Working with placement providers
During our research, problems were described where nursing mentors were not always comfortable with the reasonable adjustments proposed for a particular student. This might be about the practicality of the adjustment in the placement environment or about whether the adjustment compromised the assessment of the student’s practice.
To make decisions on whether an adjustment is reasonable, and the application of the learning outcome is proportionate, it is recommended that a process for reaching a common understanding on HEI support and placement practice is in place on a general basis.
This could include demonstrations with placement staff of how technology can be used by students with different impairments. This can then be communicated to students prior to placement in discussion on the adjustments that can be expected, and how they may differ from the adjustments made within the HEI.
Use of technology
The pace of technology is fast moving and some staff may be uncomfortable with some of these approaches. A team approach with tutors, practice mentors and disability services in discussing these reasonable adjustments and the implications for competence standards will assist in making decisions on whether or not the standard has been met. Examples included:
- Apps for smart phones and IPads for reminders, note taking and interaction with patients
- Amplified stethoscopes
- Audio recorded handover procedures
- Preparing the student in advance of placement
The research identified benefits of advance preparation for individual students to identify where reasonable adjustments are needed and are possible. For example
- A placement handbook detailing the competencies to be assessed and methods of assessment and possible reasonable adjustments is provided to each student
- Pre placement meetings and visits are arranged, including the student, the academic advisor/course director, disability officer, placement officer, staff from hospital/trust
- Placement mentors give students examples of the forms/reports that they will use on placement in advance of their start date.
Reasonable adjustments during placements
Placement mentors are responsible for ensuring reasonable adjustments are in place. Some HEIs have established placement protocols which identify the reasonable adjustments which have been agreed and are signed by the student, nursing school, the placement mentor and disability services.
Placement mentors will also have a role in helping colleagues of disabled students develop strategies to support students and to encourage students to develop self help strategies. For example:
- a student could take home some spare equipment to perfect a practical task in their own time;
- a colleague could provide opportunities for practice and explore the availability of alternative equipment
- Breaking night duty in smaller components such as twilight shifts
- Flexible placement hours
Students will still need opportunities to discuss the implementation of reasonable adjustments or other issues whilst on placement.
In several universities, disability services had adapted their advisory service opening hours to be open later, for example from 7 – 9pm on certain days, or tutors and disability services kept in touch via skype.