Improving Community Health Nursing Students’ Attitudes towards People Living with a Disability

By Barbara E. Hekel barbara.e.hekel@uth.tmc.edu

Bridgette Pullis bridgette.r.pullis@uth.tmc.edu

Allison Edwards allison.p.edwards@uth.tmc.edu

Deborah McCrea deborah.l.mccrea@uth.tmc.edu

One in 4 adults in the United States has some type of disability, constituting over 61 million individuals (CDC, 2021). People with disabilities (PWD) often have unmet healthcare needs, difficulty accessing healthcare facilities, communication issues, and lack of medical information. This is all exacerbated by lack of disability education incorporated in health care pre-professional programs.

The pandemic has hit PWD hard. People with intellectual and developmental disabilities (PWID) are six times more likely to die from COVID-19 (National Institute for Health Care Management, 2021). The pandemic has reduced access for PWD to rehabilitation and routine primary health care. Despite PWD accessing the same forms of health care as their neurotypical peers, disparities in their life span and co-morbidities continue to exist.

Factors impacting health outcomes and quality of care for people living with a disability include the healthcare provider’s implicit and explicit negative attitudes, inaccurate or inadequate knowledge, lack of educational preparation, and limited experience in providing care to people living with a disability.

Community health undergraduate nursing education provides for the opportunity to improve attitudes and build confidence. Disability-specific healthcare education can improve the ability of student nurses to communicate with PWD and improve students’ confidence in their care competence. As is true for so much of learning, more frequent and repeated exposure and immersion is key to improving educational outcomes.

We found that a classroom lecture on disability and having a panel of PWD interacting with the class did change some students’ attitudes, but it was not significant (Edwards et al., 2021). More education and exposure were needed.

We are currently embedding disability curricular components into our community health class, as well as offering a co-curricular opportunity for a disability-focused Fellowship, IPE experiences, and simulation. Dr. Edwards has developed the Joan and Stanford Alexander Fellowship, which provides a stipend and trains, nursing students to care for a broad range of disabilities through clinical immersion. In November 2021, Cizik School of Nursing students participated in the 6th annual Mass Casualty Incident Simulation, an interprofessional event, with over 200 participants. Several of the mock victims in the scenario represented PWD and included a standardized patient living with a disability. The students were debriefed after to help them understand PWD medical needs. To further student exposure to PWD, this spring the community health faculty included a PWD and a child with intellectual and developmental disabilities in 2 of the 4 community health simulations focused on vaccine hesitancy. Our goal is to improve nursing students’ attitudes and confidence in providing care for PWD.

CDC. (2021). Disability and Health Promotion. Retrieved December 10, 2021 from https://www.cdc.gov/ncbddd/disabilityandhealth/index.html

Edwards, A. P., Hekel, B., & Cron, S. (2021). Disability attitudes of nursing students: A curriculum intervention. Nursing Education Perspectives,16. https://doi.org/10.1097/01.NEP.0000000000000870

National Institute for Health Care Management. (2021). Disability, health equity & COVID-19. UpToDate. Retrieved December 10, 2021, from https://nihcm.org/publications/disability-health-equity

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