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transcript
Choice Matters: Professional Competence / Fitness to practice issues and the
inclusion of disabled students in teacher training education and employment –
Declan Treanor, Trinity College Dublin
Ahead National Conference – Access to Teaching, Dublin Castle, March 15th 2012
Executive Summary
In 2009 the Advisory Group on Candidates with Disabilities submitted a discussion
document entitled ‘Candidates with disabilities/specific learning difficulties: The
Challenge for Colleges of Education’, to the Conference of Heads of Irish Colleges of
Education (CHOICE, April 2009). This document outlined recommended procedures
for Colleges of Education (CoEs) to ensure that they are inclusive and encouraging of
both disabled applicants to the teaching colleges, and also to students completing
teacher training and transitioning into employment. This aspirational document
clearly states the requirement of a supportive environment for disabled students,
whilst they progresses through teacher training, as a realistic goal.
This paper discusses the recommendations outlined in the CHOICE document,
identifying the significant under-representation of disabled students, the lack of
promotion of teacher training as an option for this cohort of students, and the lack
of disability awareness amongst college staff. In many professions grey areas still
exist around exactly which competencies are regarded as ‘core’, and these are not
always clearly defined in the learning outcomes of a programme. For the purposes
of this discussion a review of international practice was conducted to determine how
other countries manage this complex issue. In the United Kingdom (UK), The
Disability Rights Commission (DRC, 2007) has concluded that an arbitrary
occupational health form is unhelpful to either public or professional bodies, and
that a set of core competencies needs to be identified and upheld. It can be
concluded, therefore, that a clear fitness to practice and disclosure policy document
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needs to be implemented, which takes account of relevant legislation that protects
disabled students from discrimination, and which sets out guidelines for reasonable
accommodations, competency levels, disciplinary procedures and disclosure of
disability.
The paper will examine CHOICE recommendations from the perspective of disabled
students and their concerns about discrimination, and also from the perspective of
academics and professional bodies that must support disabled students/teachers
whilst maintaining professional standards. Additionally it will outline mechanisms to
address areas of concern in the recruitment, retention, progression, fitness to teach,
disclosure and transition to employment for students and qualified teachers with
disabilities.
Key areas for further work:
Statistical information on the number of students with disabilities studying
teacher training is unknown. Only fifty nine student applied for assistance via
the HEA Fund for students with disabilities;
Promotional information for potential applicants with disabilities on CoEs
websites was not obvious;
Fitness to practice policies and procedures are required and CoEs need to
learn from other HEI who have developed policies and procedures;
The Student Medical Information form proposed by CoEs, with their implicit
assumptions about the ‘risk’ from disabled people within teacher training,
discourages positive organisational cultures. There is evidence that disabled
people, where they recognise that they are covered by equality legislation,
gain real confidence from this legislation and feel empowered to negotiate
with HEIs about adjustments.
The influence of the statutory and regulatory frameworks requiring physical
and mental fitness is less obvious at the employment stage. There is a
widespread practice of health screening which is frequently not related to the
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specific job role. This has the potential to lead to discrimination and to deter
disabled people from applying for jobs or from disclosing disabilities and
long-term health conditions.
The Teacher Training Council should review their competence standards to
ensure that any negative impact on disabled people is eliminated. They
should provide guidance on reasonable adjustments and consider what other
guidance is required to encourage others (such as HEIs) to adopt an enabling
approach to disabled people.
A framework of professional standards of competence and conduct, coupled
with effective management and rigorous monitoring of practice, is the best
way to achieve equality for disabled people and the effective protection of
the public.
Statistics
The number of students with disabilities studying in Higher Education Institutions
(HEIs) in the Republic of Ireland has increased significantly in recent years, and now
stands at almost 7,000 (AHEAD, 2011). Whilst 33 HEIs participated in this annual
survey, only 68 students from two Colleges of Education (Mary Immaculate College
(UL) 39, St. Angela’s College, Sligo 29) completed the survey, and it is unclear if this is
truly representative of the number of student teachers with disabilities. Equal
Access Data Collection (HEA, 2012) is gathered nationally at the point of student
registration, however not all HEIs complete this survey. Of the 26 HEIS that
submitted data in 2010, three of them were Colleges of Education (CoE). More
reliable data can be extrapolated from the HEA, National Access Office ESF FSD (Fund
for students with disabilities) for which HEIs submit applications for funding of
additional supports for disabled students , on an annual basis. In total, 59 students
with a disability are registered on teacher training courses at any level, 26 of those in
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CoEs which represents 0.7% of the total student body and 33 (1.2%) are enrolled in
Universities - probably on postgraduate courses for second level teaching
qualification.
