Addressing Sexual and Gender Diversity Through Inclusive Pedagogical Practices in Global Preregistration Nursing and Midwifery Education: Protocol for a Scoping Review

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Abstract
Background: Sexual and gender diverse populations experience inequities in health and health care access, as well as gaps in health professional education. Preregistration nursing and midwifery education represents a critical formative stage for developing inclusive and affirming practice; however, the integration of sexual and gender diversity within curricula remains variable and inconsistently described. Mapping how inclusive pedagogical practices address sexual and gender diversity in preregistration nursing and midwifery education will clarify current approaches and identify gaps in the literature. Objective: This study aims to map how sexual and gender diversity is addressed through inclusive pedagogical practices in preregistration nursing and midwifery education globally. Methods: This protocol follows the Joanna Briggs Institute (JBI) guidance for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting checklist and will be reported in accordance with PRISMA-ScR guidance. We will search the CINAHL, MEDLINE, PubMed, Scopus, and Web of Science databases, as well as targeted gray literature. Two reviewers will independently screen titles and abstracts, followed by full-text screening, and extract data using a piloted form through Covidence. Prior to formal screening, reviewers will pilot-test the inclusion criteria on a sample of titles and abstracts to ensure consistency. Agreement will be discussed, and the eligibility criteria will be refined as required. Data extraction will include pedagogical practices addressing sexual and gender diversity (teaching strategies, curriculum content, simulation, and assessment), theoretical or conceptual frameworks; outcomes and indicators (knowledge, attitudes, skills, confidence, and learning environment), and any identified equity considerations (attention to gender identity and sexual orientation and intersectionality). Synthesis and presentation of findings will be completed using the Patterns, Advances, Gaps, Evidence for Practice, and Research Recommendations (PAGER) framework. Results: The scoping review was initiated in May 2026 following protocol registration with the Open Science Framework. Preliminary searches conducted in November 2025 informed the final search strategy. The final searches were conducted in May 2026 across 5 databases. At the time of manuscript submission, screening and data extraction were in progress. Data charting and synthesis are expected to be completed by October 2026, with findings anticipated for dissemination in December 2026. Conclusions: This review is expected to identify diverse but inconsistently applied inclusive pedagogical practices, which show a predominance of short-term outcome evaluations and limited theoretical underpinning. It will also highlight key gaps, particularly in the inclusion of gender diverse populations, midwifery-specific evidence, and rigorously evaluated interventions. This review will provide a comprehensive map of inclusive pedagogical practices addressing sexual and gender diversity in preregistration nursing and midwifery education, identify gaps in the evidence base, and inform curriculum development and educator training. Trial Registration: Open Science Framework 10.17605/OSF.IO/8GHVD; https://osf.io/8ghvd International Registered Report Identifier (IRRID): PRR1-10.2196/93408

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