Assisting students with disabilities to enroll in allied health programs & secure jobs Dr. Bronwynne EvansDr. Beth Marks Professor Research Associate AZ State University Professor, UIC Co-Director, NOND Bronwynne Evans, PhD Professor and Director, Nursing and Healthcare Innovations, Arizona State University (ASU)
Bronwynne Evans, PhD, is professor and director of PhD in Nursing and Healthcare Innovations at Arizona State University (ASU) and the former vice president, National Organization of Nurses with Disabilities. Evans joined ASU in 2004. Before going to ASU, Evans served as associate professor at Intercollegiate College of Nursing, Washington State University, College of Nursing. Evans is an expert in recruitment and retention of nursing students from diverse backgrounds, including those with disabilities, and informal care-giving in Mexican-American families. Additionally, she has researched and is published in areas of nursing education; care-giving in border populations; psychosocial, cultural, and spiritual health disparities in end of life and palliative care; and mixed methods studies. She earned her PhD in education from the University of Washington, a masters degree in nursing from the University of Washington, and a bachelors degree in nursing from Washington State University.
Beth Marks, PhD Associate Director for Research, Rehabilitation Research and Training Center on Developmental Disabilities, University of Illinois at Chicago (UIC) Beth Marks, PhD, RN is associate director for research in the Rehabilitation Research and Training Center on Developmental Disabilities, University of Illinois at Chicago (UIC), research associate professor in the Department of Disability and Human Development, UIC, and immediate past president of the National Organization of Nurses with Disabilities. She directs research programs related to the empowerment and advancement of persons with disabilities through health promotion, health advocacy, and primary health care. She coedited a special issue in Nursing Clinics of North America on health issues for persons with developmental disabilities, a Feasibility Study Report to advance nursing education at Bel-Air Sanatorium and Hospital in Panchgani,
Maharashtra, India through the WHO Collaborating Center, UIC, and a monograph on Primary Health Care in the Americas for the Pan American Health Organization/World Health Organization. Marks produced a documentary with Bronwynne Evans, RN, PhD entitled Open the Door, Get 'Em a Locker: Educating Nursing Students with Disabilities. She has authored two books entitled: Health Matters: The Exercise and Nutrition Health Education Curriculum for People with Developmental Disabilities and Health Matters for People with Developmental Disabilities: Creating a Sustainable Health Promotion Program. Funded by the U.S. Department of Labor All material produced subject to: Creative Commons Attribution 3.0 United States License 3
This product was funded by a grant awarded by the U.S. Department of Labors Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership. Acknowledgments The National Organization of Nurses with Disabilities
Karen McCulloh, RN; Robin Jones, OT; Martha Smith, MA The Office of Disability Employment Policy, U.S. Department of Labor Barriers Wide range of influences on nursing & allied health professions Claims of social model guidance not wellsubstantiated (Scullion, 2008) Lack of knowledge r/t self-identification & disability disclosure Diagnosis often delayed until postsecondary education/expensive process
Lack of role models REALITY: Health care professions remain replete with daily barriers WWW.NOND.ORG DAILY EVIDENCE NOND inquiries Students with disabilities seeking admission to health professions programs Nurses with disabilities in danger of job
termination or seeking a return to the job market after acquiring a disability NOND inquiries Student with quadriplegia seeking admission to school of nursing Action: Student, administration, faculty, disability services Understand the ADA Develop capacity to implement accommodations Identify mentor/advisor
NOND inquiries Nurse with a disability seeking to return to her job in a cardiac step-down unit following a stroke in her late 20s. Action: Nurse, employer, human resources, supervisor Understand the ADA/ADAA/Final Rule Develop capacity to implement accommodations Identify mentor/advisor Medical model vs.
Social model disability is negative; a deficiency/abnormality disability is neutral; a difference disability resides in the person disabling qualities reside in environment (access &
attitudinal barriers) remedy for disabilityrelated problems is cure or normalization of the individual agent of remedy is the professional remedy for disability-related problems is change in interactions b/t individual & society agent of remedy can be
individual or advocate or anyone changing interactions b/t individual & society ADA (1990) definition of disability 1. has a physical or mental impairment that substantially limits one or more major life activities; 2. has a history or record of such an impairment; 3. is perceived by others as having such an impairment.
NOT ALL DISABILITIES ARE VISIBLE! 12 ADAAA (Amendments, 2008) Expanded definition of qualified disability Does not allow consideration of mitigating measures Need only substantially limit one major life activity Coverage for neurologically based impairments
DOL/ODEP, DOJ, DOE Paradigm shift! Increasingly attentive to issues of discrimination in education ADAAA has wide-reaching implications for education o increases the number of students who qualify as having a disability o intensifies reasonable accommodation efforts and overall sensitivity to disability issues
Essential functions Apply to employment, not education BUT Translated into education using Appendix A (Yocom,1996) Widely used in nursing programs Example: Walk Technical standards
Apply to education all students Able to meet these requirements with or without a reasonable accommodation Entry requirement, not skill learned in program/the what, NOT the how: able to gather vitals NOT
hear heart murmur through stethoscope (Martha Smith, 2009) Just how far do I need to go to accommodate? 17 What is an accommodation? Modification or adjustment to the way things are usually done Changes to the environment to enable
someone with a disability to have equal access Use of assistive and/or accessible devices to enable someone to accomplish a task 18 18 18 What is a reasonable accommodation?
Anything can be an accommodation Undue financial hardship to school? Fundamental alteration of program or service? Need process to evaluate and ability to defend 19 19 Forms of reasonable accommodation
Modified schedules Auxiliary aids and services Modified policies and procedures Materials in alternative formats
Accessible information technology Captioned video (YouTube, DVD, etc.) Modified requirements for procedures Assistive technology 20 20 What is NOT a reasonable accommodation? Fundamentally altering a course requirement Tolerating abusive behavior
Non-adherence to policies/procedures Personal services 21 21 Whose responsibility is it? Educational institution responsibilities: appropriate accommodations to maximize success in classroom and other degree requirements
auxiliary aids and services to ensure participation 22 22 Whose responsibility is it? Student responsibilities: Identify need for accommodation Engage in interactive process to determine appropriate accommodation
prior to activities (not after the fact) Provide documentation to substantiate disability and need for accommodations in a timely manner 23 23 What should a program do? Recognize there is more that one way to teach something; all students may not have to do all activities/methods (be prepared to respond to the question of patient safety)
Make case-by-case determination develop disability-friendly policies and evaluation processes Create technical standards Use educational criteria (not essential functions) 24 HANDOUT 9: Technical Standards versus Essential Functions 24
What can we do? Transforming practice Health professionals with disabilities have the potential to transform their disciplines and practice through provision of culturally relevant care Health professionals with disabilities can
Enhance our psychosocial skills Re-define our clinical skills Provide culturally & linguistically congruent, preventive care that Enhances communication Increases consumer involvement Satisfies consumers Leads to better health outcomes
Educational issues Training for entry to workforce Training for return to workplace Joining Forces http://www.whitehouse.gov/joiningforces [email protected][email protected]
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