'Patient' or 'professional'? Negotiating accommodations and identity in fieldwork education.

Area of Science:

• Disability Studies
• Health Professions Education
• Social Sciences

Background:

• Legislation mandates accommodation policies in postsecondary education.
• Support for students with disabilities is often lacking in health and human services (HHS) fieldwork settings.
• Discrepancies exist between mandated accommodations and their practical implementation in HHS programs.

Purpose of the Study:

• Examine how HHS students with disabilities experience accessing accommodations in fieldwork.
• Understand the relationship between disability conceptions and fieldwork experiences.
• Analyze how HHS fieldwork education understands disability, accommodations, and professional competence.

Main Methods:

• Conducted a Canada-wide study involving 10 HHS programs.
• Interviewed 35 students requiring accommodations in HHS fieldwork.
• Utilized critical interpretive analysis to develop composite narratives of student experiences.

Main Results:

• Conceptions of disability incongruent with professional competence expectations create barriers for students disclosing disabilities and obtaining accommodations.
• Fear of stigma and questioning of competence, alongside denied accommodation requests, highlight ableist systemic structures in HHS fieldwork.
• The dominant medical model of disability in HHS education forces students to navigate institutional barriers and reconstruct their professional identity.

Conclusions:

• Reworking competency standards and implementing critical pedagogical approaches are suggested to address ableist assumptions in HHS education.
• Challenging personal and practice assumptions can foster a more inclusive culture within HHS.
• Institutional support for these changes can promote diversity in HHS and lead to more equitable education and healthcare practices.