More Than Meets the Eye: What Policies Exist for Accommodating Medical Learners With Disabilities and What Do Learners Think of Them?

• In Event: 47.039 - Promoting Disability Equity Across Health Professions Education: Considering U.S. and Canadian Students' Lived Experiences

Abstract

Medical students have unique accommodations needs given their diverse and ever-changing learning environments, direct contact with patient-care, and systemic stigma (Bulk et al., 2017; Easterbrook et al., 2015). Legally, and from a social justice framework, institutions are obligated to review their processes to identify and reduce barriers to entry for medical students. There are, however, limited policies, resources, and scholarship available to guide medical students and educators about accommodations in the Canadian context. Healthcare providers with disabilities, if properly accommodated, will benefit the healthcare system as they engender compassion and empathy for their patients in a way that is different from their peers, thereby enriching the patient experience (DeLisa & Thomas, 2005; Iezzoni, 2016; vanMatre, Nampiaparampil, Curry & Kirschner, 2004). In this study, we aimed to (a) analyze current accommodations policies and procedures at Canadian undergraduate medical programs for students with disabilities, (b) identify challenges and opportunities for creating inclusive educational experiences for medical students with disabilities, and (c) identify and reflect on structural changes that educators and administrators can implement to accommodate the needs of medical students with disabilities equitably.

Through a mixed method study design, we conducted an environmental scan of existing accommodations policies at all English-speaking Canadian undergraduate medical education programs and interviewed nine Canadian learners who sought accommodations for a disability. Data for the policy analysis was collected from university websites, and phone and email inquiries with accommodations officers. We analyzed the existence and types of available policies. Learners were asked to reflect on how the policy analysis resonated with their lived experience. Interviews were transcribed verbatim and analyzed using constant comparison (Boeije, 2002). Finally, we presented emerging themes to the participants to confirm our understandings.

Based on the policy review, we found that all programs provided extensive and varied in-class didactic accommodations for their students. However, for the clinical learning contexts of the medical schools, most had no clear description of the process for providing accommodations. Those who did stated that clinical accommodations are provided on a case-by-case basis. Interview analysis demonstrated that, overall, learners in this study did not feel that existing policies were helpful to them in navigating the accommodation process. In total, four major themes were identified (a) bureaucracy as a barrier due to fragmented and contradictory nature of services, (b) “I’m left on my own” navigating the system, (c) power dynamics as a barrier, and (d) perceptions of disability in medicine as a barrier.

This study identifies gaps in accommodation policies and practices of Canadian medical schools, which result with a sense of chaos and lack of equity among learners. Our main recommendations are to: (a) advocate for a change in attitudes among stakeholders involved in the recruitment, selection, and education of medical students; (b) invest in focused engagement and recruitment of students with disabilities; (c) improve cohesion, transparency, and streamlined delivery of services; and (d) develop capacity among educators and administrators, through training for staff and faculty, enhanced support to learners, and development of resources.

Authors

• Tal Jarus, University of British Columbia

• Pam Liao, University of Toronto

• Alfiya Battalova, The University of British Columbia

• Julia Tikhonova, The University of British Columbia

• Shyama Das, The University of British Columbia

• Vera Krejcik, University of Calgary