Expanding Diversity: Disability-Related Competency Development for BSN Curriculum

Saturday, 28 October 2017

Rebecca A. Kronk, PhD MSN
School of Nursing, Duquesne Univeristy, Pittsburgh, PA, USA
Lynnette Leeseberg Stamler, PhD, MEd
College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
Suzanne C. Smeltzer, EdD, MS, RN, ANEF, FAAN
College of Nursing, Villanova University, Villanova, PA, USA

The purpose of this leadership project was twofold: 1) address the gap in BSN education to better prepare undergraduate nursing students to provide competent care to people with disabilities (PWD); and 2) generate consensus on a set of undergraduate nursing competencies to care for PWD.

Worldwide, 15% of the population lives with a disability, making it the largest minority group in the world. As rates of disability increase with age (36% of people 65 and older) almost everyone will be affected with a disability at some point. Higher percentages of PWD live in poverty compared to those without a disability, 28.1% vs 13.3%. PWD have poorer health outcomes, including higher rates of early death, chronic diseases, and disparities in preventive screenings. To improve the health and healthcare of PWD, leading organizations (i.e. IOM, WHO, Surgeon General, National Council on Disability) have endorsed parallel recommendations that identified healthcare provider training, curricula development, and competency standards as crucial elements in bridging this disparity gap.

The next generation of nurses must be equipped to care for individuals with disabilities across the life span. However, there are no published undergraduate nursing competencies on caring for PWD. Nursing schools have traditionally assumed that care for people with disabilities has been addressed as part of their overall curriculum. However, a systematic review of 33 undergraduate nursing textbooks revealed disability related content and disabling conditions were rarely addressed. A generic approach fails to recognize the unique needs of the population, the heterogeneity of the individuals, and the complexity of their care, thus contributing to the unconscionable inequities in health and healthcare that exist between individuals with and without disabilities.

The study utilized a mixed method non-experimental Delphi survey design. Participants included experts and stakeholders in the field of disability and consisted of faculty, researchers, administrators, advocates and PWD.

The scholar demonstrated educational and administrative leadership through:

  • recognizing a systemic programmatic gap in pre-licensure education and health care delivery to PWD;
  • developing and implementing an evidenced based methodological research study;
  • partnering with a network of consultants and stakeholders;
  • disseminating study outcomes at professional and educational conferences; and
  • ongoing advocacy for innovative changes in BSN curriculum, for example, adapting current clinical simulation scenarios to include PWD.