The breakdown of disability/impairments of these numbers is broadly in line with
the AHEAD Survey:
64% (AHEAD, 60%) specific learning difficulty
12% (AHEAD, 10%) significant on-going illness, 10% (AHEAD, 7%) physical disability
7% (AHEAD, 9%) mental health difficulties
2% (AHEAD, 2%) visual disability, 0% (AHEAD, 2%) deaf students
These figures although low in comparison to the overall AHEAD survey figures but a
useful basis to work from. It is important to note that many students with disabilities
on teacher training courses may not have disclosed. As is the case with most
professional courses, disclosure is a major issue and will be discussed later in this
paper.
The Teacher Development Agency (UK) recognises that there is an under-
representation of people with disabilities in teaching and the government has set a
target of 4% for the recruitment of people with disabilities to this discipline. If an
equivalent percentage was targeted in Ireland, then nationally at least 250 disabled
teacher trainees would be studying in Ireland, as opposed to the 59 students
currently registered.
Promotion
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For disabled students, transitioning to HE is a complex process and there is a
systemic ‘disconnect’ between the levels of education, with no clear transition
planning taking place (TCD, 2011). The Equality Challenge Unit UK identified pre-
entry activities as a reasonable adjustment for students with disabilities and found
that ‘the most commonly cited mechanism of communicating disability ...is the
institution’s website’ (Felsinger & Byford, 2010). The research also recommended
that strategic actions should include public dissemination of information on
requesting reasonable accommodations, entitlements and supports.
Promoting teaching as a real option for students with disabilities is essential, and
recommendations 1 and 3 recognise the need for CoEs to take positive steps to
encourage ‘suitable disabled applicants’ (CHOICE, 2009). During a review of CoE
websites (5th March 2012), five websites were reviewed using Trinity Inclusive
Curriculum guidelines (http://www.tcd.ie/CAPSL/TIC/guidelines/). It was difficult to
determine, if at all, what message is provided by CoEs to potential disabled
applicants, including the professional body itself – the Teacher Training Council
(www.teachingcouncil.ie/).
Prospective students use hard copy promotional materials (prospectus, course
handbooks) and web-based materials when considering their options. As the
internet becomes an increasingly popular research tool, all applicable information
should be inclusive, transparent and easily accessible from the relevant website.
Such information includes:
application process,
entry requirements,
aim of programme /module, year handbooks,
teaching and assessment methods,
work load involved (including contact hours, attendance policy),
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teacher placement guides,
class sizes, and
contact details for any queries.
Testimonials from disabled students are also powerful and provide some reality to
making clear choices. For example Trinity College maintains a dedicated transition
website, Pathways to Trinity, which includes a section where students offer realistic
reflections on studying a variety of courses, My Course Choice
(http://www.tcd.ie/pathways-to-trinity/choice/students/index.php)
The Teaching and Development Agency (UK) offers clear guidance for potential
disabled applicants:
‘Disabled Teachers: Our aim is to inspire talented and enthusiastic people to
become teachers. Teaching is an especially stimulating and rewarding
profession, offering excellent career and development prospects. There is
nothing intrinsic about disability that should prevent you from becoming a
teacher.’
(http://www.tda.gov.uk/get-into-teaching/life-as-a-teacher/teachers-with-
disabilities.aspx?sc_lang=en-GB)
The website goes into significant detail about training to be a teacher, the supports
available during training and into employment. It provides an excellent template
with which CoEs and Universities can work, ensuring that clear, explicit and positive
information is available to potential applicants.
Defining core competencies, disclosure and fitness to teach (recommendations 8 to
14)
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Fitness to practice has been defined as an individual’s ability to practice their
profession in a way which meets appropriate standards, meaning that a person has
the skills, knowledge, attitudes, character and health to perform necessary functions
safely and effectively (adapted from HPC, 2005).
