Overcoming Obstacles: Healthcare Students With Disabilities on Fieldwork

With the introduction of the Americans with Disabilities Act (ADA) and Individuals with Disabilities Education Act (IDEA), as of 2010, the number of individuals with disabilities seeking higher education has more than tripled over the last twenty-five years (Barnar-Brak, Lectenberger, & Lan, 2010). However, despite this introduction of legislation, many students with disabilities fail to complete their education (Barnar-Brak et al., 2010). Of the 9% of full-time college students with disabilities, only 1% to 3% percent utilize disability-related services due to failure to seek out services (Barnar-Brak et al., 2010). This presentation aims to introduce research through a pilot study and a literature review on fieldwork (FW) sites’ perceived barriers to hosting occupational therapy (OT) students with disabilities, either physical or mental, on FW.

In this pilot study, participants were recruited by convenience sampling through established FW connections of one University located in the Northeast. Criteria for contact included two or more applicable sites from each type of setting to promote anonymity of recruits. Each selected site were presently active in accepting Level II FW students.

Critical appraisals of five peer-reviewed articles were completed. Available literature was examined using CINAHL and Medline databases. Literature relevant to OT was limited; and therefore, the search was expanded to include multiple healthcare disciplines such as physicians, physical therapy, and nursing. The scope was also broadened to include literature from other countries that had regulations in place similar to ADA. Several themes were discovered from the literature review: students were more successful in receiving accommodation when they disclosed their disability early (Ward, Ingram, & Mirone, 1998); Fieldwork educators (FWEs) often felt uncertainty surrounding their role and desired more support from the university (Hirneth & Mackenzie, 2004); and open communication between the fieldwork coordinator, fieldwork site, and the student resulted in the best educational outcomes for the student (Ward et al., 1998).

A Qualtrics survey was created to examine experience, ability, and barriers to hosting a FW student with a disability. The survey was based on the literature review and was sent to 26 FW sites in the greater Pittsburgh area. Responses were received from 14 FW sites from a variety of settings. Researchers used a Person-Environment-Occupation (PEO) Model to explore themes from data analyzed through a Qualtrics report. The survey uncovered that participants had identified eight different barriers to hosting Level II FW students with physical or mental disabilities. The PEO Model was used to unpack these findings and of these barriers, 70% were classified as environmental, 15% were occupational, and 15% were person related. Participants also indicated that eight of the 14 sites had essential functions for physical capacities, but only four of the 14 had essential functions for mental capacities.

This research study offers further understanding of the educational pathways for students with disabilities to become OT practitioners. It aligns with ADA content and AOTA’s Vision 2025 pillar addressing equity, inclusion, and diversity. Future research should explore OT students with disabilities and their perceived barriers to and supports for success on FW. Understanding students’ perspectives will provide further insight into how they can begin advocating for themselves and the reasonable accommodations needed to be successful on FW.

References

Barnar-Brak, L., Lectenberger, D., & Lan, W.Y. (2010). Accommodation strategies of college students with disabilities. The Qualitative Report, 15(2), 411-429. Retrieved from https://nsuworkds.nova.edu/tqr/vol15/iss2/10

Hirneth, M., & Mackenzie, L. (2004). The practice education of occupational therapy students with disabilities: Practice educators’ perspectives. British Journal of Occupational Therapy, 67(9), 396–403. https://doi.org/10.1177/030802260406700904

Kornblau, B. L. (1995). Fieldwork education and students with disabilities: Enter the Americans with Disabilities Act. American Journal of Occupational Therapy, 49(2), 139-145. doi:10.5014/ajot.49.2.139

Ward, S., Ingram, D. A., & Mirone, J. A. (1998). Accommodations for students with disabilities in physical therapist and physical therapist education programs: A pilot study. Journal of Physical Therapy Education, 12(2),16-21.