Exploring the Integration of Disability Awareness into Tertiary Teaching and Learning Activities

A desire to have every student attending our University be aware of, and reflect on, disability in their studies and future careers, initiated our project to explore how to enhance disability awareness within all our University’s papers.In this project we systematically reviewed pertinent literature and ran an action research workshop for staff. Strategies to enhance disability awareness identified in the literature and workshop were presented and verified at an interactive conference presentation. Embedding disability awareness into curricula is challenging; staff considered themselves powerless to bring about change in their departments, but thought that one way to do so would be by modelling inclusive behaviour and by introducing subtle inclusive practices into papers taught. The identified strategies may be of use to others contemplating similar curricular modifications.

reflection of teaching practice within the disability context, b/make suggestions of how teaching and learning activities could be improved to enhance awareness of disability issues both via content and accessible delivery, and c/to inform the quality development of future such workshops. To verify and expand our findings, we then reported them at an interactive presentation at a Disability Conference and invited feedback from the audience. The project had ethical approval from the University of Otago Human Ethics Committee (11/208).

The Literature Review
We systematically reviewed the literature to answer the question: What processes/systems can be used to raise awareness of disability in teaching staff and students in higher education? We searched nine databases (ERIC, Academic Search Complete, Web of Science, Web of Knowledge, Embase, MEDLINE(R), PsycINFO, PsycEXTRA, Google Scholar) using the key words listed in Table 1. Following review of title and abstracts for relevance to the review, the search yielded 31 articles. On full text review, 18 articles held relevant information on disability awareness training and were included in our review. To be included, articles had to report on raising disability awareness in tertiary institutions. The main reason articles were excluded from our review was their focus on accessibility of people with a disability to education instead of stimulating disability awareness in the curricula.

The Action Research Workshop
In a half-day action research workshop, contextual presentations and interactive group sessions were aimed at www.ccsenet.org/jel Journal of Education and Learning Vol. 2, No. 1;2013 149 encouraging attendees to discuss and reflect on their teaching practice, and to generate suggestions to enhance teaching and learning within the disability context.
The workshop was advertised widely on campus by posters and fliers, in advertisements placed in the University newsletter and by e-mail correspondence. We sent e-mails not only to all staff, but also to Heads of Departments requesting that they encourage staff to attend. The advertising invited all University staff (both academic and general staff) to attend this workshop and it specified that staff attending would be part of an action research project, that their views and opinions would be anonymously analysed and reported at a conference, in a journal publication and in a University grant report. Interested staff were sent the study information sheet and consent form, asked to confirm attendance and to bring the signed consent form to the workshop.
Three lecturers, experienced both in disability issues and pedagogy, conducted the workshop, assisted by two research assistants. The research assistants made observations and field notes of all discussions and collated all material generated by the workshop (such as white board or small group notes) for analysis.
The workshop had three parts: (1) Awareness, (2) Challenges, and (3) Solutions. Each session was facilitated with the use of interactive activities, small group discussions, and DVDs. In the "awareness" session, workshop participants were encouraged to reflect on their own, and their departments, awareness of disability. In the "challenges" session, attendees contemplated on how comfortable they felt about pushing the disability awareness agenda within their individual departments and brainstormed what the constraints to this agenda would be. The last session focussed on "solutions" to these constraints.

The Conference Presentation
As a means of verifying the findings emerging from the workshop and literature review, we gave an interactive platform presentation at the International "Everybody-In" Disability Conference held on our Universitycampus in late 2011. Following a short presentation we invited feedback and further suggestions from the audience, which our research assistant recorded as field notes.

