Last modified on 03AUG01
[The following text is the byproduct of the real-time captioning of this event. ]
Deaf and hard of hearing students in health sciences programs. If that's what you are here for, you are in the right room, if not, you can have coffee, doughnuts, or you can stay; actually, it is your choice. Okay. I am Martha Smith. I work at Oregon Health & Science University at a place called the Center on Self-Determination, and this is a grant that I am working on, and it is one of 22 federal higher education grants that are happening around the country currently. The grants are in their second year, and the whole focus of the grants is on improving the retention of students with disabilities and higher education. And how the grants have been focused is, instead of on directly providing better services, to students, the focus has been on how can we better prepare faculty to work with students with disabilities, and if faculty are more effective at working with a diverse population of students, that, in and of itself, will increase the retention of students with disabilities in higher education. So, that's the premise of these higher education grants, all 22 of them across the country. The one at OHSU is the only one that is working in the health sciences field. All the others are working in your typical undergrad programs. The reason that Oregon Health & Science University, the Center on Self-Determination, decided to do this is recognizing the increase of students with disabilities in professional programs, both health sciences, legal programs, things like that, and that there is really not any information out there in terms of what faculty need to do, that they are kind of walking in the dark and they are scared. They don't know what to do. They are still in the place of, when a person with a disability walks in, they go -- YOU want to be a doctor? I don't think so. So, we are helping to change that. And what I am going to do today is take some of the information that we have been working with, with faculty, and I am going to present it to you in terms of how that can specifically affect how we perceive students being able to be successful in health sciences program. Specifically, deaf and hard of hearing students.
The first thing that I had to learn when I started in this program, and I have been working at OHSU about nine months, prior to that, I worked at Western Oregon University as the Disability Services director for ten years, so my background is in working with students with disabilities, lots and lots of deaf and hard of hearing students. So, the first thing I had to learn was, hmm what is it about health sciences programs that make them so unique, and there are some very unique things. So, I had to understand what are the unique issues for all students in health sciences programs. The other thing is, I needed to understand disclosure issues for students with disabilities, as it relates to health sciences programs because it is a bit different than in your typical undergraduate programs.
Okay. What are some of the unique issues for all health sciences students? Clinical settings. Your typical, undergrad programs and other professional programs, students are not working in clinical studies, directly with patients. Huge issue, patient safety. Comes up all the time from faculty, regardless of whether a student has a disability or not. This is a huge issue. When they are recruiting students, accepting students into their program and training students, is that you are going to be working directly with patient and patient safety, is a huge issue. Undifferentiated graduate. There is this -- somewhat myth in medical schools, nursing schools, that what happens is when students come in, they are trained in an undifferentiated way, meaning that they are not trained to be specialists. They are trained in -- and are expected to do a variety of clinical rotations, all students. They will go through OBGYN. They will go through surgery. They will go through ER. They will go through internal medicine; all students are expected to do that. And then when you get to your residency is where you specialize, so when you go through your medical school training, your general school training, your nursing school training, the idea is that you are an undifferentiated graduate. All students have to go through all components of it. You don't get to pick and choose and say, well, I am never going to be a surgeon, so why do I have to do the surgery rotation. Doesn't matter. Everybody has to do everything.
They are lock-step programs. This has pros and cons to it. But, what happens is, when you talk about it might take longer for a student to do something, there is a lot more flexibility in other graduate programs and undergraduate programs there is a lot of flexibility in the order in which students can take classes. You might have a basic math requirement, and unless you are going to be a math major, you can take that math requirement any time. Before you graduate. Well, in health sciences programs, you don't have that choice. The program is set up for you. This is what you take this term, and in order to go to the next term, you have to pass all these classes first. So, it is very lock step, and once you get out of that; it is very hard to get back into it. So, if you have to leave for a leave of absence, or something happens in the middle of a term, a family crisis, you can't repeat those courses for another whole year. So, you are now behind one year from your cohort of classmates. So, it makes it very difficult to have any flexibility in terms of meeting those course requirements.
