[Home-on-the-range] Simulation as a Learning Method to Facilitate Disability Awareness

[Dianne Hemphill]

Thanks for this - this really helps define the problems and most likely negative  impacts of poorly designed and carried out simulation training. The recent resolution of condemning dining in the dark simulated trainings,, is well explained here. It is so easy to have the results of such simulations result in just the opposite impact as what is intended-  if the intent is to increase understanding of   the disability ...  most participants are thoroughly frightened and  more ready  to  pull out their check books. ..  this which may be the intent anyway.. which may be the intent anyway... Dianne
On Jul 18, 2012, at 9:07 PM, Susan Tabor wrote:

> Hi, listers!
>  
> The article that I’ve pasted below was posted on the NFB human services list-serve a few weeks ago, just after the national Convention.  This is a scholarly and very well-presented article on the simulations issue.  It’s a bit lengthy but worth the read.
> All the Best,
> Susan
>  
> Subject: [humanser] Simulation as a Learning Method to Facilitate DisabilityAwareness
>  
>  
> Simulation as a Learning Method to Facilitate Disability Awareness
>  
> by James T. Herbert
>  
> Within the traditional classroom and other learning settings, educators have often used disability simulation as a method to develop awareness and promote positive attitudes toward persons with disabilities.
> As a general teaching strategy, simulations have been used because they are reported to: (a) facilitate interaction among participants,
> (b) provide opportunities to practice decision-making skills and resulting behavioral consequences, (c) convey important social messages, (d) facilitate exploration of personal values, and (e) foster empathy and insight regarding events and issues being simulated (Hyman, 1978). As applied to acquiring greater sensitivity to disability issues, simulations allow learners to duplicate particular roles so that better awareness and insight result regarding the problems, strengths, weaknesses, and lifestyles of persons with disabilities (Patterson, 1980). For example, an individual without a disability may use a wheelchair to simulate paraplegia, place cotton balls in both ears to approximate a hearing impairment , use light-filtered glasses that block the center of a visual field to fabricate blindness, or remain silent for an extended period of time to create the experience of mental illness. As opposed to passive learning activities such as watching a movie or reading a book about disability, simulations allow learners to bridge the gap between passive learning and direct personal experience (Patterson, 1980).
> Effectiveness of Using Disability Simulations Despite reported benefits of using disability simulation (e.g., Chard, 1997), empirical evidence that supports its utility as a learning method to facilitate positive attitudes toward persons with disabilities is weak. For example, Wilson and Alcorn
> (1969) reported
> no attitudinal differences among college students who simulated blindness, deafness, or orthopedic disability. Most of the new insights acquired by persons who simulated a disability were negative reactions such as displeasure with self, embarrassment, frustration, and reliance on others.
> Glazzard (1979), in a report containing excerpts of students' comments regarding hearing, orthopedic (wheelchair), and visual simulation impairments, concluded that this method promoted increased understanding of disability. Yet images of frustration, isolation, humiliation, insecurity, and apprehension were the major themes expressed. Pfeiffer (1989) reported that although being perceived as a useful learning activity, persons simulating someone who used a wheelchair felt "demeaned" during the experience. Wurst and Wolford (1994) found that college students who simulated auditory and visual disabilities for one day perceived other people without disabilities as being "distant, judgmental, [and] not as friendly" (p. 234). It was noted that several participants reported how "fortunate" they were not to have a disability. Wurst and Wolford viewed these outcomes as supporting one of the major goals of the simulation, which was "not to take their [students'] senses for granted" (p. 234). Grayson and Marini (1996) found that as a result of completing a disability simulation, students without disabilities were more likely to report stronger agreement to several counterproductive beliefs.
> In particular, reports that persons with physical disabilities have a harder time in society, become more frustrated because of their disabilities, and are often preoccupied with physical accessibility were noted.
