CASE REPORT Accommodations for a Student With a Physical Disability in a Professional Physical Therapist Education Program Nora J Francis, PT, DHS, OTR, Alice Salzman, PT, EdD, Dannee Polomsky, MA, CRC, and Eileen Huffman, PT, DPT, MS to apply for professional education programs. Background and Purpose. Since 1973, The student’s most significant impair- Often, applicants to professional physical the passage of federal laws and regula- ment was weakness in right ankle dorsi- therapist education programs have been tions has allowed increased access to ed- flexion, for which she wore an ankle foot introduced to the profession through expe- ucation and employment for individuals orthosis. Because of the spine stabiliza- riencing a personal injury. Therefore, such with disabilities. Although the number of tion surgeries, at the time of admission to programs must be prepared to address the graduate and professional students with a physical therapist program, the student needs of students with physical disabilities. disabilities has not been reported, fac- presented with functional limitations The purpose of this case report is to describe ulty in professional education programs in standing, sitting, lifting, and bend- the process used to determine reasonable ac- must be prepared to address the needs of ing. Accommodations were developed commodations and the modifications made students with disabilities. The purpose of that enabled her to participate in class- in a professional physical therapist education this case report is to describe the process room and clinical education activities. program to allow participation by a student used to determine reasonable accommo- Outcomes. The student successfully com- with a physical disability. We also describe dations and the modifications made in a pleted all required academic and clinical the challenges encountered and make rec- professional physical therapist education coursework. She is now employed in the ommendations for academic and clinical program to enable participation by a stu- outpatient physical therapy department faculty facing similar situations. dent with a physical disability. of an academic medical center where she Case Description. At the age of 17, the stu- works with patients with a wide variety of Literature Review dent in this case report sustained a Grade medical diagnoses. The Rehabilitation Act of 19732 (Rehab Act) V spondylolisthesis. She subsequently un- Discussion. The faculty faced many and the Americans With Disabilities Act3 of derwent 4 surgeries to stabilize her spine. challenges while determining and imple- 1990 (ADA) have increased opportunities for menting reasonable accommodations students with disabilities. According to Sec- that allowed the student to participate in tion 504 of the Rehab Act, students cannot Nora Francis is an assistant professor and and complete the physical therapist edu- be denied access to education at any entity assistant chair of clinical education, Depart- cation program. Many of the challenges ment of Physical Therapy and Human Move- that receives federal funding because of a arose because of physical therapists’ con- disability. The protections of the Rehab Act ment Sciences, Feinberg School of Medicine, cerns that an individual with impairments at Northwestern University, 645 North Michi- extend to programs offered jointly with enti- and functional limitations could not be- gan Avenue, Suite 1100, Chicago, IL 60611 ties outside the academic institution, such as come a physical therapist and practice ([email protected]). Address all cor- clinical education sites. Education programs safely. This report challenges physical respondence to Nora Francis. have the authority to establish technical stan- therapists to reconsider the requirements Alice Salzman is an assistant professor and dards, based on faculty expectations and pro- to become a capable practitioner. assistant chair of clinical education, Depart- gram philosophy, that students must be able ment of Physical Therapy and Human Move- Key Words: Essential functions, Techni- to complete during their professional educa- ment Sciences, Feinberg School of Medicine, cal standards, Student with disabilities, tion.2,4 A program’s technical standards can at Northwestern University, 645 North Michi- Physical therapy education, Physical dis- be used to determine whether a student with gan Avenue, Suite 1100, Chicago, IL 60611 abilities. ([email protected]). a disability possesses the abilities necessary to participate, and is therefore a qualified stu- Dannee Polomsky is the manager of services for dent with a disability. students with disabilities, Northwestern Univer- BACKGROUND AND PURPOSE sity, Abbott Hall, Room 727, 710 North Lake The ADA allows qualified applicants Shore Drive, Chicago, IL 60611 (d-polomsky@ Since 1973, the passage of federal laws and with disabilities to apply for admission to northwestern.edu). regulations has increased access to higher education programs.3 To determine wheth- Eileen Huffman is a senior physical therapist education and employment for individuals er an individual is qualified to enter a pro- at Loyola University Medical Center, Loyola with disabilities. In 2000,1 over 66,000 college fessional education program, an admission Rehabilitation Services–Maywood, 1219 freshmen reported having learning, sensory, committee can compare the applicant’s West Roosevelt Road, Maywood, IL 60153 or physical disabilities, and in the following abilities with the program’s admission stan- ([email protected]). year, 57% of undergraduates indicated that dards, which can be academic or technical The Institutional Review Board at Northwestern they were attending college to prepare for in nature. A student who does not meet ad- University approved this case report. graduate or professional school. Although mission criteria can be denied entry. Once Received September 28, 2006, and accepted the number of graduate and professional stu- a student is admitted, the ADA requires January 16, 2007. dents with disabilities has not been reported, that “reasonable accommodation should faculty can expect students with disabilities be made to allow a qualified disabled per- 60 Journal of Physical Therapy Education Vol 21, No 2, Fall 2007 son to achieve the essential functions of the the ability to make decisions based on clini- physical disabilities in classroom and clini- job.”5 Essential functions define the abili- cal judgment and the ability to judge one’s cal settings. Approval for this case report was ties required to participate in and complete limitations. received from the Institutional Review Board a program in a manner that does not com- Academic program faculty can define at Northwestern University and the student promise others’ safety;4 the nature of the job specific essential functions related to the gave informed consent for this report to be must change if the essential functions are program’s philosophy. The objective of the written. Throughout the report, the student removed.5 Essential functions for a profes- program in this case report was to “produce is referred to by the pseudonym, Mary. sional education program can be defined physical therapists who can respond to based on faculty expectations, program phi- complex patient/client needs quickly, sci- CASE DESCRIPTION losophy, and educational setting. Techni- entifically and independently.”10 (p 2) Admit- cal standards or essential functions may be ted students needed to demonstrate, with Student and Physical Therapist described in physical therapist education or without reasonable accommodation, the Program Description program mission statements, student hand- ability to practice in a manner that ensured At the age of 17, Mary sustained a Grade V books, admission materials, or in course the safety of the patient/client, self, and spondylolisthesis. Approximately 3 years after syllabi. If an admitted student cannot meet others.10 Because program graduates were the initial injury, pain and spinal instability the essential functions or components of a expected to meet the needs of clients in all led to 2 surgeries to complete a spinal fusion program with or without reasonable accom- areas of physical therapy, students were re- with rods and pedicle screws placement. Af- modations, a program may determine that quired to complete full-time clinical educa- ter a period of rehabilitation, Mary required student to be unqualified for participation. tion experiences in diverse clinical settings a manual wheelchair and bilateral forearm Academic institutions can determine the and to work with patients/clients with a vari- crutches for ambulation, due to lower ex- manner in which reasonable accommoda- ety of medical problems. While the concept tremity and trunk weakness. Because she was tions are provided to qualified students with of preparing graduates to enter any area of interested in becoming a physical therapist, disabilities. Acceptable program modifica- practice has not been debated in the physi- she volunteered at a physical therapy clinic tions might include changes in the courses cal therapist education literature, it has been and began to research physical therapist edu- required for a degree or adaptation in the discussed in the literature on medical edu- cation programs. One year-and-a-half after requirements for completion of a specific cation. A 1979 report8 to the Association of the first spinal surgeries, Mary was diagnosed course.6 Programs are not expected to make American Medical Colleges