Conceptualising responsibility and hostility within work-integrated learning placements for students with disabilities

Abstract

The expectation for universities to support students’ employability through work-integrated learning placements demands investigation into how opportunities are inclusive to students from a diversity of backgrounds. In this paper, we explore the experiences of students with disabilities during work placements, drawing on qualitative data collected through six focus groups with students (n = 27). Analysed through the frame of stigma, the results show how students bear an unfair burden of responsibility in their placement experiences, as they shoulder consequential decisions to disclose and/or request accommodations to support their learning. In this study, work placement environments were often somewhat hostile, both in relation to their built environments but also through the bias and/or prejudice of others. The results shed light on the difficulties that students with disabilities face in their placements and underscore how educational equity is multi-layered, requiring scrutiny of the student life-course including access to opportunities in professional fields.

Points of interest

• Despite work integrated placements often being positioned as opportunities for students to ‘try out’ authentic work experiences during their time at university, placements are not inclusive to students with disabilities.

• Students with disabilities shoulder an unfair responsibility in their work placement experiences, where they must negotiate the decision of disclosure and/or request for accommodations.

• Students reported hostile work placement environments, and cultures of exclusion, demanding more investigation into how universities can ensure safe and appropriate learning environments for students on placement.

• Students recommend greater education and training for placement teams (i.e., academic unit chairs, professional coordinators) and industry supervisors to reduce stigma and combat entrenched assumptions about disability.

• Universities themselves must also reflect and act on how to support inclusive cultures, including supporting training and policy that embed a strengths-based lens of disabilities.

Keywords:

• work-integrated learning
• placements
• students with a disabilities
• equity and inclusion
• stigma

Introduction

Work-integrated learning placements have frequently been cited as a key feature to improve graduate employability outcomes in higher education (Jackson 2015; Peach et al. 2016). Research has found that through placements, students can develop specific industry knowledge, transform their learning within authentic environments, and reflect on future career goals (Atfield, Hunt, and Luchinskaya 2021; Jackson and Collings 2018; ACEN, 2015). Studies have also found that placements support students to develop professional awareness, build networks, and experience mentoring, or role modelling, all of which can be critical assets in a competitive job market (Aprile and Knight 2020; Jackson and Bridgstock 2021). However, while scholars commonly agree to the benefits of work placements, there is also sustained research that discusses unaddressed issues of access and inclusion for placements, highlighting that current placement policies and practices may not be equitable to all students (Bell et al. 2021; Winchester-Seeto et al. 2015; Sachs, Rowe, and Wilson 2016; Lloyd et al. 2019).

Students with disabilities, mental health and/or medical condition may face barriers to their work placement participation (Eckstein 2022; Nolan et al. 2015; Leon 2010; Gatto et al. 2021). For years researchers have cited a range of challenges that students with disabilities can face in accessing and participating in placements including ‘inaccessible facilities’ (Bellman, Burgstahler, and Ladner 2014, 399), ‘limited/restricted placement options’ (Peach et al. 2016, 13), a lack of resources for students with disabilities in placements (Gatto et al. 2021; Nolan et al. 2015) ‘systemic prejudices, including biases about students’ motivations, capabilities and discretionary power; and detracting workplace cultures including those which are discriminatory’ (Lloyd et al. 2019, 1), and challenges related to disclosure and accommodation requests (Eckstein 2022; Hill and Roger 2016; Nolan et al. 2015). These barriers to accessing and participating in placements raise questions on the inclusiveness of work placement practices with many researchers calling for more research into how placements can be redesigned to cater for diverse students (Lloyd, Male, and Paull 2018; Winchester-Seeto et al. 2015). There has also been advocacy for greater student input into their work placements (Bell et al. 2021; Lloyd et al. 2019) and for further research on additional resources that may support ‘students with disabilities who engage in work placements’ (Gatto et al. 2020; Gatto et al. 2021).

In this paper we consider how students themselves consider their experiences in work-integrated learning placements, foregrounding the lived experience of participating in these activities. Drawing upon rich qualitative data, not only are the undercurrents of complexity and exclusion highlighted but equally the participants provide experience-informed recommendations for the ways inclusion and access in work placements might be improved. This study builds on our previous work, where we conducted an online survey with students with disabilities on experiences of work placements (n = 132) (Dollinger, Finneran, and Ajjawi 2023) by hosting a series of focus groups with students (n = 27). Through our results we showcase several key findings, including that students with disabilities face an unbalanced burden of responsibility in their work placements, and often experience hostile or unsuitable placement environments which hinder their ability to learn and contribute.