> To a great extent, the lack of strong empirical support for the use of disability simulation is a function of problems associated with research methodology, sampling, instrumentation, and statistical power. These research problems are ones often expressed in the general rehabilitation literature (Kosciulek & Szymanski, 1993).
> Consequently,
> despite anecdotal reports (e.g., Clark, Foos, & Faucher, 1995; Orlansky,
> 1979) and,
> to a lesser extent, experimental studies (e.g., Chard, 1997; Thatcher & Robinson, 1990; Wiener, 1986), it is often the case that methodological problems compromise the veracity of disability simulation as a method to promote favorable attitudes.
> Beyond the perceived advantages cited earlier by Hyman (1978) and Patterson (1980), it appears that its popularity is predicated on learner enjoyment as well as a neglect by educators to question its effectiveness. As an indication of the enjoyment factor, Twelker (1976) related a story about a noted simulation expert who was asked to comment on the research to support simulation as a general learning method.
> Reportedly, the
> educator responded, "As it stands now, all of us are admitting that we don't know exactly what we are doing, but it sure is a lot of fun" (p. 96). This characterization noted almost 25 years ago is applicable today. Within the context of disability simulation, Kiger (1992) noted that most educators simply do not question the effectiveness when using disability simulations.
> Given the apparent discordance between effectiveness and use, educators employing disability simulation as a learning method may be in a dilemma as to how to best proceed. An analysis of the disability simulation literature provides an opportunity for educators to make an informed decision on whether and how this learning method could be used effectively.
> Considerations When Using Simulations
> As noted in the earlier literature review, relying on a simulation as the only learning method to facilitate awareness and promote positive attitudes toward persons with disabilities must be questioned as an educational practice. When simulation is combined with other learning methods, however, there is clear support that positive perceptions toward persons with disabilities occur (e.g., Barrett & Pullo, 1993; Jones, Sowell, Jones, & Butler, 1981; Pernice & Lys, 1996; Pfeiffer, 1989; Schwartzwald, 1981; Wurst & Wolford, 1994). Examples of other learning methods include: (a) direct social interaction with people with disabilities through recreational pursuits, 03) reading material and/or viewing and listening to audiovisual materials (films, videotapes) about disability issues, (c) attending support group meetings that are open to the general public (e.g., Alcoholics/Narcotics Anonymous), (d) listening to panel discussions conducted by persons with disabilities, and/or (e) taking formal coursework in academic disciplines that address various disability aspects (e.g., rehabilitation counseling, special education, and therapeutic recreation).
> As evident in these learning methods, the level and type of contact between persons with and without disabilities varies considerably.
> For this reason, applying several learning methods rather than relying on disability simulation alone is more effective in producing positive attitudes, awareness, and behavior toward persons with disabilities.
> Beyond the literature to support the efficacy of using multiple learning methods, there are additional reasons that have been cited as well. First, many rehabilitation educators (e.g., Chard, 1997; Hallenbeck, 1984; Wright,
> 1978) believe that individuals who participate in simulations tend to experience only negative aspects of disability such as problems with architectural accessibility, physical fatigue, and learning how to perform tasks in a different way. This criticism seems particularly applicable when simulations are of short duration, such as a few hours (e.g., Kelley, 1993; Margo, 1983). Second, educators sometimes ask learners to focus on particular frustrations and barriers that occur during the simulation (e.g., Thatcher & Robinson, 1990; Wilson & Alcorn, 1969). By doing so, disability simulations have effects opposite to those for which the learning intervention was intended (French, 1992). Third, other interventions, such as interviewing persons with disabilities or listening to speakers who have direct personal experience, provide learners with a broader perspective about disability.
> In order to be effective, however, the contact between persons with and without disabilities must be characterized by an equal status relationship (e.g., similar in educational, social, and vocational status) (Donaldson, 1980). Furthermore, Wright (1980) contended that interpersonal contact between persons with and without disabilities that evokes aversion, fear, or guilt is not likely to result in any constructive views regarding disability.
