Are inherent requirements a barrier to diversity? An analysis of course entry information

Background and aim: Increasing the diversity of future healthcare professionals is essential to support inclusive patient care. However, course inherent requirements (IRs) may act as (un)intentional and potentially harmful gatekeepers to diverse students entering entry-to-practice courses. A decade beyond the establishment of formal IRs, it is timely to reconsider if and how IRs might be impacting diversity and inclusion. Methods: This study analysed IRs published by the 37 Australian universities offering nursing and midwifery entry-to-practice courses. Findings: IRs were not uniform across all institutions. Most universities placed the responsibility to meet IRs solely upon the student, without sufficient information about possible reasonable adjustments. When institutional support was offered, the level of and means of accessing support were often unclear, again putting the onus to navigate support structures on the student. Discussion and conclusions: Whilst it is helpful for prospective students to understand the types of tasks they will be required to undertake as part of learning within the course and upon graduation, many IRs may be better positioned as expected learning. With increasing student diversity, alternate models requiring all students to demonstrate readiness for clinical placement immediately before placement may be helpful. Rather than presenting a static list of requirements, diverse students and practitioners may be better supported through the concept of ‘fitness to practice’ where more flexible and in-the-moment evaluations can be made.