When practitioners become educators: identity, and perceptions of students who struggle

1. When practitioners becomeeducators: identity, and perceptions ofstudents who struggle CAAHP Annual Conference 08 May 2019 Dr. Christine Griffith EdD

2. A little background, and questions for reflection… • About me…my observations of my faculty, and an admission of my bias • About you… • were you a health practitioner or educator before assuming your leadership role? • What about their students do your faculty struggle most with?

3. Our reality • We will see a continuing rise in the number of students in our programs who require accommodations • We will continue to recruit our faculty from the ranks of expert health practitioners • We will need to better understand how the transition of these faculty affects their ability to support those students, and how we can help

4. There was an imposter period where I went from being a clinician to an educator, and then there was a point in the middle when I didn’t feel I was either. No one brought it to my attention that you are going to feel that way; no one talked about it. It would have been nice to know it’s normal. I was in that transition period for almost 10 years. RRT educator (Griffith, 2018) The transition to full-time teaching was the most difficult thing I’ve ever had to do. RRT and MRT educators (Griffith, 2018)

5. After I left clinical practice I realized what I was leaving behind. It really bothered me as time passed. I had to get my head around the fact I was no longer a respiratory therapist clinician but a respiratory therapist educator. That took a number of years. RRT educator (Griffith, 2018) “When I taught part-time I was in labs and felt confident, but when I got full-time I had classroom lectures. I felt so out of my depth.” MRT educator (Griffith, 2018)

6. Are these sentiments common among health faculty? • “I was no longer sure what I was; it left me feeling that I was sort of a nurse, but not quite in the same way as before.” (Duffy, 2013, nurses, UK) • “I felt competent as a therapist; I expected this competence to carry over into the classroom but I had no idea what really was required of a teacher in our college.” (Crist, 2009, OT’s, USA) • “If I could only use one word to describe my move from clinician to nurse educator, it would be fear. I had no idea what a full-time educator’s role was.” (Cangelosi, 2009, nurses, USA)

7. We may title them educators, but how do these faculty see themselves? (Griffith,2018) • “Our (health) profession is our grassroots. That’s where we come from. Am I an RRT or an educator? I’m an RRT first!” (RRT; 28 years FT teaching) • “I wouldn’t even know how to take off my (RRT) hat to be just an educator or professor. How can you ask that of us?”. (RRT; 15 years FT teaching) • “I still feel I am a working technologist as opposed to an educator”. (MRT; 5 years FT teaching) • “Technically I’m a teacher, but if asked what I am I introduce myself as a respiratory therapist. I’ll always see myself as the clinician at the bedside”. (RRT; 4 years FT teaching)

8. And again, is this feeling shared? • “I don’t see myself as an academic, because an academic is driven by academic writing, by thinking their way around work and systems”. (Duffy, 2013, nurses, UK) • “I still see myself as an advanced practice nurse, the clinician...I still see myself in that role and haven’t been able to make the change”. (Anderson, 2009, nurses, USA) • “I’ve been a physiotherapist for 20 years; I always say I’m a physiotherapist first, then that I teach. I don’t know if this will ever change”. (Hurst, 2010, PT’s, UK)

9. What does this mean for their decision making and support for accommodated students? • They may perceive a conflict exists between their responsibilities as health professionals versus as educators • They may not know how to reconcile this • They may draw overwhelmingly on their health professional ‘lens’ to guide their approaches and decisions • The best solutions and support for these students may evade them

10. Their concerns about how to be a good health professional AND a good educator are very personal • “Our duty to protect doesn’t end when we become educators”. • “How can someone expect me not to think about what kind of practitioner they’ll be?” • “How do we accommodate students who need more time to think about what to do when a patient can’t breathe?” • “We have no choice but to accommodate but the clinical environment is not that kind and generous. It’s less forgiving, and so it should be!” (all from Griffith, 2018)

11. This same inner conflict, as reported by nursing* educators… • “How could these students provide safe care?” • “How disabled is too disabled to be a nurse?” • “How do we balance the student’s right to education with maintenance of patient safety?” (Ashcroft et al,2008, Canada) • Nursing faculty were deeply concerned about nursing students with disabilities providing unsafe care while students and after graduation. (Carroll,2004, USA; Swenson et al,1991, USA; Sowers et al,2004,USA)