Very significant expertise and experience has been developed by colleges over the
last number of years around fitness to practice issues, and Trinity College Dublin
(TCD) and University College Cork (UCC) have developed clear policies in this area:
http://www.tcd.ie/about/policies/fitness-to-practice-policy.php . In TCD a working
group was set up by the Dean of Students in 2008 which included all relevant
professional course co-ordinators, student representatives and service providers.
Details of the process undertaken in TCD can be found at the following link:
http://www.tcd.ie/disability/T-Projects/archived%20projects/Fitness.php . This is a
useful starting point for development of a fitness to teach policy.
It is the responsibility of admissions and academic staff to decide whether a course
can be delivered in a manner which allows a student to complete the course and
demonstrate the required standards of proficiency. Prejudicial views or actions,
stereotypes or blanket expectations of what a person with a particular impairment
can and cannot do, may lead to unlawful action. A similar line of responsibility
applies here, with similar concern that certain actions (particularly to exclude a
student with a disability) are unlawful under disability legislation.
TCD sought legal advice on a number of reasonable accommodation issues, one of
which relates to admission of disabled applicants. The response was clear:
‘Section 7(2)(a) of the Equal Status Acts 2000-2004 states that an educational
establishment shall not discriminate in relation to the admission or the terms
or conditions of administration of a person as a student to the establishment.
However, Section 7(4) (b) of the 2000 Act states that the above does not
apply to the extent that compliance with any of its provisions in relation to a
student with a disability would, by virtue of the disability, make impossible,
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or have a seriously detrimental effect on, the provision by an educational
establishment of its services to other students. The wording here is quite
strong “impossible or have a seriously detrimental effect” and therefore I
feel that it would not be possible to exclude a student from entry merely
because it will cause difficulty, whether this is prior to or post-registration.
The defence of impossibility or serious detrimental effect to any action
brought under the Equal Status Acts 2000 – 2004 is only in relation to
individual students and cannot be used to exclude, for example, all students
with a specific disability from a particular course of study’. (TCD, 2010)
Who decides if a person is “fit to practice”, and when should this decision be made?
Currently, there seem to be a confusion of influences around such a decision.
Premature assumptions may be unlawful. The use of clearly stated, defined,
behavioural standards (such as core professional competencies), as interpreted for
those using reasonable accommodations, would mean that if a student reaches
those standards, then they can be seen to be fit to practice. If the student does not
reach those standards, they in effect “fail” the course. This approach implies that it
will be necessary for individual Departments, on behalf of the University or College,
to both provide the appropriate accommodations, but also to fail students,
regardless of disability, if they do not meet the stated core competencies.
Alongside the fitness to practice issue may be the issue of whether or not a person
will be employable. If, with reasonable accommodation, a person has the required
essential professional skills then it appears that the University’s duty is completed.
Once reasonable accommodations have been provided by the University/College,
and the graduate has demonstrated that he/she has the required competencies,
then it is the responsibility of the employer to make reasonable accommodations to
employ a disabled practitioner.
Some may argue that it is ethically unsound to accept a disabled student if it is
unlikely that they will be employable, but acting on these grounds to prevent a
disabled student from completing a course of study, is unlawful. According to the UK
Health Professions Council (HPC) it is the responsibility of those providing approved 8
courses to ensure that graduates of the course are able to meet the stated standards
of proficiency for each profession (HPC, 2005). While there are standards for some
professions in Ireland, this is a developing area in for other professions, which will be
further established when State registration requirements are enacted into law.
Difficulties may arise in the interpretation of ‘professional standards’. For example, a
required professional skill may be that a person has good listening and
communication skills, which may be interpreted as good hearing and speech; a
required behaviour may be the maintaining notes and records, which may be
interpreted as the ability to hand-write legibly. The HPC draft guidelines (2005) and
interpretations of the ‘Good Medical Practice’ (GMC) (CHMS, 2001) both state that
these interpretations of professional skills are inaccurate, and may be unlawful.
