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

STUDENT

DISABILITY OFFICE

CLINICAL FACULTY

ACCOMMODATION

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