Academic journal article Nursing Education Perspectives

Universal Design for Instruction in Nursing Education: An Integrative Review

Academic journal article Nursing Education Perspectives

Universal Design for Instruction in Nursing Education: An Integrative Review

Article excerpt

Nursing education is called upon to transform Its paradigm to embrace technology, evidence-based practice, cultural diversity, interdisciplinary communication, leadership skills, critical judgment, and teamwork using innovative and effective pedagogies that engage all types of learning styles (American Association of Colleges of Nursing [AACN], 2013; Institute of Medicine [IOM], 2010; National League for Nursing [NLN], 2005, 2009, 2016). Nurse educators are also challenged to provide meaningful and inclusive learning experiences in a content-laden curriculum for all learners, students with and without disabilities (Aaberg, 2012; Dupler, Allen, Maheady, Fleming, & Allen, 2012; Levey, 2014).

The NLN (2005, 2009) defines innovative and inclusive teaching practices in nursing education as an evolving process in which curricular design and teaching/learning practices are assessed to inspire lifelong learning necessary for professional nursing. To meet the NLN goal of an inclusive, effective, and innovative curriculum, nurse faculty need to shift from "Sage on the Stage" to "Guide on the Side" pedagogies, accessible to all learners (Stanley & Dougherty, 2010). In a 2005 article, Diekelmann asked: "What is the nature of an inclusive science of nursing education?" (Diekelmann, 2005, p. 64). Diekelmann called for funded research to strengthen diverse approaches to educating today's diverse learners. One such innovative approach for an inclusive learning environment, universal design for instruction (UDI), is not well known or researched in nursing education.

Developed around 2001, UDI creates accessible learning for a broad postsecondary student body using multiple pedagogies (i.e., physical/social environments, resources, materials, technology, and evaluations; Scott, McGuire, &Shaw, 2001). However, nursing education continues to face the challenge of providing access and authentic learning environments to meet the needs of all of today's nursing students, including those with disabilities (Marks, 2007; Stanley & Dougherty, 2010).

Over the past 12 years, UDI principles have been developed and applied to postsecondary education for accessible learning environments (Roberts, Park, Brown, & Cook, 2011; Shaw, 2011). This leads to the question: Have UDI principles been used by nurse faculty in response to calls from the IOM, the AACN, and the NLN for inclusive learning environments? The purpose of this integrative review was to ascertain the current state of UDI in nursing education.


A disability is a state of being in which an individual is considered to be significantly different ("impaired") relative to the perceived usual standard of an individual or group (Disability World, 2016). This article addresses disabilities in a global context and encompasses, but is not limited to, physical disabilities (e.g., musculoskeletal, nervous systems), sensory disabilities (e.g., vision, hearing, smell, touch), cognitive/learning (e.g., dyslexia, attention deficit hyperactivity disorder), mental illness (e.g., anxiety disorders, phobias, depression), and various types of chronic diseases (Disability World, 2016). It is important to note that the Americans with Disabilities Act of 1990, the American with Disabilities Act Amendments Act [ADAAA] of 2008, and Section 504 of the Rehabilitation Act of 1973 do not identify specific diseases or conditions constituting a disability due to the difficulty of providing an up-to-date and comprehensive list.

The ADAAA (2008) maintains the core elements of the definition of disability "as an impairment that substantially limits one or more major life activities, a record of such an impairment, or being regarded as having such an impairment" (US Department of Labor, n.d.). However, the enactment of the ADAAA modified key terms to broaden the definition of disability by "expanding the definition of 'major life activities'; redefining who is 'regarded as' having a disability; modifying the regulatory definition of 'substantially limits'; specifying that 'disability' includes any impairment that is episodic or in remission if it would substantially limit a major life activity when active; and prohibiting consideration of the ameliorative effects of 'mitigating measures' when assessing whether an impairment substantially limits a person's major life activities, with one exception" (US Department of Labor, n. …

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