1. Meloy, Faye A. PhD, RN, MSN, MBA
  2. Gambescia, Stephen PhD, MEd, MBA, MHum, MCHES

Article Content

Thank you for sharing the Letter to the Editor from Dr Leslie Neal-Boylan regarding our recently published article. While we are somewhat surprised at the accusatory tone of Dr Neal-Boylan's comments, we appreciate the opportunity to respond. At the outset we want to point out that the focus of this article is not on students with disabilities, but rather is on the myriad of student requests faculty members face each day and to highlight important considerations in dealing with such requests.


Dr Neal-Boylan asserts that a discussion about students with physical disabilities should not occur in the context of academic considerations and suggests that we imply that a student with physical disabilities is "in some way impaired to perform well academically." That is simply untrue as we were not implying that students' physical disabilities had any impact on their academic performance. Numerous students with substantial physical impairments have been supported throughout our nursing program and have successfully transitioned to professional nursing roles. It also appears that Dr Neal-Boylan assumes that our reference to "technical standards" relates only to a student's ability to perform tasks; however, it is our assertion that critical thinking and clinical judgment skills are essential components of technical standards. Furthermore, we do not suggest that "students who cannot meet technical standards should find a different career" and feel that it is the responsibility of faculty and educational administrators to decide how best to assist students (all students) in successfully achieving programmatic outcomes. We agree that many of the traditional "skill sets" associated with nursing have become outdated, concur that new and emerging technologies are redefining essential components of nursing care delivery, and support ongoing review and revision of outcome measures for academic nursing programs that reflect technical and professional standards of contemporary nursing practice.


Dr Neal-Boylan challenges the decision to address physical and mental disabilities in the same section of the article, stating that "they are vastly different and lead to erroneous conclusions in the article." The article purposely does not address either similarities or differences in these categories of disability, and the decision to combine these disabilities in the narrative was related to their mutual inclusion under the legislative mandates associated with the Americans With Disabilities Act. We believe that readers can distinguish between the 2 and will not err in our intentions.


There was never any assertion in the article that students "exploit" faculty so that a disability could work to their advantage, nor do we state that students may want to be disabled to avoid schoolwork. Dr Neal-Boylan notes that we "recommend that students not be allowed to disclose their disabilities retroactively." That is not the case in the article and not the case in practice. We wrote, quite correctly, that students who do not disclose to faculty, by way of the official AVL letter for an accommodation, cannot rescind performance of work retrospectively. These requests are made often enough and merit being reported in the literature. We are aware that students can reach out to the Office of Disability Services at any time and strongly encourage them to do so proactively. Information related to access and support from the Office of Disability Services is contained in every course syllabus and the Student Handbook. Faculty members are also encouraged to suggest that students avail themselves of the student support services available to them (including the Office of Disability Services) on a regular basis.


Dr Neal-Boylan's assessment is that we are "not acquainted with the nursing literature on this topic and have serious misconceptions and prejudices about disability, students with disabilities, and ultimately what nurses with disabilities can accomplish." However, the focus of this article is not related to disability per se, but rather to suggest that the historic use of the term "accommodation" in and of itself leads to confusion and obvious emotion. In terms of the literature, we have referenced a healthy number of statements and believe we are adding to the literature with a nonnormative tone. As authors, we do not position ourselves as experts on students with disabilities but have actually lived the experience as academic administrators and educators who have had to address the myriad of student issues and respond to students, parents, and faculty alike when there are missed expectations.


Our article suggests that a clear distinction needs to be made between the terms "consideration" versus "accommodation" to assist faculty in best supporting student needs. The latter term encompasses all of the educational supports mandated by the Americans with Disabilities Act. The term "consideration," on the other hand, comprises the spectrum of special, informal requests made by students to faculty on an ongoing basis. Such requests, in the absence of verified accommodations from the Office of Disability Services, often leave faculty members confused as to how best to proceed. Unfortunately, failure to recognize an emerging pattern of such requests or independent well-meaning faculty actions can delay student referral to needed services and/or unintentionally create inequity in the educational process. The best practices suggested herein are merely an attempt to raise faculty awareness and provide a starting point for the evolution of educational policies and supports that will assist faculty to effectively meet the needs of all students now and in the future. We are pleased that this article has generated a great deal of interest and have received several e-mails from readers who express a high level of utility this article has for themselves and their colleagues.


It is disconcerting that in our attempt to speak to this issue, experts such as Dr Neal-Boylan leap to assumptions about discrimination. Such reactions only serve to discourage much needed dialogue without providing guidance to frontline faculty. We are committed to not only fulfilling the letter of the law but also working toward enhanced diversity and ending discrimination in the nursing profession. In our closing statement, we note that "faculty members are not expected to be expert in handling the sundry of issues related to student considerations and accommodations. Thus, a collaborative systems approach is needed to give students needed consideration and accommodation while protecting the academic rigor and technical standards of the nursing program and maintaining administrative order when handling student issues." We are hoping that faculty will, over time, "get better at this" but more importantly reach out to those who understand the nuances of the faculty-student interaction in the academic setting. Most certainly, Dr Neal-Boylan would be one of these resources.


Faye A. Meloy, PhD, RN, MSN, MBA


Associate Dean


Prelicensure BSN Programs


Drexel University College of Nursing & Health Professions


Philadelphia, Pennsylvania (


Stephen Gambescia, PhD, MEd, MBA, MHum, MCHES




Drexel University College of Nursing & Health Professions


Philadelphia, Pennsylvania (