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Clinical Competency:

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Title: Clinical Competency:


1
Clinical Competency
  • Academic and Technical Standards Of A Program

2
Academic and Technical Standards
  • A program can set academic and technical
    standards for its students

3
Example Academic Standard
  • Earn at least 84 semester hours of credit while
  • Maintaining a cumulative average of C or 70

4
Example Technical Standard
  • Independently, observe the patient/client
    accurately
  • Integrate all information received by whatever
    senses employed

5
What Is A Technical Standard?
  • All nonacademic admissions criteria
  • Must be met by student
  • To enable student to participate in and
    successfully complete the chosen program
  • Including behavioral, professional and
    intellectual standards

6
Purpose Of Technical Standards
  • Assist the professional school in selecting
    retaining and graduating those applicants and
    students best qualified to complete the required
    training

7
Authorization For Technical Standards
  • Title II of the ADA and Section 504 of the
    Rehabilitation Act
  • Must be reasonable
  • Based on legitimate educational goals of the
    program
  • Must be clearly identified in the student
    handbook, field manuals, institutional catalogs,
    and/or program brochures

8
Notification
  • Student must have reasonable notice
  • Standards must be in writing
  • Brochures
  • Admissions application
  • Affidavit

9
Continual Monitoring
  • Performance must be continually monitored from
    entrance to graduation
  • Progress reports, written evaluations
  • Prevents unqualified students from making it to
    graduation and then being told at the last minute
    they may not graduate

10
Criteria for Decisions
  • Subjective grading should be a rational exercise
    of discretion
  • Students must have access and be made aware of
    the criteria for making such decisions

11
Following the Standards
  • Include the consequences for inadequate
    performance and removal procedures
  • Immediate notification by University of
    deficiencies in performance and possibility of
    failure or expulsion
  • Give opportunity to remedy deficient areas

12
Follow the Procedures
  • Decisions made in good faith, not arbitrarily or
    capriciously
  • The University must follow its procedures once a
    decision for unsatisfactory performance has been
    made
  • Students should be entitled to a hearing prior to
    dismissal

13
Example of Procedure
  • Purpose and scope of rules
  • Responsibilities and rights
  • Composition of the council
  • Violations of the rules

14
Example of Procedure - Contd
  • Procedures
  • Sanctions
  • Appeals
  • Honor/professional ethics education
  • Amendments

15
Example
  • Continuing student in a clinical program
  • Monitor progress reports and written evaluations
  • If at any time the students conduct or behavior
    is deemed to endanger the health and safety of
    that individual or others, notify the student
    immediately
  • Follow procedures for reevaluation or removal if
    necessary

16
Disabilities
  • University should make every reasonable effort to
    allow otherwise qualified persons with
    disabilities to engage in their programs
  • Including making reasonable accommodations in
    response to a request by an individual with a
    disability

17
Otherwise Qualified
  • Otherwise qualified
  • Can the disabled person satisfy the programs
    requirements despite the disability
  • One who is able to meet all of a programs
    requirements in spite of the disability

18
What Is A Disability
  • The mental or physical condition must
    substantially limit a major life activity,
  • The person has a record of such an impairment, or
  • The person is regarded as having such an
    impairment

19
What Is A Major Life Activity
  • Caring for ones self, performing manual tasks,
    walking, seeing, hearing, speaking, breathing,
    learning, and working
  • Important life activities are restricted as to
    the conditions, manner, or duration under which
    they can be performed in comparison to most
    people

20
Types Of Claims
  • ADA and Section 504
  • Contract claims
  • Negligence

21
University of Missouri v. Horowitz
  • Medical student was evaluated according to
    procedure during final year
  • Failed evaluation due to poor performance on a
    rotation
  • Council voted to dismiss the student

22
Holding
  • A subjective, expert evaluation is required to
    determine whether an individuals performance
    satisfies a predetermined set of standards
  • That standard is set by a similar academic
    judgment
  • This type of judgment is no less academic even
    though it measures actual conditions of practice
    rather than a grade for written answers

