“Someone Like Anyone Else”: A Qualitative Exploration of New Zealand Health Professional Students’ Understanding of Disability

Abstract

Background: One in four New Zealanders identify as disabled. Disabled people, including Māori (the indigenous people of New Zealand (NZ)), experience health disparities. Systemic and individual health professional (HP) biases are factors that may affect health outcomes. Disability education is a means for improving attitudes and behaviors towards disabled people. The objective of this study was to explore NZ HP students’ understanding of disability and health-related concepts. Methods: HP students from one tertiary institution in NZ were interviewed through Zoom video call about their understanding of disability and health. A relativism paradigm and contextualism epistemology (underpinned by the socio-ecological model) shaped the reflexive thematic analysis. Transcripts were analyzed at a deductive and latent level. Results: Nine HP participants, from different professional courses and cultural backgrounds, were interviewed. Three main themes influenced participants’ understanding of disability: life experiences, professional education, and societal exposure. Participants who had more experience with disabled people had a deeper and more nuanced appreciation of the challenges disabled people face in accessing health services and obtaining equitable health outcomes. Cultural background also influenced the participants’ understanding of disability. Participants preferred more experiential learning methods to improve their knowledge of disability concepts. Lastly, expectations of inclusion are determined by observing social norms. Conclusion: Participants reported learning just a few models of disability. The HP students predominantly came from a perspective of ensuring equality rather than equity. There was limited recognition of the systemic biases that exist within multiple social determinants and how these perpetuate health inequities for disabled people. A socio-ecological consideration of disability throughout the curricula, self-reflection, acknowledging systemic bias, and proactively including disabled people as HP students and teachers are potential means for addressing health inequities.