The Disability Rights Commission (DRC, 2007) undertook a formal investigation on
this matter by:
‘examining the barriers that disabled people (including people with long-term
health conditions) face when entering, and staying in nursing, teaching and
social work... specifically… the barriers posed by the statutory regulation of
health in these professions’ (DRC, 2007, p. 5).
This report included both research and formal panel inquiry elements focusing on
three main areas: regulation (particularly pertaining to health and fitness),
assessment of health status and disclosure of disability. The full report is available
from http://www.maintainingstandards.org/
Health standards and core competencies
One of the key findings of the investigation was that ‘the statutory regulation of
‘good health’ and ‘physical and mental fitness’ for students and professionals in
nursing, teaching and social work has a negative impact on disabled people and
offers no protection to the public.’ (DRC, 2007, p. 174).
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The purpose of including health requirements is to safeguard the public, and its
inclusion as a statutory regulation followed reports into high profile incidents where
professionals had caused harm to the public. Such incidents include the Clothier
Report into the actions of Nurse Beverly Allitt, and the enquiry into the actions of Dr
Harold Shipman. The DRC found that there were significant gaps, particularly in the
Clothier report, and that systems such as appropriate monitoring, supervision and
management are more likely to reduce the risk of harm to the public, than health
requirements. Another concern is that use of these health standards may provide a
false sense of security for the professions, as they were found to be ineffective in
managing risk to the public. The recommendation is that all arbitrary health
standards should be revoked.
One of the major weaknesses of most professional courses is the lack of clearly
defined core competencies required of professional trainees, in order to successfully
practice. Vague or open-ended learning outcomes are insufficient when defending a
fitness to practice case in any HEI. The TCD Fitness to Practice Policy outlines the
issue as follows:
Schools/disciplines formulating fitness to practice requirements should
address the following four questions:
What competency (ies) is/are being assessed in the specific
course/placement?
Is the competency requirement justifiable in relation to each specific
course/placement?
How is the competency assessed?
In the case of a student with a disability/specific learning difficulty, has
the School/discipline actively engaged with the Disability Service, in
accordance with the guidelines set out in Part 4 below, to determine how
the student's needs might be reasonably accommodated?
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The policy of each school/discipline should also refer to the statutory
obligation to ensure that teaching and learning methods are accessible to
students with disabilities and should give examples of how methods of
teaching, learning and assessment can be made accessible to all students,
while indicating that these examples are illustrative only and not
comprehensive. (TCD, 2009)
It is impossible to decide whether or not one applicant is unsuitable on the grounds
of disability without considering the competencies that are required by a
programme of study. Only then can informed judgements be made about whether
or not a student should be excluded on the grounds of disability. Again, as this is a
very litigious area, it is critical that these core competencies are identified clearly and
communicated to prospective applicants. It is also critical that all CoEs operate the
same process when making decisions about whether or not an applicant is suitable
for teacher training study, using consistent criteria and referring to best practice in
this area. The vast majority of applicants with disabilities will be suitable for teacher
training programmes. The rationale for the exclusion of any student should be clear,
transparent and capable of being legally defended.
The DRC recommend the establishment of core competencies. Recommendation 17
states that “Maintain high professional standards for disabled and non-disabled
students alike but not pre-judge the professional competencies of disabled
applicants or students.”
“We consider, in the light of the extensive evidence we received… an
academic, competence and conduct framework (with reasonable
adjustments, where appropriate, including as to how any standards are to be
achieved) with a focus on the skills actually needed is entirely sufficient to
meet the needs of the profession. Competencies should be reviewed to
ensure that they are designed around the skills and knowledge needed for
that profession, bearing in mind that there are a variety of job roles within
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each profession and that most people – whether disabled or not – would not
be suited to all of them. Testing a person for their competencies and ensuring
that those who commit serious acts of misconduct cannot practice is a much
more rational basis for regulating the profession than arbitrary health
standards. A diagnostic label is valueless in measuring competence and
conduct. Health might be material to compliance with competence or
conduct standards, or may not be, but diagnosis is irrelevant in determining
competence or conduct.” (DRC, 2007, p.90)
Need for clear policy that reflects disability (and non-discrimination) legislation
Another finding from the DRC that is particularly pertinent to CoEs is that HEIs in the
UK tended to have generic statements and policies around disability, but that they
lacked specific policies that balance the need to not discriminate, with the need to
recommend disclosure of disability and ensure fitness to practice of disabled
students. A recommendation is that, as a matter of urgency, HEIs should activate
such policies.
