Designing for justice: How universal design theory could bolster health professional education research
DOI:
https://doi.org/10.11157/fohpe.v24i4.791Keywords:
qualitative research; equity; justice; research design; universal design; disability studies; health professional educationAbstract
Universal design theory (UDT), emerging from the field of architecture and infused with the politics of the disability rights movement, refers to a way of planning for and responding to diversity that can be harnessed for research design. We argue that UDT is a critical tool for researchers in health professional education (HPE) to realise their obligations for social accountability, justice, equity, diversity and inclusion in HPE. This paper introduces researchers to UDT and demonstrates how it could inform research design in HPE. We provide an in-depth, socio-political explanation of the theory and why it is important for HPE research, and we elucidate ways it can inform HPE research design and process—including the tensions that may arise in activating these principles alongside some research paradigms and conditions of the field. We seek to highlight the potential of universal design to transform research practice to advance justice.References
Aibana, O., Swails, J. L., Flores, R. J., & Love, L. (2019). Bridging the gap: Holistic review to increase diversity in graduate medical education. Academic Medicine, 94(8), 1137–1141. https://doi.org/10.1097/acm.0000000000002779
Archer, J., McManus, C., Woolf, K., Monrouxe, L., Illing, J., Bullock, A., & Roberts, T. (2015). Without proper research funding, how can medical education be evidence based? BMJ, 350, Article h3445. https://doi.org/10.1136/bmj.h3445
Baglieri, S. (2020). Toward inclusive education? Focusing a critical lens on universal design for learning. Canadian Journal of Disability Studies, 9(5), 42–74. https://doi.org/10.15353/cjds.v9i5.690
Barber, C., van der Vleuten, C., Leppink, J., & Chahine, S. (2020). Social accountability frameworks and their implications for medical education and program evaluation: A narrative review. Academic Medicine, 95(12), 1945–1954. https://doi.org/10.1097/acm.0000000000003731
Barthes, R. (2000). Mythologies (A. Lavers, Trans.). Vintage. (Original work published 1957)
Beagan, B. L., Sibbald, K. R., Pride, T. M., & Bizzeth, S. R. (2022). Professional misfits: “You’re having to perform . . . all week long.” The Open Journal of Occupational Therapy, 10(4), 1–14. https://doi.org/10.15453/2168-6408.1933
Bullock, J. L., Lockspeiser, T., del Pino-Jones, A., Richards, R., Teherani, A., & Hauer, K. E. (2020). They don’t see a lot of people my color: A mixed methods study of racial/ethnic stereotype threat among medical students on core clerkships. Academic Medicine, 95(11S), S58–S66. https://doi.org/10.1097/ACM.0000000000003628
Burgstahler, S. (2013). Introduction to universal design in higher education. In S. Burgstahler (Ed.), Universal design in higher education: Promising practices. DO-IT. www.uw.edu/doit/UDHE-promising-practices/part1.html
Burgstahler, S. (2021). Universal design: Process, principles, and applications. DO-IT. https://www.washington.edu/doit/universal-design-process-principles-and-applications
Burgstahler, S., & Cory, R. (2008). Moving in from the margins: From accommodation to universal design. In S. L. Gabel & S. Danforth (Eds.), Disability and the politics of education: An international reader (pp. 1–22). Peter Lang.
Butler, K., Yak, A., & Veltman, A. (2019). “Progress in medicine is slower to happen”: Qualitative insights into how trans and gender nonconforming medical students navigate cisnormative medical cultures at Canadian training programs. Academic Medicine, 94(11), 1757–1765. https://doi.org/10.1097/acm.0000000000002933
CAST (2018). Universal design for learning guidelines: Version 2.2. http://udlguidelines.cast.org
Castrodale, M. A. (2018). Mobilizing dis/ability research: A critical discussion of qualitative go-along interviews in practice. Qualitative Inquiry, 24(1), 45–55. https://doi.org/10.1177/1077800417727765
Center for Universal Design. (1997). The principles of universal design. NC State University. https://design.ncsu.edu/wp-content/uploads/2022/11/principles-of-universal-design.pdf
Davis, G., & Came, H. (2022). A pūrākau analysis of institutional barriers facing Māori occupational therapy students. Australian Occupational Therapy Journal, 69(4), 414–423. https://doi.org/10.1111/1440-1630.12800
Dolmage, J. (2005). Disability studies pedagogy, usability and universal design. Disability Studies Quarterly, 25(4). https://dsq-sds.org/article/view/627/804
Dolmage, J. T. (2017). Academic ableism. University of Michigan Press.
