Accommodations What Are They & What Are My Responsibilities? - - PowerPoint PPT Presentation

Accommodations

What Are They & What Are My Responsibilities?

Conflict of Interest Declaration: Nothing to Disclose

Presenters: Dr. J. DellaVedova Title: Accommodations: What Are They & What Are My Responsibilities?

I have no financial or personal relationships to disclose

Objectives

• Define disabilities and learner accommodations.
• Review the NOSM policies with respect to

accommodations to learners

• Examine the roles and responsibilities of NOSM

faculty, staff and the wellness office in the support of learners with accommodations.

National Working Group on Accommodations

Accreditation

Scenarios

Scenarios

What are the issues in this situation? How would you handle it? What is your role? What resources can you access?

Faculty Roles

Caregiver Gatekeeper

Counselor Confidant Mentor

Educator

Administrator Assessor

Academic Difficulty / Wellness

NOSM PG Exit Study 2017

If applicable, did you have difficulty obtaining the necessary workplace accommodations for your health issues?

No 70% Yes 30%

Disability?

Cerebral palsy Rheumatoid arthritis Diabetes Dyslexia Depression Hearing Impairment Concussion Autism Spectrum Disorder Asthma Anxiety Hepatitis C ADHD

Disability

Disability: physical limitations, medical and mental illnesses, as well as learning and developmental disorders “any degree of physical disability, infirmity, malformation

• r disfigurement that is caused by bodily injury, birth

defect, or illness; a condition of mental impairment or a developmental disability; a learning disability, or a dysfunction in one or more of the processes involved in understanding or using symptoms or spoken language; a mental disorder; or an injury or disability for which benefits were claimed or received under the Workplace Safety and Insurance Act”. (Ontario Human Rights Code)

Disability

• Mobility issues
• Vision and hearing impairment
• Brain injury
• Chronic illnesses
• Blood borne pathogens
• Anxiety and mood disorders
• Learning disorders and ADHD
• Developmental disorders

Accommodations

Accommodations: Adjustments to the learning and working environment that permit people with disabilities to have equal opportunities to succeed, and to access equal benefits of education and employment. NB: Accommodations serve to remove the barriers to achievement brought on by disability but do not change

• r lower the standards that a learner is required to meet.

Duty to Accommodate

• NOSM has legal duty to accommodate learners with

disabilities as per OHRC

• Respond to individual requests
• Anticipate and address individual needs
• Cultivate a broader climate of inclusivity
• Applies to teaching sites as well (hospitals, clinics)
• Ensures that persons who are otherwise fit to work

are not unfairly excluded where working conditions can be adjusted without undue hardship

Discrimination

Discrimination: Discrimination occurs when an individual experiences an adverse impact where a characteristic protected by the Human Rights Code (e.g. disability) was a factor. NB: Intent is legally irrelevant for establishing that discrimination occurred.

Examples of Accommodations

• Accessible learning and work spaces
• Alternative methods of communication
• Flexible work schedule
• Alternative work or modified job duties
• Graduated return to work after prolonged absence
• Assistive devices and technology
• Adjusting assessment tools (written vs oral)
• Considering disability as a mitigating factor when

addressing behaviour that would otherwise warrant imposition of sanctions

• Lengthened training period

Undergrad Procedure

1

• Accommodation Request to the Host University (Laurentian or Lakehead University)
• Initiated by the medical student

2

• Accommodation Plan created by Host University
• Confirmation of Disability must be provided to host university
• Medical documentation housed by the host university

3

• Accommodation Plan forwarded to Appropriate Learner Affairs Officer (LAO)
• Accommodation Plan is “NOSM’ized” by LAO with student input

4

• “NOSM’ized” Accommodation Plan
• Forwarded to program/administration for input on feasibility
• Reviewed and approved or adjusted by accommodations committee
• Plan finalized and distributed

5

• Accommodations are implemented by program
• Learner Affairs assists implementation

6

• Accommodation Plans reviewed yearly and on an as needed basis

Postgrad Procedure

1

• Accommodation Request to WLC
• Resident
• Program Director or Supervisor
• Learner Affairs Office

2

• WLC Meets with Resident to Discuss
• Confirmation of Disability must be provided to

wellness program

3

• Draft Accommodation Plan
• Reviewed with resident
• Resident may involve PARO

Postgrad Procedure

4

• WLC Meets with Program to discuss draft plan
• Program confirms no undue hardship or

interference with essential duties

• Disagreements referred to Equity Office
• Plan finalized and distributed

5

• Accommodations are implemented by program
• Wellness office is available to assist