It was also found that transparency in the decision-making process is important to
reduce the risk of discrimination and that a more specific policy document can
facilitate transparency. It is suggested that this policy document should apply
disability legislation such as the Equal Status Acts 2000, 2004 in the case of the
republic of Ireland, into clear, substantive and tangible procedures and practices.
As with HEIs, it was found that the professional bodies lack reference to disability
(and anti-discrimination) legislation in their policies, codes of practice or ethics, and
that this needs to be included. A review of Teaching Council documents including the
Strategic Plan ‘A New Era of Professionalism, ‘Initial Teacher Education: Criteria and
Guidelines for Programme Providers’ (2011) and ‘Policy on the Continuum of
Teacher Education’ (2011) confirms this to be the case for the teaching profession.
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Cases where disciplinary and other issues arise in conjunction with disability
At times, issues of discipline arise where there is also a health or disability element.
The DRC report suggests that these should be dealt with “fairly and sensitively”, and
there is a protocol within the Disability Discrimination Act (DDA) for hearings of this
nature.
There is a two-stage approach to dealing with issues where discipline and disability
occur together. The first stage is to examine whether disciplinary issues or poor
performance is due to a lack of appropriate accommodations for the person. That is
to say if accommodations had been provided, then behaviour or performance would
have been improved. If this is the case the disciplinary aspect of the hearing is
abandoned, and the appropriate supports are provided, for review at a future date.
The second important stage is to ensure that reasonable accommodations are also
provided for the actual hearings of disciplinary issues.
The DRC report recommends clear, consistent, disciplinary procedures for all, which
are entirely separate from disability. It is suggested that, having clear disciplinary
procedures in conjunction with clear competence standards, it is likely to be the
most effective means to ensure fitness to practice.
Disclosure of disability
It is recognised that disclosure of disability is the ideal. Upon disclosure, reasonable
accommodations should be provided to the person if required. Although it is
possible to have mandatory disclosure, the DRC has found that this can result in fear
of disclosure - or partial disclosure to the Disability Office. It is argued strongly that
generalised health questions are not appropriate, nor do they provide adequate or
specific information. Using generalised health questions were found to be more
likely to lead to prejudicial views, resulting in an increased risk of discrimination.
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Rule 155 (4) (a) of the Rules for National Schools (1965) states that:
‘Before a candidate is admitted to a Training College the medical officer of
the College must certify that he is of sound and healthy constitution and
free from any physical or mental defect likely to impair his usefulness as a
teacher; the medical certificate shall include such details as the Minister
may require.’
Currently CoEs are required by the Department of Education and Science (DES)
under Rule 155 to instruct applicants to complete the Health Declaration, and return
it to the relevant College’s Medical Officer. On acceptance of a teaching post within
a national school, all new employees are expected to complete an Occupational
Health form
The Occupational Health Service, an outsourced provision similar to many used in
employment practice, assesses applicants and offers of employment are made
subject to the teacher or candidate being deemed fit to undertake a teaching post.
The Occupational Health Service (Medmark Occupational Healthcare
http://www.medmark4snas.ie/) requires the completion of a pre-employment
medical questionnaire to be returned directly to the Occupational Health Service
immediately following a provisional offer of a place being accepted.
This on-line form follows a standard format in which a candidate discloses a disability
and/or on-going condition and is then called for assessment. The CHOICE report
states ‘An individual who has a disability must not be shown less favourable
treatment without reasonable justification and every effort should be made to effect
reasonable accommodations such that the individual can be appointed to the post.’
(CHOICE, 2009, p. 12). This is problematic because the assessment service is
detached from the work-place, and conducting a needs assessment or making
recommendations for accommodations which would enable teachers to be fit to
practice, are usually abstract and not environment specific. It is unclear how the
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system works in practice and what number of appointments are rejected based on
disability.