Technical standards, we are going to talk a little bit about technical standards more, but technical standards are, all the nonacademic requirements to get into a program. So, it is things like, you must be able to lift 25 pounds above your head. Okay. So a lot of health sciences programs, most have developed technical standards, which are part of their admissions requirements. Most other undergraduate programs, other professional programs don't have technical standards. They look at your academic record. They do some interviews, yep, you seem smart enough, you have got the right GPA, and you are in. Health sciences programs add the technical standards piece to it.
Q: Do they have requirements for hearing?
The question is do they have requirements for hearing and vision. In some cases, yes. And when we talk about technical standards, more, in a little bit I will go into that, but they would then fall under that technical standards area, that's where that gets addressed.
Other unique issues, national exams, not only a national exam to get into the program, but while you are in the program. That you have to pass, for instance, in the school of medicine, your medical boards in your second year, before you can continue on. There are now some schools across the country, medical schools that are saying that students do not have to pass that to continue on. They are not making that part of their requirements. Part of the reason for that is students with learning disabilities are having a great deal of difficulty being able to get accommodations for medical boards, and so medical schools, which are seeing these students as very qualified, do not want to penalize them and say, you know, that you have to pass this part of the exam before you can continue in our program. It is very clear, though; that the students have to pass the national licensing exam once they graduate in order to become licensed. As a physician or as a nurse, each of the health sciences programs has their own national licensing body that you have to go through.
Health Sciences programs are rigorous and fast-paced. You thought professors talked fast in your undergraduate programs. It is no anywhere near close to these health sciences professors. And they do not like to be told, please slow down. They just go, and that lock-step program, builds right into that. You have got to get it now because if you don't get if now, you can't go onto the next part.
There is a myth of perfection, which is that physicians, nurses, doctors, themselves, because they are in the profession of healing people “perfect”. So what that sets up for students, whether it is the students, themselves, that are buying into this myth, whether it is being perpetuated by the institution, or the other professionals in the field, what it sets up for students is I can't show that I am less than perfect. Whatever that means. Maybe I am not as smart as my classmates, maybe that I have depression, maybe that I have a family with some poor history in it. Whatever it is, that it makes it very difficult for students to admit that they are not perfect. Because they have this image of -- to be a health care professional, if I am going to tell other people what they need to do to improve their health, then I have to be the picture perfect person of health. So, this pedestal thing takes place, which puts students in a no-win situation, when and if they do get in trouble.
A highly competitive environment. Most medical schools, nursing schools, dental schools, are taking the cream of the crop of students and then they are all putting those -- cream of the crop students, who are used to being the top dog, together in one program. So, now you have all the top dogs in the same program. Highly competitive. And again, so some issues around that myth of perfection come into play. Health care faculty as clinicians. Most of us have not dealt with professors who are also practicing their profession, on us. We might have professors that are going out into the field, and doing some research and we have been invited along. So, here we have faculty who are teaching the students on the one hand, and then an hour later, are going in and being practicing physicians or practicing nurses or practicing dentists. So, we have this role-switch that's happening, that sometimes faculty don't do it very effectively. It is sometimes very difficult for them to take that clinician hat off when they are working with their students.
Disclosure issues, feels unsafe. For a variety of the reasons that we listed, students do not feel safe coming forward and indicating that they need some sort of support. Whether it is legitimate or not. So students who are, for instance, hard of hearing, students who have other hidden disabilities it’s very hard to come forward. It feels unsafe to come forward. That highly competitive environment. Lots of students I have talked to will talk about; I don't want to come forward and ask for assistance because of what my peers might think. That they see me as getting an upper edge. Because of this competitive environment, where you have all these students who are used to being the best of the best, and now they are just average because they are being compared to everyone else who is the best of the best. So, they don't want to be seen as being given a foot up. Whether it is legitimate or not. Whether it is a reasonable accommodation or not. It is appropriate for you to ask for that. Well, no, the other students aren't going to understand that. They are going to see that I am getting special treatment. And therefore, you know, it is going to come back on me, by my peers. That's a fear. Olympic athletes in their fields, ties into the myth of perfection, we are the best, we are the brightest. There is nothing wrong with us. We don't need any help. Everyone else survived through medical and nursing school this way. I can, too. Peers reactions, self-esteem and pride. Great deal of self-esteem and pride involved in students who are going into health sciences programs. In terms of issues around disclosure.