> Although there is consensus in the use of multiple modalities to increase disability awareness and facilitate positive attitudes, there is no guidance from the empirical literature as to what sequence may be most effective. To my knowledge, there have been no experimental studies that have investigated whether certain sequential learning methods are more effective than others.
> On a practical level, prior instruction that reviews stigma issues and stereotypes about persons with disabilities provides a useful framework for a subsequent simulation experience. Other less directive learning strategies, such as conducting structured interviews with persons with disabilities or attending support group meetings that are open to the general public, may provide learners with personal experiences that may be augmented or challenged in an experiential activity such as disability simulation.
> Orienting Learners
> A second consideration when using disability simulation is that learners must be properly oriented to the experience (Grayson & Marini, 1996; Wright, 1980).
> Prior
> to practical matters such as the nature, length, and setting(s), and how and when learners document the impact of the experience (e.g., keeping a written diary or using a tape recorder), the purpose for using disability simulation must be considered.
> Chard (1997) asked educators to think about whether the purpose of the disability simulation was to examine attitudes and feelings about disability, raise consciousness about environmental and societal restrictions imposed on persons with disabilities, or accomplish both goals.
> As part of postsecondary training, the use of simulation may evolve from previous learning that examines individual differences, stigma and prejudice, and attitudes toward persons with disabilities. For some educators (e.g., Patterson, 1980), simulations that have little relationship to formal coursework objectives should be avoided. Other educators (e.g., Jones, 1995) seem less concerned about identifying specific learning objectives prior to the simulation and place greater emphasis on providing learners with sufficient time to reflect upon the experience.
> Regardless which pedagogic philosophy one follows, disability simulation can result in a powerful emotional experience (e.g., Glazzard, 1979; Pfeiffer, 1989).
> As a result,
> it is important that educators consider the emotional, social, and physical experiences that learners may encounter (Patterson, 1980). In particular, participants should be told during orientation to consider solutions they might use in overcoming perceived barriers associated with the physical, mental, and/or social roles they take on.
> Recognizing the solution-focused approach that Wright (1980) advocated, educators should instruct learners to identify what attitudes, behaviors, and thoughts were useful in overcoming perceived barriers as part of the simulation experience. Sensitizing participants to barriers that are self-- versus other-imposed may be helpful for later debriefing, providing an opportunity to discuss attitudes toward persons with disabilities. According to Wright (1980), it is often the case that people without disabilities use their life experience in determining what social, personal, and vocational roles are possible for persons with disabilities. For instance, a sighted person may not perceive how a person who is blind could enjoy going to a movie as that other person cannot "see the movie."
> Although
> the sighted person acknowledges that the experience is different, it is also devalued.
> To demonstrate this central point, there are three preliminary activities that I provide during the orientation process.
> The first activity involves asking learners to write down all of the images that come to mind that they associate with the word "disability." I ask learners to record as many words as they can within one minute and, after doing so, I invite them to share whatever images they wish. Often, this experience results in several themes that reflect ability, challenge, courage, devaluation, discrimination, and stigma.
> I ask learners to consider the positive and negative qualities as noted in the list.
> Following this activity, I ask learners to list various social, recreational, and vocational activities that they engage in. Participants will usually list activities such as drive a car, go to a movie, get a job, raise a family, prepare a meal, and/or go water skiing. Next, I list several disability categories such as blindness, deafness, epilepsy, mental retardation, severe mental illness, and spinal cord injury (quadriplegia).
> After writing all the activities in a column and disability categories in a row I ask learners, "In which of the following activities could members of any or all of these disability groups not participate?" I provide no other information.
> After several
> minutes, learners are asked to volunteer their responses. Usually, there is a mixed response whether members of specific disability groups can participate in a particular activity. For example, although preparing a meal is perceived as an activity that most persons with a disability can perform, there is less agreement about other activities, such as driving a car or raising a family. During the learning activity, I ask people who did not respond similarly to explain why they elected to include or exclude a group with a particular disability. After this discussion, I ask learners to consider the possibility that all identified groups could participate in each identified activity.
