The Entanglement of Invisible Work and Access in Work Integrated Learning

Although the number of students with disabilities in health professions is increasing, barriers in clinical/placement learning persist. The interdisciplinary AcTinSite team – bringing together perspectives from design, geography, occupational science, nursing, critical disability studies, knowledge mobilization, and more – set out to create a comprehensive resource that might inform access in clinical placements for students with disabilities. As part of the process to understand factors that the AcTinSite resource(s) may need to address, in-depth interviews were conducted. Twentynine participants – 4 placement coordinators, 8 placement supervisors, 6 access professionals, 4 leaders in education (e.g. heads/Deans), 3 leaders in healthcare (e.g. clinical educators), 4 students with disabilities – from two hospitals and two universities participated. Transcripts were analyzed using a collaborative thematic approach. The AcTinSite team found that clinical and academic educators and learners engage in various forms of unrecognized labour to create access: putting in extra time, doing emotional labour, engaging in relational work, and navigating complexities. This labour is unrecognized and optional, and therefore its result – access – is inequitably distributed. We discuss what aspects of this unrecognized labour should be re-valued and recognized by our institutions as important aspects of teaching/learning, and which aspects perhaps should not need to happen. Educators and institutions need to know how access is created in placement education in order to promote diversity within our professions.