In the training environment recommendation 8 states that CoEs ‘should ensure that
all students are aware of the new Occupational Health Service procedures they are
likely to encounter when attempting to secure employment’. A ‘Medical Information
Form’ has been agreed by CoEs for use in their respective institutions
A difficulty with this type of ‘Medical Information Form’, identified by the DRC, is
that it is more likely to result in non-disclosure of disability, particularly in the case of
people with mental health issues. It is argued that non-disclosure in turn has
resulted in character judgements if or when a crisis happens, and where a student
needs to disclose their disability subsequently. It is recommended that a failure to
disclose is not taken as evidence of bad character (recommendation 16). Non-
disclosure can also result in a lack of reasonable accommodation for the disabled
practitioner or student, which may otherwise improve the person’s ability to work
effectively and safely. Non-disclosure is understandable, due to negative attitudes
and assumptions, but is described as unsatisfactory, and in no way could be said to
be in the public interest. However, negative attitudes and assumptions are also
unsatisfactory and not in the public interest. Disclosure is not an ‘all or nothing’
issue. Sometimes students are reluctant to disclose because they lack the
experience of deciding what, how much, how to and to whom they should disclose
It is recommended that strategies to promote and support disclosure be put in place
which lead to reasonable accommodations and which safeguard the disabled
student or practitioner. An example of this is the Student Handbook for disabled
students registering in Trinity College (2011) which has the following statement on
fitness to practice:
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‘Fitness to Practice
In April 2009, the College Fitness to Practice Policy was approved by both Council
and Board. The policy has now been in operation for nearly two full academics years.
See: College Calendar or www.tcd.ie/disability/projects/fitness/index.php
Professional courses demand that certain core competencies are met by students in
order to graduate and practice professionally after qualification. College has a
special responsibility to ensure that all students admitted to all professional
programmes will be eligible for registration by the relevant professional body upon
graduation. It is important to us that our students are able to fulfill the rigorous
demands of professional courses and is fit to practice.
If you wish to clarify any issues or concerns you may have, in relation to your
disability, supports available, disclosure or the demands of a course or on
professional practice after qualification, please contact…’
By developing a culture in which disclosure of disability is open and by having clear
policies and decision-making routes, students are more likely to feel comfortable
about disclosing a disability and seeking supports that will enable progression to
employment.
The TCD Fitness to Practice Policy has a clear statement that no disabled student can
be brought before a fitness to practice hearing in advance of the reasonable
accommodation process taking place. This is essential for the disabled student as it
will encourage disclosure and promote an environment that is inclusive and open to
working with disabled students towards successful completion of their professional
course and placements. The outcome of this is a professionally competent employee
who is able to deal with negotiation of reasonable accommodations in the work
place. It permits disclosure without fear of discrimination from employers.
4. Student with disabilities (http://www.tcd.ie/about/policies/fitness-to-practice-
policy.php)
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If a student has a disability and there are concerns over fitness to practice, section 4
of Schedule 3 shall apply, and the guidelines outlined in this Part should be followed
prior to any fitness to practice hearing.
'Disability' is defined …
A student with a disability undertaking a professional course may apply for, and be
provided with, such reasonable accommodation as is necessary to enable the
student to participate in all aspects of the course unless the provision of such
reasonable accommodation entails more than nominal costs.
Assessment of the student's needs shall be carried out by the College Disability
Service which, following consultation with the student, the relevant school/discipline
and, where appropriate, work-based placement staff, shall produce a Learning and
Educational Needs Summary document detailing the student's needs and the
manner in which such needs should be reasonably accommodated.
Reasonable accommodation may include, but is not limited to, the provision of:
Assistive technology
Human / personal supports (such as note-takers, readers, Irish Sign Language
interpreters, etc.) For health professions, personal assistance is considered
appropriate provided that the individual's knowledge and skill are assessed,
rather than that of the assistant.
Additional time, e.g. in exams or additional time to learn specific skills.
Information in alternate formats.
Physical access to required areas and / or timetabling of course elements into
accessible locations.
Alternate forms of assessment.
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Alternate or specifically selected practice education experiences that enable
the student to demonstrate core competencies in an environment with fewer
barriers.
If there are concerns that the reasonable accommodation provided by College is not
appropriate or working well, the Disability Service, in conjunction with the student,
the relevant school/discipline and, where appropriate, the clinical educator shall
review the provision of reasonable accommodation to see if it can be improved.
