Barriers to sharing information

Bessant (2012) explored situations in HE in which some disabled students successfully negotiated reasonable adjustments with staff whilst others found this challenging. Positive outcomes related to students who had physically identifiable impairments, self-identified as ‘disabled’, understood their rights and entitlements and had insight into how

organisations worked, or not, in relation to disabled people. Adjustments were agreed with students and staff working as allies. This could be seen as positive and yet it requires disabled students to be assertive, almost becoming ‘extra visible’. There are parallels here with some feminist and BME research where the subject in question is seen as a ‘space invader’ i.e. a body out of place, not representing the somatic norm (Mirza 2014/15) and yet has to become the expert on their own condition (e.g. black woman, Muslim medical student, and in the current work – disabled person) to enlighten others. The subject is, however, seen as less capable of being in authority (Mirza 2014/15, Leyerzapf and Adma 2017) and is constantly required to prove his/her competences(Mikkonen 2016).

66 This involves emotional work. Disabled students may feel that they are a nuisance and do not want to have attention drawn to any impairments (Hopkins 2011). It would seem to be crucial for practice educators to be aware of the potentially increased stress and barriers that may be experienced by disabled students on placement. There is a tendency to focus on physical issues which conflates the approach to disability with the concrete and visible. This may cause educators to overlook more complex and challenging barriers to social inclusion (Hall et al 2004).

Those students who had invisible impairments and a less secure sense of a disabled identity were reluctant to discuss their requirements, not wishing to be singled out (Hopkins 2011). Some staff did not ‘believe’ in their disabilities (Bessant 2012) and in some cases,

adjustments were not negotiated until students had representation from an advocate. Staff often responded negatively to these ‘non-conforming’ students feeling that they were causing unnecessary work, manipulating the system and putting standards at risk. There were also suggestions that these students were ‘failures, ‘untrustworthy’ or ‘putting it on’ (Bessant 2012) reflecting the sense in the literature of an undercurrent of “grudging compliance” (Clouder et al 2016,12). While students from other minority backgrounds undoubtedly experience challenges due to bias and discrimination as a result of their protected characteristics, whether they would have to contend with the issue of being disbelieved or being manipulative in this way is perhaps somewhat open to question and in need of further enquiry.

It may be the case that practice educators expect/want students to be ‘normal’ and fail to ask about difference. Alternatively, they may not hold these beliefs but disabled students, as a result of their assumptions about how they will treated, could erect internal barriers which inevitably exerts pressure to ‘be normal’, particularly in the clinical setting. It is also important to note that due to the reactive nature of disability disclosure policies, pressure is placed upon disabled students “to define and categorise themselves as inherently “different” at a time when “fitting in” is perceived by young people as crucial to positive experiences in the educational domain” (Bryne 2014,131). In order to avoid discrimination and stigma, therefore, there may be a compulsion towards passing and assimilation: to emulate the norm through internalisation of ableism (Campbell 2009; Riddell and Weedon 2014).

67 There are valid reasons why students decide not to share their personal information (Bargerhuff et al 2012, Bryne 2014). Evidence suggests, however, that individuals who do share information about their impairments are afforded more positive responses than those who do not (Hebl and Kleck 2003). Given earlier points regarding a priori doubts in relation to disabled students’ competence and fitness to practice, it may be the case that concerns about this could influence their decisions about whether or not to talk about their requirements in the clinical setting. Disabled students on vocational programmes may inform their university about impairment as an administrative convenience to access funding and equipment (Hopkins 2001; Stanley et al 2011) although it appears that many do not, or more recently are not eligible to do so, as noted earlier. This is an example of disabled people adopting the label of disablement strategically to access social benefits but not necessarily holding to a belief that they ‘are’ disabled (Campbell 2009).

Some students who share information with academic staff assume that the information is appropriately edited and disseminated to others who ‘need to know’ (Demery et al 2012). This is not always the case and misunderstandings about the Data Protection Act mean that staff are not aware that they are able to pass information on with the student’s permission (UMHAN 2015).

This provides some context for the complex situations in which educators and disabled students find themselves in a clinical setting. Attitudes of staff towards disability and disabled students are clearly critical in the process of sharing personal information and there is a need for more training and awareness raising in this area. Inclusivity needs to be internalised as a general guiding principle rather than being ‘tagged on’ in a dis/ableist culture in response to an excluded student. While this work focuses on disability there are, as noted, at least some commonalities with students from other minority backgrounds.