The origin of this paper comes from repeated experiences witnessed throughout my 18-year nursing career. The scenarios of note occur when an experienced registered nurse discloses a specific learning disorder diagnosis before a learning session. This admission baffles the nurse educators as to how to approach their instruction strategies. Discussions following the disclosure often contain inaccurate or insufficient information and negative opinions regarding the individual’s capacity or suitability for the nursing profession. Undertones of these conversations are often rooted in stigma, fear and confusion about specific learning disorders. Acknowledging my personal knowledge gaps on the subject is the genesis of this manuscript. Throughout this paper, the term nurse educator is used for brevity but refers to all nurses who facilitate other nurses’ learning regardless of their formal role.

My contemplations do not exist independently of existing literature. Nurse preceptors “have low levels of knowledge related to legal issues and the role of accommodations” (L’Ecuyer, 2019b, p. 215). Nurse educators needing and desiring educational resources to support nurse learners with specific learning disorders is a common finding (Crouch, 2019, L’Ecuyer, 2019b, Murakami et al., 2023). Nurse educators should expect to encounter registered nurses with specific learning disorders (Major and Tetley, 2019a). The information and concepts discussed will serve as an educational brief. Presented are specific learning disorder criteria; occurrence in registered nurses; known experiences that have an impact on learners with specific learning disorders; and how nurse educators can address these through socially just and psychologically safe learning environments with inclusive pedagogy. By integrating Vygotsky’s (1978) social constructivism and concepts into practice, nurse educators can engage with nurse learners who have specific learning disorders while promoting a just and safe learning environment. As an inclusive pedagogy, Vygotsky’s (1978) social constructivist zone of proximal development and scaffolding will serve as a universal approach nurses can use to conceptualise any teaching and learning experience while reinforcing professional standards and supporting nursing colleagues’ growth.

The American Psychiatric Association’s (APA, 2022) Diagnostic and Statistical Manual of Mental Disorders (5th ed. text revision; DSM-5-TR) employs the term specific learning disorder while the World Health Organization’s (WHO, 2025) International Statistical Classification of Diseases and Related Health Problems employs the term developmental learning disorder to describe difficulties with reading, writing and numeracy. For reading, there may be difficulties in “word reading accuracy, reading rate or fluency, reading comprehension” (APA, 2022, p. 77). Written expression difficulties affect “spelling accuracy, grammar and punctuation accuracy, clarity or organization [sic] of written expression” (APA, 2022, p. 77). Numeracy difficulties affect “number sense, memorization [sic] of arithmetic facts, accurate or fluent calculation, or accurate math reasoning” (APA, 2022, p. 77). The WHO (2025) definitions are near verbatim to APA’s (2022) descriptors with minor grammatical variations alongside “other specified impairment of learning” and “unspecified” categories for learning difficulties not covered by the aforementioned entity. In the DSM-5-TR (APA, 2022), dyslexia and dyscalculia each refer to a specific combination of domains listed under reading and numerical impairments (pp. 77–78). Severity is classified as either “significant and persistent difficulties” (WHO, 2025) or one that exists along a spectrum (APA, 2022, p. 78). As such, specific learning disorders may not be evident to educators. Mild presentations cause some issues yet are addressed with targeted accommodations, while moderate presentations may cause noticeable difficulty and require assistive accommodations or interventions (APA, 2022, p. 78). These difficulties continue into adulthood and may only be exacerbated under high levels of pressure that overwhelm learnt compensatory strategies (APA, 2022; WHO, 2025). Those with a specific learning disorder can possess normative (APA, 2022, p. 79) or higher-level intellectual capacity (APA, 2022, p. 80) and difficulties are “not due to a disorder of intellectual development” (WHO, 2025). For simplicity, the term specific learning disorder is adopted throughout this discussion.

