Transferencia de carga en la colisión de iones con superficies

Logically one would expect all eligible students to disclose in order to gain access to the resources and support, but this proved not to be the case, as many

individuals chose not to disclose or were selective of when and to whom they disclosed. This section of the data analysis focuses on the factors affecting the student’s decision to disclose or withhold diagnosis, the impact the decision can have on the student’s experience on the course and the potential effects such decisions have on University and School selection and support processes.

6.4.4.1 Factors related to withholding or disclosing diagnosis

The voluntary nature of disclosure meant that access to dyslexic students for this study was restricted. Only students who had been diagnosed as dyslexic and were willing to disclose that diagnosis could be accessed directly. Limited information about students who were dyslexic (formally diagnosed or undiagnosed) came mainly second hand from the students who had agreed to disclose as part of this study. For example:

7 know one of my friends is dyslexic and is worried to tell the university,

because she got turned away from two other universities because of her dyslexia. ” (Matthew)

The above example indicates that the student’s decision not to disclose was based on their past experience and the fear that they would not be selected for the

course. It also suggests that even though they have successfully gained a place on the course, they continue to withhold the information as the fear of being rejected had persisted.

The issue of disclosure was not black and white; it appeared that some students chose to disclose only in certain circumstances. The decision by a nursing student to disclose in a clinical area appeared to be related to the attitude of staff in the area, whether they were supportive or not, or the concern the student had that staff would think differently about them. Vicky stated that she usually did disclose but not straight away. She usually left it a few weeks to see what kind of

comments the staff made or whether her mentor was supportive. If she felt comfortable then she mentioned it. Her underlying concern was standing out as different from the other students, which led to feelings of embarrassment. By

delaying telling the qualified staff until she was reasonably sure that her disclosure would be met in a supportive way she was attempting to lessen the threat to her own self-esteem (Hogg and Vaughan 2002) and ‘social identity’ (Goffman 1963).

The issue of being judged or labelled by others can affect the individual’s confidence and thus their ability to perform as a nurse. Jane, who was recently qualified and waiting to register, said she felt more confident in her abilities if her colleagues did not know she was dyslexic. She stated the need to keep the diagnosis hidden, as she feared what her colleagues would think of her. One of the consequences of her loss of confidence was her inability to instruct the unqualified members of staff in the unit where she worked. As with Vicky,

mentioned above, fearing being judged by others suggests a significant change in her levels of self-esteem and hence her levels of self-confidence.

This fear of being judged or labelled by others, particularly by the qualified staff who would be making decisions about a student’s fitness for practice, might be sufficient to inhibit disclosure. In the following example Matthew stated that he already felt labelled by being diagnosed as dyslexic and felt stigmatised

previously. The act of disclosing the nature of the problems he was facing was causing him some concern, which might or might not be realised in the clinical area. The fear itself, which could be based on past experiences, was sufficient to inhibit disclosure.

.. if they think you’re having a problem it gives them reason to give you

even more stigma when you go back out If you start saying ‘Ah well, I’ve got this problem’ it’s ‘what are you doing in nursing then if you’ve got problems doing this?’... ” (Matthew)

Some students reported negative remarks that could be considered as hurtful or were said to undermine the student’s confidence. Whether the comments were made thoughtlessly or in a more deliberate way to discourage the student, is not always clear. However, the negative effect on the students was obvious in the way it was reported during the interviews.

“A lot of tutors are supportive but my personal tutor isn’t at all. I don’t find her supportive. In fact she makes things quite difficult. She did say last week. ‘It’s quite frightening to think you’ll be a qualified nurse in about a year and a half. I wouldn’t let somebody like you nurse me. ’...” (Michelle)

Most of the students who said they disclosed to their clinical mentors, made a judgement as to the timing of the disclosure, including being willing from the outset

of the placement to disclose their diagnosis. In the following example Michelle commented that she had not received any negative or unsupportive reaction from the clinical staff so far.

“All my friends know. When I go out on placement I write it on my self- assessment and action plans that I've just found out. Maybe because I haven’t come across anything yet. My last placement, they were really good. I haven’t come across anything negative.” (Michelle)

This seems to suggest that previous experience was a deciding factor on whether to disclose on clinical placement. The apparent willingness to disclose on the clinical placement does not automatically suggest that the person will disclose in other contexts. Lisa said she was willing to tell people straight away, however she also said that she chose not to disclose her diagnosis on the application form or at anytime during the selection process. It was only once Lisa was on the course that she disclosed to her personal tutor, who by coincidence was the Specific needs tutor for the School. Lisa’s decision not to disclose on the application form was based on her concern that her specific learning need would influence the selection process and therefore her chances of gaining a place on the course. This type of decision only applied to those students who were diagnosed before they came to apply for a place on the course.

When the admission lecturers were asked whether they felt students should

disclose any problems they have, all agreed that they should. They were also keen that the student disclose to any clinical placement they went to as well. From the clinical mentors questionnaire one of the comments stated that it was “most important” for the student who is dyslexic to inform the mentor or senior nurse. What was interesting from the admission lecturers’ responses was the choice of terms they used about the student disclosing the diagnosis of dyslexia (my emphasis).

.. it’s about encouraging students to be open and have an honest

relationship between student and lecturing staff.” (Nicola, lecturer mental

“... once they’ve brought it into the open you can have an open

discussion.” (Gareth, lecturer learning disability branch)

7 do think they should be open because I think it can have an impact on

filling in documentation for patients.” (Angharad, lecturer adult branch)

.. we should be encouraging people to be open and aware of their

specific needs so that they don’t need to go underground and cover it up.”

(Elizabeth, lecturer learning disability branch)

The language used implies a strong belief that the student had a responsibility to disclose the diagnosis. The language suggests that if the students withheld the information they were being “dishonest” or “secretive” in a negative way. In contrast when the lecturers were asked whether there should be any form of screening to identify students with problems they unanimously rejected the

suggestion for practical and ethical reasons, namely if the organisation identified a need through screening it was morally obliged to respond to that need. Some lecturers could see the benefit of identifying students that needed help.

What can be drawn from the above review of the data is that the lecturers and mentors believed it was the responsibility of the student to disclose the diagnosis of dyslexia to them. The students, however, tended to make conscious decisions about disclosure of the diagnosis of dyslexia, influenced by:

• Their previous experiences, particularly the comments and attitudes

expressed by others to their specific learning needs, or by failing to secure a place on the course at other institutions due to being dyslexic.

• How sharing the diagnosis made them feel, for example if they felt embarrassed or less confident they might be less inclined to disclose. • The environment in which they found themselves, if it was supportive they

were more likely to disclose.

• The potential risk outweighing any potential gain, an example would be during the application process where the student feared that the diagnosis of dyslexia might result in the failure obtain a place on the course. This outweighed any help they were entitled to once they were on the course. The protection afforded by the Special Education Needs and Disability Act (2001) to prevent discrimination did not appear to have any bearing on their

feelings in this matter. Timing of disclosure was normally carefully considered.

When the student was first diagnosed may also play some part in the decision­ making process, although the evidence for this is less clear. A diagnosis as a child meant that the individual had time to come to terms with their condition and

develope strategies for coping. Three of the seven students interviewed in stage one were diagnosed as children and all were very comfortable with the diagnosis. However, as with the students diagnosed while on the course they were selective in when and to whom they shared information about the diagnosis, Neary (1994) describes such behaviour as the games students play.