Accommodating Students With Disabilities in Clinical Programs

Clinical or practicum requirements may be part of undergraduate or graduate programs such as nursing, social work, physical therapy, law, counseling, and teaching. If a student is “otherwise qualified” — meeting the academic requirements — to participate in the degree program, the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act require your institution to provide reasonable accommodations for their disability.

To best position your campus to handle any accommodation requests:

Set Clear Standards

• Identify all programs on your campus that require a clinical/practicum placement.
• Work with program faculty to develop comprehensive and detailed technical standards for all students. Standards must be clear and match the nature of the program. Incorporate applicable professional standards, accreditation requirements, and licensing requirements.
• Incorporate behavior and professionalism requirements into the program’s technical standards.
• Periodically assess and revise the technical requirements as professional standards (and assistive technology enabling accommodations) evolve.

Communicate Standards

• Provide faculty and students with new or revised technical standards.
• Share the standards with all applicants. Have applicants sign a statement prior to final admission acknowledging the program requirements.
• Notify students that clinical sites are distinct from the classroom. Certain accommodations that are acceptable for the classroom may be inappropriate in a clinical setting. For example, in a clinical setting, being allowed to leave during discussion of an upsetting topic may deprive the student of a meaningful learning experience.
• Communicate behavioral and professional standards to all students. Hold them accountable throughout the program.
• Encourage, but don’t require, students to disclose their disability to the clinical placement site.
• Train clinical site supervisors on your program’s technical standards.
• Inform clinical supervisors of accommodations granted to a student, but don’t share the nature of the disability. Caution clinical personnel against engaging in “unofficial” diagnoses, especially relating to behavioral issues. Be clear that evaluations and communications should document behavioral concerns and not speculate on the root of any problems.

Use Sound Practices for Fielding Accommodation Requests

• Avoid generalizations based on a student’s stated disability. Instead, engage in a good-faith interactive process by conducting an individualized assessment to determine appropriate accommodations for each clinical or practicum placement.
• Document your interactions. Keep a record of accommodations requested and offered along with reasons for accepting or rejecting requests.
• Understand how to act if disabilities are disclosed later. Often a student’s disability isn’t discovered until they participate in a clinical rotation.
• You are not required to retroactively accommodate a disability. Your accommodation duty does not begin until the student makes you aware of a disability. However, it is prudent to consider whether the student can retake the clinical portion with an appropriate accommodation. Again, engage in the individualized interactive process to determine if an accommodation will help the student succeed. Also consider whether the student has a right to appeal a dismissal from a clinical site or your overall program.