Explicit and implicit disability attitudes of occupational and physical therapy assistants

Student Pedagogical Consultants: A Strategy for Increasing Diversity, Equity, Inclusivity, and a Sense of Belonging in Curricular Approaches in Physical Therapist Education

BACKGROUND AND PURPOSE

Diversity within the physical therapy profession lags in comparison to the United States population. As the profession strives to diversify, faculty must pay attention to diversity, equity, inclusion, and belonging (DEI-B) in curricular approaches, including classroom materials, instruction, and assessment. With critical application, students from equity-deserving groups (EDGs) can provide unique perspectives to faculty about curricular approaches. Case study purposes were to 1) enable students from EDGs to partner with faculty, as student pedagogical consultants (SPCs), in 2 courses in a Doctor of Physical Therapy program to provide feedback on DEI-B efforts related to curricular approaches and 2) describe the outcomes of SPCs experience.

CASE DESCRIPTION

Eight female students from EDGs partnered with 3 White, female, faculty members in 2 courses: pediatrics and neurorehabilitation. Two SPCs teams observed the classrooms, met with faculty, and administered two-minute papers to classmates to gather feedback on DEI-B curricular approaches. Faculty and student SPCs wrote reflective papers, postproject, documenting their experiences.

OUTCOMES

Themes informed a conceptual framework describing SPCs: 1) motivation for engaging in partnership; 2) creation of a pedagogical partnership space to promote dialogue and problem-solve barriers to DEI-B; 3) deeper understanding of teaching; 4) transfer of learning from the SPC experience to future work locations; and 5) faculty modification of teaching.

DISCUSSION AND CONCLUSION

Students raised awareness regarding the pain of exclusion and provided suggestions for modifying curricular approaches to consider DEI-B. Curriculum redesign using innovative strategies can meet the contemporary needs of students from EDGs.

"But what do you really think?" Nurses' contrasting explicit and implicit attitudes towards people with disabilities using the implicit association test

AIMS

To investigate how nurses' implicit and explicit attitudes towards people with disabilities (PWD) compare to (1) other healthcare providers and (2) non-healthcare providers.

METHOD

We present an analysis of secondary data from the publicly available disability Implicit Association Test (IAT). We compare the explicit and implicit attitudes towards PWD for (1) nurses (n = 24,545), (2) other healthcare providers (n = 57,818) and (3) non-healthcare providers (n = 547,966) for a total of 630,238 respondents, between 2006 and 2021.

DATA SOURCES

We use publicly available data for the Disability IAT from Open Science Framework repository of Project Implicit available at https://osf.io/tx5fi/.

REPORTING

STROBE checklist.

RESULTS

There is a distinct contrast between nurses' explicit and implicit attitudes. While nurses have more positive explicit attitudes towards PWD compared to other groups, they also have more negative implicit attitudes towards PWD. As such there is a contrast between nurses' stated (explicit) attitudes and their unconscious (implicit) attitudes towards PWD. Further, we find that implicit bias towards PWD-among all groups-has not improved over the 15 year period of our sample.

CONCLUSIONS

We present a contrast between nurses' explicit and implicit attitude towards PWD compared to non-healthcare providers. We posit that implicit bias is driven by a combination of workload and stress which drives nurses to unconscious modes of thinking more frequently.

IMPLICATIONS

We discuss three potential tools for improved educational praxis regarding treatment of PWD; (1) more PWD service user involvement, (2) the use of mindfulness techniques to reduce stress and (3) the use of patient contact simulation to promote education and understanding.

PATIENT OR PUBLIC CONTRIBUTION

There is no patient or public contribution.

Explicit and implicit attitudes of occupational therapy workshops' staff towards people with intellectual disabilities

The aim of this article is to present explicit and implicit attitudes of occupational therapy (OT) staff towards people with intellectual disabilities. The study was conducted on a group of 77 OT employees. To explore the explicit attitude, the Conditional Respect for Persons with Disabilities Questionnaire (Kurtek, Roczniki Psychologiczne, 2018, 4, 327-344) was used, while to estimate the implicit attitude, the Intellectual Disability Attitudes Implicit Association Test was applied (Kurtek, Roczniki Psychologiczne, 2021, 1, 43-64). At the explicit level, OT staff tended to tolerate negative and overrate positive behaviours of people with intellectual disabilities, which indicates a tendency to favour the individuals. However, the opposite devalorizing tendency was observed at the implicit dimension, which indicates aversive ableism. Although the study confirmed the independence of the two dimensions of the personnel's attitude, relationships were observed between the disclosure of negativity towards antagonistic behaviours of the people with intellectual disabilities and a decrease in the level of their implicit devaluation.