Inclusion in work-integrated learning placements

Students with disabilities have a right to ‘access and participate in education on the same basis as students without disability’ (DESE, 2020, 19) and universities have a responsibility to ensure that all students are job-ready including those with a disability. In Australia, the context of our study, two pieces of legislation, the 1992 Disability Discrimination Act (DDA) and the 2005 Disability Standards for Education (DSE) make it unlawful for higher education institutions to provide non-inclusive learning experiences, or training opportunities which discriminate against students with disabilities. Universities consequentially have adopted a variety of measures such as support for students in admission, enrolment and participation, and subsequent student adjustments, to ensure some level of equality across all student cohorts (Pitman et al. 2022). However, as previous scholars have noted, the implementation of inclusive practices varies across institutions, and support for students is often unclear and/or inconsistent (Brett et al. 2016; Hughes, Corcoran, and Slee 2016). These discrepancies are particularly exacerbated in the context of work placements, which straddle the collaboration between university-industry and distribute responsibilities across stakeholders. Harvey et al. (2017) have previously pointed to the need for universities to employ a broader variety of strategies to better support a range of students from diverse backgrounds to become work-ready including students with disabilities. Recent statistics further highlight the way that students with disabilities are disproportionately underrepresented in the Australian work force with 53 per cent of people with disabilities aged between 15-64 in the workforce compared with 84 per cent of the same age group without disability (Australian Human Rights Commission 2021). A recent study by Eckstein (2022) found that one of the main reasons for the underrepresentation of students with disabilities in the work force related to limited exposure to relevant work experience. These insights combined with the lower levels of employment participation after graduation for this population highlight the imperative for universities to design more inclusive work placement experiences.

To date, the studies on how to improve equity and access in work placements have been limited. Bellman, Burgstahler, and Ladner (2014) discussed a range of strategies employed by The University of Washington in the United States to increase the participation of students with disabilities in work placements. The strategies included providing opportunities for students to meet with a panel of professionals with disabilities who share their experiences of their workplace; students undertaking mock interviews or engaging in ‘shadowing’ people in a workplace; supporting students with resume development and encouraging students to connect with other peers with disabilities in a supportive/mentorship group. Each of these strategies were shown to increase students’ motivation towards pursuing a career, knowledge of the workplace, belief in the value of work placements and likelihood of employment success. More recently, Bell et al. (2021) suggested that offering online work placement experiences can remove certain barriers for equity students such as the financial barrier of attending in-person placements resulting from the need to pay for travel or take time off paid employment to attend. However, online work placements equally present other barriers such as a lack of technical support, little opportunity to network, and finding an appropriate space to work from (Bell et al. 2021).

Understanding students with disabilities experience through the lens of stigma

Framing our study is the concept of stigma, which has been a prominent lens to understand the experiences of people with disabilities across a range of contexts (Lucas and Phelan 2012; Tsatsou 2020). Stigma is often defined as negative and unsubstantiated beliefs towards a group of people, which results in different, often worse, treatment by others. While previously considered an attribute which discredits the individual (Goffman 1974) stigma has more recently been re-theorised as a social process, which emerges from interpersonal interactions, and varies across contexts and time, but often results in the categorising of social groups (Lucas and Phelan 2012). As the research progressed, we drew on stigma as we recognised that many of the challenges discussed by participants went far beyond the commonly cited barriers to work placements that all students encounter. The students in this study reflected upon challenges that ranged from balancing workload with study or adapting to a new work environment (Peach et al. 2016), right through to instances where students discussed discrimination or unfair treatment by university staff and/or supervisors in these experiences. While the research team was surprised at the volume of data relating to stigma, these findings align to growing research across the higher education sector about the stigmatisation of students with disabilities. Recent studies, for example in Israel (Shpigelman et al. 2022) and Austria (Zaussinger and Terzieva 2018) also document students’ perspectives and lived experiences of stigma, both from peers and university staff.

