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 - Cont’d • 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 student’s 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 program’s requirements despite the disability • One who is able to meet all of a program’s 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 one’s 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 individual’s 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 College’s 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 institution’s 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. Cont’d • 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 student’s past criminal record • Crime may not be compatible with University’s goals or values, or • Prospective student failed to disclose – accurately or completely – information on the application

36. Off-Site Clinics and Internships • Student’s 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 – Cont’d • Derek Langhauser, Use of Criminal Convictions in College Admissions, 154 WELR 733 (2001). • ADA Title III Technical Assistance Manual athttp://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 Standardsat http://www.umassmed.edu//som/adm.