Exploring the factors influencing the sense of belonging among medical students with disabilities in a medical university environment

Abstract

Background Medical universities have become more aware of disability inclusion, and have begun taking cognizance of the importance of a supportive environment for students with disabilities. Faculty members can mitigate challenges to legitimacy and belonging by creating safe learning environments built on openness, humility, and an active valuing of each learner. However, the factors contributing to these students’ sense of belonging in medical university settings remain unexplored. To address this issue, the present study examines social and organizational factors influencing the sense of belonging for medical students with disabilities.

Methods A qualitative phenomenological study using paradox theory was conducted with 25 Japanese faculty members who have interacted with medical students with disabilities, to explore the social factors contributing to their sense of belonging. Furthermore, a qualitative phenomenological study using figured world theory was conducted with three medical students with disabilities and two faculty members at Harvard Medical School (HMS) to explore the organizational factors influencing their sense of comfort and belongingness. Data were collected through face-to-face and online, semi-structured interviews. Data coding and analysis were initially inductive from a social constructivism paradigm. However, as themes emerged, we used a theoretical framework to group themes into each contextual dimension.

Results In the Japanese study, faculty members believed that verbalizing appreciation for medical students with disabilities should include the entire student body, thus enhancing community perception and enabling students with disabilities to feel a sense of belonging. They felt that students’ personalities and experiences before entering medical university influenced their sense of belonging, which could be a barrier in the specific medical university environment. In the Harvard study, three themes were extracted as organizational factors related to the students’ sense of belonging: the significance of community building among students with disabilities, invisible barriers between these students and faculty, and invisible barriers between students with disabilities and other students. Although the cultural contexts of the two studies are different, it was noted that a sense of belonging may not be fostered in situations of cultural humility and authority unique to medical universities in both studies.

Discussion Research participants articulated a tension between the organization (medical university) and the individual (student with a disability) as a paradox of various social and organizational factors, and that collaboration between both the medical students with disabilities involved and the medical students and faculty surrounding them is necessary to foster a sense of belonging. The findings suggest that medical universities can play an active role in creating more inclusive environments.