VCC researching diversity and disabilities in clinical work placements

“Student life” is famous for its challenges: scraping together tuition, stressing over exams, pulling all-nighters, etc. For post-secondary students living with disabilities however, many factors in the typical learning environment can amount to real barriers to their education or careers. To explore such issues and help break down systemic barriers in health care education, some passionate Vancouver Community College (VCC) faculty and staff launched a research project that is gaining widespread attention. The project, led by VCC Disability Services department head Brianna Higgins, UBC accessibility advisor Dr. Laura Yvonne Bulk, and VCC Bachelor of Science in Nursing (BScN) instructor Dr. Maki Iwase, is entitled Access in Clinical Education: Co-creating greater Justice, Equity, Diversity, and Inclusion through connections and understanding. Its starting point is VCC’s own Students with Disabilities Policy [PDF], which outlines the college’s legal obligation to provide accommodation, or “alternate ways” for students with disabilities to fully participate in the learning environment. While VCC can and does strive to meet this obligation in the classroom, such accommodations in clinical placements are less standardized, despite being settings where nursing students complete a large portion of their education. “It’s often in clinical settings where students fall through the cracks,” says Maki. Similar to final exams, clinical placements are major tests of learning. Not only do students perform hands-on care in demanding, real-world environments, but they also complete homework and papers outside of their clinical shifts and must pass to advance in the BScN program. Clinical placements can be highly challenging for any student, but students who have visible or invisible/episodic disabilities (e.g. mobility limitations, learning differences, mental illnesses) can face additional hurdles. “They come up against a structural, idealized notion of who is or is not a good fit to enter a health care profession,” says Brianna.

Co-creating change

The first phase of research involved in-depth interviews with 38 individuals including students (with disabilities and without), instructors, alumni, and nursing professionals. “Students feel scrutinized,” says Brianna. “They do not want to self-identify as having a disability because they’re afraid of becoming a ‘problem’ in the workplace.” Overall, the researchers found a desire for safer communication, less mental pressure on students, a greater respect for diversity, and a shift away from “fitting the mold” and towards enabling diverse students to achieve success. In many cases, simple changes to instructional styles, environments, or attitudes can make all the difference. “Students at this stage already know which learning strategies work best for them,” says Brianna. “What they want is to just be seen and acknowledged for their strengths and resilience.”

The diversity difference

The benefits of diversity in any organization are becoming increasingly clear, and health care is no exception. As cited in the preliminary Access in Clinical Education report, having health professionals with various disabilities could help reduce discrimination, increase sensitivity and trust, and improve patient outcomes. Maki who herself is a successful nurse educator, says she regularly draws on her own disabilities to help her relate to students. “I have a history of anxiety and depression. I’ve also struggled with dyslexia as a child. But through support, mentorship, and funding, I was able to get a PhD!” The researchers also believe that a structural shift towards accommodating for diversity would benefit health care workers in general. “We’ve seen these patterns for years,” Maki says of nurses who sacrifice their own sleep, psychological safety, and even physical well-being for the job. “It’s a systemic issue that results in burnout, injuries, impaired judgement, and the lack of ability to self-care.” While a full report is expected in mid-2022, the research team has already collected numerous resources, hosted a research-based theatre presentation, and initiated a working group to further diversity and inclusion in clinical practice.

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VCC is excited to work with every student achieve their goals. Contact VCC Disability Services before starting your program to discover what’s possible.