Nursing Students with Disabilities in the Clinical Setting: Nursing Education Leaders' Perceptions of Accommodations

Symes, Julie M.

Background & Purpose: Nursing programs have reported an increase in the number of nursing students with disabilities. Nurse educators must be aware of federal legislation requirements of the ADA of 1990 with the ADAAA of 2008 enacted to increase access to higher education for students with disabilities. Providing reasonable accommodations for nursing students with disabilities in clinical practice is a dilemma for many nurse educators.

Research Questions: What are the reasonable accommodations typically made to support nursing students with disabilities in clinical settings in nursing programs?

How effective are reasonable accommodations made by nursing programs for nursing students with disabilities in clinical settings as perceived by nursing education leaders?

What are barriers to providing reasonable accommodations for nursing students with disabilities in clinical practice settings in nursing programs?

Study Design: Descriptive survey

Sample: 1251 potential nursing program leader respondents drawn from all pre-licensure baccalaureate and associate programs accredited through the ACEN & CCNE in the U.S.

264 nursing program leaders’ responded

157 Associate
77 Baccalaureate

Methods: Disabilities related literature was reviewed including:

Faculty Perspectives of Students with Disabilities
Students with Disabilities Experiences & Accommodations
Nursing Education Studies of Nursing Faculty and Student with Disabilities and clinical accommodations
General Accommodation Perspectives
Disability Legislation

A web-based survey instrument was designed by researcher from the literature.

Survey Part B: Demographic information: type of program: student enrollment, numbers of program clinical and simulation hours, & numbers of students with disability types—Physical, Learning, Mental Health, Chronic Illness, Other and more than 1 type
Survey Part A: Clinical Accommodations Types, Effectiveness, and Barriers

Approval obtained from University of South Dakota IRB.

An access link was emailed to 1251 potential nursing program leader respondents.

Descriptive analysis completed with SPSS 20. Frequency, mean and standard deviation were calculated.

Results: The annual numbers of nursing students with disabilities in both types of programs is relatively low, 1-10 students.

The most common disability reported was physical disability (BSN n = 68, (59%); ASN n = 98 (62%)).

The most frequently used clinical accommodation strategies were:

referrals for counseling, mentorship services, or disabilities services coordinator
supported students in disclosing issues affecting their clinical learning
encouragement of clinical instructors/preceptors to schedule regular, honest and constructive feedback sessions.

Findings showed that if an accommodation was frequently used the participants perceived it as effective.

Nursing education leaders’ do not perceive any major barriers to providing accommodations. The strongest barrier to providing accommodations was Concerns for patient safety (M = 3.15, SD = 1.28). All listed barriers’ means fell between 2.38 (SD = 1.28) and 3.15 (SD = 1.15).

Recommendations: The following recommendations for practice are made based upon the findings of this study:

Nursing education leaders must continue to find innovative ways to make nursing programs more inclusive for students with disabilities.
There is no one best clinical accommodation for a type of disability; accommodations must be specific, unique, and tailored for an individual student with a disability.
Nursing students with disabilities must be assessed and advised as early as possible in the nursing program with a team approach to provide the most effective accommodations.
Nursing education leaders need to provide guidance to disability services for the most effective accommodations.
Nursing education leaders must focus on the values and abilities of nursing students with disabilities and what they can bring to the nursing profession.

KEYWORDS: disabilities, reasonable accommodation, undergraduate nursing students, clinical

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