23
Southeastern Community College v. Davis
  • Davis applied to the Colleges nursing program
  • Serious hearing disability
  • Refused to admit because the College determined
    that her hearing disability would interfere with
    her safely caring for patients

24
Holding
  • Section 504 does not limit an educational
    institutions requirement that a prospective
    student must meet reasonable physical
    qualifications for admissions into a clinical
    training program
  • Not required to lower or substantially alter its
    standards in order to accommodate a disabled
    person

25
Anderson v. University of Wisconsin, et al
  • Law student dismissed due to poor academic
    performance caused by alcoholism
  • Student did not maintain sufficient average as
    required by the law school
  • Threatened fellow student while drunk

26
Holding
  • Can consider academic performance and sobriety
    when deciding whether an applicant is entitled to
    an education
  • Student with below the required average is not
    qualified to stay UNLESS he can show that the
    source of the academic problem has been abated

27
Professor Liability
  • Generally, as long as the professor was acting
    within the scope of their authority, there should
    not be individual liability

28
Developing The Standards
  • Should be defined as the essential functions that
    the student must demonstrate in order to fulfill
    the requirements of a program
  • They are pre-requisites for entrance,
    continuation, promotion, retention, and
    graduation from the University

29
Contd
  • Connect technical standards with the licensing
    requirements necessary for a profession

30
General Categories
  • Observation
  • Communication
  • Sensory and motor function
  • Intellectual, conceptual, integrative and
    quantitative abilities, and
  • Behavioral and social

31
Necessity
  • Explain why the requirement is necessary

32
Purpose
  • Each student must successfully fulfill the
    prerequisites for admissions, continuation and
    graduation from the program

33
ADA
  • Include a statement concerning the ADA

34
Procedure For Notification and Review
  • The materials distributed to prospective students
    should include academic and technical standards
    for notification purposes
  • Clearly define suspension and dismissal
    procedures
  • Clearly define appeal procedure
  • Strictly follow

35
Criminal Background
  • Courts generally hold that a University may deny
    or revoke admissions because of a prospective
    students past criminal record
  • Crime may not be compatible with Universitys
    goals or values, or
  • Prospective student failed to disclose
    accurately or completely information on the
    application

36
Off-Site Clinics and Internships
  • Students skills and abilities
  • Specific needs in the clinical setting
  • Goals and purposes of the program
  • Potential impact of the requested accommodation
    on the program AND on the quality of education
    the student would receive
  • Availability of alternatives

37
Monitor the Site
  • Imperative for the University to be familiar with
    the site and monitor the off-site program
  • Ensures the student is receiving a meaningful
    opportunity to participate in the program
  • Safety of site itself

38
Summary
  • Notification and awareness
  • Clarity of standard
  • Monitor consistently
  • Strict application of any procedure in place

39
Sources
  • Anderson v. University of Wisconsin, et al., 841
    F.2d 737 (1988).
  • Board of Curators of The University of Missouri
    et al. v. Horowitz, 435 U.S. 78 (1978).
  • Southeastern Community College v. Davis, 442 U.S.
    397 (1979).
  • St. Thomas University, 23 NDLR (LRP) 160 (2001).

40
Sources Contd
  • Derek Langhauser, Use of Criminal Convictions in
    College Admissions, 154 WELR 733 (2001).
  • ADA Title III Technical Assistance Manual at
    http//www.usdoj.gov/crt/ada/taman3.html.
  • SYNFAX WEEKLY REPORT, Week of April 20, Insuring
    Clinical Competency (1998).
  • Patty Gibbs, Gatekeeping in Social Work
    Education, BPD GATEKEEPING WORKSHOP, (October,
    1998).
  • University of Massachusetts Medical School
    Technical Standards at http//www.umassmed.edu//so
    m/adm.
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