Nurse educators will not find a quick answer to how often they will encounter a nurse learner with a specific learning disorder. There are no readily available statistics reflecting the rate of licenced registered nurses with specific learning disorders across Canada or in other countries (Major and Tetley, 2019a, Neal-Boylan and Miller, 2020). For example, the inaugural nursing workforce survey in Ontario, Canada, incorporating data on learning disability status, began in February 2024 (College of Nurses of Ontario, 2024). With the actual number of registered nurses with a specific learning disorder unknown, the occurrence presumably reflects the general population (Neal-Boylan and Miller, 2020). However, the true representation of self-reported data requires caution (Grimes et al., 2017), as does accounting for different age and gender ratios between the nursing profession and the general population. In Canada, approximately 8.4 % of the population aged 4–17 have a diagnosed learning disability or learning disorder (Statistics Canada, 2020). Statistics Canada (2022) reports that 5.6 % of people aged 15 years and older have a learning disability that has an impact on their daily activities. However, this statistic excludes those who report less than some difficulty in daily activities, either rarely or never (Pianosi et al., 2023). Potentially, this finding means those with successful adaptive strategies were excluded. Furthermore, this statistic is an underrepresentation of those 15 years and older with a specific learning disorder.

Similarly, nurse learners with specific learning disorders will only sometimes have a diagnosis or an accommodation plan. There is a known variance in receiving diagnoses between Diagnostic and Statistical Manual of Mental Disorders editions (Jacobs and Liljequist, 2019, Williams et al., 2022) and the use of different classification criteria outside North America (Di Folco et al., 2022). In the European Union, European Citizens’ Initiatives have also called for unified learning disorder definitions and guidelines (European Commission, 2022). Assessment and diagnosis also require access to appropriate specialists and the financial means to pay for these services if not covered by public or private health insurance. In some regions, workplace accommodations require declaring an impact on essential job functions or activities of daily living (Ontario Human Rights Commission, 2008, Williams et al., 2022). As learners are averse to advertising a label perceived as stigmatising (Grimes et al., 2017), they may conceal a diagnosis and associated needs from their nursing colleagues (Major and Tetley, 2019a) to avoid detection or labelling.

Further confounding nurse educators’ efforts to find effective teaching strategies for established registered nurses with specific learning disorders is a lack of current literature, a frustration echoed in the literature (Gillin, 2015, Hafez et al., 2023, Major and Tetley, 2019a). Recent literature focuses on nursing students with specific learning disorders (Calloway and Copeland, 2021, Crouch, 2019, Epstein et al., 2021, L’Ecuyer, 2019a, L’Ecuyer, 2019b), or on specific learning disorders in reading or dyslexia (Crouch, 2019, Gillin, 2015, Major and Tetley, 2019a, Major and Tetley, 2019b) and lacks educational theory as a supportive intervention for nurse learners with specific learning disorders. Adding to the difficulty are findings that include other disorders or disability conditions in specific learning disorders (Epstein et al., 2021, L’Ecuyer, 2019a, L’Ecuyer, 2019b). This patchwork of limited recent literature necessitates the use of international resources as a scoping review by Epstein et al. (2021) also found limited Canadian studies on registered nurses with specific learning disorders.

While extant literature on numbers of nurses with specific learning disorders may be lacking, what is known is the potential stigma and stereotypes faced by those with a specific learning disorder. A systematic review of the literature found frequent misconceptions of those with specific learning disorders include being “stupid,” “lazy,” or “careless,” resulting in moderate to significant negative effects on learners’ self-worth, self-esteem and academic performance (Haft et al., 2023). Stigmatising attitudes and perceptions experienced in education leave learners feeling they “lack of intelligence” and are an “academic failure” (Lithari, 2019, p. 287). A study of British nurses with specific learning disorders in reading reported experiences of cruel comments from nursing teachers (Major and Tetley, 2019b) and nurse colleagues (Major and Tetley, 2019a). Study participants reported enduring criticisms founded on stigma from nurse colleagues by having their safety and fit for practice questioned or being made to feel “stupid” (Major and Tetley, 2019b, p. 9). The results of these interactions are injurious. In general, adults can carry the psychological and intellectual wounds from previous learning experiences into who they are as learners today (Hegna, 2019, Lange et al., 2015). Negative experiences, such as low expectations from teachers or expectations to fail, cause wounded learners to integrate academic failure into their self-image (Lange et al., 2015) and those with specific learning disorders are no different (Lithari, 2019). Nurse educators must recognise that these unsupportive experiences can have lasting effects throughout nurse learners’ lives and have an impact on their engagement in learning.

