Sally French

Simulation Exercises in Disability Awareness Training: A Critique

ABSTRACT This paper takes a critical look at simulation exercises. Little evidence exists that these exercises have a positive effect on either attitudes or behaviour but, despite this, they are used extensively in disability awareness training, both for children and adults. It is argued in this paper that by individualising and medicalising disability, and by focusing excessively on problems and difficulties, simulation exercises provide false and misleading information, and inculcate negative, rather than positive, attitudes towards disabled people. It is suggested that simulation exercises fail to simulate impairment correctly, and address neither the coping strategies and skills disabled people develop in living with impairment, nor the cumulative social and psychological effect of encountering social and physical barriers over a lifetime. Rather than using simulation as a means of attempting to understand the experience of disability, the paper concludes by advocating the use of disability equality t...

Clinical Education: Students' and Clinical Tutors' Views

Summary Various studies have shown that clinical education is a rewarding yet problematic area of education for both physiotherapy students and clinical tutors. In this study 40 third-year BSc(Hons) physiotherapy students and 64 clinical tutors were asked for their views regarding what constitutes a ‘good’ and a ‘poor’ clinical experience. The main factors highlighted by the students were the attitude and behaviour of the tutors, the environment and social atmosphere and the quality of the learning experience. The main factors highlighted by the clinical tutors were the attitude and ability of the students, student development, and personal and professional growth. It was concluded that there is far more to the role of clinical tutor than excellence in clinical practice and that a more structured education for clinical tutors, to help them in this role, needs to be developed.

Attitudes of Health Professionals towards Disabled People A Discussion and Review of the Literature

Summary This paper outlines the structure and function of attitudes, and reviews the literature on the attitudes of health professionals towards disabled people. Although the literature is inconclusive, the weight of the evidence suggests that the attitudes of health professionals are very similar to those of the general public. The paper concludes by considering ways in which attitudes towards disabled people can be improved in both physiotherapy education and practice.

Telling stories for a politics of hope

This paper is about listening to voices from an excluded past. The oral history of disabled people challenges accepted, formal history, the history from dominant voices well established in unequal power relations. The paper draws on an oral history project conducted with over 60 visually impaired people who gave detailed accounts, telling stories of their experiences of education. This oral history research was carried out through the medium of the interview. The analysis covers school life, focusing on the recurring themes of abuse and friendships. The paper then turnd to relationships with family and community, and how participants placed schooling within the broader context of their lives. These stories are a small part of the history of disabled individuals’ exclusion within which, as we hope to demonstrate, the chinks of collective light were born.

Role Play and Simulation

In role-play exercises, learners act out roles without a specific script although they are usually given information about the characters they are to play, and the situations they are in. Role play can be used to change behavior, widen perspectives, change attitudes, improve social skills, and develop alternative solutions to problems. Perhaps, role playing is the next best thing to experience a genuine event. Role play can also be used to help learners gain skills in treating, assessing, and interviewing patients and clients, and to gain confidence when talking to groups or coping with difficult personal situations; it is used extensively in assertiveness training. The terms “simulation” and “case study” are used interchangeably. Simulation exercises are sometimes carried out in an attempt to gain insight into various disabilities, for example, the participants may be obliged to wear blindfolds or use wheel-chairs. These exercises have been severely criticized by many disabled people for being unrealistic, for trivializing and individualizing disability, and for fostering negative attitudes.

Pain: Some psychological and sociological aspects

Summary This paper considers the role of psychological and sociological factors in pain perception and behaviour. Among the issues discussed are the effects of cultural and family background, the social context, gender and individual differences. The placebo effect is examined and the article concludes by suggesting ways in which the information may be relevant to practising physiotherapists.

Health Care in a Multi-ethnic Society

Summary This article reviews the literature and takes a critical look at the provision of health and social services for people from ethnic minorities. Areas of progress are highlighted and suggestions are made about how the situation can be improved.

Teaching Practical Skills

Practical skills are widely used in therapy. There are fine gradations of movement used in passive manual mobilization techniques applied to peripheral or spinal joints, the manipulation of soft tissues used in massage, and the specialized neuromuscular facilitation techniques used, for example, in the re-education of facial musculature. Practical skills are also needed to lift patients or clients safely and to assist them with functional activities, such as feeding, dressing, transferring from bed to chair, and walking. One of the ways in which a therapist might begin to teach a practical skill is to demonstrate it to the learners while, at the same time, carefully explaining it. For observation and instruction to succeed, it is essential that learners are motivated and attentive. It is usually best to demonstrate the entire sequence first; it is vital that the demonstration is fluent and of a high standard. If the therapist has not practiced the skill recently, or if the equipment is unfamiliar, then time must be spent rehearsing the skill beforehand.

How Significant is Statistical Significance? A critique of the use of statistics in research

Summary This paper takes a critical look at the use of statistics in research, with particular reference to statistical significance. The validity of statistical evidence is questioned and the social, cultural and political forces which influence statistical analyses are briefly discussed. It is concluded that statistical evidence is rarely objective and, although statistics can be useful as an evaluative tool in some circumstances, such analyses should not be accepted at face value.

DISABILITY AND COMMUNICATION: LISTENING IS NOT ENOUGH

The usual starting point for professionals in considering ‘disability and communication’ is the development of effective communication. The improvement of health and social care services is equated with better conveyance of information and, quintessentially, better listening – improved skills and their use. The imperative of effective communication has had clear mandates for many years and it would be difficult to find a text within the professional literature that did not emphasise the need to listen to clients. Taking a more critical stance is not an easy position as it seems to fly in the face of common sense. There are, however, a number of related foundations for taking such a stance which we would like to explore in this chapter.