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    April 2015

    Accommodating Students with Disabilities in Clinical Programs

    Managing students with documented disabilities in clinical programs can present unanticipated difficulties. Clinical or practicum requirements may be part of undergraduate or graduate programs such as nursing, social work, physical therapy, law, counseling, and teaching. If a student is “otherwise qualified”—i.e., meets the academic requirements—to participate in the degree program, the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act require institutions to provide reasonable accommodations for his or her disability.

    To best position your campus to handle accommodation requests from students in a clinical program, you should:

    • Set clear standards
      • Identify all programs on your campus that require a clinical/practicum placement.
      • Work with program faculty to develop comprehensive and detailed technical standards for all students that are clear and match the nature of the program. Consider incorporating professional standards, accreditation requirements, and licensing requirements.
      • Incorporate behavior and professionalism requirements into the technical standards.
      • Periodically assess and revise the technical requirements as professional standards evolve.
    • Communicate standards
      • Distribute any new or revised technical standards to faculty and current students.
      • Share the technical standards with all applicants and consider having the applicants sign a statement prior to final admission that they acknowledge the program requirements.
      • Notify students that clinical sites are distinct from the classroom. Certain accommodations that are acceptable for the classroom may not be appropriate in a clinical setting. For example, being allowed to leave a classroom during discussion of an upsetting topic may deprive the student of a meaningful learning experience in a clinical setting.
      • Communicate the behavioral and professional standards to all students and hold them accountable throughout the program.
      • Encourage, but do not require, a student to disclose his or her disability to the clinical placement site.
      • Train clinical site supervisors on your program’s technical standards.
      • Inform clinical supervisors of accommodations granted to a student, but do not share the nature of the disability. Caution clinical personnel against engaging in “unofficial” diagnosis, especially relating to behavioral issues. Be clear that evaluations and communications should document behavioral concerns and not speculate on root of any problems.
    • Use sound practices for fielding accommodation requests
      • Avoid generalizations based on a student’s stated disability. Instead engage in a good-faith interactive process by doing an individualized assessment to determine appropriate accommodations.
      • Document your interactions. Keep a record of the accommodations requested and offered along with reasons for accepting or rejecting requests.
      • Often a student’s disability is not discovered until a clinical rotation. The law does not require you to retroactively accommodate a disability your institution was unaware of. However, it is prudent to consider whether the student can retake the clinical portion with an accommodation. Again, engage in the interactive process to determine if an accommodation will enable the student to succeed. Consider also whether the student has a right to appeal a dismissal from a clinical site or the overall program.

    While these situations can be tricky to navigate, if handled with care, you can avoid disability discrimination claims.


    Resources

    Drexel University Undergraduate Nursing Technical Standards
    University of Minnesota Policy on Medical Students with Disabilities

    University of North Dakota Physical Therapy Technical Standards

    University of Southern Mississippi Teaching Technical Standards

    Heather A. Salko, senior risk management counsel


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