Foucault, M. (2013). Archaeology of knowledge. Taylor and Francis.
Frost, H. D., & Regehr, G. (2013). “I AM a doctor”: Negotiating the discourses of standardization and diversity in professional identity construction. Academic Medicine, 88(10), 1570–1577. https://doi.org/10.1097/acm.0b013e3182a34b05
Garland-Thomson, R. (1997). Extraordinary bodies: Figuring physical disability in American culture and literature. Columbia University Press.
Hall, S. (1997). Representation: Cultural representations and signifying practices. Open University.
Hamraie, A. (2012). Universal design research as a new materialist practice. Disability Studies Quarterly, 32(4). https://dsq-sds.org/article/view/3246/3185
Hamraie, A. (2013). Designing collective access: A feminist disability theory of universal design. Disability Studies Quarterly, 33(4). https://dsq-sds.org/article/view/3871/3411
Hamraie, A. (2016). Universal design and the problem of “post-disability” ideology. Design and Culture, 8(3), 285–309. https://doi.org/10.1080/17547075.2016.1218714
Hamraie, A. (2017). Building access: Universal design and the politics of disability. University of Minnesota Press.
Haraway, D. (1988). Situated knowledges: The science question in feminism and the privilege of partial perspective. Feminist Studies, 14(3), 575–599. https://doi.org/10.2307/3178066
Jaarsma, A. S. (2016). Design, disability and play: The animal politics of education. Gender and Education, 28(2), 195–212. https://doi.org/10.1080/09540253.2015.1132301
Jain, N. R. (2022). The capability imperative: Theorizing ableism in medical education. Social Science & Medicine, 315, Article 115549. https://doi.org/10.1016/j.socscimed.2022.115549
Karani, R., Varpio, L., May, W., Horsley, T., Chenault, J., Miller, K. H., & O’Brien, B. (2017). Racism and bias in health professions education: How educators, faculty developers, and researchers can make a difference. Academic Medicine, 92(11S), S1–S6. https://doi.org/10.1097/acm.0000000000001928
Mace, R. (1985). Universal design: Barrier-free environments for everyone. Designers West, 33(1), 147–152.
Manca, A., Gormley, G. J., Johnston, J. L., & Hart, N. D. (2020). Honoring medicine’s social contract: A scoping review of critical consciousness in medical education. Academic Medicine, 95(6), 958–967. https://doi.org/10.1097/acm.0000000000003059
McGuire, J. M., & Scott, S. S. (2006). Universal design for instruction: Extending the universal design paradigm to college instruction. Journal of Postsecondary Education and Disability, 19(2), 124–134.
McKechnie, D. G. J., Al-Shakarchi, N., Tackett, S. A., Young, T. M., & Rashid, M. A. (2023). Sources of funding for research articles in medical education journals from 1999 to 2019. Medical Teacher, 45(10), 1123–1128. https://doi.org/10.1080/0142159x.2023.2192858
Meeks, L. M., & Jain, N. R. (2018). Accessibility, inclusion, and action in medical education: Lived experiences of learners and physicians with disabilities. AAMC.
Naidu, T. (2021). Southern exposure: Levelling the northern tilt in global medical and medical humanities education. Advances in Health Sciences Education, 26(2), 739–752. https://doi.org/10.1007/s10459-020-09976-9
Paton, M., Naidu, T., Wyatt, T. R., Oni, O., Lorello, G. R., Najeeb, U., Feilchenfeld, Z., Waterman, S. J., Whitehead, C. R., & Kuper, A. (2020). Dismantling the master’s house: New ways of knowing for equity and social justice in health professions education. Advances in Health Sciences Education, 25(5), 1107–1126. https://doi.org/10.1007/s10459-020-10006-x
Phillips, R. L., George, B. C., Holmboe, E. S., Bazemore, A. W., Westfall, J. M., & Bitton, A. (2022). Measuring graduate medical education outcomes to honor the social contract. Academic Medicine, 97(5), 643–648. https://doi.org/10.1097/acm.0000000000004592
Price, M. (2015). The bodymind problem and the possibilities of pain. Hypatia, 30(1), 268–284. https://doi.org/10.1111/hypa.12127
Price, M., & Kerschbaum, S. L. (2016). Stories of methodology: Interviewing sideways, crooked and crip. Canadian Journal of Disability Studies, 5(3), 18–56. https://doi.org/10.15353/cjds.v5i3.295
Schweik, S. M. (2009). The ugly laws: Disability in public. NYU Press.
