The invisible work of co-creating disability access in work integrated learning

Promoting health equity necessitates the diversification of healthcare workforces. Disability is one aspect of diversity that is increasing in healthcare. While the number of Disabled students in health professions increases, barriers in their work integrated learning (WIL), such as placements in hospitals or clinics, persist. While literature has addressed some of these barriers, there is less known about the social processes that enable access in work integrated learning when it does occur. Therefore, an interdisciplinary team from design, geography, occupational science, nursing, occupational therapy, critical disability studies, and knowledge mobilization explored questions regarding social processes involved in WIL accessibility in clinical settings. The team conducted twenty-five in-depth interviews with 4 placement coordinators, 8 placement supervisors, 6 access professionals, 4 education leaders (e.g. Deans) and 3 healthcare leaders (e.g. site education leaders) from two hospitals and two universities in eastern Canada. The team's collaborative thematic analysis of participant narratives constructed four themes regarding the invisible work clinical and academic educators engage in to create access: putting in extra time, doing emotional labour, engaging in relational work, and navigating complexities. This labour is unrecognized and optional, and therefore its result-access to education-is inequitably distributed. Educators, policy makers, and institutions need to know how access is created in WIL to promote diversity within health professions and systems.