Faculty beliefs related to
admitting and educating
nursing students with
disabilities
A dissertation
University of Minnesota
By Diane Dahl, PhD, RN
Background of the Study


Past personal history of educating a nursing
student with physical disabilities.
Nursing Programs continue to raise questions
and concerns related to admitting and
educating nursing students with disabilities.
Purpose of the Study


Explore faculty beliefs related to admitting and
educating nursing students with disabilities.
The issues are complex and are not well
understood based on past quantitative
research.



Should lead to a deeper understanding of an
important area in nursing.
May encourage faculty to contemplate their
own beliefs.
Encourage review and revision of admission
and curricular policies for nursing students
with disabilities resulting in appropriate and fair
policies.
Theory and Method

Framework of Oppression
Iris Marion Young (1990)

Medical/Individual Model of Disability

Social Model of Disability
Michael Oliver (1993)
Framework of Oppression
Five Faces or Forms of Oppression
1. Exploitation – process of transfer of the
results of the labor of one social group
(oppressed group) to benefit another.
2. Marginalization – groups of people are
excluded from useful participation in society.
3.
4.
5.
Powerlessness – imbalance of power.
Cultural Imperialism – universalization of a
dominant group’s experience of culture, and
its establishment as the norm.
Violence – random and unprovoked attacks
of a person physically or of their property.
“The conscious actions of many individuals daily
contribute to maintaining and reproducing
oppression, but those people are usually
simply doing their jobs or living their lives, and
do not understand themselves as agents of
oppression”(Young, 1990, p.41).
Medical/Individual Model of
Disability

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Emphasis on disability as a disease in need of
a cure.
Disability viewed as a deficiency or
abnormality and considered negative.
Disability resides in the individual and the
remedy is cure or normalization of the
individual (Blacklock, 1995).
Social Model of Disability


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The problem of disability exists; it does not
reside in the individual, but within the society.
“Disability is something imposed on top of our
impairments by the way we are unnecessarily
isolated and excluded from full participation in
society” (UPISAS, 1976. p.14).
Proponents state society needs to change, not
individuals.
Methodological Framework



Discipline of Nursing
Feminist Beliefs
Interpretive Research
Research Method




Purposeful sample of 10 full-time nursing
faculty from institutions offering baccalaureate
degrees.
Four private institutions and three state
institutions from the state of Minnesota.
Experience in teaching clinical and theory to
undergraduate nursing students.
Minimum five years experience as a faculty
member.


Data was obtained from two separate audiotaped, hour long, open-ended interviews.
Second interview was to further increase
understanding and for clarification if needed.
Data Analysis


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Interviews were transcribed.
Completed first reading using transcript and
audio tape (first and second interview).
Formulated questions for the second interview
to increase understanding and clarification if
needed.
Constructed meaning units, labels, and then
themes with supporting data.
Questions Posed
1.
2.
3.
4.
Explore personal definition of disability.
Describe their own experience as faculty
admitting and/or educating a student with
disabilities.
Discuss admission criteria related to
functional abilities if used by their programs.
Relate their definition to a medical or social
model framework of disability (second
interview).
Findings
I. Participant’s Stories
Themes:
1.
A disabled nursing student desiring
multiple reassurances that she could
successfully complete the nursing
curriculum.
2.
Pre-admission counseling for prenursing
students with disabilities.
3. Ethical complexity of educating a student
that may not find employment.
4. Defeatist attitude.
5. Non-disclosure/disclosure of disabilities
6. Lack of information about the disability.
Formally Counseling Prenursing
Majors
Diane: How did you help her to become aware of
what the nurse’s role would be or how did she
learn about it?
Alice: Well, she had an aunt who was a nurse
and then the prenursing course−we bring a lot
of different nurses in−who talk to, tell their
stories about the nurse because it’s kind of an
experiential type of experience.
And she also got to follow a nurse and shadow
them in the clinical setting and so I think that
was a big eye-opener for her. And she, we
made a special person attempt−an interpreter
was with her and when she shadowed the
nurse I think that’s when she really became
clear, to her, kind of where that gap is.
Disclosing Disabilities
Wendy reported hearing the following
statements from those who did not want to
disclose their disabilities: “I wanted to be like
my classmates for one time in my life,” and “I
want to be like my peer group and I am not.”
Forms of Oppression:
Marginalization
 concern about what role a disabled nursing
student could have in nursing.
Cultural Imperialism
 shadowing an able-bodied nurse, a member of
the dominant group in nursing.
 students with disabilities beliefs that they will be
perceived negatively by the dominant group.
II. Personal Definition of Disability
Themes:
1. Outside of the Normal
2. Unable to Perform/Function
3. Broad-based Definitions
4. Linking Disability to Requiring an
Accommodation
Outside of Normal
Marcia: Well, you know that’s a tough one
because there are so many definitions of what
normal is. I guess probably−a disability in my
definition would include somebody who cannot
complete the skills that are expected of them,
whether that means communication or the
physical skills or the learning, like we talked
about the learning disabilities, so someone
who cannot complete the expectations that are
outlined within whatever program that they are
in.
In the second interview, Marcia added,
I believe it truly is someone who is outside of the
norm in completing skills. And I hate using that
word norm−normal−but it is someone who
wouldn’t be able to complete the expectations
that are expected of anybody else in the
program.
Vicki: I guess I think of disability as being a
deficiency in some physical or mental capacity.
In the second interview, Vicki expanded on her
original definition.
Well, I guess the one thing I would react to in
that definition is the word deficiency because it
seems like it has a negative connotation. But
when I think of disability, I’m trying to think that
if there’s any examples that I can think of
where it’s normal
−where there isn’t something that’s lacking like
vision, hearing, dexterity, so yeah, you know
I’m not sure if I can come up with a different
word that’s not−not negative. I guess, well
alteration, alteration could be non-negative
sounding−instead of a deficiency, an
alteration.

