Reconsidering inherent requirements: a contribution to the debate from the clinical placement experience of a physiotherapy student with vision impairment

Kylie N. Johnston, Shylie Mackintosh, Matthew Alcock, Amy Conlon-Leard, Stephen Manson

Clinical placements in acute hospitals present challenges for students with vision impairment who are being educated as health care professionals. Legislation in Australia supports reasonable adjustments to education, thus students with vision impairment have completed accredited courses and gained professional registration. However the implementation of inherent requirement statements suggesting that adequate visual acuity is required to complete a physiotherapy program may create barriers to access for such students. We describe features that contributed to a successful physiotherapy clinical placement in an acute hospital setting for a student with vision impairment and use this experience to prompt debate about the use of inherent requirement statements. Planning, consultation, collaboration and problem solving commencing from the time of program entry were integral to clinical placement preparation for this student. Individualised adjustments (including a support worker for reading screens and medical records) and the student's specific qualities (professionalism, communication, problem solving, memory, kinaesthetic abilities) contributed to a successful outcome. Reflecting on this experience and published inherent requirements, there is an apparent lack of involvement of people with disability in the development of inherent requirement statements; we question the need for this level of regulation; and discuss the potential impact of inherent requirement statements on the health workforce. This experience demonstrated that an individualised approach to reasonable adjustments for a student with a disability was successful in an acute hospital setting. The implementation of inherent requirement statements may systemically reduce the capacity of education providers to develop such bespoke solutions and deserves further debate.