Okay. Very quick review of the ADA. The ADA is a civil rights law, not an entitlement law, and I bring this up because a lot of these issues come into play, particularly in professional programs, when we look at students with disabilities. ADA does not guarantee, just because you want to be a doctor that you get to get into medical school. You still have to meet the requirements. ADA is an anti-discrimination law. Again, it is not a quota bill. It is meant to be set up so that the process of getting into programs and staying in programs is based on nondiscrimination, which is that you are qualified to be there and that you are not being told you can't be there because of a disability. ADA was not enacted to foster successful learning but rather, a level playing field. IDEA was implemented to foster successful learning. The goal in k-12 is different. Because a free and appropriate education was guaranteed for all students. ADA does not guarantee your education. It doesn't guarantee your success in education. It doesn't guarantee your success in learning. What it is about is leveling the playing field. So that you have an equal opportunity to succeed or fail. Which means it is an outcome neutral law. And lots of people confuse that. They believe that ADA, if you get accommodation, it means it guarantees your success. It does not. It is an outcome neutral law, which is, if we level the playing field, you have an equal opportunity to be good at something or to not be good at something. Very different from IDEA. Which is saying, that we have to find a successful way to educate all our students. Very different.
Okay. Southeastern Community College versus Davis. Very famous supreme court case because it involves a student with a severe hearing impairment who wanted to get into a nursing program at Southeastern Community College. This case happened 11 years prior to the ADA, and it is the only higher education court case that has gone to the Supreme Court. So, it is seen, in higher education, as one of the Key cases when you talk about some issues around health sciences programs, but some other issues, we are going to go into. There have been lots of cases since then that have been heard in state supreme courts. Obviously, office of civil rights cases, we read about them, but this is the only higher ed. case that has actually gone to the Supreme Court.
The key issues in the Davis case: Was Frances B. Davis otherwise qualified? Otherwise qualified is language that most of us who have been dealing with the ADA and have become quite familiar with. In terms of it had some language about no otherwise qualified person shall be denied, and so forth and so on. So, this was a key issue. In the Frances B. Davis case, and some of the handouts that I have passed to you are summaries of this case, so you will be able to go home and read about it yourself. But, what came out this far was that Davis was not otherwise qualified. And how the Supreme Court came to that decision was way back before ADA, that what the Supreme Court looked at was whether Frances could meet the requirements of the nursing program without an accommodation. She had to be able to meet them, regardless of what her disability was, to get into the program. Now, we know that since the implementation of the ADA, that has really changed. That has substantially changed because now, in the law, it is written, can you meet the requirements with, or without, a reasonable accommodation. How the Supreme Court viewed it back then was, Frances needed to be able to meet all the requirements, regardless of what her disability was. Not taking into account accommodations, okay. So, she was not seen as otherwise qualified. That was one reason.
The other extreme of that, from my perspective is, recently the Supreme Court case, Sutton, where you have to take into account what they call mitigating measures. Which is you have to now take into account, for instance, if somebody is diagnosed with ADHD, they are on medication, regularly. You have to take into account whether they are still disabled with that medication. So, we have come full circle on that. In terms of what the Supreme court is doing from one extreme of we are not going to look at accommodations at all, to Sutton, where now you have to take into account what are the mitigating measures before you even determine whether the person has a disability or not.
Other reasons, Frances was not seen as otherwise qualified. She had no history of being able to practice nursing safely as an LPN. She was going into an RN program, wanted to go into an RN program. Most people going into RN programs have usually been an LPN, licensed practicing nurse. There is a lot of ways you can practice nursing skills before you become a registered nurse. She had no history of being able to practice safely in her previous employment. During her interview for the program, she had difficulty communicating with the interview committee. She used hearing aids and lip reading. As her primary modes of communication, that was her choice in terms of how she communicated.
Fundamental alteration of the program. The Supreme Court said that, to accommodate Frances, a student who relies solely on lip reading and hearing aids, would cause an unreasonable change in the program. Because she would need close individual, one-on-one supervision for all her clinical requirements or rotations in the program. And that would be a fundamental alteration of the program. Which would also be unreasonable. That was what Frances wanted to be able to do to participate in this program, was unreasonable. The other thing the Supreme Court came up with, as a result of looking at some of these other issues, was that she would not be able to practice safely in her clinical rotations. And as I mentioned in those unique issues, patient safety is paramount. It is number one, and so the thought process for both the school and the Supreme court was based on all this information about Frances, and what she was requesting in order to participate in the program was unreasonable, and it was also not be safe for the patients, that there was no way that someone could be with Frances one-on-one to insure the patient's safety.