If the reasonable accommodation provided by College is such as to enable the
student to participate fully in his/her course of action, s/he shall be assessed on the
same basis as any other student on the course. In particular, if there are concerns
about the student's ability to practice elements of the course, the case shall be dealt
with in accordance with the procedures outlined in Part 3 above.
If a student with a disability does not engage with the process of making reasonable
accommodation, and concerns about an aspect of professional practice remain, then
in the first instance, the student will be invited again to participate. If this is
unsuccessful, then the case shall be dealt with in accordance with the procedures
outlined in Part 3 above.
This policy has been reviewed by the Dean of Students at the end of the first full year
of operation and some minor changes suggested in the text of the policy based on
the experiences of the Schools who have used the procedures. Additionally training
for those sitting on the School Fitness to Practice Committee’s has been identified as
an issue for attention.
Placement/Practice Education
Practice Education was found to be an area of particular difficulty. Reportedly this is
because supervisors / practice settings are unaware of disability legislation, and HEIs
were found to be poor at communicating reasonable accommodation requirements 18
to practice educators. A number of interesting projects have taken place nationally
in other professional areas such as Nursing and Social Work (TCD, 2009; UCD 2010).
In the former, a ‘Clinical Placement Handbook for Nursing Students with Dyslexia’
was produced which provided tips for trainee nurses with dyslexia on coping with
the demands of nursing and seeking support. Additionally, a guide for placement
co-ordinators was produced which outlined dyslexia awareness and how to support
students on placements. The process of developing this guide allowed for the
involvement of both parties and this resulted in guides that were led by the end-
users (www.tcd.ie/disability/docs/DS%20Booklets/TCD%20nursing%20book.pdf)
The resource guide ‘Supporting Students with Disabilities in Clinical Placements’
(2011) produced by UCD School of Nursing and Midwifery is an excellent resource
which has identified supporting students with disabilities on their courses as
essential. A collaborative strategy engaging all relevant stakeholders is an example of
how and inclusive teacher training environment can be moved forward.
The needs assessment process in most HEIs results in some form of communication
with the relevant course co-ordinator, which outlines a student’s disability and
needs. It is recommended that this report/memo is also forwarded to the relevant
placement/school in the case of trainee teachers. Schools should be encouraged to
put accommodations in place well in advance of the student participating in the
placement; this will prevent any problems with successful completion.
Further work and research recommendations
Further research on supporting trainee teachers and implementing good practice
guidelines are required. The recommendations of the CHOICE report need to be
reviewed and the focus needs to shift to an inclusive environment. This should
include both the university-based and practice education settings, so that
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information about good practice can be compiled. This would also be useful for
CoEs, and within all professional practice course settings.
Suggestions:
The Student Medical Information form proposed by CoEs, with their implicit
assumptions about the ‘risk’ from disabled people within teacher training,
discourages positive organisational cultures. There is evidence that disabled
people, where they recognise that they are covered by equality legislation,
gain real confidence from this legislation and feel empowered to negotiate
with HEIs about adjustments.
The influence of the statutory and regulatory frameworks requiring physical
and mental fitness is less obvious at the employment stage. There is a
widespread practice of health screening which is frequently not related to the
specific job role. This has the potential to lead to discrimination and to deter
disabled people from applying for jobs or from disclosing disabilities and
long-term health conditions. The DRC report referenced here found no
evidence that the use of generalised health standards is an effective way of
assessing or managing risk
The Teacher Training Council should review their competence standards to
ensure that any negative impact on disabled people is eliminated. They
should provide guidance on reasonable adjustments and consider what other
guidance is required to encourage others (such as HEIs) to adopt an enabling
approach to disabled people.
In contrast to this, the DRC’s Inquiry Panel heard repeatedly that the
regulations requiring good health or physical and mental fitness create a
climate where disability is not perceived positively, affecting willingness to
disclose and to request adjustments.
A framework of professional standards of competence and conduct, coupled
with effective management and rigorous monitoring of practice, is the best
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way to achieve equality for disabled people and the effective protection of
the public.
The suggestion of linking closely with professional bodies to establish clear,
legitimate, core competencies remains highly relevant and is an important step.