Results of the Literature Review
Details of the 18 included articles are presented in the appendix (Appendix 1). A number of innovative approaches to raising disability were described or investigated in the reviewed articles. These approaches or interventions included one day workshops (focusing on communication or impairment simulation activities) (Anderson, et al., 2011;Goddard & Jordan, 1998;Lock, 2003;Moroz, et al., 2010), courses that included clinical placements (Keselyak, et al., 2007;Thompson, et al., 2003), field trips (Livingston, 2000) and classroom work (Matthews, 2009;Wurst & Wolford, 1994), and the use of YouTube and other similar online video sites (Columna, et al., 2009). More novel initiatives were a national project, involving students, which encouraged the book world to include disabled people in children's books (Matthews, 2010); a course described for social work students which used materials, knowledge and theory developed by disabled people (Meekosha & Dowse, 2007); suggestions from a first-year literary composition class which described four ways to incorporate disability studies into the curriculum (Patterson, 1994); and a year-long study unit which used students' geography knowledge and skills to address a real-world problem (Treby, et al., 2006). These approaches were used with a variety of students: health professional students (medical, nurses, social work, speech and language, hygiene dental, physiotherapists, occupational therapists, health management) and students of art, design and multimedia, humanities, geography and psychology.
Although a number of innovative methods were described, the effectiveness for many of these interventions was not investigated. In one study that did evaluate their intervention, a significant change in the Attitude Towards Disabled Persons Scale scores (p=0.05) was reported; course attendants (nurses) had a more positive attitude towards disabled people after completion of a nine month chronic illness course (Thompson, et al., 2003). A meta-analysis of studies investigating simulation of disability activities showed that these activities had little effect on behavioural change (Flower, et al., 2007). Interventions that appeared most effective, based on qualitative feedback, were those which had on-going engagement (Treby, et al., 2006) and real-life/contextualised activities (Matthews, 2010).

Results of the Workshop
Twelve people volunteered to attend the workshop; however only ten staff members (1 male, 9 females) participated in the workshop on the day.

Identified Challenges
Workshop attendees felt that little was being done to create awareness for disability in current curricula. The majority of participants perceived that the power to change this was in the hands of the Heads of Departments and the University's Higher Education and Development Centre (HEDC); only a minority considered they could themselves do something to change this. Barriers were seen in 1) attitudes and knowledge, 2) the prescriptive curriculum, and 3) resources (time) and funding constraints.

Suggested Solutions
Workshop participants suggested numerous ways to increase disability awareness amongst University staff and students and in the curricular and these suggestions are listed in Table 2. Attendees further recommended that a campaign increasing disability awareness should be targeted at a number of levels, namely a departmental approach, at an individual level with "modelling", networking across campus (and the wider community), building up resources, and inviting guest speakers. Participants held the view that there is generally more acceptance of diversity/inclusion in society today and that this, hopefully, will eventually filter through to universities. Working as a department to embed disability issues across a paper.  Think about diversity and focus on strengths.  Assessment practices -it would be helpful to the working party to review current assessment practices and make suggestions of new and diverse methods to cater for the differing learning needs and skills of students.  Prescribe a disability-focussed journal article for students to read and critique on issues.  Using stories and resources in class that reflect first person experiences.  Incorporate disability artwork in presentations and posters.  Assist marketing strategies for disabled groups.  Develop a resources/inventory of diverse ways disability has been embedded into curricular.  Invite guest speakers from across the university to present in student papers, thus building relationships with people who have a common interest across departments.  Think about power base we all work from -who you are as a student/teacher etc. verses those that do not have power. Need to develop "whole"/ critical thinking people because of the "power" they get when they leave university to influence others.  Students no longer seem to have issues to fight for, because New Zealand students mostly are from "privileged" backgrounds or the fact that students are not challenged? Can we mobilise students on this issue of disability rights?

Evaluation of the Workshop
All who attended completed an evaluation questionnaire of the workshop, the main outcome of which was that attendees rated the workshop as highly valuable. When asked what they thought were the best things about the workshop, attendees were enthusiastic about the opportunity to meet others across the University with an interest www.ccsenet.org/jel Journal of Education and Learning Vol. 2, No. 1;2013 151 and passion for disability issues, the exposure to a range of expert knowledge about disability including life experience as well as academic expertise, and the group discussions and reflections. By sharing information in this way, with the chance to discuss with and learn from peers in the workplace who share a mutual interest, helped broadening perspectives. One participant said: "my energy to engage in disability issues was restored!" Suggestions made to improve future such workshops, included: (1) spending more time on finding solutions, (2) making process and outcome expectations clearer, (3) developing a shorter workshop, (4) trying to get wider university involvement, (5) providing more information beforehand about what was to be covered, (6) including an overview from The Disability Office about the services that they currently offer, and (7) providing more specific information to assist students, such as how to provide lecture material in an accessible format.

