Gateways to the Professions

Appendix

Examples of reasonable adjustments

Medical schools could keep a record of reasonable adjustments they have made and the costs involved, so that they can share their experiences and perhaps achieve future economies of scale.

Physical environment

Examples of reasonable adjustments to the physical environment: 

  • ramps to all necessary locations
  • accessible lifts and lift buttons
  • automatic doors
  • accessible external paths and landscaping
  • accessibility within buildings, including their interior layout
  • vibrating and light fire alarms for deaf people
  • adapted fire alarms and door bells in university accommodation
  • vibrating pagers
  • fire refuges or alternative escape routes for people with mobility impairments
  • quiet refuges and first aid facilities where people with epilepsy, for example, might go after an attack
  • rooms without fluorescent lighting
  • enhanced signage and colour or tone contrasts to aid orientation
  • enhanced lighting to facilitate lip reading
  • effective sound system with T loops
  • desks, laboratory benches, work surfaces and reception desks at varying or flexible heights
  • appropriate seating
  • reserved areas in all teaching and learning locations, including the library
  • accessible technology, including screen readers, and libraries
  • accessible toilets
  • accessible services, such as catering facilities, or payphones in a corridor
  • convenient and reserved parking spaces
  • lowered kerbs.

 

Application process

Examples of reasonable adjustments to the application process:

  • text phones for the enquiry stage
  • information, such as university policies and course leaflets, in potentially accessible formats: such as email, braille, easy read, large print, audiotape, and computer disc
  • electronic information that can be accessed by a range of screen readers and assistive software
  • staff trained in communicating with a wide range of disabled people.

Where possible, all information should be:

  • offered in both visual and audible formats
  • available in different font sizes
  • available with different background and foreground colours
  • available without enhancements such as boxes
  • easily navigable, if electronic, using either a mouse or keys.

 

Teaching and learning

Examples of reasonable adjustments to the teaching and learning environment:

  • audience-facing lecturers under good lighting
  • elimination of background noise
  • adjustments to the physical environment as above
  • availability of laptops or hand-held devices for taking notes
  • availability of a note-taker for lectures
  • full lecture handouts
  • lecture notes available in different text formats
  • written materials available in audio format
  • availability of notes in electronic format to enable use of assistive software (such as text to speech; speech to text; mindmapping software)
  • intranet material that meets established guidelines for compatibility with specialist software
  • availability of searchable reference texts
  • availability of spell checkers
  • small groups for practicals keeping the same group throughout
  • stethoscope linked to a display screen
  • compatibility of online teaching resources / websites, patient records, X rays and test results with the student's software magnification programmes
  • availability of screen readers
  • microscopes linked to CCTV screens
  • additional learning support and coaching
  • support in researching booklists for those unable to ‘browse’ in the library
  • provision of study skills support covering essay writing or dissertation skills
  • additional time and flexible deadlines for assignments for those with variable conditions
  • adjustments to assignments, such as allowing a student to submit a piece of work on video rather than in writing
  • comments on course work in alternative formats
  • additional training for teachers in making teaching and learning more accessible to disabled students.

 

Assessments

Examples of reasonable adjustments to assessments and examinations:

  • flexible seating arrangements in examination halls
  • written exams being done in a small room as opposed to a large sports hall
  • appropriate timing during the day
  • examination papers and assessment instructions available in different formats
  • individuals given more time to complete examinations
  • assistants, such as a scribe to transfer answers onto computer paper
  • flexibility in ways of enabling students to answer, such as: an oral rather than written assessment; a written exam, extended essay, or PowerPoint presentation rather than a verbal presentation
  • flexible deadlines for those with variable conditions
  • partial retakes and deferred exams for those with illness
  • extension of the registration and completion period for Royal College examinations.

For practical assessments such as OSCEs:

  • students given additional time to read instructions
  • timing of OSCE exams to earlier rather than later in the day
  • individual circuit for OSCE assessments
  • OSCE stations made more accessible, for example a resuscitation manikin placed on a couch
  • trainee allowed to use own modified stethoscope
  • examiners briefed about individual trainee requirements
  • a signer entering the assessment cubicle with the student to place a microphone on the manikin while the student reads the instructions.

 

Clinical placements

Examples of reasonable adjustments on clinical placements:

  • additional support for students in finding placements that meet their requirements
  • clinical placements being suitably located if possible to minimise travel
  • transport to locations or checking availability of public transport
  • buildings made accessible for wheelchair users and others with mobility impairments
  • checking of lighting and obstacles
  • alternative learning opportunities where placements cannot be made accessible
  • an electric scooter for getting around a hospital
  • replacement sets of wheels for entry to the operating theatre
  • training of work placement providers in disability equality and how to work with disabled students
  • increased supervisory support
  • slowing of ward rounds, help in carrying notes
  • arrangements made to ensure that disabled people can take personal assistants or assistive technology with them where necessary
  • amplified stethoscopes
  • compatibility of patient records, X rays and test results with the individual’s software magnification programmes
  • flexible working hours
  • adjustments to working hours, for example reduced hours, reduced daytime on-call duties, fewer or no night time duties or weekend calls
  • adjustment made to duties, for example no crash calls for wheelchair users
  • part-time placements
  • extra time and time out
  • time off to fit treatment schedules, therapy and out-patient appointments
  • placements modified to allow attendance at signing and lip reading classes in the evening.

 

Other support:

  • time out from studies for those with illness
  • appropriate treatment assured
  • links with specialist organisations if help is needed, for example by dyslexic students
  • a mentor or additional mentoring
  • local ‘buddy system’ between disabled and non-disabled students
  • disability-awareness training for staff to increase awareness of common disability related issues
  • staff in accommodation blocks made aware of the disabled student’s needs
  • staff trained in communication with a hearing impaired person
  • colleagues made aware of individual’s circumstances.