Canadian Association of Allied Health Programs
Reasonable Accommodation for
Students with Special Needs
Karen Gabriele
Biomedical Laboratory Technology
May 29, 2014
About us
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Biomedical Laboratory Technology
3 year program leading to a diploma
Entering class of about 32-35 students
Graduating approximately 22-24 students
26 weeks of internship completed in the third year of
the program
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About us
Biomedical Laboratory Technology
• Program is designed locally to address:
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competencies from the Québec Ministry of Education
national competencies defined by the Canadian Society for
Medical Laboratory Science (CSMLS)
• Accredited by the Canadian Medical Association
(CMA)
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About us
Biomedical Laboratory Technology
Entry into the Profession in Québec
• Graduates receive their license from the professional
order (OPTMQ*) to practice as medical technologists
upon completion of the program
• Graduates can also become nationally certified by
passing the CSMLS examination
* l’Ordre professionnel des technologistes médicaux du Québec
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CRISPESH
Dawson as a Centre of Expertise
The Research Centre for the Educational and Professional
Inclusion of Students with Disabilities (CRISPESH)
• Recognized by the Ministry of Education, Recreation and Sports (MELS) in
October 2010.
• Partnership between the Cégep du Vieux Montréal and Dawson College
• College Technology Transfer Centre in Innovative Social Practices (CCTTPSN)
CRISPESH Mission
To promote the educational, social and professional inclusion of
people living with disabilities through
• advancement of knowledge
• development and promotion of social practices
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DAWSON
AccessAbility Centre
AccessAbility Centre provides support mechanisms for
students with diagnosed disabilities
(hearing, visual, or motor/coordination impairments, learning disabilities,
mental health issues, or chronic medical conditions)
• Note takers
• Shadowing the students
• Specialized equipment and software
• Alternative formats of textbooks and documents
• Pre-registration and course selection; reduced course loads
• Extended time for exams and access to exam services (invigilation in
an environment with no distractions)
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AccessAbility Centre
DAWSON
Increasing number of special needs students every year at Dawson:
700
47%
increase
650
600
550
500
450
400
W2012
350
F2012
47%
increase
300
W2013
F2013
250
W2014
200
94%
increase
150
100
50
0
Auditory
Learning
Disability
Mental Health
Motor
Neurological
Organic
Visual
Total
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Quebec
Legal Responsibilities
Quebec General and Vocational Colleges Act
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No provisions obliging colleges to provide special services to disabled students
Quebec Charter of Human Rights and Freedoms
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Recognizes the rights of the disabled and establishes the legal framework of
the responsibility that colleges have in this regard
S.10 prohibits discrimination founded on a handicap or the use of any means
to palliate a handicap
The Commission des droits de la personne et des droits de la jeunesse
responded to many requests for clarification at the College level.
A report was produced in March 2012:
“l’Accommodement des étudiants et étudiantes en situation de handicap
dans les établissements d’enseingement collégial”*
* Daniel Ducharme (Ph.D. sociologie) and Me. Karina Montminy (conseillère juridique), Cat. 2.120-12.58
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Quebec
Legal Responsibilities
Educational institutions
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cannot refuse to admit any disabled student who meets the established admission
conditions
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cannot refuse to provide educational services
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are required to show that all possible and reasonable measures have been taken to
accommodate such individuals
Regarding the conditions of the Accommodation :
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Standards and objectives are the same as for other students; standards should be as
inclusive as possible.
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Accommodation should not affect the quality of the diploma of studies to preserve the
credibility of the certification process.
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Accommodation measures should support learning and learning assessment
a change in the context in which the competencies are evaluated or the way in which they are evaluated
without compromising the competencies.
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The accommodation must be reasonable
(i.e., the student can not choose the time for an evaluation according to his/her own convenience)
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The accommodation should not place an undue hardship on the college
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Quebec
Legal Responsibilities
Undue hardship (contrainte excessive)
• Organization of services
accommodation becomes excessive over time, availability of human resources
required, flexibility of schedule, availability and adaptability of the facilities,
number of students involved, respecting the Règlement sur le régime des études
collégiales
• Financial resources
cost of the accommodation vs. the capacity to pay, available grants, external
financing
• Security and rights of other people
increase risk for the health and security of other people or the disabled student,
state of vulnerability of those exposed to the risk, level of interference, morale
and motivation of other students, evaluation criteria
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Program
Accommodation requests
Common request for extra time for theory exams to process
information
• Allowed to take the exams in the AccessAbility Centre
Emerging populations: students with an anxiety disorder are
requesting additional time for practical laboratory exams as well
as theory
• Anxiety disorders have been found to occur more commonly in the ADHD
population.
• The actual medical diagnosis is not communicated to us.