12. What have allied health faculty reported helps them? (the literature and my research) • With their transition from practitioner to educator • most important (!!!) is peer mentoring, extended beyond one year • proactive conversations about their dual identities, focusing on perspectives, ie ‘pedagogical versus professional’ understanding • orientation activities that focus on their ‘uniqueness’ (customized sessions) • With their management of students with accommodations • early initiation of relationships with counselling and accessibility staff • support with designing curriculum content and assessments

13. What can we do as their journey into education begins? • explore the possibility of extending peer mentoring support beyond the first year of teaching • identify peer mentors with specific experience withclinical practicums for accommodated students • identify onboarding and PD activities that augment their lack of formal preparation and/or experience in education • begin guided conversations about the challenges commonly faced by practitioners when transitioning • ensure connections with counselling and accessibility staff are initiated early, so that relationships can develop

14. Principles to help guide you… (*Ashcroft et al) To shift their perspectives, faculty need to know about: • legal requirments, professional obligations, and organizational policies related to students with disabilities (eg admissions, accommodations) • how the internal processes for approving and implementing accommodations are managed • effective learning strategies and evaluation approaches for students with disabilities and accommodations (best practices, universal design) • management of accommodations in clinical settings (collaboration with counsellors and practicum supervisors)

15. And as their journey into education continues • Acknowledge their challenges, and demonstrate your intent to help them reach a balanced coexistence of their dual health and educator identities • Be their advocate and intermediary in explaining their dual sets of obligations to those who may not understand them (think of admissions officers, ombuds, counsellors, OD&L) • Create a safe environment that actively promotes and supports open dialogue

16. Concluding thoughts • Our allied health faculty may have been experts in their clinical settings, but they are novices in the educational milieu • They want educational leaders to view their dual identities as advantages, not impediments • They are committed to supporting students with challenges • They will need time and support to evolve into educators

17. References • Anderson, J.K. (2009). The work-role transition of expert clinician to novice academic educator. Journal of Nursing Education 48.4 (April), 203-8. • Ashcroft, T.J., Chernomas, W.M., Davis, P.L., Dean, R.A.K., Seguire, M., Shapiro, C.R. & Swiderski, L.M. (2008). Nursing students with disabilities: One faculty’s journey. International Journal of Nursing Education Scholarship, 5(1), Article 18 (4). From novice to expert: Excellence and power in clinical nursing practice. Mento Park; CA: Addison-Wesley. • Cangelosi, P., Crocker, S. &Sorrell, J.M. (2009). Expert to novice: Clinicians learning new roles as clinical nurse educators. Nursing Education Perspectives, 30(6), 367-71. • Carroll, S.M. (2004). Inclusion of people with physical disabilities in nursing education. Journal of Nursing Education, May 43(5); 207-212. • Crist, P. (1999). Career transition from clinician to academician: Responsibilities and Reflections. American Journal of Occupational Therapy, 53, 14-19.

18. References, continued • Duffy, R. (2013). Nurse to educator? Academic roles and the formation of personal academic identities. Nurse Education Today, 33: 620-624. • Griffith, C. (2018). A study of respiratory therapy and medical radiation technology faculty who transitioned from clinical practice into academia: their transition experiences, and perceptions of students with disabilities. (Doctoral dissertation). University of Western Ontario, London, ON, Canada. • Hurst, K.M. (2010). Experiences of new physiotherapy lecturers making the shift from clinical practice into academia. Physiotherapy, 96: 240-247. • Sowers, J. & Smith, M.R. (2004). Nursing faculty members’ perceptions, knowledge and concerns about students with disabilities. Journal of Nursing Education, May, 43(5): 213-218. • Swenson, I., Havens, B.B. & Champagne, M. (1991). Responses of schools of nursing to physically, mentally and substance-impaired students. Journal of Nursing Education, 30(7): 320-325.

19. Thank you!