership with community clinic staff and transgender and nonbinary persons. The session was well received by learners and patient-teachers. Learners demonstrated significant improvements in comfort and skills in history taking in this setting and provided favorable feedback about the experience. This simulation can serve as a guide to others providing education to future midwives, women's health nurse practitioners, and obstetrician-gynecologists.

Original languageEnglish (US)
Pages (from-to)778-786
Number of pages9
JournalJournal of Midwifery and Women's Health
Issue number6
Early online dateAug 25 2021
StatePublished - Nov 1 2021

Bibliographical note

Funding Information:
The authors wish to acknowledge the patient-teachers; Family Tree Clinic, St. Paul, MN; Michelle Mathiason, MS, Biostatistician, University of Minnesota, School of Nursing; Institute for Diversity, Equity, and Advocacy-University of Minnesota; the University of Minnesota School of Nursing; and the Josiah Macy Jr. Foundation for their generous support of this project. This study was presented in part at the 2020 National Organization of Nurse Practitioner Faculties 46th Annual Conference, April 25, 2020; the Best Practices in Health Sciences Education Conference at the University of Minnesota, April 30, 2020; and the Association of Standardized Patient Educators 2020 Annual Conference, June 12, 2020.

Publisher Copyright:
© 2021 by the American College of Nurse-Midwives


  • health professions education
  • interprofessional education
  • midwife
  • nonbinary
  • nurse practitioner
  • obstetrics and gynecology resident
  • simulation
  • transgender


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