International Journal of Healthcare Simulation

Background and aim:

In July 2018 the government launched the national LGBT action plan to advance the rights of LGBT people to improve the way that public services work for them, regardless of their sexual orientation, gender identity or sex characteristics [1]. Transgender and gender diverse (TGD) [2], individuals continue to experience discrimination and disadvantages in accessing healthcare whilst often having complex health needs, furthermore, there is a gap in undergraduate curriculums on TGD patient care [3].

Activity:

A workshop was co-produced with members of the TGD community; scenario content was translated from their own experiences of prejudice and disrespect. In order to maximize participation, the scenario is delivered through forum theatre. It centres on an individual from the TGD community (played by a trans-actor) and the assumptions of a health professional (played by an actor). Audience members watch the scenario unfold; at closure of the first run through, the audience have a facilitated discussion. During the second run through, audiences are invited to change the behaviour of the health professional, leading to preferable, respectful and safe care. The actors have been trained to amend their actions as instructed by the audience members via the facilitator. After the simulation, the trans-actor de-roles and then describes the journey of transitioning their gender identity and presentation. The simulation and the lived experience are separated and treated as two separate elements of the training.

Results:

The co-produced scenario-based simulation has been successful in promoting respect and understanding of those from the TGD community. Audiences have been a broad range of professional groups: vocational, undergraduate and registrants. This session has been repeated over fifty times, with changes made to suit the audience background. Health professionals have had the opportunity to learn and practice appropriate communication skills. The lived experience component post-simulation was impactful in providing a personal insight into the challenges faced by TGD individuals. Participants reported an increase in knowledge of the needs of, and confidence in communicating with, members of the TGD community.

Conclusion:

The co-produced, replicable, scenario-based simulation, featuring forum theatre and lived experience, is an effective method of promoting respect and understanding of those from the TGD community. The simulation provides healthcare professionals with the opportunity to learn and practice appropriate communication skills. Separating the simulation with lived experience is an essential component, due to ethical and safety issues, although linking the two, strengthens the authenticity of the session.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.