Un código sui generis

Professional experience indicates that academic teams assume that practice educators share their understanding of the ways that teaching and learning is approached and that assessment is carried out in a dialogic and agreed manner with students. This may not be the case, however, particularly if educators are constrained by the field in which they practice. Universities offer workshops for educators to provide opportunities for them to develop an understanding of teaching “beyond basic tacit pedagogical principles” (Kinchin et al 2008,273). Given the attention to a gatekeeping role, however, there was perhaps an inevitable focus on content and competence which may have been at odds with an appreciation of the student’s learning experience. Arguably, ideas of student-centred learning might have been problematic for participants particularly if they did not see themselves primarily as educators.

While participants’ accounts indicated acknowledgement of individual differences, there were many occasions when they identified a ‘norm’ in relation to what students should be able to do, falling outside of this led to perceptions of increased challenges. A need for resources was specifically mentioned, often relating to human cost: the effort that

educators had to expend, such as more time and more supervisory input being required for a disabled student, in comparison to other students. This is a complex story which may result in both students and educators having inconsistent experiences of the clinic as an educational field.

Participants felt they did not have the expertise regarding disabled students requiring specialist equipment or more extensive reasonable adjustments, wanting advice and guidance from the academic team. This perceived lack of knowledge and skills appeared to disempower the educators; they lacked control over the situation and could not support the student which they believed had a subsequent effect on the student experience. As noted in Chapter 4 given the pressures experienced by practice educators, the provision of effective support from universities is considered to be crucial (Tee and Cowen 2012). Participants anticipated high levels of assistance from academic teams but they all

described unsatisfactory experiences and issues in this regard, indicating lack of knowledge, awareness or willingness to help in cases of challenging situations with disabled students. It

150 appears therefore, that in this small sample the role of the university was found wanting in relation to both student and educator support. This mirrors the concerns noted by the Quality Assurance Agency (2007) regarding support sometimes being inadequate and the consensus that practice educators across a range of healthcare professions do not feel well prepared to take students (Kenyon and Peckover 2008; Walker and Grosjean 2011).

If assistance was provided by the university, this was usually a discussion between the participant and the academic team; the voices of disabled students were generally absent. Perhaps this approach disempowers the student given that both practice educator and academic have far greater levels of symbolic and cultural capital in the clinical education field. I noted one participant stating that academic staff do not know what it is like in the ‘real world’ perhaps indicating a difference in perceived habitus: that her cultural capital was higher than theirs in the clinical field, relating to back to ‘a sense of one’s place’ and the ‘sense of the place of others’ (Bourdieu 1989). This positioning may not be helpful in building a consistent approach to supporting disabled students.

In my professional experience working with many universities in the UK, academic

workshops offered to educators often allude to ‘challenging’ students. Issues relating to the support of disabled students are discussed under this heading, along with a range of other identified ‘categories’ of student. If not presented appropriately in the workshops this could accentuate or consolidate negative assumptions or expectations, with all disabled students presented as challenging. It would perhaps be more productive to think about all students arriving on placement with varying skills, knowledge and abilities which may translate into strengths or challenges. As noted by Cook et al (2012) provision of

adjustments should be part of a continuum of support for all students, not as a separate entity.

8.10 Summary

To conclude this section, while participants were committed to their role as educators and to supporting disabled students, there were elements of capital and habitus within the co- mingled clinical education field that generally reproduced practices, many of which were largely unquestioned (doxa), at least in a critical sense. High value was placed on their abilities to support and enable disabled students to be ‘the same’ and perform ‘as well’ as their non-disabled peers. Participants applied their tacit knowledge of the social order and did what needed to be done according to their own internalised logic about their roles as

151 educators and the positive outcomes of clinical education. If it was not possible to enable this ‘normal’ performance, issues arose about lack of support or lack of participants’ own knowledge, skills and expertise. Arguably these factors went some way to (re)producing the habitus of participants and the doxa of the clinical education field and perhaps the

physiotherapy profession itself in relation to disabled students and academic members of staff.

The way that disabled students were discussed and represented could be considered as worsening their social positionings and improving those of the educators. Being a ‘well adjusted’ disabled student with effective strategies in place could be viewed as a positive source of cultural capital by practice educators perhaps enabling these students to enhance their status in the clinical placement field. The converse would then be true for those disabled students seen as ‘challenging’.

When participants had experiences where initially a disabled student did poorly but then through disclosure, support and sometimes help from the university, successfully

completed the placement, negative capital was transformed into positive for the educator and to some degree, the student. It is perhaps useful to counter this to an extent by remembering that participants viewed the turnaround in students’ fortunes as a result of their hard work with little attention paid to students’ efforts, characterised by one participant’s comment: “Well done us!”

Disabled students who failed retained their negative status as not having adjusted to their impairments, not putting strategies in place and however hard educators worked, even with academic support, the perception often was that they could not be successful as a direct result of their disability. This type of hierarchical valuing of individuals because of presence/absence of impairment and perceived ability to ‘manage’ is a concept rarely addressed by physiotherapy educators.

It is useful here to remind ourselves of the concept that habitus is a reciprocal process in which individuals subconsciously embody and in part create the social structures of their world through everyday interaction in it (Smith 2014). Bourdieu (1990b,116) talked about habitus as a result of social conditioning and that it could develop “…in a direction that transforms it and, for instance, raises or lowers the levels of expectations and aspirations”. I aim, through this work to offer some opportunity to ‘defy the doxa’, to offer the invitation

152 to educators and disabled students to enter into dialogue and reflective activities that might begin the process of moving the habitus in a direction that could effect some transformation; to raise expectations and aspirations through a change in thinking and practice.

153