Implicit and Explicit Attitudes Toward People With Physical Disabilities among Clinicians, Rehabilitation Assistants, and Other Occupations: A Comparative Study

Abstract

Objective: Ableism is rooted in attitudes that influence behaviors and decisions toward people with disabilities. To assess whether these attitudes vary by occupation, we compared the preferences for people with and without physical disabilities between clinicians, rehabilitation assistants, and individuals in other professions.

Methods: Data from 213,191 participants, collected online through Project Implicit, were analyzed, including 6445 clinicians, 3482 rehabilitation assistants, and 203,264 individuals in other occupations. Implicit attitudes were assessed using D-scores derived from the Implicit Association Test. Explicit attitudes were assessed using a Likert scale. Regression models were conducted to examine the association between occupation groups and attitudes toward people with and without physical disabilities, while controlling for demographic variables.

Results: Clinicians and rehabilitation assistants showed both an implicit and explicit preference for people without physical disabilities. Implicit attitudes of clinicians and rehabilitation assistants were equivalent to those in other occupations. Compared to other occupations, clinicians had more unfavorable explicit attitudes toward people with physical disabilities, whereas rehabilitation assistants had more favorable ones. Older age, male sex, and no personal experience of disability were associated with less favorable attitudes toward people with physical disabilities. Associations with education, race, geographic region, and year of data collection were also observed.

Conclusions: This study provides evidence suggesting the persistence of ableist attitudes among clinicians and rehabilitation assistants. Moreover, implicit attitudes were similar to those of other occupations, while explicit attitudes of clinicians were even slightly less favorable.

Impact: Our findings suggest that despite ongoing educational shifts toward more inclusive approaches, the longstanding framework of disability as an abnormality to be normalized may still affect healthcare practitioners. This underscores the need for continued efforts to address ableism not only in healthcare, but throughout society, by promoting disability-inclusive education and training.