UCLA Nursing: Community Engaged Learning

A significant portion of educating nursing students is devoted to placing them in clinical environments, where they work with mentors to learn the core skills involved in caring for patients. So when Dr. Lauren Clark, UCLA School of Nursing professor and the Shapiro Family Endowed Chair in Developmental Disabilities Studies, speaks on the importance of community-engaged learning (CEL), she is sometimes met with skepticism.

“Students taking part in CEL aren’t there to learn clinical skills or practice being a nurse,” notes Clark. “They are there to engage with the community — as a partner and at times an advocate, learning and growing around the community’s chosen priorities.”

Clark views CEL as foundational for preparing nurses to best serve people with disabilities. “If we don’t employ our skills to help people in communities live their best lives, we will never be able to be effective in using nursing skills, theory, and interventions,” she says. “Only after students have an understanding of where nursing is positioned relative to the lived experience of disability can they begin to learn and effectively apply those clinical skills.”

Clark has been an advocate for CEL since the outset of her career, when it was referred to as service learning. The principle remains largely the same. “It’s not just volunteerism, and it’s not clinical,” she says. “It’s a balance that helps the student come up with new ways of thinking about themselves and the role of compassion, empathy, communication, and other basic nursing skills. In this case, it’s exposing them to the disability community and learning what their challenges are, as well as how nursing can be a force for good in their lives.”

For the last three years Clark has taught a course, “Care Work: Disability Justice and Healthcare,” that includes both a two-unit theory portion and a three-unit, 60-hour CEL practicum. Offered through both UCLA Nursing and the interdepartmental Disability Studies Program on campus, the course brings nursing students together with students from a wide array of majors — both within and outside of the health sciences. “Nurses are partners in caring for people with disabilities, so having our nursing students learning alongside students who will be going into other professions is invaluable preparation for them,” Clark says of the course, which has tripled in enrollment over the three years it’s been offered.

During the theory section of the course, students learn about the “webs of care” people with disabilities have — including family members and other close relationships; schools, hospitals and clinics; and society at large, in the form of policies and laws that confer services and rights. “Those of us in the caring professions need to appreciate the care work that is already embedded within the disability community, and amplify those efforts rather than trying to supplant the work that’s occurring,” Clark explains.

The CEL experience is facilitated by Momentum, a disability organization that empowers children and adults with disabilities through community partnerships, services, and advocacy. Students are paired with an adult recipient of Momentum services — their “learning leader” — as well as meeting with a panel of adults with disabilities to learn more about the lived experiences of being disabled in Los Angeles and ways in which care work falls short. “We talk in class about issues such as access to reproductive healthcare for people with disabilities, or being able to obtain various levels of care for their children and themselves as they enter into parenting,” Clark says. “More than just the theoretical understanding you get from a lecture, it’s so important to see things through the eyes of an individual.”

As part of the CEL practicum, the students develop a project in collaboration with a person with disabilities. One student worked with a woman with cerebral palsy to create several episodes of a video food blog showing ways to overcome fine motor challenges through certain recipes and approaches to cooking. Another advocated for a woman who hadn’t had a pelvic exam in 12 years because of problems with accessible exam tables and the lack of knowledgeable providers. The student’s efforts continued well after the class ended, and when she ultimately helped her learning leader find an appropriate provider, the student accompanied her to the appointment.

Clark is part of another community-engaged project as the first recipient of the Judy Heumann Award through the UCLA Disabilities Studies program. The award aims to amplify disability justice and challenge ableism on campus through a community partnership. It is named after the late disability rights activist and icon for the movement, whom Clark was instrumental in bringing to UCLA as the Regents Lecturer in 2021. With the award, Clark is working in partnership with Keris Myrick, host of the “Unapologetically Black Unicorns” podcast, to screen the film Unseen on campus, depicting chasms in care for people with disabilities.

In preparing future nurses to best serve patients with disabilities, Clark feels strongly that learning both in and from the community is essential to understanding the challenges they bring to the healthcare setting.

“Many of our students have had very limited exposure to people with disabilities before the class, and they are often incredibly nervous the first time they meet an adult with a disability,” Clark says. “They keep journals throughout the community-engaged experience, and it’s not uncommon for them to reflect at the end and marvel at how much they’ve grown. They realize that this is a person with many similarities to them, and express that they now fully understand the humanity of that individual in a way they didn’t before.”