Finally, there is a need to carry out research into discrimination in the HE sector
within nursing, teaching and social work courses. There is anecdotal evidence of
students being excluded from professional courses based on disability grounds - but
no clear research has been carried out in this area. This would assist HEIs in ensuring
their courses are inclusive, thus benefiting all by making a more diverse culture.
21
References
Ahead Participation Survey 2010, Ahead
‘Fitness to Practise in the Medical Profession’ – A Report to Universities UK and the
Council of Heads of Medical Schools by Eversheds Solicitors (July 2001)
(http://www.chms.ac.uk/fastuds.htm)
Council of Heads of Medical Schools (CHMS) (1999) Guiding Principles for the
Admission of Medical Students CHMS (http://www.chms.ac.uk/fastuds.html)
Disability Act, 2005, link
Felsinger, A. & Byford, K. (2010) ‘Managing reasonable adjustments in higher
education’. London: Equality Challenge Unit
Fitness Standards Formal Investigation - The Disability Rights Commission (DRC)
launched a general formal investigation (FI) on 22 May 2006 looking at the barriers
people with impairments and long-term health conditions face in trying to pursue
careers in teaching, nursing and social work. Maintaining Standards: Promoting
Equality Professional regulation within nursing, teaching and social work and
disabled people’s access to these professions Disability Rights Commission. Report
published 2007, Available at www.equalityhumanrights.com/advice-and-
guidance/before-the-equality-act/guidance-for-education-providers-pre-october-
2010/maintaining-standards-promoting-disability-equality
Health Professions Council (2005) A disabled person’s guide to becoming a health
professional. Consultation document London: The Health Professions Council.
Higher Education Authority (2012), 10/11 Higher Education Key Facts and Figures
Howlin & Halligan (2011) Supporting Nursing and Midwifery Students with a
Disability in Clinical Practice: A Resource Guide for Clinical and Academic Staff
http://www.ucd.ie/t4cms/Supporting%20Nursing%20and%20Midwifery%20Students
%20with%20a%20Disability%20in%20Clinical%20Practice.pdf
22
Medical Council (2004) A Guide to Ethical Conduct and Behaviour 6th ed. Dublin:
Medical Council (Ireland)
National Access Office, ESF-FSD statistical information on applications to Fund for
students with disabilities by CoEs, HEA, 2010-11
Roberts, T., Butler, A., Boursicot, K. (2004) The Higher Education Academy, Special
Report 4: Disabled students, disabled doctors – time for a change? A study of
different societal views of disabled people’s inclusion to the study and practice of
medicine Newcastle-upon-Tyne: The Higher Education Academy.
Teacher Training Council (2011) A New Era of Professionalism: Fas, Forbairt agus
Foghlaim 2012-14.
Teacher Training Council (2011), Initial Teacher Education: Criteria and Guidelines for
Programme Providers
Teacher Training Council (2011), Policy on the Continuum of Teacher Education’
Trinity College Dublin Disability Service Strategic Plan 2011-2013 (2011):
http://www.tcd.ie/disability/projects/index.php
Trinity College Dublin Fitness to Practice Policy (2009)
http://www.tcd.ie/about/policies/fitness-to-practice-policy.php
Bibliography / Further Reading
Council of Heads of Medical Schools (CHMS) (2005) Recommendations on Selection
of Medical Students with Specific Learning Disabilities including Dyslexia
Wray, J., Fell, B., Stanley, N., Manthorpe, J., Coyne, E. (2005) Best Practice Guide:
Disabled social work students and placements Hull: The University of Hull
‘Good Medical Practice’, General Medical Council, (Third Edition, May 2001)
(http://www.gmc-uk.org/global_sections/search_frameset.htm)
23
‘QAA Subject Benchmark Statements: Medicine’, The Quality Assurance Agency for
Higher Education (2002)
(http://www.qaa.ac.uk/crntwork/benchmark/phase2consult.htm)
‘Tomorrow’s Doctors’, General Medical Council (July 2002) (http://www.gmc-
uk.org/med_ed/default.htm)
‘Student Health and Conduct: Guidance for Universities and Medical Students’,
General Medical Council (November 2002)
(http://www.gmc-uk.org/med_ed/default.htm)
24