Issues of technical standards. That Frances did not meet the technical standards. What are technical standards? Gets to your question now. Technical standards are all nonacademic criteria that are essential to participate in the program in question. They have specifically come into play, as I mentioned, for health sciences programs, because health sciences programs realize there are all these other things they expect students to be able to do, other than academic requirements before they even get into a program. Technical standards should look at the what, and not the how. Which means if a technical standard is, that you must be able to lift 25 pounds above your head, that's the what. In my technical standard, I should not write, you should be able to lift 25 pounds above your head, with your hands, with no assistance. That's the how. An exit criteria condition cannot be used as entrance criteria. For instance, you must be able to hear to use a stethoscope, okay. Using a stethoscope is an exit criterion. You are going to learn how to use a stethoscope in your nursing program. When you are going into the nursing program you don't know how to use a stethoscope, so you can't use that as an entrance criteria.
Technical standards have been used and abused. Particularly, when ADA first passed health sciences programs across the country scrambled to put technical standards into place, in many cases, to bar students with disabilities from being able to get into health sciences programs. Where they put in specific language around, you must be able to hear normally. You must be able to see normally. Well, what's normally? The ADA has come down and said that technical standards cannot be written specifically to exclude a group of people from participating in a program. However, you can have technical standards that do include specific physical sensory requirements, if they are specific to your program. There is a huge movement across the country dealing with technical standards where some folks are saying; we need to not have technical standards at all. Albert Einstein's school of medicine does not have technical standards. Where other folks are saying, that technical standards need to be written in a whole different way because what we are setting up from the get-go is the dynamic of excluding people. And other folks are being very thoughtful about how they write technical standards, and really trying to be aware of not writing the how, but being very clear of the what. So, for instance, a typical technical standard might be, you must be able to stand and balance someone else's weight to transfer a person from, from a bed to a wheelchair. That would be a typical, technical standard for a nurse. You have to help transfer a patient to a wheelchair so they can go somewhere else. Well, those are being rewritten things like, must be able to balance your own weight while moving a person from one place to another. Doesn't tell you how. Doesn't tell you have to stand to be able to do it. Lots of people who use wheelchairs, themselves, can balance someone else moving from one place to another. You don't have to stand to transfer someone. Okay. So really, trying to get at some of those issues. There are technical standards that are still be used to exclude people. Sometimes appropriately, sometimes inappropriately.
The issue around patient safety, as I said, it is a huge issue. Schools can look at direct threat, using the EEOC guidelines. Is there significant risk of substantial harm? Is it a specific risk? It’s not something you think might happen, maybe sometime down the road. But, you have a specific risk in mind. And with Frances Davis, these guidelines were not developed yet, but the Supreme Court and the school went through some very deliberate thought around how they thought that she was going to be a risk to her patients.
Q: Do they take into account specific risk to the person who was actually -- applying to the program?
Do they take into account specific risks to the person who is applying to the program? Yes. In terms of when students apply to the programs, in application material and information about the schooling, that schools are very clear about, about the risk that students might encounter. Medical students, nursing students, any students who are working directly with patients have to regularly be screened for TB, have to get other regular screenings, so there are places where that comes into --
Q: I mean, specifically for people with disabilities. I mean, you know, because for people with disabilities, in terms of the risk that might happen to them as a result of they having a disability and wanting to go into this program.
Not that I have heard of. Although it wouldn't surprise me if that comes into play.
Q: Because at voc rehab, we have to look at that, and in employment, you always have to look at the risk to the client let's say, you have a back injury, you are not going to put them in a job where they -- or if they were in a situation where they were left alone and many times people are, are pushed beyond what they are supposed to, especially in nursing --
Right, in VR, you have to look at the risk to the client, when you go to look at employment placement, if a person has a specific injury, for instance, a back injury, is this going to further aggravate their back injury by being placed in this employment.
