Transcript Placement support and disabled students The PEdDS Project

Professional Practice and Placement Support –
working with education providers, placement
providers and professional courses
Judith Waterfield
Head of Disability ASSIST
Services
University of Plymouth
[email protected]
01752 587654
Jane Wray, Research
Fellow, Faculty of Health
and Social Care
The University of Hull
[email protected]
01482 464606
Today’s presentation
 Outline the experiences of students, practice and academic
staff in health and social care disciplines using research
including:
 The CEPPL and Disability ASSIST joint project on the
experience of health and social disciplines of placements
and the development of a placement provider access tool
 The Professional Education Disability Support Project
(PEdDS)
 Summarise the key benefits of organising and delivering
inclusive placement experiences
 Identify the implications for organising reasonable
adjustments in the workplace
Legal and HE imperatives
 UK Equality Legislation (SENDA 2001, DDA 2005)
 Quality Assurance Agency (QAA) – Code of Practice:
Students with Disabilities
 Widening Participation Agenda
 ‘Pressure Groups’ e.g.. SKILL National Bureau for
Students with Disabilities
 Recommendations from the DRC FI into Fitness
standards – specific recommendations on placements
University of Plymouth
 Pilot study for a placement tool to help practice educators
plan accessible placements ; individual student interviews
(20) and placement assessments to capture the views and
perspectives of disabled students in placement settings
The Professional Education
Disability Support Project (PEdDS)
 Funded by HEFCE Disability Fund (2003 – 2005)
 Semi-structured interviews with a voluntary sample from 10
institutions in the North of the England


50 disabled social work students
50 staff (25 Placement staff, 12 academic staff and 12
Disability support staff
The University of Hull
 Using PDP to organise adjustments on placement.
Evaluation data collected from 5 students and 7 clinical
mentors, and 5 personal supervisors
 Making decisions about disabled students and their
fitness to practise in Nursing, Teaching and Social Work
funded by the DRC. Survey of 39 education providers
across the UK
What is the experience of disabled
students at present?
Common challenges across the two institutions
 Attitudes
 Communication
 Disclosure
 Emotional Factors
 Fitness to Practice
 Learning Outcomes
 Reasonable Adjustments
 Venue Accessibility
Attitudes
Of the mentor, supportive or not ?
 ‘Really nice people, really laid back, maybe luck of
the draw; pacing myself wasn’t an issue’. CEPPL
 ‘My supervisor was hard to get on with; he admits
he’s really arrogant, but says he doesn’t care’.
CEPPL
 “What did shock me was, considering the whole
area of study that I’m in, how many people are so
intolerant and so unaware of, you know, sort of
disability, they’re not tuned in at all” (PEdDS
Student with a medical condition)
Communication
 Early, clear and frequent communication essential
 Reviews, schedule extra meetings
 ‘there was no wake up call at the half way stage’ (he
was failed)
 “you’d be knocking your head against a brick wall half
the time because they wouldn’t communicate back with
you…lecturers weren’t always as supportive as they
could be” (PEdDS Placement mentor)
Disclosure
 No duty on student to disclose except for health and safety
requirements or ‘good health’
 Confidentiality is a right – unless safety of self and others is
compromised (Data Protection Act and DDA)
 Assumptions that disclosure had taken place
 Partial disclosure
 No clear policy on managing disclosure – Who needs to
know?
Disclosure
PEdDS SW Placement Co-ordinator - “They are worried that
if they disclose that will have an impact on their placement.
It is mainly the attitudes of the actual placement provider that
I think is the main barrier rather than the actual needs.”
PEdDS SW Student with a SLD - “I mean I am sort of slightly
concerned about what people’s reaction would be in terms of
- you don’t quite know who’s going to be looking at the form
and what kind of preconceptions and prejudices they’re
gonna have.”
Emotional factors
 Anger re ‘unfair criticism’ CEPPL
 ‘I fear imposing my clumsiness on patients’ CEPPL
 ‘Do people get exasperated with me?’ CEPPL
 ‘I felt bullied, was told not to complain’ CEPPL
 Feeling a burden/nuisance “If I complained about there
not being anywhere to sit properly in the first one I did
feel like I was just being a pain sort of thing.” (PEdDS
student with mobility difficulty)
Emotional Factors - Stress
 “Well, it’s going to stress the
student - stress levels are
going to be high, and stress
levels on placement are high
anyway. The nature of the
practice placement is
stressful. So they’re going to
have like at least a double
dose of stress simply dealing
with the pragmatics of
managing their disability”
(PEdDS Placement Mentor)
Treated differently?