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All definitions supported a belief in the medical
model of disability; the disability resides within
the individual; the goal is normalization.
These definitions may inform nursing practice.
This practice may result in the oppression of
nursing students with disabilities.
III. Admission Criteria Statements
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Physical, mental, and behavioral performance
requirements
Nursing admission criteria documents in 4 of
the 6 schools.
Two schools had disability documents that
applied to all programs.
Several participants were not aware a
document existed, or were unsure of what it
said or how it was used.
Examples of Use
1.
2.
3.
Using an attribute or activities statement as a
means of helping students be proactive in
seeking accommodations.
Used as a gate-keeping tool to screen out
students with disabilities.
Applied to progression issues if a student
were to become disabled during the program.
Admission Criteria Statements…
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were developed in response to admitting and
educating a nursing student with disabilities.
define nursing curricula from a medical model
framework.
do not encourage movement toward a barrierfree environment.
discourage students with disabilities from
considering nursing as a career.
IV. Safety
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Safety of patients
Safety of nursing students
Employment requirements of safe care
Student awareness of safe employment
environments
Marcia: I think that my concern is for the client, I
mean ours is two-fold really when we’re in
education, we’re concerned about the student.
We advocate for the student. But we also have
to think about the safety of our client, and if
they are in a position where they are not safe
and able to care for their client, I don’t feel
okay with that.

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No documented studies that would support
students with disabilities have more unsafe
episodes or have harmed themselves at a
greater percentage than do other students.
Assumption is made by nursing faculty that
there is an increased safety risk.
Unconsciously contribute to the oppression
nursing students with disabilities experience.
Other Themes
V. National Licensing Exam
VI. Disclosure of a disability
VII. Student self-awareness of strengths and
limitations
VIII. Post-graduation employment
IV. Nursing faculty themes
Implications for Nursing
Through dissemination of this study, nursing
faculty will:
 take time to contemplate personal beliefs
related to admitting and educating a nursing
student with disabilities.
 dialog about beliefs as they relate to mission
and philosophy.
 consider assumptions made when defining the
nursing meta paradigm.

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consider the implications of developing and
implementing curricula using the medical model.
contemplate being participants as agents of
oppression.
explore the impact of developing curricula using
the social model of disability.
change admission and educational policies that
are oppressive to students with disabilities.
Limitations

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Always more questions to ask.
Limited member checking.
Faculty voice – interested participants versus
others.
Suggestions for Further Research

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Repeat study interviewing an increased
number of faculty from different regions.
Interview nursing students with disabilities
related to their admission and educational
experiences.
If programs chose to move to a social
framework for admission and curricular design,
it would be important to research the effects.
Questions?