One of the issues that comes into place, certainly, when students are applying to health sciences programs, is they have to make those decisions, with, you know, appropriate information being given to any student applying to a health sciences program, that's a risk factor they take into account, themselves. Is this something that I am willing to put myself at risk for? Or further risk, if, in fact, for instance, I have a back injury. Back injuries are a huge issue in the nursing field in general. Huge issue. But that is something the student has to decide. That's not something necessarily the school, itself, takes the responsibility for. The school is saying we are giving you the information. You decide whether you are applying to the program or not.
Q: I wanted to ask when a school is looking at a student, are they just looking at the situation they are in now or if they know that this disability is progressive, do they take that into consideration?
Want to know if the school is looking at a student who has a current disability, but the disability might be progressive, are they taking -- that into account when they regard the student as being potentially qualified for the program. Health sciences programs get caught in this double bind. A lot of times, which they get scolded for, also. They are an educational program. Their requirements are based on what they have heard or what they have experienced or what they have seen is that nurses are going to be expected to do when they are actually in the field, when they actually have the job of a nurse. But while they are in the program, themselves, the students aren't nurses. They are students. And so you will hear lots of schools talk about well, you know, but you are going to have to be able to do this when you get a job. Or, you might not get an accommodation for this once you get out of this educational program. And so it is kind of a double bind because what we tell schools is, you can't determine whether a student is qualified for the program based on what accommodations they may or may not receive when they get a job. That's the employer's responsibility. That's why you have essential functions written for your job description. That's not the school's responsibility. At the same time, schools are saying, well, but we don't want to graduate students that aren't going to be able to get jobs. It is like, well, yeah, you are right. And we need to be real clear about that with students. So, it is kind of this double bind, and that progressive disability can come into play with that, which is maybe the program, itself, is very willing to work with the student, but by the time the student graduates, the disability has progressed to the point of, it is going to make it very hard for them to get a job. But, I know that at OHSU, they have admitted students in the past who have come forward and have said, I have this degenerative disease, and they have admitted those students.
Current risk, not speculative or remote, EEOC guidelines. Where this comes from, in part, is one of the people that helped write this was a man by the name of Tony Cuhelo, in Washington D.C. he, himself, experiences epilepsy, and so for years, he was denied getting a driver's license because anyone who had a seizure disorder, it didn't matter if he had a seizure a month ago or 25 years ago, you are not allowed to get a driver's license. So, this was put into address that is the risk a current risk? It is not because you might have a seizure in 25 years. It is you are not going to be safe with a patient right now. That degenerative disease, we can't deny you access to the program because the disease that you have ten years from now might make you unsafe to work with patients. We have to look at now.
Q: What about mental health issues where you have students that meet all of the, of the physical and intellectual requirements, but it could be an issue of delusional disorder, an issue of schizophrenia, where, you know, some things are untreatable, so it is very unclear, at the time, at the time of the interview, maybe, that it is a delusional disorder or if they get information, is it very hard to predict any type of risk?
She's asking about, folks who might experience psychological disabilities, psychiatric disabilities. Schizophrenia, delusional disorders. Same thing. Up front, you might not know the student experiences the disorder. The student might not know that they experienced that disability, and it might come into play once they are in their program. They are going to go through the same steps as any other student, who tends to be unsafe or not meeting the requirements once they are in the program. They might go through the review board. And they can bring information forward. With lots of students, both in undergraduate programs and professional programs, with psychological disabilities, if, in fact, they are doing things that are unsafe, and not necessarily just a patient, unsafe to themselves, living in an unsafe way, that often what the school require is some kind of documentation from an ongoing health care professional that says yes, in fact, they are safe to be in that environment, continuing schooling. That's not uncommon for that to happen in health sciences programs.
Individualized assessment. You have to have an individualized assessment to determine that this particular student you are working with is actually unsafe in working with patients. It is not because all people who experience CP are unsafe. We are looking at this individual person. And the risk can't be eliminated or reduced by a reasonable accommodation. Okay. One of the nice big changes that ADA brought about was not only do we have to look at all these things but also then we have to take into account, is there a reasonable accommodation that can take care of these issues.