Do you feel as though you've been treated
differently because of your disability whilst on
placement?
dk
6%
yes
no
61%
yes
33%
no
dk
Concerns about future employment
(students)
Are you concerned that your
disability may affect your
chances for employment?
Yes
73%
No
23%
Yes
No
dk
4%
dk
Technology
 Supportive (e.g. mild dyslexia)
 Crucial (severe VI)
 Maintenance “they wouldn’t make sorting
it out a priority
 Assisting technologies don’t always work
alongside providers systems
 Confidentiality?
 Good for the student – good for patients
and clients
Fitness to practise
 Can someone with dyslexia or dyspraxia be a health
professional?
PEdDS SW Placement Co-ordinator - “There was a student
who was struggling to produce written work to the appropriate
standard and people were struggling to know whether it was
an issue of disability or whether it was the fact that she just
didn’t understand what was going on, or whether it was the
two together.”
Fitness to practice
 Maths & Drug Calculations: anxiety and concern of clinical
mentors but see ‘Strategies’
DRC Nursing Academic staff - “initial concerns related to
capability for moving and handling of patients, reacting quickly to
emergency situations including running after a patient who
absconds from the ward, level of stamina for shift work, including
12 hour shifts.”
PDP Placement Mentor – “there were very few issues. The
literacy problems this student ostensibly displayed were no
different to a significant proportion of students already
encountered.”
Learning outcomes
…must not be compromised.
• All students must meet criteria of competence.
• Is there another way the criteria can be met? i.e.
can we change the mode of assessment to achieve
demonstration of knowledge
‘Its about reducing the particular barriers that the
individual student faces’
‘This may mean finding a different path to the same
goal’
‘Reasonable Adjustments’
 A keynote of the Disability legislation
 Potential conflicts with ‘practice realities’?
 A reasonable adjustment - advance notice to allow
preparation
 “We had to do preparation work and make sure that
supervision was reinforced with notes…We also got a tape
recorder so she could tape the notes straight away without
waiting to come back. We tried to set up a lot of systems”
(PEDDS Practice Assessor/Teacher)
 Attitudes again!
Strategies
 Very powerful for student to be aware of and describe
them clearly, especially building towards employment
and interview.
 ‘Not a week goes by without an issue arising – I have to
come up with coping strategies for each new activity’.
 Important for academic and placement staff to be aware
of the strategies the student uses
Venue Accessibility
 Communication – last minute changes can cause stress
 Small changes make a big difference
 Everyone benefits
 “They’ve made sure that shelf space for me is at the right
height so I am not bending you know, any of the other
workers will pick up files or anything else that I can’t lift.”
(PEdDS SW student with a mobility disability)
The benefits of inclusive practice
 Facilitates disclosure “It is very helpful to me as a
practice teacher if students do disclose information and
being able to do that thinking and planning and
discussing in advance rather than confronting the
situations as they arise” (PEdDS SW Practice
Assessor/Teacher)
 “It gives me a lot more empathy towards the client groups
and a lot more patience. (PEdDS SW student with a
medical condition)
 Helps us to attract and retain high quality disabled people
onto professional programmes and in the workplace
The benefits of inclusive practice
 Creates a more positive and productive learning experience
for students
 Enhances relationships between placement staff and student
 “----checking out how was I feeling, are you alright? He
(practice teacher) ran the computer, you know making a
laptop available to me and stuff like that, giving me the
space and not giving me grief when----I was feeling a bit
rough.” (PEdDS SW student with a medical condition)
The benefits of inclusive practice
 Recognises diversity and not difficulty
 Eliminates discriminatory practice. Authorities have
positive duties too (DDA 2005)
 A more positive and productive mentoring relationship for
placement and programme staff
The key challenges for disability equality
and professional placement learning
 Communication – How do we ensure that there is effective
communication between academic and practice settings and
the student?
 Attitude – How can we ensure that the mentor has sufficient
support and information to facilitate the learning experience
of the students? How can we stop equating ‘disability’ with
‘difficulty’
The key challenges for disability equality
and professional placement learning
 Strategies – How can we support the student to
‘translate’ the strategies learnt in an academic
environment into a placement environment and take
responsibility for their learning?
