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Participants’ reported that they have varying, sometimes conflicting, roles and responsibilities in relation to disabled students completing placements. These include facilitation, standards of practice and the realities of employment. As noted, placement experiences involve professional socialisation and early development of physiotherapy identity. Students can extend and apply previously acquired theory and practice, so increasing their knowledge, skills and competence in a ‘real world’ setting.

7.7.1 Responsibilities of being an educator

Participants emphasised facilitation of good learning experiences for positive outcomes: “We’re here to support you…not to fail you. We’re here to give you an experience and for you to learn.” P6

Empathy was shown for disabled students’ issues and there was awareness of feelings and fears they might experience, ultimately, however, educators expected students to manage their disability and perform to the required standards or risk failing the placement. As one explained:

“pastoral care is part of what we do…at some point we have to judge them, we have to apply…standards and say, “Do you reach these standards because if you don’t you’re going to fail this placement?””P3

Anxiety was expressed by some participants when they had to fail disabled students. They exhibited personal investment in the situation and a sense of failure in their own

responsibility if they had not expended considerable efforts to enable student success. They found this challenging:

“you know it doesn’t come back to you personally but I feel I’d let myself down if I hadn’t done everything I could”P1

“you’re there to facilitate students, not to fail them...it was extremely difficult”P6 Some students though, were said to have engaged effectively and were perceived as investing the required effort. Participants noted that it was these students who performed to expected levels, similar to their non-disabled peers:

128 “the ones that can do that, and have done that by the end of the placement, feel that they are being measured equally with everyone else” P5

It appears that in the participants’ opinions, both for themselves and the disabled students, this ‘equal measurement’ was very important.

7.7.2 Gatekeepers

While participants found that failing students was difficult they indicated their responsibility to maintain standards and to act as gatekeepers to the profession by ensuring student competence. This sometimes translated into questions regarding the suitability of disabled students to qualify if they fell below expectations:

“if they can’t complete a placement how do they complete their degree?”P1

This participant felt that she had a professional responsibility to address these issues. Some educators questioned decisions they had made in the past, wondering whether they had let emotion (empathy with, or sympathy for a student) cloud their judgement:

“what preys on your mind is have I, out of a misplaced sense of…sympathy for this person…foisted onto the general public someone that is not capable of doing the job?”P3

The motivation of academic teams was also questioned in relation to the powerful drivers within HE for students to successfully complete their degrees:

“Well maybe that person isn’t cut out to do this job...sometimes I think

that...universities are...more concerned about passing the student than unleashing unsafe physios on to the world”P3

This perception of conflicting priorities resulted in an emotive response, ‘unleashing’ a damaging force into the world. Student retention, progression and decrease of attrition are major HE drivers, arguably then, practice educators may feel pressured to pass students, given that their assessments are key in providing evidence of students’ professional development.

When disabled students were successful on placement, educators were positive. However, there was little acknowledgement of student effort; student success equated with educator success; the disabled student eventually did well perhaps because of the efforts of the educator and the team rather than because of his/her own abilities:

129 It was also seen as a learning experience:

“in retrospect she did really well. It totally changed my…perspective…yes it was good for me…I think…I was being a little bit discriminatory...it worked really well…so that was quite positive for us”P7

When a student was not successful, however, sometimes there was a perception that perhaps the team had failed:

“it was very unsatisfying for us because we felt that…we like to have good placements…part of the reason we have students is because it’s beneficial for all the staff”P3

Anxiety was expressed about passing students who, in the future, might not perform effectively:

“I’d be horrified if I passed a student who then went on to qualify…then couldn’t function”P1

Whether universities expected practice educators to enact a role in gatekeeping or not, accounts indicated that they felt that this was their role, consequently, they experienced challenges when supporting disabled students:

“we’re there to respect the wishes of that individual…yet provide a structured learning environment…keeping our team sane at the same time…is incredibly stressful”P5

This section concerned the ways in which participants discussed their educator role in relation to outcomes. When students were successful, participants experienced this as positive, gaining a sense of satisfaction and fulfilment. When disabled students did not perform well, educators were frustrated and viewed this as less satisfying and did not necessarily feel they were supported well in these situations.

7.7.3 Realities of the employment context

Some participants expressed reservations about the NHS as an employment context for disabled individuals:

“The NHS…has no excuse not to be the golden employer for this [disabled employees]…if anyone should understand these issues it’s the NHS. Having said that, that’s not always the case...it’s very much…looking at the turnover…if I have someone that is, for whatever reason, less productive, I can only carry that for so long…whether you acknowledge it or not, it is going to make you think twice before appointing people to certain jobs...I think that…changes in the NHS…are pushing us

130 towards less diversity because diversity can be more expensive or can be perceived to be more expensive”P3

There were misgivings about the ability of disabled students to perform effectively, particularly in the employment setting; what is a reasonable adjustment?

“That’s not real world [dyslexic students accessing reasonable adjustments - more time/less clients]...is it acceptable and…who’s going to take you on as a qualified member of staff?”P1

Although there is support available for qualified disabled employees there were doubts about whether the system really works:

“I think it’s…very difficult…there isn’t the support...almost the tolerance. Because everything is at such a pace and there’s such time constraints…people probably aren’t as tolerant as they should be...there aren’t huge resources and strategies to help these people. Nobody…most people don’t have the time to give that support and it makes it very difficult...things are tending to get dehumanised nowadays”P6 Participants felt they knew what was required to support disabled students. These

accounts illustrate, however, that there were fundamental concerns about the NHS being a suitable environment in which disabled employees can perform effectively. Arguably these concerns could influence their overall approach to disabled students from pre-entry to conclusion of the placement.

This chapter has provided an overview of the findings from the interviews. Key themes have emerged related to the field of the practice placement embedded within the larger field of NHS healthcare. The influence of participants’ habitus and doxa as well as issues concerning the relative capital of the individuals involved will be further explored in the next chapter.

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