In this week’s blog, Dr Sarah McLaughlin (L) collaborates with Dr Florence Neville (R) to provide a flavour of an increasingly popular topic of exploration chosen by students studying on the Health Professions Educations Diploma and MSc – neurodiversity. Sarah and Florence wrote this blog to introduce the concept of neurodiversity and how it relates to medical education.
Photo by Peter Burdon on Unsplash
The neurodiversity paradigm is an increasingly popular area of interest amongst professionals engaging in the Health Professions Education Programme. This is not surprising considering the field of Health Professions Education (HPE) has seen an increase in awareness and strategies to promote inclusivity and diversity; clinical educators are increasingly in contact with students, and colleagues, from a diverse range of backgrounds (George and Sidhu, 2023). So, what are we referring to when we say ‘neurodiversity’ and what questions does the concept of neurodiversity raise in relation to HPE?
When we say ‘neurodiversity’, we are referring to the diversity of human minds: the natural and valuable differences in how human brains process and respond to information, and how these differences shape how individuals perceive and interact with the world. These differences, or ‘neurotypes’ include, but are not limited to, ADHD, autism, dementia, dyscalculia, dysgraphia, dyslexia, dyspraxia, OCD, Tourette’s, and being neurotypical (having a brain that functions within dominant societal standards of “normal”). Traditionally, neurodivergent people (the 1 in 5 of us who are not neurotypical), have been considered inherently lacking or disordered. However, the neurodiversity movement has been instrumental in challenging this pathologisation of minority cognitive styles (Walker, 2021; Chapman, 2021).
The neurodiversity movement – a social justice movement comprising of various groups and organisations formed since discussions around neurocognitive diversity took place in global online groups in the 1990s – advocates for civil rights, equality, respect and full societal inclusion for neurodivergent people (Walker, 2021; Botha et al., 2024). In this way, the movement draws on (1) the social model of disability, which considers how external physical and social barriers limit individuals from taking part in communities on an equal level with others (Oliver, 1998), and (2) the neurodiversity paradigm, which sees neurodiversity as natural and valuable, and considers the dynamics of social power inequalities in relation to neurodiversity (Walker, 2021).
Accessing accurate statistics relating to the number of students and health professionals who are neurodivergent is difficult. Universities rely on self-disclosure, but not all neurodivergent students are aware of their neurodivergent identity, let alone have a diagnosis. Additionally, universities vary in how they collect data on neurodivergence. For example, data on neurodivergence may be collected as a mental health condition or as a learning disability. Thus, if students (1) do not consider themselves to have a health condition or a learning disability, (2) do not have a clinical diagnosis, or (3) are unaware that they are neurodivergent, their neurodivergence may not be recorded. However, current estimates suggest that at least 20% of the UK adult population is neurodivergent and there is no reason to suppose that this is not reflected in the HPE student population (BPS, 2022).
Change is needed. We must depart from rigid one-size-fits-all pedagogical approaches which higher education has traditionally encompassed. These approaches fail to embrace the diverse cognitive styles and strengths present among students, particularly those who are neurodivergent.
To create a more inclusive learning environment, HPE must embrace flexibility, individualisation, and support, as part of their curriculum planning. Neurodivergent students and educators bring unique perspectives, abilities, and talents to the learning environment. Through exploring alternative approaches to learning, educators can tap into these strengths, and foster success for a diverse student body. We need to create work environments where neurodivergent educators feel safe to be open about their own neurodivergence, so that students see their own neurodivergence represented. Some of the difficulties faced by neurodivergent students may be addressed by increasing the diversity and openness of senior role models and educators. The positive impact of fostering a more inclusive learning environment for students, is the potential for medical school graduates becoming medical educators, and role models, themselves. We also need to listen to our neurodivergent colleagues who have additional insight into specific learning and wellbeing supports for our students.
When it comes to neurodiversity, we advocate for creating inclusive, compassionate, and supportive learning environments. This includes understanding and destigmatising neurodivergence, and regularly assessing how we can make learning environments, teaching and assessment practices, and pastoral support more accessible for a wider range of learners. Once accessibility is fully considered and incorporated into institutional structures and environments, individual accommodations (which are legal requirements under the 2010 Equality Act) become easier and less time consuming to manage – both for staff and students.
Policies and practice that support neurodivergent students should include regular staff and faculty training about neurodiversity and inclusive teaching practices, individualised support plans to ensure unique needs are addressed, peer support networks, and flexible learning environments (Clouder et al., 2020).
The growing interest and awareness of neurodiversity is promising. However, alongside raising awareness of the need for inclusivity we should be enabling a shift towards a more holistic approach to educating our future health care professionals. Harnessing the full spectrum of cognitive diversity among future health professionals has the potential to translate into improved outcomes for patients, innovation in research and practice, and the fostering of a more compassionate and inclusive healthcare system.
References
- Botha, M., Chapman, R., Giwa Onaiwu, M., Kapp, S., Stannard Ashley, A., & Walker, N. (2024). The neurodiversity concept was developed collectively: An overdue correction on the origins of neurodiversity theory. Autism. 28(6), pp. 1591-1594.
- British Psychological Society (BPS). (2022) Celebrating neurodiversity in Higher Education. [Online] Available: https://www.bps.org.uk/psychologist/celebrating-neurodiversity-higher-education. Accessed 24/4/2024
- Chapman, R. (2021). Neurodiversity and the Social Ecology of Mental Functions. Perspectives on Psychological Science. 16(6), pp. 1360-1372.
- Clouder, L., Karakus, M., Cinotti, A., Ferreyra, M.V., Fierros, G.A. and Rojo, P., (2020). Neurodiversity in higher education: a narrative synthesis. Higher Education, 80(4), pp.757-778.
- George, R.E. and Sidhu, M.S. (2023). Promoting inclusivity in health professions education. The Clinical Teacher, 20(6), p.e13606.
- Hamilton, L.G. and Petty, S., (2023). Compassionate pedagogy for neurodiversity in higher education: A conceptual analysis. Frontiers in Psychology, 14, p.1093290.
- Kapp, S. K., Gillespie-Lynch, K., Sherman, L. E., & Hutman, T. (2013). ‘Deficit, difference, or both? Autism and neurodiversity. Developmental Psychology, 49(1), 59–71.
- Oliver, M. (1998). Theories of disability in health practice and research. British Medical Journal. 317(7170), pp. 1446-1449.
- Sedgwick, J.A., Merwood, A. and Asherson, P. (2019). The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11(3), pp.241-253.
- Walker, N. (2021). Neuroqueer Heresies: Notes on the Neurodiversity Paradigm, Autistic Empowerment, and Postnormal Possibilities. Fort Worth: Autonomous Press, LLC.
Author Biographies
Dr Sarah McLaughlin is the MSc Health Professions Education Co-Lead and lecturer. Her research interest relates to the sociology of education, widening participation and inclusive practice.
Dr Florence Neville is a Senior Associate Teacher in the School of Education. She supports education providers in becoming more accessible, and thus inclusive, for neurodivergent colleagues, students and young people.