Accommodations in Health Education
Deaf professionals bring valuable skills, perspectives, and contributions to the healthcare field. To ensure their equal participation and effective communication, the Americans with Disabilities Act and Section 504 of the Rehabilitation Act mandate that reasonable accommodations be provided when requested. These protections grant deaf students the legal right to participate in healthcare education with accommodations.
There is no one-size-fits-all approach to meet the diverse needs of deaf students. Start with a conversation with each deaf student to ensure effective communication and access to the educational experience. Courts have ruled that the disability services office must prioritize the student’s subjective experience. Engaging in an interactive process with the deaf student, frequently checking in, and iteratively monitoring and evaluating the quality of services is the best way to ensure effective accommodations.
Key Points
There is no one-size-fits-all accommodation.
Accommodations may change from setting to setting (classroom versus operating room).
You are legally obligated to ensure effective communication.
Disability services may have to procure specialized equipment for deaf students.
Documentation is an important part of the process for determining reasonable accommodations, but you must equally consider the deaf student’s subjective experience.
Learn about the range of accommodations that may be a good fit for deaf students by visiting Accommodations 101. You may want to consider the following categories: service providers, equipment, media, telecommunications, and physical environment.
Service Providers: Interpreters, Captioners, and Note Takers
Many deaf students benefit from accommodations that involve service providers (e.g., sign language interpreters, captioners, and note takers). Service providers ensure that instructional material, classroom discussion, and the overall learning experience is accessible for deaf students.
Having a designated service provider, such as a designated interpreter, provides consistent and reliable access over longer periods of time is beneficial, especially for content that is more complex. In clinical learning settings, designated service providers can quickly understand each person’s role and relationship with the deaf student, enabling more effective service.
To learn more about service providers, explore our introduction pages: interpreting, speech-to-text services, and note taking.
Healthcare-Specific Considerations
- Service providers with advanced healthcare education training, experience, and credentialing are preferred.
- Service providers should be outfitted in personal protective equipment and trained in its use in clinical settings when appropriate.
- Education and clinical site administration should engage in conversations with service providers about how to optimally protect their health in ways similar to healthcare professionals, such as immunity screening and vaccinations.
- Use of an interpreter or captioner is not a HIPAA violation (for more information, see Health and Human Services FAQs).
Equipment: Assistive Technology and Virtual Connectivity
Deaf students use a range of assistive technologies and auxiliary aids, including assistive listening devices or specialized equipment. For example, there are stethoscopes specifically designed with deaf people in mind. Institutions are legally required to provide auxiliary aids for effective communication when requested.
Virtual learning and telehealth strategies have increased dramatically in recent years, where healthcare students may be in the virtual classroom or may be observing or participating in a clinical telehealth visit. Virtual connectivity can be leveraged to utilize remote services, such as providing speech-to-text services in the operating room, or providing note taking in the classroom. To learn more, explore our topic pages: Remote Services and Assistive Listening Systems.
Many video conferencing platforms offer automatically generated captions. While auto captions are an inconsistent and unreliable accommodation, some students may use auto captions as a supplement or a temporary solution for accessibility issues.
How is your bandwidth?
For more information, check out Minimum Standards for Video Remote Interpreting Services in Medical Settings.
Healthcare-Specific Considerations
- Masking can make speech reading difficult. Additional accommodations may be needed in certain contexts. Alternative options can include facemasks with transparent windows, many clinical sites provide these for deaf patients as well as deaf clinicians or learners.
- If you provide students with free stethoscopes, you are obligated to purchase an accessible one for the deaf student.
- For any assistive technology or accessible devices, allow time and space for students to try more than one to find one that works for them.
- It is common for institutions to provide devices that are used for accommodations (e.g., monitors to access captioning) – consider portable devices for deaf students to borrow.
- Many personal hearing devices include bluetooth technology. Institutions are responsible for providing access to their systems via bluetooth, which may involve purchasing an intermediary device.
Media
All video content must be accessible to deaf students by having captions or subtitles. If materials are not already captioned, institutions have a legal obligation to add captions. Auto captioning is not an equitable accommodation for instructional content. Errors increase when there is a lot of specialized and technical jargon. Institutions should explore how they provide professionally produced captioning on a short turnaround time.
Establishing caption media policies and procedures can help ensure deaf students have timely access to video content, while also facilitating ease of implementation for the school and providing transparency for current and future students about access procedures.
Pro-tip: Captioning is most effective when the text is placed near the speaker or directly next to the focal point of a demonstration. Deaf students report difficulty with attending to classroom content when captions are provided in a separate window or not connected to what is happening.
Telecommunications
Deaf people will need access to telecommunication systems and emergency clinical announcements (e.g., code blue or safety-related announcements) made over a hospital’s public address system. As examples, some institutions may already make this accessible via text messages, secure message systems, or more traditional pagers, and the deaf person can be added to those systems.
You may need to install specialized equipment such as a video phone that can connect to a sign language interpreter, or a telephone that can produce captions. Many common video conferencing platforms have accessibility features built in, but not every product works for every deaf person. For example, some platforms have poor video quality and do not allow you to pin the interpreter for better visibility. Provide time for experimenting to find out what works best for the deaf student and work with your information technology team to procure the right equipment and software. Learn more by reading Tip Sheet: Telecommunications & Video Relay Service.
Is using Video Relay Service a HIPAA violation?
No, confidential information is protected while using VRS and allowable according to federal regulations.
Deaf Students & Autonomy
Technical Standards & Accommodations
Active Involvement with DSS
Physical Environment
The physical environment can present several barriers for deaf people. Masking and poor acoustics can make it difficult for deaf students to participate fully in clinical and formal learning environments. Program leaders and deaf learners may need to proactively visit clinical sites, such as examination rooms, to anticipate how additional people (eg, interpreters or other service providers) will best fit in that space. Existing infrastructure may not have visual notifications for emergency alerts and public announcements. Performing a structural and acoustic audit may help mitigate some of these barriers. Read more about how one residency program engaged a variety of stakeholders and provided training to optimize their workspace for a deaf resident.
For additional questions or supporting deaf healthcare professionals and students contact [email protected].
