Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Julie M. Brandy


LGBT (lesbian, gay, bisexual, transgender) health care is considered a national priority by The Institute of Medicine (IOM, 2011) and HealthyPeople 2020 (2013). The shortage of LGBT culturally competent health care providers is a top contributor to the oppression and discrimination affecting LGBT health (2013). The purpose of the evidence-based practice (EBP) project was to improve the cultural competence of nursing students by improving their knowledge, attitudes, and skills in working with the LBGT population. A multi-method intervention was provided to seniors in a baccalaureate program. The project took place at a private Midwestern university and utilized a pretest/post-test design. The Purnell Model for Cultural Competence provided the framework for this project and the Model for Evidence-Based Practice Change guided implementation. A questionnaire including demographics, knowledge, attitudes, and skills items, was completed by students during a required nursing course. A PowerPoint lecture, a panel discussion with members of the university LGBT group, and an interactive role-play activity between nursing students and LGBT group members was implemented during three 50-minute class periods over one week. The questionnaire was completed again following the intervention. Paired t-tests of the subscales knowledge, attitudes and skills revealed statistically significant improvement of each subscale, indicating improved cultural competence. The knowledge subscale t-test revealed a pretest mean of 4.21 (SD = 1.64) and a post-test mean of 6.81 (SD = 1.12), and a significant increase in knowledge from pretest to post-test (t(51) = -12.717, p =.000). The attitudes t-test found a pretest mean of 13.08 (SD = 3.99), a post-test mean of 11.34 (SD = 3 .17), and a significant decrease in negative attitudes (t(52)=4.86, p=.000). The paired-samples t test for the skills subscale identified a pretest mean of 20.23 (SD = 4.71), a post-test mean of 16.34 (SD = 4.87), and lack of skills significantly decreased, (t(52) = 5.64, p = .000). Maintenance of this intervention at the university would increase LGBT cultural competence of nursing students.