Volume 38 Number 1 | February 2024

Sara A. Taylor, PhD, MLS(ASCP)CMMBCM, ASCLS Diversity Advocacy Council Councilor-at-Large

Patricia Marterer, PhD

Sara A. Taylor Patricia Marterer

The terms learning disability and difficulty/disorder are similar, and they are often mistakenly used interchangeably. Learning disabilities refers to specific neurological conditions that affect an individual’s ability to learn. Thus, learning disabilities are often associated with an intelligence quotient that makes it difficult for the affected individual to acquire knowledge and skills.1,2 Moreover, people with learning disabilities are entitled to certain legal rights.3

An individual with learning difficulties does not have low general intelligence, but they do display a wide range of learning challenges that affect their ability to learn effectively.1,2 Learning difficulties include dyslexia, difficulty reading due to problems identifying speech sounds and interpreting their relation to letters and words, and Attention Deficit Hyperactivity Disorder (ADHD), which presents with a short attention span, poor impulse control, and hyperactivity.2 Additional learning difficulties include dyspraxia, difficulty with motor coordination, most notably fine motor skills; dysgraphia, difficulty in writing legibly and coherently; and dyscalculia, a learning disorder that affects a person’s ability to work with math related concepts.2 It should be noted that individuals with learning difficulties are not entitled to the legal protection afforded to those with learning disabilities.3

More recently the term neurodivergent is being used to acknowledge the neurological diversity of all people. It is widely accepted that every brain is wired in a unique way, but there are individuals whose cognitive processing is acknowledged to be “more different than others.” This group includes people with dyslexia, ADHD, dyscalculia, and dyspraxia.4,5 It is estimated that approximately 18 percent of the population are “neuro divergent.”5 The new term promotes the strengths and contributions of individuals of all neurotypes, while minimizing the negative connotations that are associated with the tag, “disability.”

“Inclusion of individuals with learning difficulties requires positive guidance, support, and mentoring, not only from supervisors and top management, but from colleagues and team members as well.”

People with learning difficulties are among the most excluded in society.6 The importance of recognizing this and finding ways to ameliorate difficulties faced by people who are neurodiverse cannot be disregarded. It is an important topic, as it transcends race, age, religion, gender, and self-identification. Certainly, there are obstacles to be considered in developing strategies that can assist people with learning difficulties in developing into productive members of the healthcare team. It is a key premise of this article to promote self-efficacy and self-directed learning in clinical laboratory training as a means of assisting people who deal with learning difficulties. This approach is likely not only to benefit people with learning difficulties, but it is also likely to benefit all people in developing their skills to their fullest potential.

Self-efficacy is defined as an individual’s belief in their ability to succeed. As such, it is heavily influenced by an individual’s self-confidence and by the emotional history they have, which is related to their assignment.7 A self-directed learner is an individual who takes initiative and assumes responsibility for their own learning. As self-directed learners gain independence, they become capable of critical thinking, and they often realize significant gains in self-efficacy.8,9 Employee training that supports self-directed learning addresses several key factors in developing self-directed training protocols.

First, barriers that might reduce employee engagement in training must be acknowledged and corrected. Distracting environments, insufficient time for completing training, lack of training resources, and expectations that are not communicated clearly must be changed prior to commencement of training.10

Next, it is crucial that training be organized to be effective. Clinical laboratories make extensive use of standard operating procedures (SOPs), which are detailed instructions designed to ensure that all tasks associated with laboratory operations are performed in a consistent, accurate, and efficient manner. A well-written SOP is an invaluable resource for all employees, and especially so for those with learning difficulties.

A robust SOP can provide a consistent framework for completing laboratory tasks. It is helpful to “chunk” information into manageable segments. This strategy helps reduce feelings of being overwhelmed by training expectations. SOPs should be designed to help divide complex tasks into manageable segments.11 A sound training strategy allows self-pacing in training. Organizing training so that, within reason, employees can control how quickly material is mastered is especially helpful for learners with difficulties.11,12 SOPs can easily be designed to incorporate this learning strategy. Moreover, the training should be collaborative; research has shown that learners with difficulties benefit from learning from others who learn with difficulty rather than exclusively learning from articulate experts.13

Lastly, it is important to evaluate the training effectiveness. This allows trainees to track their progress and determine which areas need more work. On the flip side, it allows supervisors to monitor which employees need more training and allows supervisors to identify the specific area in which each employee requires additional training to achieve mastery.14

In this article we promote the practice of employee self-efficacy and self-directed learning amalgamated with colleague and institutional support for all employees. A neurodiverse strategy designed to promote employee success must begin with support from top management.15 The strategic objectives, resources, limitations, and plan of execution should then be communicated to department supervisors who have a direct role in implementing the strategic objectives that have been developed by the organization.

Importantly, the plan of execution must include educating all laboratory employees about neurodiversity with the specific aim of developing a culture of inclusion in the workplace.15,16 An inclusive management strategy includes establishment of policies and practices that promote inclusiveness, but it also encourages all employees to actively engage in promoting inclusion. The importance of an inclusive environment can hardly be over-emphasized. Inclusion of individuals with learning difficulties requires positive guidance, support, and mentoring, not only from supervisors and top management, but from colleagues and team members as well. Studies have consistently shown that a climate of inclusiveness, more than any other determinant, makes the greatest contribution to employee success, productivity, and job satisfaction.15,16

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  2. The difference between learning disorder and learning disability. Available at: The difference between learning disorder and learning disability (understood.org) Accessed 10.25.2023
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  6. Ward, N., Raphael, C., Clark, M., & Raphael, V. (2019). Involving people with profound and multiple learning disabilities in social work education: Building inclusive practice. In Service User Involvement in Social Work Education (pp. 59-73). Routledge.
  7. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215.
  8. Aagten, D. (2016). Healthcare professionals’ self-directed learning at the workplace (Master’s thesis, University of Twente).
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  10. 10 Barriers to Learning and How to Overcome Them. Available at 10 Barriers to Learning and How to Overcome Them (ispringsolutions.com). Accessed 11.29.2023.
  11. Nemec, P. B. (2011). The self-directed learner. Psychiatric Rehabilitation Journal, 35(1), 71.
  12. De Kleine, E., & Verwey, W. B. (2009). Motor learning and chunking in dyslexia. Journal of motor behavior, 41(4), 331-338.
  13. Mohanty, P. C., Dash, M., Dash, M., & Das, S. (2019). A study on factors influencing training effectiveness. Revista Espacios, 40(2), 7.
  14. Rao, B. and Polepeddi, J. (2019), “Neurodiverse workforce: inclusive employment as an HR strategy”, Strategic HR Review, Vol. 18 No. 5, pp. 204-209. https://doi.org/10.1108/SHR-02-2019-0007.
  15. Silver, E. R., Nittrouer, C. L., & Hebl, M. R. (2023). Beyond the business case: Universally designing the workplace for neurodiversity and inclusion. Industrial and Organizational Psychology, 16(1), 45-49.
  16. Brimhall, K. C., & Mor Barak, M. E. (2018). The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization. Human Service Organizations: Management, Leadership & Governance, 42(5), 474-492.

Sara A. Taylor is Assistant Professor at UNC-Chapel Hill, Division of Clinical Laboratory Science in Chapel Hill, North Carolina.

Patricia Marterer is a Clinical Psychologist, Clinician with the Federal Government (retired), specializing in PTSD, depression, and wellness.