Grace Hoyer

Date Approved


Date Posted


Degree Type

Open Access Dissertation

Degree Name

Doctor of Education (EdD)

Department or School

Leadership and Counseling

Committee Member

Ronald Williamson, EdD, Chair

Committee Member

Jaclynn Tracy, PhD

Committee Member

Barbara Scheffer, RN, EdD

Committee Member

James Berry, PhD


Higher nursing education has demonstrated effective modalities in leadership, practice, and health policy (Antrobus & Kitson, 1999). However, advancement in understanding populations of non-binary sexual identities need further recognition in nursing academic education, within both faculty and administration realms.

This study is about transcultural efficacy (TSE), an essential component of nursing education and leadership, as it relates to aspects of non-binary sexual identities. Non-binary sexual identities include groups and individuals identified publicly or personally outside the binary (male/female), majority group of heterosexuals. This group may include but is not limited by the titles of gay, lesbian, bisexual, transgendered, queer, genderqueer, asexual, and cross-dresser.

The primary purpose of this study is to explore transcultural self-efficacy in nursing education leaders and faculty and to gain meaningful understanding of study participants’ individual and professional confidence related to non-binary sexual identity issues.

The study was a quantitative, non-experimental, correlational design in which the researcher determined if there was a relationship between nursing faculty and administrator Transcultural Self-Efficacy Tool (TSET), (Jeffreys, 2000) scores. The researcher surveyed 535 nursing leaders and faculty employed at Commission on Collegiate Nursing Education (CCNE) nursing programs in Michigan, Indiana, Ohio, Illinois and Wisconsin. Data were gathered using an online survey format throughout a three week period during April 2013. The survey included 11 demographic questions and 83 TSET items. The TSET questions were divided into three subcategories which contained cognitive, practical, and affective related questions.

Findings indicate that nursing education administrators are more transculturally confident than nursing education faculty in their personal attitudes, values, and beliefs (affective). Those age 50 and older are more confident in knowledge concerning the ways cultural factors may influence nursing care (cognitive), compared to younger age groups. Three areas contribute to an increase in confidence in cognitive, practical and affective areas. These include receiving continuing education credits in transcultural nursing, specific education related to LGBT/various sexual identities in formal education, and confidence discussing LGBT issues with the management team. There is a positive relationship between TSET results and confidence with providing nursing education related to LGBT issues. Educational opportunities increase cognitive and practical scores.

Future researcher may include study findings in areas including leadership development, learning modules, curricular development, qualitative research, identification of self-efficacy barriers, and exploration of discrepancies associated LGBT/sexual identity issues.

Included in

Nursing Commons