University of Bradford Logo
University of Huddersfield Logo
Managing Impairment in Professional Practice:
Disability and Fitness to Practise: A multi site
investigation into the application of the Equality Act
(2010) to health care students in practice settings
within the NHS.
Case study 1: Sophie
Yorkshire and the Humber SHA Logo
Funding body: Yorkshire and the Humber NHS Strategic Health Authority
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Contents
Background ................................................................... 3
Starting year 1 of Professional Programme ................... 3
Starting year 1 (repeat).................................................. 4
LSP ............................................................................... 4
End of second semester year 1 (2) ............................... 4
Specific issues related to practice placements .............. 5
Suggestion .................................................................... 5
Questions ...................................................................... 6
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Background
Sophie is 45years old and has five children between 4 and 27 years old. She left
school at 16 and has working in the caring industry ever since. This has included
nursing and residential homes, working with children and young adults with learning
disabilities.
Before commencing training to be an occupational therapist, Sophie worked as a
support assistant. She was aware during this time that she had some problems with
reading and writing, but had always got by. She had undertaken some competency
based assessments that related to the work of Occupational Therapists. She
undertook an access programme in 1999
Starting year 1 of Professional Programme
When Sophie started on her undergraduate programme, and completed the
screening test for dyslexia, which is routine in the University, she was told that she
had “classic symptoms” of dyslexia and asked to go to the disabilities office to see
the educational psychologist.
Sophie’s account of this appointment is informative but does not make happy
reading. Firstly, she was thrown because the educational psychologist was male,
which made her uneasy and anxious. She felt her anxiety levels rise when asked a
number of questions and was required to undertake a range of ‘tests.’
Following the test she was given the outcomes on the same day. This she says left
her “in a heap.” She was told that she had a very low IQ, would not have the ability to
complete a degree and should think about doing something else that would be
easier. At this time she was struggling with her course, struggled with lectures and
couldn’t take notes.
However, Sophie went back to the Disability Office, where a second educational
psychologist assessment was arranged. There was some feeling that the original
test Sophie had been asked to do was designed for younger students, whereas
Sophie had been out of education for some years.
The second assessment took four hours, after which Sophie was told that she had
classic dyslexia. She says she felt more comfortable with this, but still distraught (it is
recognised that a diagnosis of dyslexia for mature students often brings a mixture of
emotions that include distress tinged with relief that they finally have a reason for
their difficulties and are not ‘thick’ as they have often been led to believe).
Following this diagnosis, Sophie reports that “everything fell into place” and she
finally understood why she had always struggled academically, whilst been good at
“practical hands on” activities, which she had always been able to manage.
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It seems to have taken most of the first year for these tests to be completed and
everything put into place to support Sophie. The result was that she had to retake
the year.
At the end of her first year on the course, there were a number of assessments that
Sophie had not passed. She reports that nothing had been put into place. Nothing
about her dyslexia had gone to her practice educator and she reported her concerns
about the responsibility for disclosing; “you’re never sure how to approach it – they
might be negative towards it.”
Starting year 1 (repeat)
When Sophie started the first year again, everything was put in place to support her.
She has a Dictaphone to record lectures on and finds this really helpful as she can
listen over again to these and doesn’t “loose things”. She reports that the equipment
she was supplied with “made a vast difference.”
LSP
Before going out on placement, documentation was prepared for her practice
educator. N.B. this was not the LSP or the report from the educational psychologist.
For some reason this report seems to have been inaccurate in that it claimed she
had a mental health difficulty, which she has not. Sophie was able to remove this
element so that she was comfortable with the information shared. She used her LSP
instead, and asked for his support
Sophie reports a very successful placement with an educator who fully supported her
in the following ways:





Offered very practical help
Listened
Helped with planning
Set up a timetable
Asked permission to let the team know (Sophie deemed this to be REALLY
important and helpful
End of second semester year 1 (2)
Sophie has had a successful year in terms of assignments (2 currently outstanding:
a repeat presentation and a practical). However, shortly before the submission date
for a written assignment, she received an email saying that she could have a routine
extension because she had dyslexia. She took advantage of this, but reports being
surprised because it was the first time this had happened.
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Specific issues related to practice placements

Struggles with professional language

Has developed coping strategies

Uses her Dictaphone and makes notes (NB research findings indicate that a
PDA with reminder system, spell check and audio functions on would be
better)

Don’t always get to know where they are going on placement soon enough

Would be helpful if educators received some information about the student
before they go out

An early discussion about specific needs is essential – it needs to be dealt
with and ‘out of the way’ so that student anxiety about disclosure and
acceptance is minimised.
Suggestion
That after the LSP has been developed, the student should meet with personal tutor
and agree what this means for practice placements. A separate pro forma is then
agreed on for use in practice. This needs to be reviewed and amended annually, or
after each placement.
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Questions

How could Sophie have been better prepared for her original appointment
with the educational psychologist?

What emotional support systems are in place within the School for students
who get a diagnosis of dyslexia following our routine screening?

To what extent are students currently able to select which elements of their
LSP they wish to share/disclose and to what extent is it appropriate for them
to do so? – how do we manage this?

How can we ensure practice educators are prepared to provide this level of
support?

How can we ensure that university based lectures are prepared to provide
appropriate levels of support?
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