C920 Task 1 Curriculum Needs Analysis Example

Curriculum Needs Analysis: The Case for a Required Module on the Health of LGBTQ+ Patients in a Baccalaureate Nursing Program

Student Name

Leavitt School of Health, Western Governors University

C920: Contemporary Curriculum Design and Development in Nursing Education, Task 1

Course Instructor

Month Day, Year

Curriculum Needs Analysis: The Case for a Required Module on the Health of LGBTQ+ Patients in a Baccalaureate Nursing Program

Purpose and Framework

This needs analysis examines whether a composite four-year baccalaureate nursing program should add a required module on the health of lesbian, gay, bisexual, transgender and queer (LGBTQ+) patients. It uses the analysis phase of the ADDIE model of instructional design, which asks designers to establish the performance gap, the learners, the resources and the constraints before designing any instruction (Branch, 2009). The program enrolls about 120 students per cohort, has no dedicated content on LGBTQ+ health and addresses it only in a single lecture slide on sexual orientation in the health assessment course.

Evidence of a Workforce and Practice Gap

The national evidence is long-standing. A landmark report on LGBT health concluded that LGBT people face health disparities across the life course, including higher rates of certain mental health and substance use conditions and barriers to care that include clinicians' lack of knowledge, and called for better training of health professionals (Institute of Medicine, 2011). Nursing education has been slow to respond: a national survey of faculty in baccalaureate programs found limited preparation among faculty to teach LGBT health and little curricular time devoted to it (Lim et al., 2015). The profession's current agenda asks schools to prepare graduates to advance health equity for all populations, which includes sexual and gender minority patients (National Academies of Sciences, Engineering, and Medicine [NASEM], 2021).

Practice partners confirm the gap locally. In interviews with the nurse educators at the program's three main clinical partners, all three described new graduates who were uncertain how to ask about sexual orientation and gender identity during admission, who used a transgender patient's legal name rather than the name in the record's preferred-name field, or who did not know how gender-affirming hormones affect laboratory reference ranges and medication decisions. One partner's patient experience team reported two formal complaints in the past year from transgender patients about being misgendered by nursing staff.

Program Data on Graduates and Students

The program's own data point in the same direction. On the most recent end-of-program survey, 64% of graduating students rated themselves as 'not prepared' or 'somewhat prepared' to care for transgender patients, compared with 12% for older adults and 18% for patients with limited English proficiency, the two populations the curriculum addresses explicitly. A review of course syllabi found no learning outcome that mentions sexual orientation or gender identity, and the health assessment course's history-taking template asks only about 'sex' with two options. Faculty survey responses echoed the national finding: 7 of 18 faculty said they would feel comfortable teaching the content without preparation.

The Performance Gap Stated in Measurable Terms

The analysis phase requires the gap to be stated as a difference between what graduates can do and what they should be able to do. Desired performance: graduates ask about sexual orientation and gender identity respectfully during health assessment, document and use a patient's name and pronouns correctly, recognize health risks and screening needs that differ for LGBTQ+ patients, account for gender-affirming hormones in medication and laboratory interpretation, and advocate for inclusive care. Current performance: on the end-of-program survey, fewer than four in ten graduates felt prepared to do so, partners report errors in name and pronoun use and in history-taking, and no course outcome addresses these skills. The gap is therefore one of knowledge, skill and confidence, and it is large enough to affect patient experience and safety.

Learners and Context

The learners are traditional and second-degree baccalaureate students who will care for a diverse metropolitan population. Students vary widely in prior exposure: some identify as LGBTQ+ themselves, some have never discussed the subject, and a few may hold religious or cultural views that make the content uncomfortable. The module therefore needs to be framed around professional competence and patient safety, leave room for respectful discussion and protect students who share personal experiences. Placement matters: content is most useful once students have learned basic health assessment and before they begin their medical-surgical and community rotations, which points to the second year.

Resources and Constraints

Resources include two faculty members with clinical experience in an LGBTQ+ health center, a simulation lab with standardized patient funding, a university center for inclusion willing to co-teach, and national teaching materials. Constraints are real. The curriculum is already full, and the state board requires a set number of clinical hours, so any new content must fit within existing credit hours by replacing or integrating material. Faculty development is needed before the module launches. And some community stakeholders may object, which requires the program to explain the module's grounding in patient safety and professional standards.

Stakeholder Input

The curriculum committee, student government, clinical partners and the program's community advisory board were consulted. Students and partners supported a required module; the advisory board supported it on the condition that it focus on clinical skills and outcomes; two faculty members preferred integrating content into existing courses rather than creating a separate module. The design phase will address this by combining a short dedicated module with threads in existing courses.

Alternatives Considered

Three alternatives to a new module were considered. Leaving the curriculum unchanged would not close the gap, given the survey and partner data. Relying on an optional elective would reach only students already interested in the topic, not the whole cohort who will care for these patients. Integrating content only as brief threads in existing courses, as two faculty members preferred, would be less disruptive but risks the content being cut when courses run short on time, which is what happened to the single lecture slide in health assessment. A required module combined with threads in existing courses balances depth with integration and gives the content protected time in the curriculum.

Conclusion and Recommendation

The needs analysis establishes a clear gap between what graduates need to provide safe, respectful care to LGBTQ+ patients and what the curriculum currently teaches, supported by national evidence, practice partner reports and program data. It recommends a required two-credit module in the second year, integrated with threads in health assessment, pharmacology and community health, and preceded by faculty development. The course design and evaluation plan that follows turns this recommendation into objectives, learning activities and evaluation methods.

References

Branch, R. M. (2009). Instructional design: The ADDIE approach. Springer. https://doi.org/10.1007/978-0-387-09506-6

Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. The National Academies Press. https://doi.org/10.17226/13128

Lim, F., Johnson, M., & Eliason, M. (2015). A national survey of faculty knowledge, experience, and readiness for teaching lesbian, gay, bisexual, and transgender health in baccalaureate nursing programs. Nursing Education Perspectives, 36(3), 144-152. https://doi.org/10.5480/14-1355

National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. The National Academies Press. https://doi.org/10.17226/25982