Okay. Profiles of health care professionals with disabilities as successful practitioners. One of the parts of our grant that we are doing is we are going around the country and we are interviewing health care professionals who experience disabilities. Doctors, nurses, dentists, emergency medical technicians, and then we are taking these two-hour interviews and we are, essentially, turning them into 15-minute videos, so I am going to show you one of those. It is of a nurse. Molly Jenkins, who experiences a severe hearing impairment.
[Showing of video]
We are also in the process of interviewing several deaf physicians, and I was hoping to have one of those interviews, but it hasn't been done yet. So that is coming down the road, also.
Q: I am curious of her level of hearing loss. Do you know her level of hearing loss? Is it mild or profound, her hearing loss?
My understanding is her hearing loss was profound, and it is genetic in her family. Her mother is actually an audiologist. And so, it was picked up very early. But it is a genetic trait in her family on the female side. And she, as she mentioned, she started wearing hearing aids when she was 5 years old. It has not been a stable loss. It did get progressively worse. My understanding, though, is that it is severe to profound. But, I have not seen her audiogram. Technology is a wonderful thing. She talks a lot about technology. I was talking to someone recently in a recent hospital that was built where they have gotten rid of all of the overhead PA system, announcements, and that, in fact, all doctors and nurses are being given pagers, and so that when a message needs to be given to them or it is programmed into the patient rooms of the patients they are working with, it goes directly to that person. So, some of these issues that, in 1979 were an issue for Frances B. Davis, are no longer issues now. Technology has opened many, many doors for lots of people.
Q: Martha, that was inspiring. How many of those videotapes have you produced already? How many do you predict you will be making, and are they available for us?
Questions about the videotapes, how many have we made? How many will we make and when are they available? If you look at that glossy, sort of newsletter that you got handed out we have a website, and on the back of that, it says our products, hopefully, will be available next spring. Right now, we have videos that have actually been condensed. We have about five. We have about 25 interviews in the can, as they say. We have one of my colleagues right now is in Virginia interviewing a blind physician. He was actually the first student to go through medical school, totally blind. He's interviewing him today. Our goal for the videotapes is that we are going to have a series, and what the series will be is there would be one tape, which would have anywhere from 4 to 6 on it, and so we would have one of doctors, we would have one of nurses, we would have one of dentist, we would have one of allied health professionals. So, on the doctor one, we would have these vignettes where we would have a deaf doctor, a doctor who is visually impaired, a doctor who has a physical disability, a learning disability, psychological, whatever. We are trying to get the whole range in each of the fields. And so, those will become available next spring. Is the goal. And as you can see, we use these with training, with the faculty. They have a huge impact. I can talk all I want and they go, yeah, yeah, yeah, right, Martha. But when they see one of their colleagues talking, big difference. Big difference.
What is our role? Are we limiting what we think our clients and students can do? Lots of people use the Davis versus Southwestern, in particular, as a way to limit particularly, students with hearing impairments, deaf and hard of hearing, from going into the health sciences field because this was such a huge case. What we need to be aware of, both from the side of nursing schools, medical schools, and from the side of VR clients, educators, is that you really need to understand the case and the limits of the case, so that we can be more accurate with our students. The doors are not wide open. It doesn't mean because of the ADA, that you are going to be a nurse, if you want to be a nurse. You still have to meet requirements. And some of those requirements might be ones that you are not able to meet with, with or without a reasonable accommodation. The flip side of that is, just because you have a hearing loss, doesn't mean you can't be a health care professional. There is so much technology out there, lots of schools have really opened their doors and opened their minds. Lots have not. And so part of the work for the students, for us, as educators, VR counselors, is to do your research. Look at the schools that are accepting students with disabilities who see that as a plus. A value-added that they are recognizing that the patient population we, we serve is diverse, and therefore, our health care professionals should represent that diversity, as well. That physicians, nurses, dentists have a valued aspect, like Molly talks about. It is not just the fact that she is a good nurse. Her disability brings value-added aspects to her profession.
Q: Many VR counselors are generalists, and do you do -- if we were to send a client to you do you do an assessment to help us decide whether or not the accommodations could be put in place? To help us make some decisions because, you know, you don't want to spend the money up front, not just VR, but, but the client, themselves, can't be affording to go into a direction that they may not be able to complete.
