Addressing Access in Health Sciences: Externships in the Community College Curriculum
Michelle Mitchell, M.Ed., 
Lehigh Carbon Community College
mmtchell@lccc.edu
Discussion Points 
■	The Why
■	The How 
■	The What 

Why You Do
Recruiting Students with Disability 
■	Increase diversity
■	Improve community health outcomes
■	Improve student retention/graduation
■	Meet new NIH requirements and grant applications
■	Compliance with disability law
Barriers to Healthcare Clinicals
■	Strict technical standards 
■	Effectively communicating with patients
■	Needing to have a vast breath of knowledge
■	Assistive technology (patient safety, confidentiality, interactive process),
■	Disclosure and a clinical/professional setting
■	Knowledge of self & needs
But… Concerns We Hear 
■	Patient safety
■	Will they get this in "real world"

How You Can Do
Open Communication
■	Periodic Meetings 
–	build trust
–	set expectations
–	determine when training may be needed
Be Wise 
■	Know your programs (consult others)
■	Make sure students are aware
■	Communicate early & often
■	Gather information from student (previous accommodations
■	Anticipated barriers
Be Wise 
■	Help students plan in advance 
■	Treatment location/frequency
■	History & prognosis
Be Wise
■	Be creative
■	Support students
■	Review technical standards & learning outcomes
Academic/Technical Standards
■	Define essential learning experience 
■	Focus discussion on what can be:
–	 accommodated
–	Wave
–	altered with explanation
Be Wise
■	Understand program policies
–	attendance
–	time to degree
–	leave of absence
■	Not otherwise qualified
What You Can Do
Clinical Accommodations
■	Uphold standards while creating equal access
Clear Policies
■	Take a practical approach
Accommodations 
■	Scheduling (location, order)
■	Leave 
–	Overnight call
–	Release from clinic to attend appointments
–	Modification to attendance policy
■	Modified approach (simulation labs)
Accommodations 
■	Assistive technology 
–	screen readers
–	smart pens
■	Communication
–	cell phones/text features
–	CART/interpreters
–	amplification devices
–	early notification of patient presentations
Accommodations 
■	Alternate methods of providing care can be equally effective and legitimate
■	Work collaboratively to determine 
–	essential functions
–	core competencies
–	alternative approaches
Accommodations Questions to Ask 
■	Would the accommodation fundamentally alter the educational program
■	Would the proposed accommodation cause an undue burden to the school
■	Would the proposed accommodation results in a failure to meet any technical standard of the program
■	With the accommodation legitimately jeopardize patient safety (must be legitimate, not presumed)

Patient Safety 
■	28 CFR 36.208 “In determining whether an individual poses a direct threat to the health or safety of others, a [school] must make an individualized assessment, based on reasonable judgment that relies on current medical knowledge or on the best available objective evidence, to ascertain: the nature, duration, and severity of the risk; the probability that the potential injury will actually occur; and whether reasonable modifications of policies, practices, or procedures or the provision of auxiliary aids or services will mitigate the risk.”
create scenarios to review and discuss 
■	physical, chronic (stability of condition, triggers, flares look like), mental health
Admission Scenario
■	While submitting application materials to the medical assisting department, a student discloses her disability to the assistant director of nursing.  The director is a member of the selection committee for admittance into the program.  Is this appropriate?
Accommodation Scenario 
■	A professor of an EMT class refuses to allow a student with a disability to use a tape recorder in class, citing that students discuss personal information related to topics covered in class.  Is the denial legal?
Admission Scenario
■	As the director of EKG technician program, you believe that a student with a disability enrolled in your program will not be employable because of his disability.  You state this to him and recommend that he withdraws and chooses another major.  Is this appropriate?
Accommodation Scenario 
■	A professor of a phlebotomy class does not want the student who is deaf in the course, as the professor feels student will not be able to effectively communicate with their patient. What would you do? What accommodations would you recommend?
Questions??
■	mmitchell@LCCC.edu
■	Do not forget resources available on AHEAD’s website
■	Please do not forget to complete your evaluation!