Feedback from the Conference Presentation
The audience's opinions regarding challenges to raising disability awareness in academic curricular can be broadly categorized as: communication issues, physical and structural barriers, isolation, and teachers' lack of knowledge; verifying our literate review and workshop findings.The audience had additional suggestions for embedding disability into the curriculum. One suggestion made was: I think when you do something like that (the workshop) you have a great day, but you forget about it. What I did when I was teaching was something that was called "the Deaf world". It was part of a paper. Pupils were taught sign language over three weeks. The people from the Deaf community came and did a workshop. They represented a village and the students had to be the people on the "other side" and had to be understood in sign language. A Deaf person signed a life story to the students. The feedback was that the experience was so strong.
A parent with a disabled child suggested another method to raise awareness. She had participated in inclusive education classes and had told of her experiences of raising a disabled child to students in these classes. She felt she had made an impact on the students and they later said it had been one of their more interesting classes. A final suggestion made was that a change to the Academic Promotions Policy could result in incentivising academics to include disability teaching in their curriculum.

Discussion
We considered this project successful, in that it generated discussion and identified challenges to embedding disability awareness into the curricular. It also provided solutions, many of which were practical ideas that could be implemented immediately by individuals, and others that would need invested time and commitment to realise. We are however cognisant of the limitations to our work. In spite of both wide and targeted promotion, we only attracted a small sample of people to our workshop, people who already had a passion for raising disability awareness. The University employs about 3,700 full-time staff (academic, research and general staff), yet only 10 people participated. The reasons for this small number may be varied; it was a busy time of year with the final university exams in full swing, potential attendees were deterred by the research involvement of the project, or staff members were not interested. We thus did not gain the opinions and suggestions from a large or diverse group, although our attendees did come from all faculties of the University. Our greatest challenge for future such work lies in attracting larger numbers of staff, as well as staff who presently may not be as interested in the topic as we are.
We initially considered the staff at the University to be the starting point of embedding disability awareness into the curricula, but perhaps, given modern societies increasing acceptance of diversity, we should target young people who generally are more accepting of new ideas, and start the change at the grass-roots level. Perhaps we could elicit advice and assistance from the University's Student Association and that of more philosophically focussed student groups, such as the Students for Environmental Action (SEA), the Queer Support Group, and religious or ethnic/cultural groups. This said; modifying higher education curricular is not easy. The curriculum is fundamental to a higher education institution (Barnett & Coate, 2005). A case study which explored a curriculum review process at a higher education institution made a number of recommendations for such a process, crucial to which was the need for a collectively shared guiding vision for the curriculum (Hyun& Oliver, 2011). Supportive administrative leadership was seen to be essential (Hyun& Oliver, 2011). To embed disability awareness fully into our University curriculum will require a shared vision involving academic and administrative staff, and students; reaching this collaborative point would take concerted effort and time.
Probably asimpler strategy to begin with would be to target multiple starting points, both at staff and students levels. Treby et al. (2006) also suggested targeting development at a number of levels, including the personal, output (planning, research skills and presentation and communication) and curriculum level.
Given the importance of University curricular, and the overwhelming task of bringing change to it, may have  (2011) highlight as important and requiring attention if change is to be successful. Perhaps another starting strategy would be to focus on small changes. One of the key solutions suggested by workshop attendees was that of "modeling", as individuals we could start modelling what we would like to see in others, and this might be a "small" place to start. In an essay on teaching spirituality and leadership, Rogers (2006) argues that for her students to make sense of life's ethical dilemmas, they required role modelling, to learn from the real-life experiences of their teachers, as one of her students expressed (Rogers, 2006, p. 1): "It was so important in this course that the instructor participates in this journey with us. I never got the sense that she was sort of leading from afar, or orchestrating some kind of predetermined scheme with us as the spirituality-seeking guinea pigs." As with spirituality, for many students, with little previous disability (or spiritual) exposure, conceptualising exclusion maybe a difficult, and even a foreign, concept (Livingston, 2000), and seeing fully inclusive behaviours in the everyday actions of their teachers may be a powerful intervention. In addition to modelling inclusive behaviour, individual "modeling" could be done by introducing subtle inclusive practices into papers we teach.
Other "small" strategies that can be incorporated into teaching to increase acceptance of diversity, as suggested by our workshop and conference attendees, include respectfully using pictures of diversity or verbal disability examples to illustrate points made in lectures, using large font size on power point slides, or presenting verbally and in sign. Real-life problems that students have to research and solve, which involve interacting with disabled people (Treby, et al., 2006), may also be useful ways in which to raise awareness. From our literature review, however, we are informed that such strategies should not be short-term, such as a one day workshop, but should be an on-going engagement (Treby, et al., 2006). Furthermore, introducing students using artificial simulation activities appears ineffective and may, in fact, produce the opposite to what was intended. French (1992) considers that participants of such activities tend only to focus on the negative aspects of disability, reinforcing undesirable stereotypes. Participants may trivialise disability, as the simulation activities represent a sudden onset of impairment rather than what it is really like to live with a long-term disability (French, 1992). Real-life and contextualised activities (Matthews, 2010) and reflection and discussion on one's own behaviours towards disabled people, exploring disabled identity, and the oppression of disabled people may encounter and ways in which this oppression can be removed, as suggested by French (1992), may be better strategies to employ.
More ambitious strategies were suggested by our workshop and conference attendees. One suggestion was a review of current assessment practices to make suggestions of new and diverse methods to cater for the differing learning needs and skills of students, a sentiment shared by Hurtado (2009). A second suggestion was that the University's Academic Promotions Policy could be changed to incentivise academics to include disability teaching in their curriculum. Such a policy change had been successfully implemented to drive research (Harland et al., 2010). These "larger" changes would need to be driven from higher academic administration.
Another practical suggestion made was to create a disability network across campus; individuals in this network could meet to discuss disability issues or discuss journal articles. Such a network may be effective in bringing about change as it fulfils the requirements of Wenger's "communities of practice" (Wenger, 1998). Communities of practice, which are epitomised by a group of people who take part in communal learning in an area of shared interest, have been found to drive strategy, problem solve, and foster best practice (Wenger, 1998). Another example of a community of practice was our workshop, which attendees considered valuable; especially appreciated was the opportunity to discuss with and learn from peers in the workplace who share a mutual interest. In the future we would like to improve our workshop programme (based on our participants' suggestions) and run more staff workshops.

