Exploring the learning experiences of visually impaired physiotherapy students

Many years ago, as a new and very novice academic I was asked to be personal tutor to a new 1st year physiotherapy student. I agreed, and in passing, heard that he was visually impaired and that because I was nice, I would be a good tutor for him! And that’s where it all started.

Fast forward to today. My entire academic career was changed by meeting this one student. Through worry, lack of knowledge, zero confidence and lack of any skills that I could actually support this student, I learnt so much. I had to ask a lot of questions, ask for lots of support and think creatively and differently about how I could make my classes accessible for him. In retrospect, I was really just using all the skills I’d learnt as a physiotherapist, making assessments, identifying challenges and putting in plans to address them. I encountered barriers and enablers, and had to face many misconceptions, and bias and even discrimination from my colleagues and peers, mainly from ignorance. And that was just me. The lecturer. Imagine how it felt for the student?

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Dr Helen Frank

That one student experience made a huge impact on the way I taught, practiced, communicated and ultimately how I researched. My research as a doctoral student at VICTAR explored the learning experiences of visually impaired physiotherapy students. I learnt an incredible amount about visual impairment and education through my own experience. That very first student showed me that it was ok not to know anything, especially when he politely told me that asking him how much he could see wasn’t very useful. But we worked together, and learnt by asking for support, and exploring and trying out new things in class. And over time we got there, he qualified and is a practicing physiotherapist now. This experience was the start of my need to find out how it really was for visually impaired students learning a profession that had been accessible for visually impaired people for decades, and had a long history of success.

My research used a case study approach and I focused my exploration on the barriers and enablers in learning physiotherapy, both in the university and in the practice setting. My study was nationwide and overall, I interviewed 7 student physiotherapists with varying degrees of visual impairment. Their experiences varied, and there were many examples of really positive, student centered and holistic support. Physiotherapy educators were enthusiastic and motivated to offer proactive support, and to find solutions where challenges arose. They worked closely with the students to ensure they met the requirements of the profession. But there were also some very negative and challenging experiences, where students faced discrimination and difficulties learning their professions. As a physiotherapist, this saddened me. Physiotherapists are caring professionals who work closely with patients to problem solve, to maximise independence and function. It still puzzles me why the same principles were not universally applied to the visually impaired student physiotherapists in my study. The final chapter of my thesis allowed me to consider this and think about why this may be and this will be the focus of a paper in due course. However, I am confident that my being a physiotherapist, as well as a lecturer, was what enabled me to work collaboratively and successfully with students.

In the 10 years I was at that same institution I taught and supported six visually impaired physiotherapy students. I often hear how educators make huge impressions on their students, but I wonder if they know the impact they have made on me?

Helen Frank, Course Leader BSc (Hons) Physiotherapy, University of Worcester

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Engaging with the sector – ESRC Festival of Social Science

On 10th November VICTAR and VIEW collaborated to host a workshop entitled ‘Supporting young people with vision impairment through post-16 transition’. This event was arranged as part of the ESRC Festival of Social Science.

Various professionals who have contributed to the Longitudinal Transitions Study and provided teaching support for the MQ programme were invited to attend the event, which was held at Impact Hub Birmingham. The purpose of the event was to present our findings from the ongoing longitudinal study and to discuss the appropriate response of the sector to these findings.

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The event was chaired by VICTAR co-director, Mike McLinden.

The afternoon commenced with a presentation from Graeme Douglas and Rachel Hewett (VICTAR) and Sue Keil (VIEW) who discussed some of the key findings from both the Longitudinal Transition Study and a RNIB Freedom of Information Request of Local Authority specialist services. The presentation focused on the role of specialist services in preparing young people with vision impairment for adulthood, whilst acknowledging the conflicting pressures which local authorities face due to a narrowing of the curriculum and budget constraints.

