03/02/2023
By Maureen Martin

The Zuckerberg College of Health Sciences, Solomont School of Nursing, invites you to attend a doctoral dissertation defense by Courtney Orelup-Fitzgerald on "The Impact of Gender Identity and Gender Outness on Incivility, Stress, and Professional Identity in Health Care Students."

Date: Thursday, March 16, 2023
Time: 3 to 6 p.m.
Location: This will be a virtual defense via Zoom. Those interested in attending should email Courtney_OrelupFitzgerald@student.uml.edu and committee chair Lisa_Abdallah@uml.edu at least 24 hours prior to the defense to request access to the meeting.

Committee Chair: Lisa Abdallah, Ph.D., RN, CNE, Professor, Solomont School of Nursing, University of Massachusetts, Lowell

Committee Members:

  • Ainat Koren, Ph.D., DNP, PMHNP, Solomont School of Nursing, University of Massachusetts Lowell
  • Rebecca Gore, Ph.D., Zuckerberg College of Health Sciences, University of Massachusetts Lowell
  • Suha Ballout, Ph.D., RN, College of Nursing and Health Sciences, University of Massachusetts Boston

Abstract:

Background: Individuals who identify as noncisgender report experiencing stigma in nearly all aspects of their lives, including in the college and academic setting. Studies show that noncisgender identifying students report incivility in the classroom setting (both in person and online), but there is a dearth of literature on the experiences noncisgender identifying students have in educational work outside of the formal classroom. Health care students perform educational work providing care to patients in a clinical learning environment (CLE), where they interact with health care professionals. The perception of incivility between noncisgender students and health care professionals while in the CLE has not been well studied. There is also a research gap in investigating the effects of incivility on students and whether experiencing incivility in the CLE impact a students’ sense of professional identity.

Aim: To determine if cisgender and noncisgender health care students report differences in incivility experiences in the CLE, and the relationship between incivility, stress, and sense of professional identity. Additionally, for noncisgender identifying participants, the impact of openness about gender identity on incivility experiences, stress levels, and sense of professional identity, and if a sense of fortitude mediates the relationship between the variables.

Method: This cross-sectional study used the Gender Minority and Resilience Model to investigate the impact gender identity and gender outness has on health care students’ experiences in the CLE. A national sample of nursing, occupational therapy, and physical therapy students at all educational levels completed validated survey tools reporting on incivility experiences, level and type of stress, and sense of professional identity. Students identifying as noncisgender completed an additional tool asking about gender outness, internalized transphobia, and fortitude. Qualitative data to enhance and clarify the quantitative results was obtained via open-ended items and interviews with noncisgender identifying students.

Results: Students identifying as noncisgender report higher levels of incivility, higher levels of stress, and significantly lower professional identity compared to cisgender students. Noncisgender students who were more open about gender identity reported increased stress levels and a reduced sense of professional identity. Reporting a higher level of incivility or stress predicted a lower sense of professional identity. Students with higher levels of internalized transphobia also reported higher levels of stress and reduced sense of professional identity. Fortitude was not a significant mediator for any variable.

Conclusion: Incivility does exist for noncisgender health care students outside of the formal classroom. Noncisgender health care students face challenges in the CLE that can lead to more stress and a lower sense of professional identity, possibly impeding their ability to achieve successful program outcomes. Both educational health care programs and health care facilities must have awareness of this issue and work to engage students and staff in healthy, civil behaviors to promote personal and educational achievement and ensure workforce diversity.