Clinical Competency:
Academic and Technical Standards
Of A Program
Academic and Technical
Standards
• A program can set academic and technical
standards for its students
Example: Academic Standard
• Earn at least 84 semester hours of credit
while
• Maintaining a cumulative average of C or
70
Example: Technical Standard
• Independently, observe the patient/client
accurately
• Integrate all information received by
whatever senses employed
What Is A Technical Standard?
• All nonacademic* admissions criteria
• Must be met by student
• To enable student to participate in and
successfully complete the chosen program
• Including behavioral, professional and
intellectual standards
Purpose Of Technical Standards
• Assist the professional school in selecting
retaining and graduating those applicants
and students best qualified to complete the
required training
Authorization For Technical
Standards
• Title II of the ADA and Section 504 of the
Rehabilitation Act
– Must be reasonable
– Based on legitimate educational goals of the
program
– Must be clearly identified in the student
handbook, field manuals, institutional catalogs,
and/or program brochures
Notification
• Student must have reasonable notice
• Standards must be in writing
– Brochures
– Admissions application
– Affidavit
Continual Monitoring
• Performance must be continually monitored
from entrance to graduation
• Progress reports, written evaluations
• Prevents unqualified students from making
it to graduation and then being told at the
last minute they may not graduate
Criteria for Decisions
• Subjective grading should be a rational
exercise of discretion
• Students must have access and be made
aware of the criteria for making such
decisions
Following the Standards
• Include the consequences for inadequate
performance and removal procedures
• Immediate notification by University of
deficiencies in performance and possibility
of failure or expulsion
• Give opportunity to remedy deficient areas
Follow the Procedures
• Decisions made in good faith, not arbitrarily
or capriciously
• The University must follow its procedures
once a decision for unsatisfactory
performance has been made
• Students should be entitled to a hearing
prior to dismissal
Example of Procedure
•
•
•
•
Purpose and scope of rules
Responsibilities and rights
Composition of the council
Violations of the rules
Example of Procedure - Cont’d
•
•
•
•
•
Procedures
Sanctions
Appeals
Honor/professional ethics education
Amendments
Example
• Continuing student in a clinical program
• Monitor progress reports and written evaluations
• If at any time the student’s conduct or behavior is
deemed to endanger the health and safety of that
individual or others, notify the student
immediately
• Follow procedures for reevaluation or removal if
necessary
Disabilities
• University should make every reasonable
effort to allow otherwise qualified persons
with disabilities to engage in their programs
• Including making reasonable
accommodations in response to a request by
an individual with a disability
Otherwise Qualified
• Otherwise qualified
– Can the disabled person satisfy the program’s
requirements despite the disability
– One who is able to meet all of a program’s
requirements in spite of the disability
What Is A Disability
• The mental or physical condition must
substantially limit a major life activity,
• The person has a record of such an
impairment, or
• The person is regarded as having such an
impairment
What Is A Major Life Activity
• Caring for one’s self, performing manual
tasks, walking, seeing, hearing, speaking,
breathing, learning, and working
• Important life activities are restricted as to
the conditions, manner, or duration under
which they can be performed in comparison
to most people
Types Of Claims
• ADA and Section 504
• Contract claims
• Negligence
University of Missouri v.
Horowitz
• Medical student was evaluated according to
procedure during final year
• Failed evaluation due to poor performance
on a rotation
• Council voted to dismiss the student
Holding
• A subjective, expert evaluation is required to
determine whether an individual’s performance
satisfies a predetermined set of standards
• That standard is set by a similar academic
judgment
• This type of judgment is no less academic even
though it measures actual conditions of practice
rather than a grade for written answers
Southeastern Community College
v. Davis
• Davis applied to the College’s nursing
program
• Serious hearing disability
• Refused to admit because the College
determined that her hearing disability would
interfere with her safely caring for patients
Holding
• Section 504 does not limit an educational
institution’s requirement that a prospective
student must meet reasonable physical
qualifications for admissions into a clinical
training program
• Not required to lower or substantially alter
its standards in order to accommodate a
disabled person
Anderson v. University of
Wisconsin, et al
• Law student dismissed due to poor
academic performance caused by
alcoholism
• Student did not maintain sufficient average
as required by the law school
• Threatened fellow student while drunk
Holding
• Can consider academic performance and
sobriety when deciding whether an
applicant is entitled to an education
• Student with below the required average is
not qualified to stay UNLESS he can show
that the source of the academic problem has
been abated
Professor Liability
• Generally, as long as the professor was
acting within the scope of their authority,
there should not be individual liability
Developing The Standards
• Should be defined as the essential functions
that the student must demonstrate in order
to fulfill the requirements of a program
• They are pre-requisites for entrance,
continuation, promotion, retention, and
graduation from the University
Cont’d
• Connect technical standards with the
licensing requirements necessary for a
profession
General Categories
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•
•
•
Observation
Communication
Sensory and motor function
Intellectual, conceptual, integrative and
quantitative abilities, and
• Behavioral and social
Necessity
• Explain why the requirement is necessary
Purpose
• Each student must successfully fulfill the
prerequisites for admissions, continuation
and graduation from the program
ADA
• Include a statement concerning the ADA
Procedure For Notification and
Review
• The materials distributed to prospective
students should include academic and
technical standards for notification purposes
• Clearly define suspension and dismissal
procedures
• Clearly define appeal procedure
• Strictly follow
Criminal Background
• Courts generally hold that a University may
deny or revoke admissions because of a
prospective student’s past criminal record
– Crime may not be compatible with University’s
goals or values, or
– Prospective student failed to disclose –
accurately or completely – information on the
application
Off-Site Clinics and Internships
•
•
•
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Student’s skills and abilities
Specific needs in the clinical setting
Goals and purposes of the program
Potential impact of the requested
accommodation on the program AND on
the quality of education the student would
receive
• Availability of alternatives
Monitor the Site
• Imperative for the University to be familiar
with the site and monitor the off-site
program
• Ensures the student is receiving a
meaningful opportunity to participate in the
program
• Safety of site itself
Summary
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•
•
•
Notification and awareness
Clarity of standard
Monitor consistently
Strict application of any procedure in place
Sources
• Anderson v. University of Wisconsin, et al., 841
F.2d 737 (1988).
• Board of Curators of The University of Missouri et
al. v. Horowitz, 435 U.S. 78 (1978).
• Southeastern Community College v. Davis, 442
U.S. 397 (1979).
• St. Thomas University, 23 NDLR (LRP) 160
(2001).
Sources – Cont’d
• Derek Langhauser, Use of Criminal Convictions in College
Admissions, 154 WELR 733 (2001).
• ADA Title III Technical Assistance Manual at
http://www.usdoj.gov/crt/ada/taman3.html.
• SYNFAX WEEKLY REPORT, Week of April 20, Insuring
Clinical Competency (1998).
• Patty Gibbs, Gatekeeping in Social Work Education, BPD
GATEKEEPING WORKSHOP, (October, 1998).
• University of Massachusetts Medical School Technical
Standards at http://www.umassmed.edu//som/adm.