Informing our study is also the recognition that stigma is not always what is done to a group or individual, but rather what is not done. Such (in)action is generally deliberate, albeit potentially unreflected upon, by the individual or the organisation. This indifference or inattention to groups has been described by Neel and Lassetter (2019, 624) as ‘interpersonal invisibility’ manifesting for example when people are ‘not seen as a viable friend, romantic partner, teammate, or being passively excluded from social situations’. The determinants of stigma also arise in how the stigmatised groups predict future consequences, such as loss of status or exclusion. To illustrate, in a study of people with autism, researchers found that higher perceived stigma predicted higher levels of camouflaging (the concealment of autism) leading to greater stress and subsequent mental health difficulties (Perry et al. 2022; Botha and Frost 2020). In the higher education context, students may not disclose when applying for university for ‘fear that they may not be offered a place’ (Vickerman and Blundell 2010, 26). Grimes et al. (2020, 23) explored the decision of non-disclosure and found that students found it to be ‘necessary to protect them from being discredited within their learning environment, and for some, in future employment’. They further found that the choice to mask or camouflage disability, as a result of perceived stigma, often related to the nature of the disability or condition, with those most likely to camouflage as having mental health conditions. Similarly, Sniatecki, Perry, and Snell (2015) found that staff were more likely to hold negative attitudes to students with mental health issues, rather than physical disabilities. Given these findings, it is perhaps unsurprising that students with disabilities are often required to self-manage decisions of what course to study, and/or to continue study if faced with inaccessible learning environments, alone or in isolation (Hammer, Werth, and Dunn 2009). And as we discuss below, this prediction of future stigmatisation or discrimination also created fear for some participants, leading to non-participation in work placements, despite having the opportunity to do so.

Context and methods

Our study was undertaken at a university located in Victoria, Australia. The university has several campuses located across the state and caters to a large student cohort which study fully online (32% of the student cohort, including undergraduate and postgraduate). Data retrieved from the university estimate that approximately 12% of the current student cohort identify as having disabilities, mental health and/or medical conditions. However, the number of students with disabilities is likely much greater, given that some students may not choose to disclose (Pitman et al. 2022) or register with the university’s disability centre. In our study we defined disability as extending to students with learning, physical or sensory disabilities, as well as mental health, neurological, and/or chronic medical conditions. Full ethical consent was received by the university Human Research Ethics Committee (reference number 2022:021) before conducting this study.

Our study hosted a series of focus groups to engage with students with disabilities to discuss their work placement experiences. Students were recruited through the university disability centre (via an email) and the student union (through a Facebook post). Focus groups were hosted online and approximately 1 hour in duration. All students who signed up for the study were supported to engage in a focus group, and eventually we hosted six sessions, with a total of 27 students attending. Of the 27 student participants who attended, 6 students had already commenced a work placement, with the other participants planning to engage in one during the following academic year. This diversity of experience was highly generative, both prompting conversations about what occurred in placements and equally, providing an opportunity for students to share their fears about future stigmatisation they predicted might occur once they participated in a work placement. All students who attended focus groups were also emailed a $40 gift voucher as recognition of their time.

We chose focus groups rather than individual interviews to promote students’ sense of safety in sharing their experiences and to enable them to build on others’ recommendations (Farquhar 1999). Focus groups were semi-structured and guided by two key questions:

1. What challenges have you faced (or do you predict you might face) in a work placement?

2. What more can university staff, industry workplaces, and/or students do to improve inclusion or access in work placements?

Data collection was guided by recent research conducted by Trevisan (2021) on how to ensure inclusion and access in focus group data collection. This included reassuring students that the online focus group would be attended only by others with disabilities (i.e. a safe space), sending question prompts in advance, and supporting diverse engagement by allowing both oral and text submission of responses, via an online whiteboard called Padlet. We also indicated to participants that they did not need to turn on their video cameras, and that they could contact us afterwards, either via email or phone to support ongoing communication and engagement, or if they did not feel they could share fully during the session. We also clarified that we would not ask about their specific disabilities, and while some participants chose to share this information during the session (as discussed in quotes below), others chose not to. Finally, we also asked participants to share their emails so we could send through any practical resources or publications that would arise from their data.

