Nursing Students and Facilitating Student with Disability
Identifying and Developing Competencies in Nursing Students
Once the expected program outcomes are defined, the next step in curriculum development is identifying the competencies that students must develop to achieve these outcomes. Competency statements clarify the knowledge, skills, attitudes, and values that nursing students need to acquire to meet the program’s goals.
Competency statements are student-focused and behaviorally anchored. They outline the foundational knowledge and skills necessary for success in nursing, rooted in both general education and nursing-specific education.
Nursing curriculum outcomes should reflect not only discipline-specific competencies but also those that lay the foundation for lifelong learning. These competencies encompass a range of nursing-related skills, values, and knowledge that prepare students for both undergraduate and graduate-level practice.
Competency statements serve as critical tools in assessing student learning because they provide the foundation for evaluation. When designing these competencies, faculty must ensure that they are specific and aligned with the level of student (e.g., pre-nursing, sophomore, senior, or graduate-level) and the context in which the behavior should be demonstrated.
For example, if a faculty member believes that students should demonstrate specific skills, knowledge, or attitudes across various healthcare settings or with specific patient populations, the competency statement should define these parameters. It is important for faculty to avoid overly specific parameters that limit flexibility in evaluation. For instance, specifying that a behavior must be demonstrated with postoperative patients in an outpatient surgical setting could become problematic if such experiences are not available to all students.
Competencies should also align with national and international standards, such as those set forth by nursing accreditation bodies. These competencies ensure that nursing students are adequately prepared to provide quality patient care upon graduation. Furthermore, competency-based education fosters critical thinking, communication skills, and the ability to work effectively within interdisciplinary teams.
Facilitating Learning for Students with Disabilities in Nursing Education
In 1973, the Rehabilitation Act was enacted, stating that any program or activity receiving federal funding must not deny access or participation to individuals with disabilities. Section 504 specifically prohibits public postsecondary institutions from discriminating against individuals with disabilities.
Furthering these protections, the Americans with Disabilities Act (ADA) was passed in 1990 and updated in 2008 under the ADA Amendments Act (ADAAA). The provisions of these laws have enabled increased enrollment of students with disabilities in higher education, including nursing programs. According to the National Center for Education Statistics (2011), more than 640,000 students with disabilities were enrolled across postsecondary education institutions during the 2008–2009 academic year.
While the data did not isolate nursing students, it is reasonable to infer that a portion of these students were enrolled in both pre-licensure and post-licensure nursing programs. Nursing education for students with disabilities is not unique to the United States. In the United Kingdom, the Discrimination Act of 1995 and its amendments in 2005, along with the Nursing and Midwifery Council’s 2006 standards, have provided guidance for nursing educators working with students with disabilities (Tee et al., 2010).
Nursing students with special needs often present unique challenges to faculty in both classroom and clinical environments. These students may include those with physical disabilities (e.g., visual, hearing, or mobility impairments), chronic illnesses, learning disabilities, or chemical dependency issues.
Many nursing programs have experience in accommodating students with disabilities. A study by Betz, Smith, and Bui (2012) surveyed 65 nursing programs in California, finding that about 5% of students in associate degree programs, 2% in baccalaureate programs, and 0.6% of master’s students had some form of disability. Learning disabilities were the most common type of disability reported, and many students did not disclose their disabilities before admission.
Despite the increasing enrollment of students with disabilities in nursing programs, faculty often express concerns about their ability to provide safe patient care. A nationwide survey of baccalaureate nursing programs revealed that educators tended to prefer able-bodied students (Aaberg, 2012).
Some nursing faculty, however, advocate for a more open approach to accommodating students with disabilities. Dupler, Allen, Maheady, Fleming, and Allen (2012) challenge educators to broaden their perspectives and embrace the potential of students with disabilities to succeed in nursing.
Griffiths, Worth, Scullard, and Gilbert (2010) proposed a holistic, student-centered approach to working with students with disabilities. This approach involves using tailored strategies and involving clinical partners to create appropriate learning environments. Additionally, surveys conducted by Wood and Marshall (2010) revealed that nurse managers rated the performance of nurses with disabilities as “exceptional or above average.”
However, Wood and Marshall also discovered that the work environment and attitudes of coworkers could hinder performance, even when accommodations are available. This indicates that attitudes toward disabilities within nursing teams play a significant role in the professional success of nurses with disabilities.
As the number of students with disabilities entering nursing programs increases, it becomes crucial to ensure that they are provided with appropriate accommodations to facilitate their learning. Furthermore, as the nursing workforce ages, retaining nurses with disabilities becomes essential. Without a shift in attitude toward accommodating these students, the profession risks losing a valuable pool of talent.
The barriers that students with disabilities face often stem from misconceptions about their abilities rather than actual limitations. With the right support and accommodations, many of these students can thrive in both academic and clinical settings. For example, assistive technologies and adaptive learning environments can play a crucial role in ensuring that students with visual, auditory, or mobility impairments succeed in their programs.
Additionally, nursing educators need to familiarize themselves with the legal obligations set by the ADA and other disability laws. Faculty should receive training on how to accommodate students with disabilities without compromising the integrity of the nursing program or the safety of patients.
Universities must also provide students with disabilities access to resources such as counseling, assistive technology, and specialized academic support. Building partnerships with healthcare facilities that support nursing education can create inclusive clinical experiences for students with disabilities.
Moreover, developing clear policies on how to accommodate students with disabilities in clinical practice is crucial. These policies should address issues such as patient safety, technical standards, and the role of accommodations in competency-based assessments. A proactive approach, involving both faculty and students in the conversation about reasonable accommodations, can help dispel myths and ensure that students receive the support they need to succeed.
It is important to emphasize that accommodating students with disabilities does not mean lowering the standards of nursing education. Instead, it involves providing equal opportunities for all students to demonstrate their competencies. By focusing on what students can do, rather than their limitations, nursing programs can foster an environment that values diversity and inclusion.
Conclusion
Facilitating the development of competencies in nursing students, including those with disabilities, requires a thoughtful, inclusive approach. By identifying key competencies and adapting learning environments to accommodate the needs of students with disabilities, nursing educators can ensure that all students have the opportunity to succeed. Legal frameworks such as the Rehabilitation Act and the ADA provide essential protections, but it is the open-mindedness and proactive strategies of educators that ultimately determine the success of these students.
As the nursing profession continues to evolve, creating inclusive environments for students with disabilities will not only enhance diversity in the workforce but also ensure that nursing retains talented individuals who might otherwise be excluded. By embracing flexibility, innovation, and a commitment to equity, nursing education can meet the needs of all learners, contributing to a stronger, more resilient profession.