A Collective Case Study of Nursing Students with Learning Disabilities

Article excerpt

ABSTRACT This collective case study described the meaning of being a nursing student with a learning disability and examined how baccalaureate nursing students with learning disabilities experienced various aspects of the nursing program. It also examined how their disabilities and previous educational and personal experiences influenced the meaning that they gave to their educational experiences. Seven nursing students were interviewed, completed a demographic data form, and submitted various artifacts (test scores, evaluation reports, and curriculum-based material) for document analysis. The researcher used Stake's model for collective case study research and analysis (I). Data analysis revealed five themes: I) straggle, 2) learning how to learn with LD, 3) issues concerning time, 4) social support, and 5) personal stories. Theme clusters and individual variations were identified for each theme. Document analysis revealed that participants had average to above average intellectual functioning with an ability-achievement discrepancy among standardized test scores. Participants noted that direct instruction, structure, consistency, clear directions, organization, and a positive instructor attitude assisted learning. Anxiety, social isolation from peers, and limited time to process and complete work were problems faced by the participants.

STUDENTS WITH LEARNING DISABILITIES (LD) CONSTITUTE APPROXIMATELY 50 PERCENT OF STUDENTS WITH DISABILITIES IN COLLEGES AND NURSING PROGRAMS (2,3).

Interpretative research into the meaning of being a nursing student who is learning disabled can assist nurse educators who teach students with special needs. The knowledge obtained from this collective case study provides research-based evidence of educational experiences and needs of students with LD.

Three research questions guided this study:

* What does it mean to be a baccalaureate nursing student who has a learning disability?

* How does a baccalaureate nursing student with learning disabilities experience various educational aspects of the nursing program?

* How do the student's disabilities and previous educational and personal experiences influence the meaning that the student gives to nursing education experiences?

Integrative Review of the Literature Learning disabilities are a heterogeneous group of disorders that manifest themselves in the acquisition and use of listening skills, listening comprehension, speaking, reading/language, writing, reasoning, spelling, and mathematical calculating and reasoning skills. These disorders are manifested in a person with average to above-average intellectual abilities (4). Difficulties in information processing (short- and long-term memory, conceptualization, and attending to details), social information processing, and executive Functioning (planning, organizing, prioritizing, and sequencing) are also recognized as manifestations of a learning disability (5-9). Approximately 32 percent of all individuals with LD also have a co-existing attention deficit disorder/hyperactivity disorder (ADD) (8).

A variety of strategies are used to support nursing students with learning disabilities, but, essentially, little is known about the students themselves or nursing faculty responses to individuals with disabilities in the academic setting. There is a need to identify learning disabilities in students already admitted to nursing programs. Faculties may be aware that campus support services are available, but unaware of which services are needed by individual students with specific disabilities (2).

Despite legal mandates from the federal government with regard to accommodations that faculties must consider as they work with students with disabilities (9-11), only a few articles have been published on the needs of nursing students who are learning disabled. In one of the earliest studies of college nursing students with LD (12), 17 students who received support services were followed through a learning disability program. …