Data were analysed informed by framework analysis (Ritchie and Spencer 1994) with stigma as a sensitising lens. Framework thematic analysis is frequently used in applied qualitative research, to employ an organised structure of inductive, and later deductively derived themes (Goldsmith 2021). We followed five steps: 1) data familiarisation, 2) inductively identify the thematic framework, 3) indexing the data against the framework (i.e. deductive coding), 4) charting to summarise indexed data, and 5) interpretation of patterns (Ritchie and Spencer 1994). Further, the creation of our analytical coding framework was guided by the literature on stigma in disability studies, including how stigma often manifests through social categorisation with an “us” vs “them” mentality, where the group that has been ‘othered’ frequently experience social loss, rejection, or discrimination (Link and Phelan 2001). And also recent scholarly findings relating to threat-based stigma, operationalised in terms of how others perceive people with disabilities as receiving unfair resources or advantages (Neel and Lassetter 2019). This perception sometimes results in aggressive behaviour, avoidance, or in some cases, infantilisation (Robey, Beckley, and Kirschner 2006). Reviewing literature to inform our framework alongside our own process of data familiarisation, we identified two categories in our data: the unfair burden of responsibility for students with disabilities and perceived/experienced hostility students with disability faced during work placements.

Results

To discuss our results, we first identify the burdens of responsibility for students with disabilities to take part in work placements, and how this often resulted in students’ need to perform or mask their disability in order to enable their participation. Second, we discuss the theme of hostility that was developed from the data, relating to the social or built environments of placements that resulted in students feeling unwelcomed or disenfranchised. And finally, we present data on students’ ideas on how work placements could be redesigned to better support inclusion and equity for students with disabilities. Pseudonyms have also been assigned to participants, however, please note that as we did not ask for gender, hence all names are gender inclusive.

Burden of responsibility

The first theme we developed identified the burden of responsibility on students in work placements, which was framed through students’ experiences of disclosure and mediated through perceived stigma from the placement organisation, or the university. For example, students reflected that they often had to camouflage, physically and/or mentally, to adapt to the placement environment. One student shared that loud noises were a trigger for their condition, yet they felt ‘they had to just push through because … there’s no point in telling them… I don’t want them to treat me differently, so I just want to skate by and see if I can do it’ (Alex). Frequently, students also shared stories of how they were asked to do something on placement that was incongruent with their strengths and capabilities, for example a student being asked to read aloud when they had dyslexia (Lindsey). The students were then expected to “perform” according to the norms of the workplace without any recognition of the complexity of their lived experiences.

The burden of responsibility to fit into heteronormative norms meant that students had to either exert themselves to fit into their new learning environments (i.e. the placement locations), or face potential stigmatisation for requesting reasonable accommodations to support their learning. The additional burden was solely placed on the individual rather than being negotiated as a shared responsibility between the university, the student, and the placement organisation. One student shared that the impetus to disclose their disability only occurred before they began their placement at university, as they had previously decided not to disclose to the university due to a lack of clarity around the process, explaining: ‘I had no idea where to start. I didn’t know what accommodations I needed because I was so used to having to over-exert myself in order to compensate’ (Taylor).

Students also discussed the complexities that influenced decisions to disclose to placement supervisor(s). Choices in this regard were described as binary and continuous/dynamic, either choosing to withhold, which resulted in significant discomfort and/or pain, or opting to disclose, which then required a burden to educate. This decision-making needed to be continually revisited according to the nature of the engagement, the context and the people involved. This could be exhausting and largely invisible emotional work, as one student put it,

It’s hard you have to make some decisions. Am I going to lecture this person at the start, and so everyone knows everything which can be quite overwhelming for the other person, and put them off from wanting to take you on as a placement work-experience student, or do I just educate them as I go along? Then if you’re having a flare-up in that moment, it’s like you’re trying to deal with your flare-up and educate at the same time (Charlie)

Evidenced through our data was that the burden of disclosure and subsequent education sat with the individual student. This responsibility meant that these students often had to adopt the role of educator or equity advocate rather than simply being situated in a learning experience. To illustrate one student shared how their disclosure to a supervisor had resulted in the team reflecting on their processes and policies around disclosure and privacy, as the supervisor, without prior permission, had told a colleague during a meeting about the students’ medical condition, The student reflected on the difficulties of this situation:

She [the supervisor] says, ‘I’m sorry, if I left the cat out of the bag’ or whatever. I said, ‘Look, it doesn’t bother me. By the time it’s impacting and I’m using a walking stick or whatever, I have no problems with that.’ [On reflection] I think, I feel this person should’ve been told, because I’m part of their team. At the same time because of privacy, they weren’t told… [Looking back now] they may be, trying to come from the right angle and the most understanding perspective, but they may not be on the mark, and they may not be educated. Therefore, they just go, ‘Now, it’s just easier if we don’t have someone with these problems. We’ll go for someone else.’ (Jordan)

