From accommodation to inclusion: understanding barriers and facilitators in clinical dental education for Chilean students with hearing disabilities: a qualitative study

PURPOSE: This study aimed to describe inclusive mechanisms supporting dental students with hearing disabilities, focusing on facilitators of and barriers to participation in clinical education. METHODS: A qualitative case study was conducted at a Chilean university. Data were collected through semi-structured interviews with 2 students with hearing disabilities, 3 clinical instructors, and 1 Chilean Sign Language interpreter who works at the university and supports dental students with hearing disabilities, as well as through direct observation. Data were analyzed using inductive thematic analysis. Participant validation was used to enhance credibility. RESULTS: Facilitators were identified across pedagogical, technological, communicative, and relational domains. Pedagogical adaptations included early access to materials, visual resources, and flexible assessments. Technological tools such as real-time transcription supported communication and access to information. Alternative communication strategies included lip reading, written support, visual cues, and Chilean Sign Language. The presence of an interpreter was a key enabling factor. Relational support from faculty, peers, and family members also contributed substantially. Faculty flexibility and willingness to adapt were particularly important. Barriers were identified at structural, institutional, communicative, and attitudinal levels. Clinical environments presented physical and acoustic challenges, including noise, limited space, and complex interactions. Institutional responses were often reactive and involved limited planning. Communication barriers affected interactions with patients and peers, as well as academic literacy. Faculty reported limited training in inclusive education. Attitudinal barriers included misconceptions about disability and limited experience with disability. CONCLUSION: Inclusive mechanisms are present but insufficiently systematized. Strengthening institutional planning and structural adaptations is essential to ensuring equitable clinical education.