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Sue Keil presenting findings from the RNIB Freedom of Information request

The second presentation came from Kay Wrench who reflected back on her thirty years’ experience working as a qualified teacher of children and young people with vision impairment (QTVI). She emphasised the importance of QTVIs using their time resource wisely, such as equipping schools to produce materials in alternative formats to allow the QTVI to focus on working with children and young people with vision impairment to develop important skills such as self-advocacy, mobility and assistive technology skills.

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Kay Wrench

Lucy Dixon from RNIB followed by sharing information about a sector wide campaign which is set to highlight dwindling specialist support services for children and young people with vision impairment, and to expose the negative impact that this has on young people with vision impairment being able to fulfill their potential and to live and work independently when adults. Further information about this campaign can be found on the RNIB website.

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Lucy Dixon

The second half of the afternoon allowed opportunity for discussion in small groups and for delegates to provide their thoughts and reflections on the issues raised. Those who attended contributed enthusiastically, drawing upon their wealth of experience working in both educational and voluntary sectors.

The afternoon was concluded by Rory Cobb from VIEW who drew together the main points of these discussions. The outcomes of these will be summarised and shared on the VIEW website for consideration by other QTVIs, and will also guide important discussions between VICTAR, VIEW and members of the steering group for the longitudinal transitions study over the coming months and years.

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We would like to thank ESRC for providing funding to support this event, Impact Hub Birmingham for hosting the event and the delegates who engaged with the workshop with such enthusiasm.

Rachel Hewett

Thank you to Rory Cobb and Sue Keil

On Friday the 20th October 2017 Rory and Sue both retired from RNIB – combined, they had contributed over 50 years of work to RNIB and the field of vison impairment education.  They have done this with great skill, openness, friendliness, good humour and passion. Thank you both, and very best wishes for a happy and healthy retirement!

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Sue and Rory at their retirement celebration

I met Rory in 1994 when I first started working in the field – he advised us on a technology development project and was typically thoughtful and helpful. In the 2000s we worked more closely together on his MPhil – in which he researched assessment access. This was part of his sustained and successful efforts to gain fair access to public examinations for students with vision impairment.  We struck up a friendship and through those discussions lay some of the seeds of our theoretical thinking about vision impairment education: balancing social adjustments (inclusive practice) on one hand and developing children’s agency and independence on the other. As a programme and regional tutor, Rory has offered wonderful support to the Mandatory Qualification for Teachers of Children and Young People with Vision Impairments. In fact Rory’s development work on the programme has helped align it to new and changing government policies while maintaining a theoretical integrity with young people’s interests at its core.

I met Sue in the late 1990s, initially as a researcher and author on the influential RNIB Shaping the Future survey work which gathered the views of a large cohort of young people across the UK. At the same time Sue was a key RNIB contact for much of VICTARs research work, initially the ‘Steps to Independence‘ project (which has links to the emergence of the habitation specialist as a key professional in our field). Sue is a brilliant advocate for research as a vehicle to bring about positive change and to challenge inequality – this is both as a ‘user of research’ through exemplary briefing documents, and also as a ‘producer of research’. For example, Sue’s ‘state of the nation’ reports based on survey work with local authorities continue to be hugely important. More recently she has worked on significant research projects at both ends of the educational age range – the Great Ormond Street Hospital/UCL OPTIMUM project concerned with early development in blind or partially sighted infants, and the VICTAR Longitudinal Transitions Project concerned with Post-16 transition experiences.

We all work in a relatively small field, and as such we rely on collaboration and friendships. VICTAR and field generally have benefited greatly from Rory and Sue as individuals, but in recent years we have gained even more from them as a brilliant team.  Their complementary areas of expertise are amazing and have helped us glue together important strands of research and teacher training in the field of vision impairment education. This is also enhanced by a quality they share – both are superb spoken and written communicators. This has been clearly illustrated through their contributions to writing in our field.

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Sue and Rory and other members of the Longitudinal Transition Study steering group

Good luck next stage of your lives – I’m sure that will involve some continued working together here at the University and through your planned work with VIEW. I hope it will also involve some well-earned time to relax!

