accommodating students with disabilities in a clinical setting postsecondary disability training...
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Accommodating Students with Disabilities in a clinical setting
Postsecondary Disability Training Institute
June 11, 2014Lynnett Van Slyke, CRC
Director Disability Resources and Services
University of Pittsburgh
Disability LawsSection 504 of the Rehabilitation Act of 1973 • prohibits discrimination of handicapped individuals from any entity
receiving federal funds
The Americans with Disabilities Act of 1990 (ADA) • prohibits discrimination against any qualified individual with a disability.
Defines who is an individual with a disability and mandates appropriate aids or services
The ADA Amendments Act of 2008 (ADAAA)• revises the definition of “disability” to more broadly
encompass impairments that substantially limit a major life activity.
Disability Laws
Is one who with or without reasonable accommodations or modification, meets the program’s essential eligibility requirements known as core standards also referred to as Technical Standards http://www.sreb.org/page/1390/the_americans_with_disabilities_act.html
Slide credit K. Jarvis, Director Office for Disability Services Penn State University
A qualified individual with a disability
Technical Standards
Not all essential requirements are academic, particularly in clinical
or field based programs. The Amendments increased emphasis on
the questions of appropriate accommodation suggests proactively
establishing a process for reviewing and creating technical
standards. Technical standards are nonacademic criteria for
admission and continued program participation. They may include
such things as abilities in context (ability to discriminate breath
sounds) Behaviors in the present (compliance with an established
code of conduct) or Safety (a direct threat to health and safety). Slide credit K. Jarvis, Director Office for Disability Services Penn State University
Technical Standards, cont. A collaborative process analogous to the one discussed in Wynne is
useful in establishing technical standards. Standards should be
anchored to the curriculum, supported in policy and practice and utilize
objective performance criteria that can be reliably applied to all
program applicants or participants. Finally, an individualized interactive
process must be used to determine if reasonable accommodations
would allow a student to meet technical standards. (From:
http://ahead.org/resources/government-relations, retrieved 5/7/12.) Slide credit K. Jarvis, Director Office for Disability Services Penn State University
How does the College meet its obligations under the ADAAA and Section 504 of the Rehabilitation Act?
• Removing architectural barriers• Installing power doors• Assigning student to accessible clinical site
• Establishing procedures for effective communication• Clearly established policies and procedures for requesting
accommodations
How does the College meet its obligations under the ADAAA and Section 504 of the Rehabilitation Act?
• Modifying policies and practices of the college.• Reduced course load• Extending clinical rotation (reducing days in the clinic)
• By providing auxiliary aids and services/accommodations.• Interpreters• Assistive technology
• Key Points: Wynne tells us what thought process an institution should go through
before refusing to provide an accommodation on the basis that doing so would
lower academic standards and /or substantially modify a program of study. In
essence, an institution should show that (a) officials with relevant duties and
experiences considered the accommodation request; (b) that they meaningfully
considered the impact on the program and the availability of alternatives; and (c)
that they reached a rational conclusion that accommodations could not be offered.
Wynne Clarifies "otherwise qualified" to mean "can complete program requirements
with or without reasonable accommodation". (From:
http://gwired.gwu.edu/dss/faculty/legal/ninecases/, retrieved: 5/7/12.)
• Slide credit K. Jarvis, Director Office for Disability Services Penn State University
Wynne vs. Tufts School of Medicine:
Meghan Wilson's impossible dream to be doctor comes trueParalyzed 17 years ago, she gets her M.D. from Pitt Monday.
May 19, 2013 Pittsburgh Post Gazette
.
Meghan Wilson chats with her personal aide, Laura Leigh Watson, 20, on their way to a meeting at the School of Medicine in April
Read more: http://www.post-gazette.com/stories/local/region/meghan-wilsons-impossible-dream-to-be-doctor-comes-true-688258/#ixzz2UtWEtQp5
• Student who is low vision (birth) is admitted into the SOM – Admitted in 2000, no technical standards – Multiple problems with technology – Established precedent that SOM procures technology (magnifier for ENT care)– Agree to loan technology to UPMC for residency
• Student who is an individual with a spinal cord injury (C-4/5) is admitted into the SOM– Established technical standards are waived (2005)– University is committed to non standard degree program– Student agrees to pay for all required intermediary services*– Clinical faculty determine what procedures/courses can be done by intermediary or waived
• Student who is blind (acquired) is admitted DPT– Technical standards were not established (2009)– Significant problems with came into play for accessing images in textbooks, etc. School takes
on responsibility for hiring pictorial describer– No ability to make EMR’s accessible– Student could not effectively/safely execute procedures on patients – Student is dismissed from program– OCR investigated no discrimination
• Student who is congenital dominate arm amputee is admitted into SON Nurse Anesthesia masters degree program– Student did not disclose disability – Multiple problems with technology – Long delays in waiting for CDC and other regulatory agencies approval for prosthetic
equipment in OR– Hospital staff not willing to work with student
What we learned
1. Disability office must be actively engaged in the process.
2. Disability office must actively and continuously educate the health sciences community about the rights of students with disabilities.
3. Department faculty must continually be engaged in the process.
4. Clinical faculty and staff at clinical sites must be actively engaged in the process
5. The interactive process must continue at all levels