Sayed Ibrahim Ali, Mostafa Shaban
Students frequently chose concealment over support because the perceived costs of disclosure outweighed the uncertain and stigmatising accommodation processes. Dismantling ableism requires structural change: normalising disability as professional diversity, embedding universal design for learning, reforming fitness-to-practise standards and building confidential, trustworthy disclosure pathways.
AIM: To explore how nursing students with invisible disabilities experience ableism and how these experiences shape their decisions about disclosure and the use of academic and clinical accommodations.
BACKGROUND: Disability is increasingly represented in nursing education, yet disabled students remain marginal within many diversity and inclusion agendas. Rigid fitness-to-practise norms and stigma can deter students with invisible disabilities from disclosing and from using academic or clinical accommodations.
DESIGN: A qualitative descriptive study.
METHODS: Twenty undergraduate nursing students with self-identified invisible disabilities were recruited through purposive maximum-variation sampling at a university nursing programme in Saudi Arabia. Individual semi-structured interviews (Arabic or English) were analysed in the original language using Braun and Clarke's reflexive thematic analysis; selected extracts were translated into English only at the reporting stage.
RESULTS: Four themes were constructed: (1) "Reading the room before revealing myself," capturing the anticipatory appraisal of stigma and disbelief; (2) "Choosing silence over support," describing masking and the forfeiting of accommodations as self-protection; (3) "Proving I belong in the uniform," reflecting an internalised, able-bodied ideal of the 'real nurse'; and (4) "When the system bends, I can breathe," identifying trusted allies and universally designed learning as enablers of inclusion.
CONCLUSIONS: Students frequently chose concealment over support because the perceived costs of disclosure outweighed the uncertain and stigmatising accommodation processes. Dismantling ableism requires structural change: normalising disability as professional diversity, embedding universal design for learning, reforming fitness-to-practise standards and building confidential, trustworthy disclosure pathways.