With very best wishes and thanks from all at the University of Birmingham.

Graeme Douglas

A new academic year commences for our MQ programme – 1-3 September 2017

The start of September is always a busy time here in VICTAR as it marks the start of the academic year for our MQ programme (Mandatory Qualification for Teachers of Children and Young People with Vision Impairments). Over 100 students and a range of speakers and presenters joined us at the university across three days .

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There are approximately 50 trainees across two year groups undertaking  the two year qualification. The majority of those registered on the programme work in either local authority sensory support services, mainstream settings or in special schools and are seeking to obtain the MQ which allows them to become a Qualified Teacher of Children and Young People with Vision Impairment (QTVI).

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For those in Year 1 the Friday provided an opportunity to get to know other students, to learn about the content and structure of the course and to learn more about the field of visual impairment. This included visiting stands run by Guide Dogs Children and Young People’s Services, Positive Eye, VIEW, and researchers in VICTAR. The first day also provided plenty of opportunities for the trainees to learn together as they took part in small group activities.

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During the Saturday and Sunday, both cohorts heard from a broad range of speakers, including: local authority heads of service; educational psychologists; educational consultants; mobility officers; braille tutors; assistive technology consultants; optometrists; representatives from the voluntary sector; and academics in the field of vision impairment. The Year 1 cohort also had the opportunity to hear two presenters’ give their personal reflections on vision impairment – a part of the programme which our trainees often identify as being particularly enlightening.

As the majority of the teaching is delivered through online delivery, an important aspect of the course design is the use of regional groups. These are run by regional tutors who offer support and guidance throughout the programme. On the Saturday the Year 1 cohort had the opportunity to meet with their provisional regional tutors, and find out about the tutorial system.

We hope that the attendees had a positive experience, and we look forward to welcoming them back in April! If you are interested in training to become a QTVI, you can find out more about the course on the University of Birmingham website.

Reflections on my practice

This month’s blog comes from Josie Hervey who is studying at Visual Impairment Centre for Teaching and Research for the Mandatory Qualification for Teachers of Children with Visual Impairments.

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Josie Hervey

As part of the course, Josie conducted a short piece of research in which she asked young adults with visual impairment to reflect back on their experience in education, by asking four key questions:

  • What was helpful?
  • What wasn’t helpful?
  • What do you wish your teachers had known?
  • What do you wish you had known?

The conversations that resulted led to Josie reflecting on her own practice as a specialist teacher working with young people with visual impairment.

“We know how important it is to listen to young people, and that ignoring their voices can lead to a whole range of negative outcomes. They are the experts when it comes to their own vision, and must take centre stage in their own lives. At the same time, though, young people don’t always have the understanding to make informed decisions about their needs, because their life experience is limited. This means that their views may be only one of several factors we take into consideration when planning provision, and this can lead to tension.

Equally, sighted school teachers (like me) are not always as well-equipped to make decisions about provision as we would like to be. In the rush of the school day, long-term aims can get lost; and we may have almost no real idea what life is like for an adult with VI in further education or in the workplace.

Within the framework of the research unit on the QTVI course I was able to talk to adults with VIs about their time at school and to collect first-hand insights which could be valuable for young people and their teachers. I asked them what had gone well for them at school, what had not gone well, and what advice they would give to schools and to young people. As I expected, they had a unique perspective on provision for young people – being able to combine their personal experiences with broader life experience, and to place their school education in a wider context.

The interviews helped me rethink some of my priorities and assumptions. I learned how common it is for adults to look back and wish they had worked more on mobility and independent life skills while at school. The importance of learning self-advocacy came through clearly, as did the need to improve the balance between academic lessons and social/emotional skills. I also realised how important it is to ensure that young people are able to use a wide range of different skills, strategies and technologies so they can pick and choose when they find themselves in new situations. I wished that my students were there to hear the adults’ reflections, opinions and advice for themselves.”