Another student, doing a teaching placement and with autism, ADHD (attention-deficit/hyperactivity disorder), and CPTSD (complex post-traumatic stress disorder) after disclosing to their supervisor was ‘outright asked to mask those things on placement… she’s like, “look you need to not be showing this as outwardly, because it’s not working for the kids.’” (Avery). Linking to this, was how the student-supervisor relationship heightened the pressure and burden of disclosure, ‘if you need to speak up because you don’t understand, especially when it’s someone that you don’t know, that can be a really scary thing’ (Ali). These insights were similarly reflected in the parameters of the study, with many of the research participants we spoke to, choosing to mask or downplay their disabilities or conditions. Not only were students shouldering the burden of responsibility around their decision to disclose and what aspects to share with supervisors, but when they did so, many felt stigmatised as being considered a burden or different, rather than as a valuable team member in the workplace.

Hostility and exclusion

The second theme concerned the hostilities and exclusion that students faced. Hostility is often conceived in terms of personal aggression or antagonism but here we consider hostility in a much broader sense that ranges from physical or built environments to the perception that some workplace organisations were not inclusive of students with disabilities. This presence or feeling of hostility often resulted in students feeling excluded and unable to participate in development opportunities afforded by their placement – the very reason they are there. For example, one student, on a placement in occupational therapy noted, ‘in the building I was studying there were no lifts, only stairs. Why are there no elevators or ramps in a building that teaches occupational therapy, isn’t that ridiculous?’ (Gabriel). Another student discussed stand-only lab benches, when standing for long periods of time caused them pain (Dylan).

Students also referred to the inflexibility of the placement work hours. One student participating in a nursing placement shared that they were told by university staff, ‘It has to be an eight-hour day no matter what. They [the university staff] don’t want to break it up for you, which I find really problematic’ (Charlie). Frances also reflected on how they had experienced hostile language pre-placement, with staff using phrases such as ‘…”super hard to get into”, “competitive”, “lots of work” which has stopped me in the past from wanting to pursue [placements], and has made the later years of my degree an anxiety-inducing thought because I know I’ll eventually have to do this “super hard” unit and if not I won’t get my degree’.

Students also often perceived the placement organisation to be a potentially threatening or hostile environment to people with disabilities. As Charlie discussed, ‘nearly every place now says that they’re inclusive, but that’s no guarantee. But having current workers in the organisation give a testimony saying yes this in an inclusive environment could be more comforting’. To manage the hostility that students faced, students spoke of the need to create a more participatory or distributed model of responsibility. As one student explained,

I think it needs to be a conversation before they even start their placement with the employer and a disability support worker like where you can explain that, "I’m not lazy. I’m not lying. Yes. This is genuinely what’s happening and explain that this is the accommodations that I need." If the employer can’t or won’t make those exceptions, then looking for employment somewhere else that will make changes rather than you [makes changes]. (Alex)

Interestingly, Alex’s quote above represents a thread that ran through students’ stories in focus groups, where they felt the university had a greater responsibility to appraise the inclusiveness of the work placement sites before matching takes places. In Australia context, however, the current structures to support placements are already under-resourced and stretched. Placement coordinators for example often struggle to source enough placements for the student cohort (students with or without disabilities) and have a limited time to devote to specific cases, leading to rise in students’ self-sourced placements (Kay et al. 2019). Ultimately, one way to understand the current context is through a position of deference, where the university readily accepts the terms of the placement provider, and does not have the resourcing, nor the motivation, to assess the quality of the placement itself.

Students’ recommendations for change

The experiences students reflected upon in this study emphasised the critical need for universities to reassess and reflect on how they offer inclusive placements to diverse students. The participants also offered suggestions about how placements could be better supported which largely fell across three sub-themes, education and training, mentoring, and cultural changes.

1. Education and training

In regard to education and training, students identified that both work placement academic coordinators and supporting professional staff should receive more training on how to interact with and accommodate students with disabilities. Students emphasised this training should extend to all staff working in the placement space, including greater awareness of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) as one student expressed,

I’ve had to explain to psychology headteachers that, because my autism or ADHD or whatever, the DSM-5 or whatever it’s called has this set criteria that no, we don’t or have that textbook definition. That comment, some have more, some have less, some have comorbidities that affect things completely differently. You’re a psych teacher, you should know this (Max).

