Learning Model In Nursing Education In nursing education, various models and definitions are used to conceptualize how disabilities are understood and addressed within both the healthcare system and society. These models inform how nursing educators approach teaching about disability, promote inclusivity, and adapt healthcare practices. Kaplan (2010) outlines four models of disability that shape the way disabilities are perceived and managed: the moral model, the medical model, the rehabilitation model, and the social model. These models have different implications for nursing education and healthcare delivery, especially when it comes to addressing the needs of individuals with disabilities.

Models in Nursing Education

1. The Moral Model

The moral model views disability as a result of sin or a moral failing, reflecting a belief that individuals with disabilities are responsible for their conditions. This model is deeply rooted in historical contexts and persists in some cultures today. When disability is viewed through this lens, individuals and their families may experience guilt, shame, and stigma, leading to exclusion from care and societal support.

The United Nations has developed the Standard Rules on the Equalization of Opportunities for Persons with Disabilities, ensuring the rights of people with disabilities to access care, rehabilitation, and support services (United Nations, 1993; WHO, 2015b). These international efforts help counter the outdated beliefs of the moral model and promote a more equitable approach to disability care.

2. The Medical Model

The medical model views disability as a defect or illness that requires intervention. This approach often focuses on curing or minimizing the impairment, positioning healthcare professionals as central to the care process. While this model has contributed to the development of medical treatments and devices (e.g., prostheses), it has been criticized for promoting expensive procedures that may not always lead to improvements in quality of life.

In nursing education, the medical model emphasizes the importance of clinical interventions, but it also highlights the need to consider the limitations of medical approaches, especially for conditions that cannot be cured.

3. The Rehabilitation Model

Similar to the medical model, the rehabilitation model aims to address disabilities through therapy, training, and counseling. However, instead of focusing on curing the disability, the rehabilitation model aims to help individuals adapt to their condition by improving functionality and reducing limitations. This model supports a less invasive approach to disability management compared to the medical model and often includes physical therapy and vocational training.

In nursing education, this model is valuable for teaching nurses how to support patients in managing their disabilities, focusing on adaptation rather than cure. Rehabilitation nursing involves empowering individuals to regain independence and optimize their daily living activities.

4. The Disabilities (Social) Model

The social model of disability represents a more modern and inclusive framework. It views disability as a social construct, emphasizing that barriers in society, such as discrimination and lack of access to services, are the real issues faced by individuals with disabilities (Matthews, 2009). Rather than focusing on the individual’s impairments, the social model looks at how social, cultural, and environmental factors limit opportunities for people with disabilities.

The disabilities model has been influential in shifting nursing education towards more inclusive practices, where nurses are taught to focus on removing societal barriers and advocating for policy changes that promote equity for individuals with disabilities. This model encourages nurses to adopt a holistic view, where disability is seen as a normal part of life, and the role of the nurse extends beyond medical treatment to include advocacy and social justice.

Definitions of Disability in Nursing Education

Disability definitions vary widely, reflecting the different models and perspectives on what constitutes a disability. Most definitions are broad, covering a range of physical, mental, or cognitive impairments. These definitions help inform the framework used in nursing education for teaching about disability care.

1. World Health Organization (WHO) Definition

The WHO (2016a) defines disability as “a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives.” This definition aligns with the social model, recognizing that disabilities are not solely individual problems but are shaped by societal expectations and environmental barriers.

The WHO uses the International Classification of Functioning, Disability and Health (ICF) as a framework for understanding disability. This classification system focuses on the impact of disabilities at both the individual and population levels, categorizing disability into three dimensions: body function/impairment, activity/restrictions, and participation/restrictions (CDC, 2012b).

2. Social Security Administration (SSA) Definition

In the United States, the Social Security Administration (SSA) defines disability in terms of an individual’s ability to work. According to SSA, disability is only recognized if it is long-term or fatal, and if it prevents the individual from continuing in their current job or adapting to other employment. This definition is used primarily for determining eligibility for disability benefits.

In nursing education, the SSA’s definition highlights the economic and functional aspects of disability, focusing on how impairments affect an individual’s ability to engage in work and other life activities.

3. Americans with Disabilities Act (ADA) Definition

The Americans with Disabilities Act (ADA), signed into law in 1990, defines disability as a physical or mental impairment that substantially limits one or more major life activities (U.S. Department of Justice, 2009). These activities include caring for oneself, standing, hearing, speaking, and learning.

The ADA’s definition provides legal protections against discrimination and promotes equal access to employment, public services, and accommodations. In nursing education, the ADA serves as a foundation for teaching students about the rights of individuals with disabilities and the importance of creating accessible healthcare environments.

Nursing Implications of Disability Models and Definitions

Nurses, as frontline caregivers and educators, must understand how different models and definitions of disability shape patient care. The shift from the medical and rehabilitation models to the social model challenges nurses to move beyond focusing on the impairment itself and instead address the broader societal factors that affect patients’ lives.

Practical Applications for Nurses:

1. Advocacy and Social Justice: Nurses play a crucial role in advocating for equal access to healthcare, education, and employment for individuals with disabilities. Understanding the social model empowers nurses to promote inclusive practices and address the barriers that limit opportunities for people with disabilities.
2. Tailored Patient Education: Nurses must adapt their education strategies to meet the unique needs of patients with disabilities. This includes ensuring that communication is accessible, using assistive technologies when necessary, and addressing psychosocial aspects of care.
3. Promoting Independence: In the context of the rehabilitation model, nurses help patients achieve greater independence through adaptive skills, physical therapy, and counseling. Teaching patients how to manage their conditions and lead productive lives is a critical component of nursing care.
4. Compliance with Legal Standards: Nursing educators must ensure that students are familiar with laws such as the ADA, which mandate reasonable accommodations for people with disabilities in various settings, including healthcare environments.

Conclusion

Understanding the various models and definitions of disability is essential for nursing educators and practitioners. These frameworks influence how nurses approach patient care, advocacy, and education, particularly in promoting inclusive environments and addressing the unique needs of individuals with disabilities. By integrating these models into nursing education, nurses can play a vital role in improving the quality of life for people with disabilities and advocating for a more equitable healthcare system.