6

• Accommodation plan reviewed every 3-6

months or as necessary

The How

The Plan Reality

Undue Hardship

• Overwhelming financial cost
• Compromise health and safety of learner
• Compromise of health and safety of patients,

colleagues, and supervisors

• Substantial interference with rights

Patients Learners Training Program

Hardship

• Financial cost
• Coverage gaps
• Extra shifts
• Extra patients
• Extra time

Patients Learners Training Program

Essential Duties

• Residents requiring accommodations are not exempt

from performing the job duties that fulfill the terms of their contract

• Accommodations do not alter academic standards;

learners must still demonstrate the competencies required for successful completion of training

• Neither the disability nor the accommodations will

compromise patient safety or the quality of patient care

Essential Duties

Observation Communication Motor Function Intellectual & Integrative Behavioural & Social

Incapacity

• Disabilities may exist that are incompatible with

dispensation of job duties or with successful completion of training

• The right to be free from discrimination is not infringed

if incapable of performing or fulfilling the essential duties of employment or education

• A finding of incapacity may require involvement from

an external medical expert

• NOSM provides guidance and reasonable supports to

learners who can no longer remain in the training program, such as career counseling or help with seeking a transfer to another program

Confidentiality

• Confirmation of disability from healthcare professional

is required

• All PHI is kept confidential and stored securely
• Only the recommendations (and not the nature of the

disability) are forwarded to the program

• Accommodations can be further shared on a need-to-

know basis without the need for express consent

• For residents: any training interruption due to

incapacity must be reported to CPSO, but not the reason (CPSO follows up with resident)

What Are My Responsibilities?

• Know the policy and procedure for accommodations
• Disseminate knowledge
• Refer learners requiring accommodations to Learner

Affairs or the PG Wellness Program

• Keep learner information confidential to the extent

possible

• Address stigma related to accommodations

Scenarios

• Dr. Bailey is referred to PG Wellness

Program where she discloses long- standing diagnosis of ADHD

• Dr. Bailey starts treatment
• An accommodation plan is drafted:
• Limited number of simultaneous

patients

• Distraction-reduced prep area
• 10 extra minutes prior to case

presentation

• Dr. Bailey develops templates to
• rganize patient information
• She successfully completes enhanced

learning plan and avoids remediation

• No interruption to training

Scenarios

• You remind your colleagues that it is

your legal and ethical duty to support residents with health issues, otherwise they will be withdrawn altogether

• The fellows and staff cover the early

morning consults for Dr. Grey’s 6 call shifts that month

• Dr. Grey is assigned to come in for extra

weekend day shifts to help with rounding where there was no coverage

• therwise
• She proves to be a competent resident

and successfully completes her surgery rotation

Scenarios

• You contact the Learner Affairs Office
• They confirm the motor restrictions: she

has full use of upper limbs but requires a wheelchair for mobility

• The LAO discusses some solutions

applied to previous students

• They contact the hospital where

personnel confirm the ORs and clinics are wheelchair accessible, and locate and provide a standing wheelchair

• You distribute the accommodation plan

to the student’s direct supervisors for the rotation

• You review and confirm the surgical

competencies that are required of all medical students

Scenarios

• The PG Wellness Program provides a

plan for Dr. Karev’s return

• He returns with half-days only with no

call for the first month

• He has been studying while away and he

is good at requesting assistance with clinical skills when needed

• After two weeks of enhanced

supervision he has earned your trust with respect to clinical skills

• The plan is re-evaluated after one

month with your input and Dr. Karev is cleared to return to full time work

Scenarios

• Dr. Shepherd has been receiving

psychotherapy and medication for his anxiety and panic disorder

• Despite this, he is assigned to probation

after failing two rotations

• During the probation Dr. Shepherd

begins to rethink his career options and receives counseling with the wellness

• ffice
• A new independent medical evaluation

arranged by the wellness office determines he is incapable of the essential duties of an anaesthetist

• Dr. Shepherd is successful at transferring

into a diagnostic imaging residency at another school

Scenarios

• Andrew has been suffering from

burnout, and the limited hours constitute part of his recovery plan

• You contact the program director who

advises you to fill out an interim evaluation based on the information you have

• Andrew is assigned a two-month

extension on his clerkship so he can further learn and demonstrate his competencies