Comparative effects of disability education on attitudes, knowledge and skills of baccalaureate nursing students

Abstract

Aim: This study aimed to examine if participation in a required clinical course or elective fellowship pertaining to care of people with disabilities (PWD) had an impact on attitudes, knowledge and skills of nursing when compared with those with no clinical exposure to PWD.

Background: Worldwide, over 1 billion people live with a disability, 93 million are children and an estimated 1-3% have an intellectual disability; 6.9 billion live with 'impairment producing health condition'. (WHO, 2011; Maulik et al., 2011; Roscigno, 2013 p.21). Barriers that contribute to health disparities in PWD are numerous; repeated themes of inadequate education of nursing students and faculty, deficient communication skills and negative attitudes are pervasive in the literature (Alshammari et al., 2018; Anyinam et al., 2019; Cervasio et al., 2010; Ilkhani et al., 2015; Lyon & Houser, 2018; Polikandrioti et al., 2020; Temple & Murdoch, 2012; Werner & Grayzman, 2011; WHO, 2011).

Study design: A singular institution descriptive quantitative design using a purposive sample of student volunteers explored differences among pre-licensure senior nursing students which examined perceptions prior to and following a clinical experience specific to the care of PWD.

Methods: Analyses of the change in scale scores by student type and experience working with PWD were evaluated using one-way ANOVA. Spearman correlations were used to test for an association between the change in scale scores and birth year.

Results: There was no statistical evidence of differences between the elective fellowship (n = 9), clinical (n = 13), or control (n = 24) groups for change in attitudes (p = 0.1383), scenario 1 (p = 0.1996), or knowledge scores (p = 0.2854) (Table 3). Mean pre- and post-test scores for attitudes within the fellowship (69.78, 75.11) and clinical (67.62, 74) group increased more than the control (66.92, 68.29). There was evidence of a difference detected in the attitude questions, scenario 2 scores, with the fellowship and clinical groups showing a larger increase in scores compared with the control group (p < 0.0001) (Table 3). Also, the clinical group experienced a larger increase in skill scores compared with the control group (p = 0.0154).

Conclusions: Results from pre-post surveys exemplify the need for disability specific undergraduate education. Students will experience confidence and competence in their transition to practice because at anytime, anywhere, they will encounter someone with a disability. Further research is needed to determine the amount and type of education that translates to quality care of PWD.

Keywords: Attitudes; Disability education; Knowledge; Nursing students; Skills.