UCD School of Nursing, Midwifery and Health Systems Ireland UCD Access & Lifelong Learning Scoil Na hAtrachta, an Cnaimhseachais agus na gCoras Slainte UCD A Model for Supporting Nursing and Midwifery Students with a Disability on Placement Frances Howlin, Julie Tonge & Phil Halligan

Aim Describe the UCD model for supporting nursing and midwifery students with a disability in clinical practice.

Introduction Background & context. Clinical Assessment Subcommittee (CASC). Disability Liaison Team (DLT). AHEAD & UCD Access & Life Long Learning.

Disability Profile – SNMHS 2012/13 Specific Learning Disabilities (SpLD) – 31 Significant On-going Illness (SOI) – 6 Mental Health – 3 ADD/ADHD – 3 Hearing Impairment – 1 Visual Impairment – 1 Physical Disability - 1

Developing model of support Student Support Phase One Phase Two Phase Three Phase Four

Phase 1: Review Literature & Current Supports Literature Legislation. Disability. Reasonable accommodations. Disclosure. Competence & fitness to Practise. Current supports Academic. Personal. Exam accommodations. Assistive technology.

Phase 2: Partnership & Collaboration UCD Access & Life Long Learning. Students. AHEAD. Clinical staff. Academic staff.

Phase 3: Clinical Needs Assessment (CNA) Development Implementation Evaluation

Development Clinical Needs Assessment Part 1 ◦ Background. Part 2 ◦ Detailed history. ◦ Reasonable accommodations. Part 3 (Clinical site) ◦ Reasonable accommodations. ◦ Consent. Part 4 (Std & Clinical site) ◦ Review of reasonable accommodations.

Implementation & Support Pathway: Main clinical partner sites 1. Student registers with UCD Access & Lifelong Learning, Conduct Needs Assessment. 2. Reviewed by Occupational Health. 3. Disability Liaison Team conduct clinical needs assessment. 4. Clinical contact person received CNA. 5.Student contacts CCP (Clinical Contact Person to discuss disclosure & CNA (Clinical Needs Assessment).

Implementation & Support Pathway: Main clinical partner sites (cont.) 6. Student identifies staff who receive list accommodations & brings list to clinical placement. 7. Student discusses accommodations with identified staff. 8. Accommodations implemented. 9. Review of accommodations completed end placement.

Evaluation of CNA Sample (student profile). Data collection: , interviews- semi- structured, open ended, individual, & audio taped. Ethics – confidentiality and anonymity. Thematic analysis. Key Findings – Process of Disclosure. – Receiving Support.

Process of Disclosure: Excerpts ‘there is so much to take in and you don't want to single yourself out’ (Int 1) ‘...you didn't want to, in front of everyone, say, well actually I have dyslexia, it might take me a couple of minutes to catch up’ (Int 5) ‘you are not ever going to be by yourself with her’ (Int 1)

Process of Disclosure: Excerpts ‘I decided to tell them just... not to watch my back... but say if something did happen at least I would know that I have told them I have dyslexia’ (Int 4) ‘I found that the forms …[CNA] were helpful the pressure was taken off me, we didn't have to verbally disclose, I just handed the sheets and then they could ask me questions if they needed to...’ (Int 5)

Receiving Support: Excerpts ‘...they are all so busy and not everyone remembers or whatever...I found in some situations the nurses just didn’t have the time’ (Int 2) ‘I had a different preceptor almost every day which I found really difficult’ (Int 3) ‘...she'd [nurse] say a big long word and I'd try and keep repeating it and then someone else might say, oh can you grab this when you are in there as well’ (Int 4)

Receiving Support: Excerpts ‘... Definitely the CPCs coming down... and going through things with me … it was absolutely fantastic (Int 3) ‘I found the support of the other students...really helpful...they can understand what you are saying to them (Int 5) Student self support strategies

Phase 4: Educational resources and other supports Consultation & disability awareness training. WAM (AHEAD). Student workshop, Resource Guide & Student guide.

Resource Guide Launched Mar 2011 Two formats Clinically focused Evaluation Revision? Available free to download from: UCD School of Nursing, Midwifery & Health Systems Website UCD School of Nursing, Midwifery & Health Systems Website

Educational Resources: UCD & AHEAD UCD: The Clinical Placement: Student’s essential guide to frequently used terminology and abbreviations. Available to download free from: UCD School of Nursing, Midwifery & Health Systems Website AHEAD: National Guidelines for Working with Nursing and Midwifery Students with a Disability or Specific Learning Difficulty in Clinical Practice Available to download free from: AHEAD Website

Final Model Clinical Needs Assessment. Partnership, Collaboration & Consultation. Disability Awareness Raising and Education. Evaluation and Research.

…more to do Address environmental impact. Address student ownership & responsibility. Promote shift in culture, attitudes & practices. Increase expertise, knowledge & skills. Lobby for regulatory guidance. Dissemination - evaluation & research. Other professional courses in UCD.

Acknowledgements Thanks to all our contributors, clinical partners, colleagues and students. Special thanks to AHEAD and UCD Access & Lifelong Learning for their support.

Any Questions? Disability Liaison Team: Frances Howlin Phil Halligan Disability Advisor: Julie Tonge