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John Scott

Jun 28, 2019

Reimagining Educational Possibilities

Supporting Equity and Inclusion in Healthcare Education

A Mission Most Possible 

The impossible happens every day. People break down barriers every day. Just ask Amy Bockerstette, the first person with down syndrome to earn a college athletic scholarship, whose heroics on the golf course recently captured the nation. Or Dr. Philip Zazove, one of the country’s first physicians with profound hearing loss. After being told as a child he would have limited professional opportunities because of his disability, Dr. Zazove now has his own medical practice and serves as the department chair of family medicine at the University of Michigan. In the field of medicine generally, breakthroughs and innovations continue to redefine what’s humanly possible. 

During our Tour stop at the Medical University of South Carolina, I had the chance to chat with Dr. Melissa Hortman, Director of Instructional Technology at the Medical University of South Carolina (MUSC). She also believes in reimagining what’s possible for educational opportunities in the healthcare field by championing a campus-wide commitment to inclusive education and universal access. For Dr. Hortman, a key first step to inclusion is helping faculty recognize that accessibility and accommodation do not compromise academic rigor; rather, providing people equitable opportunities to participate and be successful will result in more diverse medical professionals who can benefit patient care and research broadly. Still, the stigma that a person with a disability would not be capable of meeting the physical and cognitive demands of the profession has contributed to the current lack of faculty awareness about digital accessibility best practices. But sentiments and understandings have begun to shift at MUSC, as equity and inclusion have become key pillars of the university mission, and as Universal Design for Learning principles have become more deeply woven into everyday instructional practices.


You can see instructors' faces light up and go: “Oh you mean I can upload my content in this way, but students can just grab it this entirely other way, and be able to listen to it, and or use the epub and annotate it?” It’s really powerful. But also it leads down to the bigger conversations about how they’re designing their courses: how are you currently representing your content, how are you assessing students, how are you providing multiple ways to demonstrate what they know. 


Alex Walters, senior instructional designer and Digital Accessibility Specialist

Clearing Pathways to the Possible

I also spoke with Dr. Scott Bragg, professor in the College of Pharmacy, who explained to me that accessibility has become a bigger priority for faculty not only because of the need to meet legal requirements, but also because it is the right thing to do and it supports student learning. As an example, he mentions how he observed many students using audiobooks to study, taking advantage of their time stuck in local Charleston traffic to review their course materials. By making his lectures more accessible with image descriptions and correct formatting, he’s helping ensure students can take full advantage of text to speech tools like Blackboard Ally’s MP3 alternative format to improve their learning outcomes.  

While awareness about the benefits of inclusive course design may be growing on campus, there are still challenges for time-pressed faculty to make complex healthcare curricula accessible, as well as for instructional technologists to retrain faculty in using authoring tools and updating inaccessible materials. Consider, for example, writing image descriptions for dozens of images of patient x-rays in a lecture presentation, or captioning hundreds of hours of lecture video. Faculty like Dr. Bragg and curriculum advisors like Daniel Berg in the College of Dental Medicine advise faculty to look for impact when making fixes to their existing content, and develop skills with authoring tools to create new content that meets accessibility standards; content that is more usable and more directly aligned with learning objectives.

One-to-one consultations with faculty have been effective in helping build these fundamental skills and UDL practices, but the instructional technology and curriculum design teams also recognized the need to more efficiently scale and sustain their inclusive learning efforts. In Blackboard Ally, they’ve found a tool that Dr. Hortman describes as “doing the work of 15 people” by reaching faculty within their course and making accessibility a recognizable and quantifiable aspect of their teaching. The percentage based-scoring and colored gauges seem to appeal to the data-oriented faculty at a healthcare institution, which for professors like Dr. Bragg, provide both insight into accessibility issues and some motivation to achieve green indicators.

We had a faculty in a meeting, the meeting didn't have anything to do with education, and we were going through 'wins'. Then he stood up and showed his computer. And I was wondering, what is on his computer? [...] and he had his course open and then he said: "I just wanted to share my 'win' that I made one of my courses all green." And his face lit up, he was just so happy. 

Melissa Hortman, Director of Instructional Technology at the Medical University of South Carolina (MUSC)

New Realms of Possibility  

To broaden the scope impact of their accessibility efforts, the teams at MUSC have used Ally to bring various campus stakeholders together to address barriers to inclusion. For example, collaborating with library services to identify PDFs with missing tags in the Institutional Report, and then using the Library Reference to add a link to a more accessible version of the PDF in the library database. Instructional Technology consultant Bernard Jansen and his team in the College of Nursing are using Ally to check a range of content shared to institutional websites and broader campus and hospital communities.  

In becoming a more inclusive campus, MUSC is blazing a new pathway forward for healthcare education and patient care. Moving from a deficit orientation about people with disabilities toward recognizing the unique ways people with diverse abilities can contribute to the profession, helps create a more empathetic, innovative healthcare community. Heroes like Amy Bockerstette and Dr. Philip Zazove show us that impossible is merely a state of mind. So while the road to accessible instructional content may be a long one, along that journey, campuses like MUSC who have made a commitment to inclusion are opening new realms of possibility for people to pursue their dreams without barriers.  


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