Some students also mentioned that their diagnosis was often questioned even after they had shown staff their access plan, ‘I just feel like sometimes [my access plan] is questioned when it shouldn’t be questioned. That sense of awareness of how even if the intention was good, that that can be perceived by a student that is not always necessarily in the best headspace’ (Charlie). Students also suggested creating resources to help students and supervisors understand the expectations of roles during placement, as one student shared,

I usually need things explained a few times, or in writing, to make sure I understand them, so having guides for students, for example, what’s expected, how it will work, how they support us and so on, rather than just relying on communication after the application process. This would allow more students to feel confident (Dylan).

1. Mentoring

Students also suggested programs or support around peer mentoring, which could help normalise some of the anxiety or stressors students might feel on placements. One student for example explained, ‘First-day placement. “How’d you go?” Obviously, peers can’t be psychologists or whatever, but it’s just that peer support of, “Hey, I’ve done that,” or, “I’ve just had this”’ (Taylor). Another student suggested ‘get students with disabilities who have successfully completed placements to share their experiences, including challenges they faced, what they learnt, how it helped them, if their disability prevented them’ (Lindsey, focus group response). Other suggestions on how to make this practice scalable included creating a support group so students with disabilities can meet others in similar situations. They shared,

I feel like we’re quite ostracized, we don’t really know each other. We can’t really talk about our experiences with each other. Then when I’ve found people in class who have disability, it’s been really nice to actually talk to them, so some kind of connection or something would be really good (Nico).

1. Cultural changes

Finally, another suggestion offered by (number) students related to the need for cultural change within university in order to effectively improve access and inclusion for students with disabilities. This means going to the root of problems or issues and taking the pain-points of the experience seriously. One student expressed,

Clearly, [the lack of inclusion for students with disabilities] is a systemic issue coming from the academic institutes, … It all came back to the top academics not wanting or not caring to understand. [It] Felt like the students with disabilities are a burden. If that’s been taught through the education system that goes into the formal law firms, hospitals and all that, so then they got to treat their staff the same. It’s just a never-ending cycle, to start at the universities with the professors, the students, all that, teach them, correct. Disabilities aren’t a burden. There’s not a one size fits all system, and then that’ll slowly trickle into the workforce (Jordan).

Students noted that the intentions behind the staff member or supervisor making the accommodations (or not) was clear, and that some were doing it because they understood, and others, because of legal reasons, or fear of negative repercussions. One student communicated for example, ‘I do just think unfortunately, we’re still at the point of finding good industries, good employers, good people, and finding ones that I suppose, being able to recognize the ones that are just saying, "Yes, we’re inclusive," because legally they have to…’ (Ali). Students expressed the onus of responsibility was unfairly resting on them, as one student commented,

It’s just so exhausting. It’s like mentally fatiguing all the time because, for me, I’m trying to reserve my energy for placement and all of the activities that I need to do. It’s also stressing if they’re going to change their mind or opinion about me and what I’m capable of, and that fear of maybe they don’t actually want me here because it’s too stressful (Devin).

Students suggested to mitigate this anxiety that universities needed to take a more proactive approach, as one student asked, ‘Why don’t you start here at university demonstrating a person-centred approach’ (Charlie).

Discussion

The challenge of creating an environment where students with disabilities can successfully access, engage, and complete work placements is complex. Through the frame of stigma, it’s clear that students’ previous lived experiences of prejudice and/or avoidance from others based on their disability, likely plays a role in how they may choose to disclose or approach accommodations in their higher education experiences. While some of these pre-conceived attitudes and perceptions are outside the realm of control for the university, university staff and services can do more to confront and honestly address these perceptions through their own practices and culture. To illustrate, although many of the students in our study shared that they disclosed their disability upon enrolment at the university, there were others who did not, and then subsequently found it difficult to know how, when, or why they should disclose. As previously discussed by Grimes et al. (2020), university policy makers/support staff could do more to situate the act of disclosure as a decision-making process, one that has benefits and drawbacks (Stanley et al. 2011). Mitigating drawbacks, for example, could manifest through transparent and open discussion of how students’ data is stored, and benefits could include the promotion of what accommodations students could receive based on their disclosure. It is important to note here that we are not advocating for students to disclose their specific disability and/or mental health or medical conditions, but rather to share generally what accommodations they need and medical certification, if needed.

