When you don’t fit the nursing student ‘ideal’: overcoming academic barriers

Why we need to re-evaluate how we support and assess students with a specific learning difficulty

I have spent my school and college years – and most of my nursing degree – struggling with academic work.

I never understood why until six months ago, when I was diagnosed with dyspraxia. It was a relief to be able to put a name to my difficulties and my love-hate relationship with these academic challenges.

Disorder affects how people memorise and process information 

A specific learning difficulty (SpLD), dyspraxia is a developmental coordination disorder that affects the way I am able to memorise, process and organise information. This means I am not able to read an academic text, or any book for that matter, and take in the information fully. I can read for hours and still be none the wiser.

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I learn best through visual interaction and engagement. Such is the power of the tone of someone’s voice when telling a story, I am able to relate, engage and memorise the information.

Our ability to express ourselves as human beings is why we relate so well to each other, but this type of engagement is easily lost through written text. I am even having difficulty describing it to you now. I wish I could jump out of the page and use my hands, arms and voice to tell my story.

Problems with academic methods of assessment for nursing students

All nursing students are assessed using a mixture of presentations, exams, academic writing and objective structured clinical examinations (OSCEs). But I am not all nursing students, I am an individual with dyspraxia and need to be assessed in a way that meets my learning needs.

‘People with dyspraxia should not be discriminated against because our brains work differently, and it is high time that those undertaking a nursing degree are assessed according to their individual needs’

If I were able to verbalise my understanding of a subject, my thoughts and feelings, I feel I would excel at academic work. But the rules of university exams and assessments mean I am not able to communicate verbally or through the use of body language, other than a rare presentation or OSCE.

This can make it difficult for me and others with dyspraxia to showcase our unique talents. We may be passionate and innovative, but unable to articulate this through academic writing.

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We struggle to make sense of it because our brains cannot organise this information in the same way as others. As a consequence, many of us find ourselves just meeting the minimum requirements necessary to pass our academic assignments.

As nursing students, we are required to meet clinical competencies in practice, as set out by the Nursing and Midwifery Council code and encompassing the 6Cs (care, compassion, competence, communication, courage and commitment). If I was assessed in a similar way to how I learn, and graded on my nursing qualities in practice rather than just receiving a ‘pass’ or ‘fail’, I am sure I would surpass expectations and thrive academically.

Re-evaluation of support and assessment for students with learning difficulties

Dyspraxia affects individuals differently, but people with the condition often feel their qualities are not recognised, and that they are not celebrated in the same way as their high-achieving peers who better fit the narrative of the ‘academic’ nursing student.  

I have received a lot of support from my university throughout my studies, but my dyspraxia diagnosis means I now have to adapt to a new way of working at the end of my nursing degree, at the same time as completing my final, graded assignment.

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I have always had to work extremely hard just to pass an academic assessment and, as my academic work before my diagnosis highlighted how I am unable to translate my thinking into high quality academic writing, I am sure I will get a lower grade than my peers. I am also academic – I just don’t fit this ideal when it comes to assessments.

With the recruitment and retention of future nurses of such importance to the NHS and universities, we need to collectively re-evaluate how we support, educate and assess students with specific learning difficulties.

Recognising different ways of expressing passion for nursing 

I am writing my dissertation on the use of play for children in hospital, a subject I am passionate about. I have actively encouraged play among children when in clinical practice and have been involved in a preoperative video for children to watch before attending hospital for surgery.

I can articulate myself through speech and expression, showcasing my passion for and knowledge of a subject. But transferring this to the writing of an academic paper is like translating it into a foreign language I am unable to speak or understand.

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People with dyspraxia should not be discriminated against because our brains work differently, and it is high time that those undertaking a nursing degree were assessed according to their individual needs.

The unique qualities of people with dyspraxia need to be recognised, rather than expecting us to adapt to an academic process that is damaging to our self-esteem and not conducive to our learning.

Ricky Baker is a third-year children’s nursing student at the University of Worcester and founder of the Children and Young People Student Nurse Network @CYPStNN

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