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Program
Laboratory Examinations
Practical laboratory component of most didactic concentration courses
Requirement that the laboratory component and theory component
must be passed separately to pass the course
Evaluation of students in the laboratory component
o weekly laboratory exercises (formative)
o midterm laboratory exam (some courses)
o comprehensive practical examination at the end of the term
Laboratory exams are designed to evaluate the students’ attainment of
the competencies.
o perform a series of analyses that are set up at a work station
o to rotate through a number of stations at which certain demonstrations are set up
or single tasks are performed
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Program
Laboratory Examinations
Discipline
Laboratory Exam Activities (Performance Requirements)
Transfusion
• perform all of the required tests to find a compatible donor unit
Microbiology
• inoculate, perform gram stains and other biochemical tests to
identify pathogens in a specimen
• interpret a set of prepared tests to identify a pathogen
Histotechniques
• embed tissue specimens, cut the embedded blocks into thin
sections, stain the sections according to a given staining procedure
and evaluate quality of sections and stains under the microscope
Biochemistry
• perform some manual tests and operate automated analyzers
including the quality control) on patient specimens
Hematology
• identify cells and cell morphology through microscopic examination
• perform manual and automated tests
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Program
Laboratory Examinations
Questions may be asked that involve the application of theory
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understand the underlying principles of laboratory tests
evaluate and interpret results
troubleshoot technical errors
validate results according to quality control measures
make calculations as part of a lab protocol
make decisions as to any follow up
Laboratory exams are timed
• if the exam is comprised of different stations, each station is timed and
students would rotate from station to station.
Laboratory exams are designed so that complexity and content
increase from first year to third year.
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Program
Preparation for internship
and workplace
The goal of the didactic component of the program is to ensure that
students are prepared for the internship in the third year
• at a level which is expected by the clinical sites
• at a level which would lead to successful completion of the program.
Terminal competencies from the CSMLS:
7.02 Demonstrates the ability to adapt to rapidly changing situations, e.g., responds
appropriately to critical situations, retains composure in stressful situation, applies
existing skills to new situations
9.02 Demonstrates acceptance of the need for change and anticipates, contributes to,
responds to and effectively works in a changing environment (e.g., external forces,
instrumentation, workplace organization, etc.)
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Program
Lab Exam Accommodation
Our initial feeling about extending the time for laboratory
exams was negative:
Students are being prepared for a clinical lab with challenging
working conditions:
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High volume of workload
Stress, noise, distractions, constantly changing demands
Multi-tasking
Critical thinking, judgment
Time-sensitive workflow (includes STAT requests that are of critical
importance)
o Teamwork – everyone depends on all members of the team to complete
their portion of the tasks quickly, efficiently and accurately
o Reality of evening, night and weekend shifts - work alone
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Program
Steps taken by the Program
Consultation to ascertain the nature and extent of an
appropriate accommodation in the context of the MLT
profession
• Consulted with other Biomedical Laboratory Technology Programs in
Quebec
• Consulted with our Advisory Committee and clinical sites
• Consulted with the OPTMQ (professional order)
• Attended a presentation by the Quebec Human Rights Commission
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Program
Resources and Pedagogy
• Scheduling difficulties in extending the timing of a
laboratory exam for one or two students
• Redesigning laboratory exams to accommodate extra
time
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Reconfigure the logistics and organizational aspects of the lab exam
May compromise the competencies that are being evaluating
Limits the number of competencies that can be examined
Access to the equipment is a limiting factor
May require extra time on the part of the technician to prepare the
specimens and materials
o Requires extra time to invigilate (can not be run at the same time as
the other students); financial implications, availability of faculty and
staff after hours
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Program
Final Accommodation
Decision: Compromise
Gradual decrease of the additional time in the laboratory
exams so that by the third year the student is able to work
at the same pace as the other students and is ready for the
internship
• First year:
• Second year:
• Third year:
Time + ¼
Time + ⅛
No additional time
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Program
Additional Steps…
Provide information on the website to prospective students
• Non-academic standards that students are expected to meet
o Physical (motor dexterity, color differentiation, endurance)
o Intellectual and behavioral (manage time, prioritize work, work
under pressure, exercise judgment and make decisions, adaptability
to change)
o Interpersonal (work with different people in different situations,
work in a team, communication skills)
o Professionalism (professional conduct and dress, ethical, honesty,
manage stress)
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Program
Additional Steps…
Provide information on the website to prospective students
• Expectations of employers regarding
o Ability to work in different sectors and willingness to work different shifts
o Open minded
o Good interpersonal skills, work in teams and autonomously
o Show initiative
o Attention to detail, careful, vigilant
o Good critical thinking skills and judgment
o Manage time, prioritize work, work quickly and accurately in stressful
situations, manage a typical workload
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Program
Success Rate?
• 1 student is a practicing MLT (CSMLS certified) and
clinical instructor
(with extra time for theory examinations)
• 1 student was given additional time for both theory and
laboratory examinations in the first and second years but
did not return to complete the program
• 2 students are currently in their first year
Success of the measures? Inconclusive
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Program
Future Challenges…
• Autistic student has been accepted for Fall 2014
(high performing, dispractic)
• Hearing impairment
• Wheelchair access
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Overview
The Challenge
• Delicate problem to balance the rights of individuals with
professional requirements
• Rights must be examined in the context in which the
accommodation is requested (i.e., the profession)
• College’s mandate is to provide an education
• Diploma also certifies that graduates meet the entry level
requirements for the profession
• As health care educators, how do we balance our role to educate
with our professional responsibility to safeguard the public and the
rights of patients to timely and quality health care?
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Questions?
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