Combating stigma and easing the burden of responsibility for students with disabilities, also needs to be explicitly addressed in the structures of inclusive practice at the university, including those that support work placements. As Adefila et al. (2020, 2) reflect universities should not patronise students or adopt ‘tokenistic inclusive practices [which] avoid the messy process of evaluating and disrupting traditional practice’. Students should be considered through a strength-based lens and recognised for the skills and capabilities that they can bring to an organisation (Lee 2022). And as students routinely shared through our study, university placement teams could do more to appraise potential organisations to ensure they have adopted genuine equity-based practices, and also be cognisant of their language in how placements are organised, supported and evaluated. Striking findings from previous research, that resonate with ours, was the stigmatisation of students with mental health conditions – so called invisible disabilities – by members of university staff (Langørgen, Kermit, and Magnus 2020; Sniatecki, Perry, and Snell 2015). Yet rather than see this solely as the individual’s intolerance, Moriña, Perera, and Carballo (2020) write that staff are already self-aware of their inadequacy on how to support students with disabilities, and in fact, request additional support and training from the university (Cook, Rumrill, and Tankersley 2009; Gelbar et al. 2015). To alleviate the issue therefore university senior leaders may need to do more to clarify the responsibilities and expectations of staff in the context of supporting diverse students. They may also need to support the additional workload that may accompany upskilling and building a more knowledgeable and positively inclusive culture, as well as adopt appropriate evaluation methods to ensure improvement (Moriña, Perera, and Carballo 2020).

It is also through relationships, including peer-to-peer, and teacher-student that issues related to stigma can be ameliorated. As students in our study suggested, the provision of peer mentoring programs where students can share experiences and reflect on challenges that may arise in placement would help create sources of support. Hillier et al. (2019) found that a general university program to support students with disabilities in peer-to-peer mentoring improved students’ navigational capability of university resources and programs and had long-lasting impact beyond one year of completion. One-to-one mentoring relationships between staff and students with disabilities, where the students are situated as mentors, have also been shown to improve staff understanding of students’ lived experiences and generate empathy for issues relating to access and inclusion (Dollinger and Hanna, under review).

Our findings highlight that students with mental health conditions may be particularly suspectable to stigma in their university and placement experiences. Well evidenced in existing literature are findings that people with mental health conditions are often viewed suspiciously by others, leading to greater stigmatisation and potential discrimination (Lyndon et al. 2019). This is particularly relevant in the higher education sector, where many students are young adults, who as a cohort report a higher incidence of mental health conditions (Price 2023; Solmi et al. 2022). And unfortunately, students discussed that not only were their mental health conditions sometimes not appropriately recognised by university staff or placement supervisors, but that the process of the placement itself, including securing a placement, entering a new learning environment, and navigating new roles and responsibilities may worsen stress and aggravate conditions. We recommend that universities examine how they support greater flexibility for placements, including allowing students to work shorter hours over a longer period, and helping students transition to a different placement if the first match is unsuitable, to lessen the rigidity of placements.

While not a direct aim of our study, through our findings we also suggest that universities can do more to clarify the inherent requirements of specific courses, and corresponding work placements. Inherent requirements, or the core abilities, skills, or minimum requirements necessary to enter and qualify for degrees are currently uncritically stated and rely too frequently on outdated ideas of disability (e.g. the medical model of disability) (Brett et al. 2016). Yet reimagined, as Corcoran, Whitburn, and McCandless (2022) have suggested, inherent requirements could highlight the tasks student might be required to perform, rather than the attributes they possess. By doing so, these requirements would become informative, rather than discriminatory, documents that ‘seek to diminish any physical or social barriers to an individual’s capacity to participate materially in learning and professionalisation’ (Corcoran, Whitburn, and Knight 2022, 71).

Conclusion

As legislated by law in Australia and elsewhere, every student has the right to access and participate in higher education experiences on the same basis, regardless of disability. Yet through our study, we find that students with disabilities are not currently able to access, or experience work placements in the same ways that students without disability can. Rather, as we have discussed, students with disability face significant challenges such as the burden of responsibility to disclose and potentially hostile work environments, situations further heightened through the frame of stigma, where students often expressed concern regarding discomfort, exclusion, or prejudice based upon their disability. Subsequently, while work placements are positioned to be opportunities for students to gain authentic skills and network with professionals, for students with disabilities they are too often stressful and lonely experiences, inconducive to learning. Through our findings we advocate for universities to reflect and act on how work placements can be equitable to all students, not just through structural and procedural practices, but through creating a culture of inclusion.

Disclosure statement

No potential conflict of interest was reported by the authors.