An insidious impact of stigma is stereotype threat. Individuals remain fearful that their actions will somehow confirm a negative stereotype and they will, in turn, be viewed and treated per that negative stereotype (Spencer et al., 2016). Regardless of the educator’s intent, these learners remain vigilant to detect subtle signals of stereotyping, which in turn activates this vulnerability (Haft et al., 2023, Spencer et al., 2016). This ongoing vigilance is a distracting pressure that can undermine performance, especially when undertaking difficult activities (Spencer et al., 2016). The level of impact is variable but can negatively affect a learner’s sense of belonging, long-term well-being (Spencer et al., 2016) and academic performance (Haft et al., 2023). Nurse educators striving to develop effective learning settings must consider these factors alongside other invisible impacts those with specific learning disorders face.

While not all registered nurses express stigmatising attitudes towards nurse learners with learning disabilities (L’Ecuyer, 2019b), healthcare professionals are not exempt from holding stigmatising beliefs. Nurse educators may not realise what attitudes, values, or perceptions they are conveying about disabilities if it is unconscious. In an extensive population study of American healthcare providers, including nurses, VanPuymbrouck et al. (2020) found that only 27.5 % had “truly low prejudiced” attitudes towards people with disabilities while 60.5 % were “adverse ableists” (p. 106). Adverse ableists tend to be well-meaning and open-minded by consciously expressing low prejudiced attitudes towards those with disabilities, but their thoughts or actions convey a preference for someone without a disability (Friedman, 2019, VanPuymbrouck et al., 2020). This attitude may result in a phenomenon known as othering. Exclusionary othering is when a dominant in-group segregates those with different attributes as “outside the norm” and treats them poorly (Nye et al., 2022, p. 3). This marginalisation can happen regardless of intent and why nurse educators must consciously examine taken-for-granted structures and processes to prevent repeating them (Nye et al., 2022). What is unintentionally conveyed by unconscious thoughts and attitudes must be considered when teaching. By recognising these as potential lived experiences of registered nurses with specific learning disorders, nurse educators can develop a strategy to mitigate these effects in the education setting.

When facilitating learning experiences, nurse educators are responsible for offering education to all without bias. What is just and what is safe are conceptually linked to inclusion, but they are not one and the same. Social justice in education is a complex and contextually influenced subject (Abu and Moorley, 2023, Boyadjieva and Ilieva-Trichkova, 2017) and goes beyond the scope of this paper. A learning environment founded on social justice is one that promotes fair, inclusive and equitable access to learning for all (Abu and Moorley, 2023, Boyadjieva and Ilieva-Trichkova, 2017, Shyman, 2022). A socially just learning environment is one where nurse educators make efforts to identify inequities and barriers that allot some individuals more value than others. An approach stemming from social justice is vital for addressing marginalisation (Abu and Moorley, 2023, Shyman, 2022) and is more than the philosophical components of teaching (Shyman, 2022). Morality and social justice are core drivers of delivering education fairly and open-mindedly (Shyman, 2022). Humble introspection on the assumed truths of all participants (Levine et al., 2022) is also required of nurse educators seeking to develop a socially just learning environment. Identifying potential perceptions that have an impact on interpersonal connections is the reflective approach necessary for optimum learning and teaching practises.

Nurse educators must be cautious, for one can have social justice without psychological safety in a learning environment. Psychological safety within a group is feeling included, safe to learn and contribute and safe to challenge norms without fear of reprisal or ridicule (Edmondson, 1999, Kim et al., 2020). A low-threat atmosphere allows learners to fully engage in the instructional process and expose themselves to vulnerabilities, such as asking questions or admitting to erroneous understanding in front of colleagues (Edmondson, 1999). The positive impacts of a psychologically safe learning environment include enhanced interpersonal connections for strong engagement, improved efficiency and risk mitigation (Newman et al., 2017). This trust (Newman et al., 2017) contributes to the creation of safe-to-fail environments where participants can trial new skills, knowledge, or processes they wish to adopt (Nicolaides and Poell, 2020). Essentially, it is the space and opportunity to try and learn something new without the pressure to master it promptly. Both socially just and psychologically safe factors hinge on inclusive interpersonal elements. Adopting a pedagogy emphasising high-quality educator-learner relationships will support both social justice and psychological safety.