Traditional tertiary teaching models shortchanging neurodivergent students in health care studies

Recent Deakin research into the experiences of neurodivergent students studying for future health care careers showed many experience stigma, inadequate help in classroom and clinical settings, and hard-to-navigate support systems. The study, led by Associate Professor Laura Gray from the Damion Drapac Center for Equity in Health Professions Education, surveyed 183 graduate students from universities across Australia studying a variety of health courses, including occupational therapy, nursing and medicine.

The study, published in Teaching and Learning in Medicine, revealed neurodivergent learners, mostly reporting autism and ADHD diagnoses, face multiple barriers and are not always well served by an education system set up for neurotypical students.

“There are many neurodivergent students in health care courses, and they have the resources to be phenomenal health care professionals. They have that lived experience, the ability to care and connect with a range of patients and the potential to be really valuable members of the health care community,” said Associate Professor Gray.

“However, as educators, we don’t always create the kind of environments that enable them to thrive, and that can make it so much harder for them to successfully join the workforce.

“I think part of that is the need to unpack how we think about neurodiversity.”

Barriers to learning in a system not designed for neurodiversity

The study found formal accommodations were often available only through institutional pathways for disability access and inclusion. However, not all neurodivergent students identify as disabled, and disclosing neurodivergence or disability can be challenging.

It also found that while disclosure may enable access to necessary supports, it also exposed students to educators disbelieving or discounting students’ experiences, perceiving students as less capable or trustworthy, or restricting students’ access to learning opportunities.

One student noted, “[asking for accommodations] massively backfired in the clinical space … it was assumed that I was always at fault … made the environment very toxic.”

Students surveyed said generic, all-purpose accommodations that weren’t designed with neurodivergent students in mind had sometimes made the situation worse.

Another student said, “While the extensions were helpful in some ways, I never felt like part of my cohort because I was always behind and stressed.”

Gray said it was important to give students the ability and opportunity to identify their own learning needs without unnecessary burden.

“Educators have a responsibility to provide all students with the opportunity to recognize their own learning preferences and engage their strengths. We want students to feel empowered and advocate for themselves, but the burden shouldn’t be on them.

“Studying at tertiary level is hard enough as it is. Universities need to play a role in adapting our systems to reduce pressure on students, who are having to push and learn for themselves how to find help.”

Creating truly inclusive and flexible learning environments

Based on the study’s findings, Assoc. Prof. Gray’s team has broken down the aspects of the higher education system that can help or hinder health students, including social interactions, course structure, learning environments and how these fit into broader social trends.

“Those broader social trends we are seeing in how we understand and approach neurodivergence have actually flowed down into courses and processes and the way teachers engage with students,” Gray said.

“We found that there were lots of opportunities for educators to question their assumptions about who makes a good health practitioner and recognize that having students who do things in different ways is of real benefit.

“When neurodivergence is framed as a kind of deficit and when stigma is attached, education systems become inflexible and unresponsive, producing additional burdens for students and stopping them getting the help they may need to thrive.”

One student surveyed said, “To build a health care workforce that values, supports and empowers neurodivergent members, we need to build a positive understanding of neurodivergence among health care educators, educational environments and health care systems.

“Neurodivergent health care workers are everywhere. You will find us at all levels and often in leadership roles. Upstream prevention of ableism is essential.”

Empowering students to reach out for help

The study also found that, in contrast to the barriers created by inadequate or deficit-oriented recognition of neurodivergence, recognition grounded in a neuro-affirming perspective was experienced by participants as empowering.

Likewise, once equipped with an understanding of their own needs, respondents described self-advocacy’s powerful impact. When providing advice to future students, many emphasized the importance of recognizing their right to access supports and unapologetically but constructively requesting them.

“There is no shame in asking for flexibility, accommodations or what is available to you, and if you still feel the shame, ask anyway!”

Assoc. Prof. Gray said the research was not about identifying problems with students or educators, but an opportunity for educators to understand students better and think carefully about how to adapt and better meet their needs.

“It starts with understanding what neurodivergent students’ experiences actually are.”

Who’s behind this story?

Lisa Lock

BA art history, MA material culture. Former museum editor, paramedic, and transplant coordinator. Editing for Science X since 2021.

Full profile →

Advertisements

Andrew Zinin

Master’s in physics with research experience. Long-time science news enthusiast. Plays key role in Science X’s editorial success.

Full profile →