Intellectual Humility: How Recognizing the Fallibility of Our Beliefs and Owning Our Limits May Create a Better Relationship Between the Physical Therapy Profession and Disability

Despite the many advancements over the history of the profession, physical therapy remains in a somewhat paradoxical relationship with disability. The physical therapist profession values disability as diversity but continues to focus on the normalization of body functions as the primary means to promote functionality in people with disability. This focus, consistent with a medicalized view of disability, may prevent physical therapists from empowering individuals with disability to explore alternative, yet effective, perceptual-motor strategies to achieve their functional goals. Additionally, recent research documents implicit, negative biases of physical therapists and physical therapist assistants toward people with disability, again consistent with the medicalized view that disability is the product of an imperfectly functioning body. Dominant underlying beliefs in any profession are often difficult to counter because they are so pervasive, and those beliefs can be reinforced and made stronger when challenged. The purpose of this Perspective article is to introduce physical therapists to a rising construct in psychology-intellectual humility-that may help to facilitate the profession's relationship with disability. Intellectual humility is predicated on recognizing the fallibility of one's beliefs and related practices. Intellectual humility is a promising construct for physical therapy to address the disability paradox and confront implicit attitudes that have served as the basis for many dominant ideas about disability. This Perspective synthesizes views and evidence from the behavioral and social sciences, philosophy, and critical disability studies to contribute to the ongoing evolution of the profession with respect to disability.

IMPACT

The development of enhanced intellectual humility in physical therapy may help to challenge long-held beliefs among physical therapists about disability-many of which are unnoticed, unquestioned, and difficult to counter.

Bias among managers: Its prevalence across a decade and comparison across occupations

Employees from minoritized and subjugated groups have poorer work experiences and fewer opportunities for advancement than do their peers. Biases among decision makers likely contributes to these patterns. The purposes of this study were to (a) examine the explicit biases and implicit biases among people in management occupations (e.g., chief executives, operations managers, advertising and promotions managers, financial managers, and distributions managers, among others) and (b) compare their biases with people in 22 other occupations. The authors analyzed responses from visitors to the Project Implicit website, including assessments of their racial, gender, disability, and sexual orientation biases from 2012 to 2021. Results indicate that managers expressed moderate levels of explicit and implicit bias across all dimensions. Managers differed from people in other occupations in roughly one-third of the comparisons. The biggest differences came in their implicit biases, with managers expressing more bias than people in other occupations. The study's originality rests in the scope of the work (the authors analyzed data from over 5 million visitors representing 23 broad occupations); comparison of people in management occupations to those in other work settings; and empirically demonstrating the biases that managers have.

Infusing disability equity within rehabilitation education and practice: A qualitative study of lived experiences of ableism, allyship, and healthcare partnership

Background

Addressing issues of diversity, equity, and inclusion (DEI) has become central in implementing inclusive and socially responsible rehabilitation education and clinical practice. Yet, the constructs of disability and d/Deaf identity and culture, as well as ableism and allyship are often overlooked. Or, these concepts are approached using outdated philosophical perspectives that pathologize disability and fail to prioritize the lived experiences, expertise, intersectionality, and self-identified needs of people with disabilities. A Critical Disability Studies (CDS) framework may provide a background for better understanding and responding to these issues through allyship.

Purpose

This study employed a CDS framework to understand the lived experiences of ableism and allyship from faculty, staff, and students on University of Washington (UW) campuses who identify as d/Deaf, disabled/with a disability, or as having a chronic health condition.

Methods

During 2020–2021, we conducted in-depth, semi-structured interviews and focus groups with 22 diverse undergraduate and graduate students, faculty, and staff with disabilities, one third who also identified as people of color. Encounters were audio-recorded, transcribed verbatim, and coded using constant comparison until themes emerged.

Results

Four major themes that emerged from the data are: (1) Ever-present ableism in healthcare, (2) Ableism at the intersections, (3) COVID: Surfacing ableism and expanding access, and (4) Disability allyship and healthcare partnership building. Experiences of ableism and allyship were identified at individual, group/unit, and institutional/systemic levels, though participants reported significantly fewer instances of allyship compared to experiences of ableism. Participants identified intersections between disability and other marginalized identities and juxtaposed the benefits of widespread adoption of many access-increasing practices and technologies due to the COVID-19 pandemic, while also highlighting ways in which the pandemic created new obstacles to inclusion.

Conclusions

This analysis provides insights into ways of implementing inclusive practices in rehabilitation education, practice, and beyond. Rehabilitation students, faculty, and staff may not be aware of how ableism affects their disabled peers or underpins their professional education. It is important to cultivate opportunities within professional education and clinical training to explicitly address our collective role in creating inclusive and accessible academic and healthcare experiences for our diverse community post COVID-19. Drawing on a CDS framework, the research team devised the mnemonic TRAC, which includes Training, Recognition and Representation, Attendance and Action, and Calling to account as strategic guidelines for operationalizing such opportunities.