Conclusion
This was a small project which explored, with interested staff, ways in which we can enhance the content and delivery of disability awareness within papers at our University. Whilst our participants considered major curriculum change was beyond their power, they suggested many smaller ways in which change could be instigated. These suggestions were confirmed and expanded by a review of current literature. The identified strategies may be of use to others contemplating similar curricular modifications. We plan to incorporate some of the strategies suggested into one or two existing University courses and evaluate their success in raising disability awareness in students attending the course. Intervention: participation in one day (8 hour) Sensitivity Day -a simulation activity in the community, panel presentations by disabled people or carers and a debriefing segment in small groups.
No statistical differences found between the groups at each stage, but a trend for scores to increase from baseline at 6 weeks and 6 months in both groups.  Case studies were prominent with students encouraged to reframe the social work intervention in light of their new learning. (Livingston, 2000): USA Descriptive paper of a medical sociology course on illness and disability.
-Course students: medical students, physiotherapy, occupational therapy, health management, and those that plan to work with older people or people with disability.
Course: Describes an exercise (field visit, follow-up discussion and assignment) in which student groups analysed a building's architectural barriers to gain an understanding of how disabled people are excluded from everyday social interaction.
Common learning themes have appeared over the years: (1) physical space or lack of, (2) recognition that knowing how people with disabilities feel is impossible, (3) the link between social acceptance and the demands of the physical environment, (4) the meaning of disability is socially constructed (Lock, 2003): -

Course students: First year literary composition class
Incorporating disability studies within the curriculum: proposed 4 ways: (1) balance the negative, stereotypical view of disability in texts by also using texts that challenge this view, (2) be aware of the biases of the writer, the culture in which the text was written as well as the readers own biases -use texts from all walks of life to balance the views, (3) organise part of course around disciplinary approaches such as women's rights, gay rights, disability rights movements and set assignments for students to examine all sides and argue for one based on own experiences, (4) organise part of course around ethical dilemmas which can easily incorporate disability issues such as abortion, euthanasia.