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

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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)

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‘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)

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