Sara in Medical School: A Case Study on Dealing with Deafness in a Clinical Health Setting

DO-IT Factsheet #346
http://www.washington.edu/doit/Stem/articles?346

Background

My name is Sara and I'm 23 years old, profoundly deaf and in medical school. I use interpreters and speak American Sign Language (ASL) when I can in order to communicate with my professors and classmates. When I have an interpreter in classes I understand the material and I feel well liked by my classmates. I am also a proficient lip reader, a skill which helps me out in many situations, too.

Access Issues

I am starting to encounter more clinical experiences now that I am going into my second year of school. I am worried about whether I will be able to effectively communicate with patients during a relatively short encounter, perhaps in an emergency room or when I need to assess several patients quickly. Furthermore, I answer questions orally and participate in class discussions, but sometimes do not do as well on written exams. I feel like I need more time to fully comprehend what is asked of me and to write a well thought out answer. However, I'm not sure my instructors will understand this problem as it does not seem to be directly related to my deafness.

Solutions

I contacted the office of disability services at my University and explained my problem to a counselor. She explained to me that it is actually common for individuals who are deaf to have comprehension on written exams that is slower than other students. A study done by Gallaudet University (1971) actually showed that comprehension tended to be the most difficult component on academic achievement tests for individuals who are deaf. It was later supported by Holt, Traxler, and Aelen (1992), who indicated that there was an indirect relationship between hearing loss severity and reading comprehension. Once my counselor and I explained this to my professors and to the state Board of Medicine, I was granted additional time to take exams and, eventually, to complete my board exams.

Regarding my apprehension of clinical situations, it turned out to be of little concern to my clinical coordinator. The office of disability services was sure to pair me with an interpreter during my clinical rotations and none of my patients refused care from me - we are required to ask permission to provide care. Many patients told me that they were impressed with my educational accomplishments, given my communication challenges. My professors actually trained my interpreter to help me in specific assessment situations like listening to someone's heart and lung function (auscultation). She would perform this part of my physical assessment and then describe the sounds to me, but never analyzing it. I was responsible for interpreting and determining the significance of this data. Because I am a proficient lip reader, many times I did not need my interpreter for this, but he/she was available, just in case. I was often praised for using all of my senses in my physical assessments, which I think was more difficult or rare to see in my classmates who were not deaf. At one point, I was able to interpret for a patient who was having difficulty with his breathing tube. The other doctors and nurses could not understand what he was saying verbally, and I was able to read his lips.

Conclusion

This case study illustrates the following:

  1. Students who are deaf have a range of levels of communication skills; in this case, Sara is a proficient lip reader, but this is not the case with all students who are deaf. In her case an interpreter was not always neede, but provided a back-up measure for her; with another student, the interpreter may be a necessity.
  2. Disability service offices may have current research or other information about an issue that may be related to a disability that the student and/or faculty member were not aware of. This knowledge may lead to more effective services as it did when Sara received extended test time.
  3. When researching a university or department to enroll in, it is good to meet with your future instructors to determine their flexibility in working with you and providing assistance as needed. In this case, Sara's professors helped train her interpreters. It is important for students to feel supported by those from whom they are receiving training and accommodations.
  4. Sometimes fears that a student may have about particular contexts and their performance in them as a deaf individual are unfounded. In this case, Sara was really nervous about how her patients would react to her as a person who is deaf; surprisingly to her, they were very accepting.
  5. Some students who have disabilities can compete in clinical health fields and can bring new strengths with them. In this case Sara used her holistic sensory abilities to her advantage.