 Time factors – How can we address organisational
constraints?
How do we ensure there is effective
communication?
 Establishing clear lines of communication within a policy
that has shared responsibility
 How should a Department manage the disclosure of a
students’ disability to the placement? Who needs to know?
And when? Who should inform the placement?
 Has the Department discussed and agreed mutual
responsibilities with placement provider partners?
 What constitutes a reasonable adjustment? ‘How
reasonable is reasonable’? Who will meet the costs?
How do we ensure there is effective
communication?
 Formalise communication procedures
 Written procedures /flowchart disseminated to all staff
 Written agreement on what adjustments will be
implemented, how they will be monitored and
reviewed
 Build this into existing documents and
monitoring/evaluation approaches
What needs to happen to facilitate
the student learning experience?
 Pre placement planning
 Identifying any skills or knowledge deficit and addressing
this i.e. awareness of potential and actual barriers facing
disabled students
 Regular communication
Supporting the student to ‘translate’
strategies from academic to placement
environment
 Taking responsibility for their learning
 Involving the student in pre placement planning
 Understanding of professional accountability
 Developing skills for employability
 Enabling the student to use their technologies in the
placement setting
Time factors
 Placements are often allocated at short notice
 Students are always ‘extra-numerary’, but does
the mentor have time to give extra support and
training? “I’m happy to check with someone
when I can’t read handwriting but others are
often far too busy’” CEPPL
Time factors
 “There is certainly time; extra time to
discuss. Space; extra space to
reflect on what they are doing and
making sure that others members of
the team have access to information
that the student wants them to
have… to ensure that the placement
runs smoothly really” (PEDDS SW
Practice Assessor/Teacher)
How can we address organisational
constraints?
 Work placements are covered by DDA part 4 and
staff organising such events should anticipate the
requirements of disabled students (DRC 2007)
 Policy that acknowledges shared responsibility
and obligations “The duty to make reasonable
adjustments applies to a placement provider in
the same way as it applies to an employer” (DRC
Codes of Practice on Employment and
Occupation (2004: 9.46)
How can we address organisational
constraints?
 Facilitating access to additional funding where this
is available
 Academic staff ‘understanding’ the realities of
practice – “worried I would not be able to provide
the student with the support she required, due to
the work pressures on the ward. I explained this
to the SSL and felt happier that she was involved
and aware of this.” (PDP Placement Mentor)
 Flexible deadlines, part-time placements
Key considerations prior to organising
reasonable adjustments in the workplace
 Early, pre-placement planning involving programme staff,
placement staff, students and disability expertise
 Importance of having a clear and transparent approach
for managing disclosure and ensuring confidentiality
 Negotiation and delivery of adjustments with shared
responsibility and formal agreement
 Adequate preparation of both student and mentor
 Monitoring student progress (including impact
assessment of placements)
 Post placement evaluation
Key considerations for staff organising
reasonable adjustments in the
workplace
 Pro-active positive approach to duties under legislation
 Embedding of approach into policy and procedures rather
than as an ‘add on’
DRC Code of Practice on Trade Unions
and Qualifications Bodies (2004)
It would be reasonable to expect the sending organisation
and the placement provider to co-operate in order to ensure
that appropriate adjustments are identified and made. It is
good practice for a placement provider to ask a disabled
person about reasonable adjustments before the placement
begins, and to allow him to visit the workplace in advance to
see how his needs can be addressed.
DRC Code of Practice on Trade Unions
and Qualifications Bodies (2004)
Once a particular adjustment has been identified, it would
be reasonable for the sending organisation and the
placement provider to discuss its implementation, bearing
in mind their respective obligations under the Act.” (9.49)
Positive advantages of disability equality
in professional placement learning and
employment
 Personal insight
 Stimulates ideas
 Empathy between patient and practitioner
 Potential improvements for student/employee
improves the experience of clients and patients
 Inspire confidence and a positive outlook
 Determination compensates for challenges
For more information about individual projects...
 CEPPL/DAS
Deidre Ford (CEPPL) http://www.placementlearning.org/index.cfm
Terry Dowling (DAS) [email protected]
 PEdDS project – research report and best practice guide free
to download at www.hull.ac.uk/pedds
 PDP project – report available from Jane Wray on request
 DRC project on ‘Making decisions about disabled students
and their fitness to practise in Nursing, Teaching and Social
Work’ available at www.maintainingstandards.org.uk