Earlier this week we asked Karen Atkinson, CPN member, Physiotherapy Professional Lead at University of Hertfordshire, and contributor to the Project Advisory Group that helped produce the WCPT’s recent briefing paper Access to physical therapist entry level education and practice for persons with disabilities, to comment on the paper and provide some background. Karen has longstanding expertise in supporting disabled students and qualified professionals during their education and employment and real insights into the process that made this important report possible. Karen kindly provided us with the following overview:
As someone who has worked to support disabled students and qualified physiotherapists in academic and work based settings over the last 25 years, I really welcome the publication of the WCPT guidance document: Access to Physical Therapy Education and Practice for People with Disabilities.
In the UK, disabled people have been part of the physiotherapy profession for over 100 years. This started with blind and partially sighted servicemen returning from the wars. Over time visually impaired physiotherapists have made a great contribution to the profession and in more recent years we have seen people with many different impairments successfully undertaking physiotherapy education and moving into practice. This, along with an increase in numbers of individuals from other diverse backgrounds can only be good for the profession meaning that it more closely resembles our client base.
The WCPT document could be considered a mandate for this work to be promulgated worldwide, aiming to provide guidance to educators and employers enabling them to support and encourage the entry of more disabled people into the physiotherapy profession.
Whilst this is a very positive step, it must be acknowledged that disability is regarded very differently by cultures around the world. Physiotherapy organisations may be able to use the guidance to initiate the process and to argue the case, but everyone will be starting from very different positions particularly with regard to attitudes towards disability and the beliefs about what disabled people may, or may not, be capable of.
In Western countries where disability legislation has been in place for a significant number of years the gradual inclusion of disabled people into physiotherapy and other health care professions has not been (and indeed, is still not) an ‘easy ride’ – every move forward has to be fought for, sometimes every 2 steps forward are accompanied by one step back. Changes also occur as a result of whichever political party is in power – in the UK, the teeth of the Equalities legislation are gradually being pulled and many of the hard fought accomplishments of the Disability Rights Commission undermined. Arguably, if the British public vote to exit Europe in the June referendum this process might accelerate with Human Rights issues being overshadowed by employers’ financial drivers which will not be good news for disabled people.
There is extensive literature relating to students in HE studying vocational programmes and some that focuses on disabled students generally in higher education. Little attention has been given, however, to the ways in which being immersed in a biomedical, largely reductionist health care educational setting might influence the behaviour of, and relationships between, physiotherapy educators and their disabled students in the clinical environment. In the UK disabled physiotherapy students appear in the clinical field and are supported more or less effectively by their educators and are more or less successful depending on a range of factors.
Unfortunately, however, the situation often seems to be regarded as one of difficulty, anxiety and extra stress for both the educators and the disabled students (Adams and Brown 2006, Carey 2012, Opie and Taylor 2008, Ryan and Struhs 2007). Reading of the available literature indicates that this situation is often mirrored in other countries. It is the challenge for groups such as the CPN to problematise these taken for granted, common assumptions and to present them to the profession in ways which might allow for new viewpoints and ideas for possible action to emerge. It is hoped that this process could enable recognition of the existence of these issues and proffer an invitation to educators, physiotherapists and disabled students to take part in conversations, encouraging dialogue about these assumptions and ways of being.
This type of discussion provides some perspective for the issues with which educators and employers in different countries may have to grapple when using the WCPT guidance to encourage more disabled people to join the physiotherapy profession. It will not be an easy process but it is worthwhile and rewarding. In our society of ableist assumptions and perfectible bodies – how great is it for patients to see therapists in whom they recognise themselves?
Adams M, Brown S (Eds) (2006) Towards inclusive education: Developing curricula for disabled students. Routledge, London.
Carey P (2012) Exploring variation in nurse educators’ perceptions of the inclusive curriculum. International Journal of Inclusive Education. 16 (7) 741 – 55.
Opie J, Taylor M C (2008) An exploratory Delphi study on the integration of disabled students into physiotherapy education. Physiotherapy 94: 4 pp 292 – 299.
Ryan J, Struhs J (2007) University Education for All? Barriers to full inclusion of students with disabilities in Australian universities. International Journal of Inclusive Education. 8 (1): 73 – 90.