This research has led to Josie collaborating with Rachel Hewett and staff from RNIB to develop a series of videos which can be used by professionals working with young people with visual impairment.

“Our video series is designed for use with school pupils and their teachers as part of the Transitions project. We want to create a resource to help decision-making about provision become a more genuine dialogue between young people and their teachers – and to help make school a better preparation for transition to the wider world.

The video resource aims to bring the insights of adults with VIs to a wider audience, including young people and their teachers. The videos will show young people with VIs in conversation with adults about their school days and the skills they are using now. We hope that teachers can improve their practice in the light of these narratives – and that young people can gain a wider perspective so that when we listen to their voices, they are better informed about what their needs and wishes are likely to be once they leave the familiar world of the classroom.”

These videos are being co-funded by VIEW, RNIB and University of Birmingham and form part of our dissemination for the Longitudinal Transitions Study.

Josie Hervey and Rachel Hewett

 

New blogs!

Two of our projects have been featured in external blogs.

Elena Schmidt from Sightsavers has written for the Impact Initiative about our ongoing collaborative work in Malawi. You can find this on The Impact Initiative website. 

Rachel Hewett has written about some of our dissemination activities in relation to the Longitudinal Transitions Study for University of Birmingham’s Think:Research publication.

Higher education: challenging the stereotype

For the past couple of days I have noticed quite a few of my friends have shared on social media the story of a young man with a severe visual impairment who came to the UK as a refugee and moved into a council estate.

When thinking about these key demographics, you could definitely say that the odds have been stacked against him in life, but despite this he has just graduated from University of Cambridge with a First Class Law degree.

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Students celebrating their graduation

What has struck me is that when reporting this story, the media have focused so heavily on his visual impairment, even in the context of the other barriers that he has faced in life. This has led me to consider how many of the young people that I have been working with would respond to this message. Undoubtedly they would recognise the young man’s achievement, as they would for any other student. However, at the same time I know they would be frustrated at the perceptions being highlighted by the media reaction; that is so ‘extraordinary’ for a person with visual impairment to perform so highly.

As part of my research for the Longitudinal Transitions Study I have followed the experiences of almost 40 young people with visual impairment during higher education (HE). It is true to say that many of the young people have experienced considerable challenges in accessing their courses and university life in general. However it is important to note that in many cases these challenges should already have been overcome through HE institutions offering an inclusive learning experience.

HE institutions are required by the Equality Act to make ‘reasonable adjustments’ for disabled students to ensure that they are not at a disadvantage in comparison to their non-disabled peers. Importantly these adjustments should be ‘anticipatory’, thus requiring institutions to plan in advance to remove barriers, and not simply in response to challenges faced by a particular student. For example, in the case of a student with visual impairment often anticipatory adjustments can be as simple as ensuring that lecture notes are made available in advance of lectures in a format that is compatible with their assistive technology. Alternatively it may involve the institution making timetables available in advance which can enable a student with visual impairment to be taught routes to get to lectures independently and for reading lists to be provided in sufficient time to request accessible copies of textbooks.

Of course there are cases where the barriers faced can be more complex, such as the need to put in place adjustments to ensure that a student can take part in practical sessions or be able to use a particular piece of software. However, the experiences of the young people taking part in the Longitudinal Transitions Study testify that, providing the institution and student work together, such barriers can be overcome.

Lastly, and as we often remark in the Inclusive Curriculum Committee that I sit on, inclusive practice benefits the student population as a whole! Providing lecture notes in advance of lectures gives all students the option of reviewing slides before lectures and having copies of notes in front of them. Lecture capture means that all students can go back and revisit lectures while they prepare for their exam. Whilst well-structured virtual learning environments mean that all students can navigate online content more smoothly to identify the information that they need.

If you would like to know more about the experiences of our participants in higher education, please check out our summary report. Alternatively if you are a student with visual impairment preparing to go into higher education, you may be interested in these resources we developed with RNIB.

Rachel Hewett