Scott, S. S., Loewen, G., Funckes, C., & Kroeger, S. (2003). Implementing universal design in higher education: Moving beyond the built environment. Journal of Postsecondary Education and Disability, 16(2), 78–89. https://www.semanticscholar.org/paper/Implementing-Universal-Design-in-Higher-Education%3A-Scott-Loewen/8623a9b67f01a93feefb8322b2b1136fcfbf9141
Scott, S. S., McGuire, J. M., & Shaw, S. F. (2001). Principles of universal design for instruction. Center on Postsecondary Education and Disability, University of Connecticut.
Sins Invalid. (2019). Skin, tooth, and bone: The basis of our movement is people. https://www.sinsinvalid.org/disability-justice-primer.
Southgate, E., Brosnan, C., Lempp, H., Kelly, B., Wright, S., Outram, S., & Bennett, A. (2017). Travels in extreme social mobility: How first-in-family students find their way into and through medical education. Critical Studies in Education, 58(2), 242–260. https://doi.org/10.1080/17508487.2016.1263223
Titchkosky, T. (2007). Reading and writing disability differently: The textured life of embodiment. University of Toronto Press. https://www.jstor.org/stable/10.3138/9781442683839
Todres, M., Stephenson, A., & Jones, R. (2007). Medical education research remains the poor relation. BMJ, 335(7615), 333–335. https://doi.org/10.1136/bmj.39253.544688.94
Varpio, L., Paradis, E., Uijtdehaage, S., & Young, M. (2020). The distinctions between theory, theoretical framework, and conceptual framework. Academic Medicine, 95(7), 989–994. https://doi.org/10.1097/acm.0000000000003075
Volpe, R. L., Hopkins, M., Haidet, P., Wolpaw, D. R., & Adams, N. E. (2019). Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis. Medical Education, 53(2), 119–132. https://doi.org/10.1111/medu.13781
Weedon, C. (1987). Feminist practice and poststructuralist theory. Blackwell.
Williams, A. S., & Moore, S. M. (2011). Universal design of research: Inclusion of persons with disabilities in mainstream biomedical studies. Science Translational Medicine, 3(82), 82cm12. https://doi.org/10.1126/scitranslmed.3002133
Withers, A. J. (2012). Disability politics & theory. Fernwood Publishing.
Wyatt, T. R. (2022). “The sins of our forefathers”: Reimagining research in health professions education. Advances in Health Sciences Education, 27(4), 1195–1206. https://doi.org/10.1007/s10459-022-10111-z
Wyatt, T. R., Balmer, D., Rockich‐Winston, N., Chow, C. J., Richards, J., & Zaidi, Z. (2021). “Whispers and shadows”: A critical review of the professional identity literature with respect to minority physicians. Medical Education, 55(2), 148–158. https://doi.org/10.1111/medu.14295
Wyatt, T. R., Casillas, A., Webber, A., Parrilla, J. A., Boatright, D., & Mason, H. (2023). The maintenance of classism in medical education: “Time” as a form of social capital in first-generation and low-income medical students. Advances in Health Sciences Education, 1–16. https://doi.org/10.1007/s10459-023-10270-7
Young, M. E., & Ryan, A. (2020). Postpositivism in health professions education scholarship. Academic Medicine, 95(5), 695–699. https://doi.org/10.1097/acm.0000000000003089
Zaidi, Z., Young, M., Balmer, D. F., & Park, Y. S. (2021). Endarkening the epistemé: Critical race theory and medical education scholarship. Academic Medicine, 96(11S), Si-Sv. https://doi.org/10.1097/acm.0000000000004373
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Focus on Health Professional Education: A Multi-Professional Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
On acceptance for publication in FoHPE the copyright of the manuscript is signed over to ANZAHPE, the publisher of FoHPE.
