Universal Design for Learning for Clinical Educators: Design Thinking in Clinical Settings

Introduction

In the United States, college and university classrooms are populated by students who are diverse across many intersecting variables, including age, race, ethnicity, culture, language, gender, health, religion, sexuality, ability, academic preparation, socioeconomic status, and ideologies. According to the U.S. National Center for Education Statistics (Snyder, de Brey, & Dillow, 2019), approximately 19% of undergraduate students and 12% of graduate students disclosed a disability. In 2015-16, 56% of undergraduates were first generation college students (RTI International, 2019). Additionally, English language learners (ELLs) are the fastest growing student population in the United States, with an estimate that nearly 25% of U.S. public-school students will be ELLs by 2025 (National Education Association, 2020). Unquestionably, the growing diversity of students in U.S. institutions of higher education (HE) increases the responsibility of college and university faculty to provide equitable learning experiences for all students. Diversity at the classroom level, whether visible or invisible, presents faculty members with the pedagogical challenge of building inclusive and respectful learning environments that supports the goal of learning for all students.

Within U.S. healthcare education programs, the challenge of designing high-quality clinical practice experiences that engage a diverse student body and support them toward becoming competent professionals is especially significant for clinical supervisors (e.g., preceptor, educator). In the healthcare professions, clinical practice experiences are an essential and integral component of healthcare program curricula (Fanelli Toussaint & Glennon, 2020). They are formal fieldwork (e.g., internships) opportunities during which students are expected to translate theories learned in the classroom into professional practice. Clinical practice experiences typically take the form of a credit-bearing course. The design, implementation, and evaluation of these learning experiences will vary from discipline to discipline based on the field of study, degree program learning outcomes, and accrediting body standards. Clinical supervisors are appropriately credentialed professionals (e.g., licensed, registered) who have expertise aligned with their responsibilities. In the educator-student relationship, supervisors serve many critical roles, including instructional designer, teacher, role model, counselor, and evaluator (Higgs & McAllister, 2005).

This chapter focuses on the clinical supervisor’s role as an instructional designer, and using what is known about how people learn and retain information to support students in meeting their academic and professional goals. Presented first is background information on clinical supervisors’ responsibilities and the need to have a framework to support access to learning for all students. Then, a brief review of the limited literatures related to how the Universal Design for Learning (UDL) framework (CAST, 2018) has been applied in healthcare education clinical practice settings is presented. Provided next is a discussion of UDL as a lens for designing inclusive learning experiences with particular emphasis placed on four interrelated curricular components: goals and outcomes, assessment, methods, and materials (Meyer, Rose, & Gordon, 2014). A description of the design thinking cycle follows. Clinical vignettes from three health professions—occupational therapist, physician assistant, and pharmacist—are threaded throughout the explanation. The aim of the vignettes is to illuminate how supervisors, in their instructional designer roles, might apply design thinking and UDL solutions to remove learning barriers and support students in clinical settings.