Mark’s story

Mark’s story illustrates some common challenges experienced by students on health courses, including studying as a mature student and the challenges in accessing support for learning differences.

“The hardest part about having an ADHD diagnosis for me was this fear of inadequacy, so, I’ve made it this far, I’m a mature age, it shouldn’t be that difficult…”

Many students enter healthcare courses following careers in other industries and this can be challenging; students report it can be difficult to go back to being ‘the student’ when they have been used to operating with autonomy, expertise and credibility elsewhere. It can also constitute a big financial change. Mark speaks about quitting his job as a nurse to pursue his dream in radiography and the struggles he experienced on returning to study…

“I came back and I found it so difficult and I couldn’t really understand why I was finding it difficult.”

Mark engaged with support services at the university who supported Mark through some assessments that indicated he may be showing signs of ADHD. Mark’s story highlights the importance of both engaging with university support services but also on the power of reasonable adjustments to transform the learning experience; whether this is through extra time for assignments or support from specialist academic skills experts as Mark found.

“The university network has been really supportive… knowing that you can reach out for that support and people will understand and you’re not a failure for it.”

Interestingly, following assessments through the University, Mark chose not to pursue a formal diagnosis. This is becoming increasingly common and there are a number of reasons why students may decide to either self-diagnose or choose not to pursue a formal diagnosis, like Mark.

“I haven’t really followed up with a diagnosis… part of ADHD is like, ahh I’m fine, I’m coping, I don’t need that support.”

Alternatively, Mark’s strategies for coping have been around increasing self-awareness…

“Really know yourself… understand what gives you energy and what takes energy away from you.”

Resources for course teams

Considerations for academic teams

• are students made aware of processes for agreeing reasonable adjustments and extenuating circumstances for both theory and placement? Are all staff aware of these processes?
• how does your institution communicate with applicants, students, their previous employers or education institutions to discuss what has worked previously so this can be seamlessly incorporated into their learning in higher education?
• how and when do staff review and access student demographic data so they are aware of the backgrounds and experiences of the students they are teaching? How do we avoid the mindset that all students are younger with limited working experience?
• how do you direct students who have real financial difficulties? What are their options? How are staff supported to keep informed of this?
• what is your attitude (or your institution’s attitude) to students who self-diagnose or resist ‘official’ medical diagnosis for learning differences or difficulties? How can they be supported?
• how are students enabled to access tools for increasing self-awareness?

Tools for academic teams

• direct students to explore NHS learning support funds for further financial aid.
• students with ADHD may also be eligible for benefits, find out more by searching the .gov.uk website – students can often apply via their student finance account
• support networks exist within multiple professions for both students and staff with an experience of disability or neurodiversity, for example the royal college of nursing (RCN) have a network which you can direct students to – search for ‘peer support services’.
• how can you develop students’ ability to develop self-awareness? There is much talk about compassionate curriculum in developing the skills students need to embrace selfawareness and change. Good work has been done here by skills development Scotland in formulation of their skills 4.0 model

Resources for students

Considerations for students

• if you had an adjustment or accommodation with your school, college or previous employer, the sooner you can engage with the university and share this the better. Don’t wait until it becomes a problem
• think about what has worked for you before in learning new information, retaining it and communicating it. The chances are this strategy will still be helpful, talk about it with your personal tutor to adapt it to the context of higher education
• if you have self-diagnosed a condition such as ADHD or Autism do not be feel like this cannot be shared; this is valuable information, even if it does not meet ‘official’ criteria or if you have no desire in seeing if it does, it can reveal incredible self-insight that can help with university work and placement. If you are able, speak to your personal tutor about this in the first instance to direct you to further support
• any tools you can find that increase your own understanding of how you study and learn best are useful, seek these out, speak to peers about what works for them and try out different approaches. Understand that no one is the same and no one size fits all

Tools for students

• for mature students, you may be able to borrow money to help pay for university or college tuition fees and to help with living costs. The maintenance loan currently includes an amount that is not means tested student finance for undergraduates: New full-time students. You may be able to get a higher loan if you’re on a low income. You might also get extra grant money on top of this, for example if you are disabled or have children
• use structured approaches to engage with your course team or practice if you find it harder to structure your thoughts because of a learning difference. See examples such as those used by ADHD UK – search for ‘work welfare pack’
• ADHD UK also provide initial screener tests for those people who might suspect ADHD with advice on what to do next

Resources for practice staff

Considerations for practice staff

• remember students who have disclosed difficulties with the university may not have disclosed these to practice educators, supervisors, or assessors (and the university is usually unable to share details directly). How can you create safe spaces for students to speak to practice staff and disclose these if they wish? Are students ever asked? When are they asked about this and by whom?
• how do you reinforce amongst staff the diversity of students who are in practice? Remember that many may be older, have significant experience in healthcare or another industry. How can you encourage curiosity and appreciate and incorporate existing skills into practice?
• remember students who have disclosed an ADHD diagnosis or learning difficulty with the university may not have disclosed this to practice educators, supervisors, or assessors (and the university is usually unable to share details directly). How can you create safe spaces for students to speak to practice staff and disclose these if they wish?
• there is much stigma associated with self-diagnosis of ADHD, autism and mental health conditions, particularly amongst health professionals. Whilst a full diagnosis is usually not possible without evaluation by a qualified professional, many assessments that can be accessed directly by students can provide the student with insight and self-awareness that may be useful in practice

Tools for practice staff

• lead by example: demonstrate openness by sharing your own experiences and challenges when appropriate. This sets a tone of vulnerability and trust
• access, read and consider how you can implement the ‘safe learning environment charter’ for students in your practice area
• promote Psychological safety: Make it clear that all concerns and disclosures will be met with understanding and not judgment
• access resources such as the work welfare pack from ADHD UK to help support the welfare of those in practice – search for ‘work welfare’
• have a look at the SSHINE initiative which has fantastic resources for supporting neurodiverse students in practice