Disability Competency Frameworks Reshape Healthcare Curricula, Review Finds

More than one billion people worldwide live with a disability, and in the United States more than one in four adults does, yet people with disabilities continue to face persistent barriers to equitable healthcare. A sweeping new analysis suggests a surprising root of these disparities: the way healthcare professionals are trained. Published in BMC Medical Education, the research offers the most comprehensive map to date of how disability competency frameworks are shaping curricula across the health professions, and its findings are already fueling calls for mandatory disability education in every healthcare program.

The study, led by Rebecca N. Weston of the University of Maryland School of Nursing together with colleagues including Brian Abery of the University of Minnesota’s Institute on Community Integration, took the form of a scoping review conducted under PRISMA-ScR guidelines. Working with a health sciences librarian, the team searched Medline, CINAHL, Embase, and Scopus for peer-reviewed studies published from 2010 onward that used an identifiable framework, competency set, model, theory, or professional standard to guide disability-focused education within a formal healthcare program. Three independent reviewers screened the results in Covidence, a rigorous process designed to minimize bias in study selection.

Forty-seven studies met the inclusion criteria, spanning twelve countries and an unusually broad range of learner populations: medical, nursing, dental, pharmacy, physical and occupational therapy, and social work students. Medical students were the most frequently studied group, a detail that itself reveals how much of the field’s evidence base rests on a single discipline. The geographic spread was equally telling, with significant gaps in representation from large parts of the world, meaning the conclusions drawn largely reflect high-income, English-speaking educational contexts.

What emerged from the analysis was not a single dominant blueprint but four distinct categories of frameworks guiding disability education. The first comprises formal competency frameworks issued by accrediting bodies or national health authorities, the kind of top-down standards that carry regulatory weight. The second draws on educational theory from the learning sciences, grounding disability content in established principles of how people learn. The third category encompasses disability rights and justice frameworks, which reframe disability not as a deficit to be managed but as a matter of civil rights and social equity, echoing the United Nations Convention on the Rights of Persons with Disabilities. The fourth includes practice-specific or hybrid frameworks that blend elements of the other categories for particular clinical settings.

Technically, the review identified a remarkably diverse array of named frameworks, theories, competency sets, and professional standards, but relatively few recurred across multiple studies. Among those that did were the Core Competencies on Disability for Health Care Education developed by the Alliance for Disability in Health Care Education, competency-based medical education models aligned with the International Classification of Functioning, Disability and Health, and instruments such as the Multidimensional Attitudes Scale Toward Persons with Disabilities used to measure learner attitudes. This fragmentation, the authors suggest, reflects a field still in its formative stages, one where the commitment to structured disability education matters more than allegiance to any particular framework.

The instructional approaches catalogued in the review ranged widely in both creativity and technical sophistication. Simulation and experiential learning formed the backbone of many programs, including encounters with standardized patients with disabilities, actors trained to portray specific conditions in controlled clinical scenarios. Virtual platforms and telehealth-based modules extended reach beyond the classroom, while interprofessional education brought learners from different health disciplines together to practice collaborative disability care. Perhaps most striking were the arts-based methods, from narrative medicine exercises to visual arts encounters, designed to build empathy through modes of engagement that traditional lectures cannot replicate.

Nearly every included study reported at least one positive learner outcome, and most documented statistically significant improvements in self-reported attitudes, knowledge, and confidence. Instruments like the Attitudes and Perspectives Toward Persons with Disabilities scale and the Approach to Disability, Empathy, Practical skills, Training; Clinical Approach to Respectful Encounters framework, known as ADEPT-CARE, appeared repeatedly as outcome measures. But the review also exposed a critical weakness in the evidence base: very few studies assessed whether these gains translated into actual clinical behavior or improved patient experience. Self-reported confidence, the authors caution, is a fragile proxy for competence at the bedside.

The strongest and most durable outcomes emerged from a specific pattern that the review’s findings elevate into a design principle. Studies that incorporated people with disabilities as educators or co-designers of the curriculum, and those that relied on experiential approaches rather than passive instruction, reported outcomes that were not only stronger but more lasting. This aligns with intergroup contact theory, which holds that meaningful, structured interaction between groups reduces prejudice more effectively than information alone. Authentic partnership with disability communities, in other words, is not an optional enhancement but a core mechanism of effective disability education.

No single framework emerged as superior, a conclusion that may disappoint those hoping for a definitive answer but that carries its own practical weight. What mattered, across all twelve countries and every discipline studied, was the intentionality of the educational design: the presence of a structured, deliberate approach to disability content, regardless of which framework anchored it. The authors argue this supports calls for mandatory disability competency requirements embedded in accreditation standards, longitudinal curriculum design that reinforces learning across years rather than confining it to a single module, and genuine co-delivery of programs with disability communities.

The review’s gaps are as instructive as its findings. Evaluation rigor varied widely, few studies tracked outcomes beyond immediate post-training measures, and the durability of measured gains remains largely unknown. Geographic representation was thin, disciplinary coverage uneven, and the near-total reliance on self-reported outcomes leaves the field without solid evidence that better-trained clinicians actually deliver more equitable care. The authors, who completed the project as part of a fellowship through the Golisano Institute for Developmental Disability Nursing, published their work open access so that educators worldwide can act on it. As healthcare systems confront the needs of an aging population with rising disability prevalence, the message from this analysis is unambiguous: structured disability education works, but the field must now prove it works where it matters most, in the clinic, with the patient.

Subject of Research: The impact of disability competency frameworks in guiding curriculum development in healthcare education: a scoping review

Article Title: The impact of disability competency frameworks in guiding curriculum development in healthcare education: a scoping review

Article References: Weston, R. N., Abery, B., Couser, A. H., Fernandez-Dizon, A., & Fu, Y.-T. (2026). The impact of disability competency frameworks in guiding curriculum development in healthcare education: a scoping review. BMC Medical Education. https://doi.org/10.1186/s12909-026-10452-y

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10452-y

Keywords: impact, disability, competency, frameworks, guiding, curriculum, development, healthcare, education, scoping, review, scientific research