Professional Practice and Placement Support working with education providers, placement providers an

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Professional Practice and Placement Support
working with education providers, placement
providers and professional courses

• Judith Waterfield
• Head of Disability ASSIST Services
• University of Plymouth
• jwaterfield_at_plymouth.ac.uk
• 01752 587654

• Jane Wray, Research Fellow, Faculty of Health
  and Social Care
• The University of Hull
• J.Wray_at_hull.ac.uk
• 01482 464606

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Todays 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

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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

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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

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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

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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

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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

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Attitudes

• Of the mentor, supportive or not ?
• Really nice people, really laid back, maybe luck
  of the draw pacing myself wasnt an issue.
  CEPPL
• My supervisor was hard to get on with he admits
  hes really arrogant, but says he doesnt care.
  CEPPL
• What did shock me was, considering the whole
  area of study that Im in, how many people are so
  intolerant and so unaware of, you know, sort of
  disability, theyre not tuned in at all (PEdDS
  Student with a medical condition)

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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)
• youd be knocking your head against a brick wall
  half the time because they wouldnt communicate
  back with youlecturers werent always as
  supportive as they could be (PEdDS Placement
  mentor)

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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?

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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
peoples reaction would be in terms of - you
dont quite know whos going to be looking at the
form and what kind of preconceptions and
prejudices theyre gonna have.
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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)

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Emotional Factors - Stress

• Well, its 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 theyre going
  to have like at least a double dose of stress
  simply dealing with the pragmatics of managing
  their disability (PEdDS Placement Mentor)

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Treated differently?
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Concerns about future employment (students)
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Technology

• Supportive (e.g. mild dyslexia)
• Crucial (severe VI)
• Maintenance they wouldnt make sorting it out a
  priority
• Assisting technologies dont always work
  alongside providers systems
• Confidentiality?
• Good for the student good for patients and
  clients

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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 didnt understand what was going on, or
  whether it was the two together.

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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.

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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

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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 notesWe 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!

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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

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Venue Accessibility

• Communication last minute changes can cause
  stress
• Small changes make a big difference
• Everyone benefits
• Theyve 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 cant lift. (PEdDS SW
  student with a mobility disability)

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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

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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)

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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

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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

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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?

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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?

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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

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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

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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

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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? Im happy to check with someone when I
  cant read handwriting but others are often far
  too busy CEPPL

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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)

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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)

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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

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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

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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

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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.

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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)

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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

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For more information about individual projects...

• CEPPL/DAS
• Deidre Ford (CEPPL) http//www.placementlearning.
  org/index.cfm
• Terry Dowling (DAS) terry.dowling_at_plymouth.ac.uk
  
• 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