VR counselors are generalists so do we provide resources, consultation to help VR counselors and clients decide whether, in fact, the student would be an appropriate candidate for a health sciences program? Not per se, I think our website, some of the resources we are developing. I am learning a lot. I am more than happy to always share my information with folks, you know, if you e-mail me or if you call me on the phone to say, this is what I have learned. Here are some folks you can go and talk to. Here are some things to think about. I am more than happy to do that. I am learning a lot. And one of the things I am learning is to ask questions. That all programs are not the same. That some schools are really seeing this as a wonderful opportunity, and some schools are stuck in the dark ages of, this is the only way you can do it. And we don't see it any way else. And you can't be a nurse, you can't be a doctor if you can't do it the way I did it. And until they retire, it is not going to change. It reminds me of the military, sort of like that, I had to go through it, so you have to go through it too, kind of thing.
Q: One area that might be fruitful for you to do some interviews in, to do some training, I was involved in clinical setting, in a hospital, as a chaplain, and most clinical, practical education programs really, have really skewed views of people with disabilities. And seminary, typically they use the idea of having disabled priests or pastors, especially in the hospital setting as, as exclusionary. I had to threaten to, to retain an attorney just to do the normal clinical, practical, educational things in a normal hospital setting. So, that is one area that I don't think you should neglect.
He talked about paying attention to, for possible interviews hospital, pastors or priests, and that, in fact, most clinical settings have very traditional views of folks with disabilities, both in terms of what they can and can't do. And that his experience was, that he had to, in fact, threaten legal action in order to have access to the normal clinical rotations that a pastor or a priest in a pastoral program in a clinical setting has. And that's a very good suggestion. And in fact, your comment about that, that view of what people with disabilities can or can't do or what we think that they can, one of the issues that's coming out is that there needs to be more training for students in health sciences programs, just in general, in terms of working with people with disabilities. One of the interviews we have is of a doctor who uses a wheelchair. She's on some rotation and she is talking to one of her colleagues, and a person is coming out and has seen a young woman, who uses a wheelchair, who was talking about that she had a yeast infection or something, and so the guy is like, I don't know, what about this and that. And the doctor, who uses a wheelchair said, well, did you ask her, is she sexually active, and the guy said, people in wheelchairs don't have sex. And she was like, okay, we need to talk.
Can we change our misperceptions? Use the Davis case to understand program limitations, not as a deterrent for students with hearing loss to go into nursing programs, to go into medical programs. All sorts of resources, our web page, which you have listed. Websites, association of medical professionals with hearing loss (AMPHL), they are combining with SHHH, for their national conference in Cherry Hill, NJ in June. Northwest Outreach Center, Cheryl Davis, my partner in crime for some things. They have great resources. Technology, the Job Accommodation Network (JAN). There are things now like you can get clear surgical masks. So, that lip reading when people have masks on is actually possible. The electronic stethoscopes. There is also now electro-cardio visual grams where you can get the heartbeat and it gives you a visual readout -- there is all sorts of cool technology out there. Harris communication, NOISE a List-serve chat group. Network for Overcoming Increased Silence Effectively. We have dropped lots of ideas into NOISE and gotten feedback, since we have been working on this project and working on videotapes to see what people in the field are doing, and what they are experiencing. One of my favorites, this will be my parting story palm pilots are very popular right now. So, a story I heard was about a deaf student who was in medical school, who used a combination of interpreters and real-time captioning. And used the real-time captioning because if she really wanted to be sure that they were getting the specific vocabulary that was very important in some cases, for classes, but then in other cases, interpreters were more effective. So, the student was in their gross anatomy class, you know, and they have to work on the cadaver, and they couldn't get the real-time captionist close enough so that the student could see the monitor and look at the cadaver and sort of figure out how this was going to work, so what they found -- and the student didn't want to use an interpreter doing that up and down thing because you really have to be in the cadaver working, so when you look up at the interpreter, it just wasn't effective. So, what they finally figured out was they took the palm pilot, they made it talk to the real-time captionist machine, sat the real-time captionist in one corner, took the palm pilot, put it in a plastic bag inside the cadaver, so the student is reading off of their palm pilot, what is being typed by the real-time captionist in the cadaver. Technology can be great. Thank you.
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Last modified on 03AUG01