The Process for Determining Disability Accommodations

Laird, Elisa P.; Serrantino, Jan; Culley, J. Leigh

doi:10.1891/9780826182234.0004

Cited by 5 publications

(13 citation statements)

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“…50 In parallel, multiple calls support the benefit of having specialised disability personnel for the medical school to enhance effective accommodations and communicate support for the population of students with disabilities. 26,51,81 Our findings support these recommendations and the need to remove structural barriers to disability disclosure and accommodation request. 50,82 Commonly reported structural barriers include, but are not limited to, conflicts of interest in the disability disclosure process (e.g.…”

Section: Discussionsupporting

confidence: 77%

“…50,82 Commonly reported structural barriers include, but are not limited to, conflicts of interest in the disability disclosure process (e.g. when individuals who hold a role in students' assessment or promotion are involved in the review of students' requests for accommodations), 25,29,81 lack of expertise and knowledge about accommodations among disability resource professionals 26,50 and disability disclosure systems that are not informed by best practices and relevant disability and case law. 81 This study has limitations.…”

Section: Discussionmentioning

confidence: 99%

“…when individuals who hold a role in students' assessment or promotion are involved in the review of students' requests for accommodations), 25,29,81 lack of expertise and knowledge about accommodations among disability resource professionals 26,50 and disability disclosure systems that are not informed by best practices and relevant disability and case law. 81 This study has limitations. First, its cross-sectional design does not allow definitive conclusions about causality or the direction of the identified associations.…”

Section: Discussionmentioning

confidence: 99%

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Disability, program access, empathy and burnout in US medical students: A national study

et al. 2022

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Objective The objective of this study is to investigate whether self‐disclosed disability and self‐reported program access are associated with measures of empathy and burnout in a national sample of US medical students. Methods The authors obtained data from students who responded to the Association of Medical Colleges (AAMC) Year 2 Questionnaire (Y2Q) in 2019 and 2020. Data included demographic characteristics, personal variables, learning environment indicators, measures of burnout (Oldenburg Burnout Inventory for Medical Students), empathy (Interpersonal Reactivity Index) and disability‐related questions, including self‐reported disability, disability category and program access. Associations between disability status, program access, empathy and burnout were assessed using multivariable logistic regression models accounting for YQ2 demographic, personal‐related and learning environment measures. Results Overall, 23 898 (54.2%) provided disability data and were included. Of those, 2438 (10.2%) self‐reported a disability. Most medical students with disabilities (SWD) self‐reported having program access through accommodations (1215 [49.8%]) or that accommodations were not required for access (824 [33.8%]). Multivariable models identified that compared with students without disabilities, SWD with and without program access presented higher odds of high exhaustion (1.50 [95% CI, 1.34–1.69] and 2.59 [95% CI, 1.93–3.49], respectively) and lower odds of low empathy (0.75 [95% CI, 0.67–.85] and 0.68 [95% CI, 0.52–0.90], respectively). In contrast, multivariable models for disengagement identified that SWD reporting lack of program access presented higher odds of high disengagement compared to students without disabilities (1.43 [95% CI, 1.09–1.87], whereas SWD with program access did not (1.09 [95% CI, 0.97–1.22]). Conclusions Despite higher odds of high exhaustion, SWD were less likely to present low empathy regardless of program access, and SWD with program access did not differ from students without disabilities in terms of disengagement. These findings add to our understanding of the characteristics and experiences of SWD including their contributions as empathic future physicians.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Disability, program access, empathy and burnout in US medical students: A national study

et al. 2022

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“…A major structural barrier to student disability disclosure occurs when there is a conflict of interest in the process of requesting accommodations. 1 , 17 One mechanism for conflict of interest occurs when individuals who hold an evaluative role, or a role in student promotion, review student’s primary documentation as part of the request for accommodations. 1 , 7 , 9 Those who participate on committees that adjudicate disability determination may also have a conflict of interest 1 , 18 and may not have a full knowledge of best practices or relevant laws related to the provision of appropriate accommodations for students with disabilities.…”

Section: Introductionmentioning

confidence: 99%

“… 19 - 21 Indeed, the process of determining appropriate accommodations in medical school requires a nuanced understanding of medical education curriculum and the clinical learning environment including the federal regulations for determining whether an accommodation results in a patient safety concern or direct threat, and an understanding of the assistive and adaptive technologies that reduce barriers to clinical care for students with disabilities. 1 , 3 , 9 , 17 , 22 Medical schools that utilize an undergraduate campus, non-health-science-specific DRP risk making uninformed decisions. 3 , 9 , 20 , 21 , 23 DRPs that are not familiar with medical education curriculum, particularly clinical curriculum, and who were not trained specifically for health professions education may not be aware of best practices or case law governing the provision of accommodations within medical education.…”

Section: Introductionmentioning

confidence: 99%

Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools

Meeks

Case

Stergiopoulos

et al. 2021

Journal of Medical Education and Curricular Development

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Introduction: Leaders in medical education have expressed a commitment to increase medical student diversity, including those with disabilities. Despite this commitment there exists a large gap in the number of medical students self-reporting disability in anonymous demographic surveys and those willing to disclose and request accommodations at a school level. Structural elements for disclosing and requesting disability accommodations have been identified as a main barrier for students with disabilities in medical education, yet school-level practices for student disclosure at US-MD programs have not been studied. Methods: In August 2020, a survey seeking to ascertain institutional disability disclosure structure was sent to student affairs deans at LCME fully accredited medical schools. Survey responses were coded according to their alignment with considerations from the AAMC report on disability and analyzed for any associations with the AAMC Organizational Characteristics Database and class size. Results: Disability disclosure structures were collected for 98 of 141 eligible schools (70% response rate). Structures for disability disclosure varied among the 98 respondent schools. Sixty-four (65%) programs maintained a disability disclosure structure in alignment with AAMC considerations; 34 (35%) did not. No statistically significant relationships were identified between disability disclosure structures and AAMC organizational characteristics or class size. Discussion: Thirty-five percent of LCME fully accredited MD program respondents continue to employ structures of disability disclosure that do not align with the considerations offered in the AAMC report. This structural non-alignment has been identified as a major barrier for medical students to accessing accommodations and may disincentivize disability disclosure. Meeting the stated calls for diversity will require schools to consider structural barriers that marginalize students with disabilities and make appropriate adjustments to their services to improve access.

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Legibility: knowing disability in medical education inclusion

Jain

2023

Adv in Health Sci Educ

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How medical students, their teachers, and school administrators understand disability appears connected to ongoing, unequal access to medical education for disabled people. The stigmatization of disability within medical education affects students’ disability disclosures, yet few studies have explored how understandings of disability influence inclusion practices beyond individual student actions. This paper develops the concept of legibility, derived from a constructivist grounded theory study that examined disability inclusion at four U.S. medical schools through interviews with 19 disabled students and 27 school officials (faculty and administrators). With two dimensions (recognition and assessment of possibility), legibility demonstrates that knowing disability is relational, contextual, and equivocal. Drawing from the field of disability studies, the paper argues that the current paradigm of disability inclusion demands that students’ disability experiences be highly legible to themselves and others, yet increased legibility comes with potential risk due to prevalent ableism. While individual interactions can shift understandings of disability towards greater inclusivity, systemic action that embeds liberating discourses of disability into medical education is needed.

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The Process for Determining Disability Accommodations

Cited by 5 publications

References 0 publications

Disability, program access, empathy and burnout in US medical students: A national study

Disability, program access, empathy and burnout in US medical students: A national study

Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools

Legibility: knowing disability in medical education inclusion

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