> Usually, this response is met with various levels of doubt among participants because the word "participate" is perceived as being analogous to engaging in an activity in the same way as someone without a disability would. This comparative framework by persons without disabilities often results in restrictive roles as perceived by persons without the disability.
> Recognizing this framework serves as an important context when disability simulation is used as a subsequent learning method.
> The final preliminary activity that I provide involves making a list of various disability categories that are arranged alphabetically. This list includes alcohol/drug addiction, blindness/visual impairment , deafness/hardness-of-hearing, HIV/AIDS, learning disability, mental illness, mental retardation, multiple disabilities, paraplegia/quadriplegia, and traumatic brain injury. I ask learners to rank-order their preferences as to whom they would most prefer to work with. I further indicate that there cannot be any categories with the same ranking. Learners are asked to make two copies of their rankings, one that they submit anonymously and one they keep for themselves. After completing rankings, learners are invited to share their responses. Rankings are recorded on poster board or blackboard, or in some other way displayed for participants to view.
> After rankings
> are tallied, I ask participants to consider what factors influenced their rankings.
> One theme that frequently emerges is that people's preferences are dictated by previous experience with a particular disability. This result is consistent with research studies that indicate that increased contact is likely to yield more favorable attitudes (e.g., Biordi & Oermann, 1993; Stewart, 1988), particularly when the person with a disability is perceived as coping successfully (Strohmer, Grand, & Purcell, 1984; Weiner, Perry, & Magnusson, 1988). Using this final preliminary activity as part of the orientation process usually results in persons having different responses toward disabilities that they perceive as "controllable." For example, persons with alcohol/drug addiction , mental illness, and/or HIV/AIDS may be valued more negatively than other disabilities that might occur congenitally. This perception is consistent with several research studies (e.g., Alston, Wilkins, & Holbert, 1995; Furnham & Pendred, 1983; Home & Ricciardo, 1988). In other instances, preferences can be a function of the perceived extent of accommodations needed to engage in a specific activity or social role and, therefore, the requirement of greater assistance on the part of persons without disabilities.
> Within the professional community of therapeutic adventure providers, this issue seems particularly applicable (Herbert, in press).
> These preliminary activities help clarify the importance of perceptual sets that many persons without disabilities have toward persons with disabilities. As an educator who often criticized the single use of disability simulation, Wright (1980) contended that if this experiential method was used, then learners must understand the distinction between succumbing and coping frameworks prior to conducting any simulation experience.
> According to Wright, a succumbing framework emphasizes what an individual cannot do; it does not address what types of adaptations are needed to meet everyday challenges.
> Persons who subscribe to this framework believe that disability remains the central focus of one's life and any individual personality characteristics are superceded by disability. In contrast, persons who subscribe to a coping framework hold a "constructive view of life with a disability" (p. 275).
> People with disabilities are not passive victims who are devastated by life challenges. Rather, persons holding a coping framework recognize that in order to manage life challenges, persons with disabilities must change their environment. A coping framework embodies a solutionfocused approach to solving architectural and social barriers. In short, disability is only one aspect of a person's life that presents both challenge and gratification.
> Wright recommended that if simulations were used, participants should consider how it might be possible to live with a particular functional limitation (i.e., use a coping framework). When confronted with architectural barriers (e.g., no curb cuts for someone using a wheelchair), learners should think about ways to reduce or eliminate them. Wherever possible, participants should interact with environments having varying levels of accessibility (e.g., drinking fountains that accommodate wheelchairs versus those that do not).
> According to Wright, simulations should "find solutions to problems, not to remain stuck with them" (p. 275).
> Viewed from this perspective, simulations provide opportunities for learners to gain a better understanding of environmental barriers and how they may be overcome. This understanding is not likely to evolve using "one-time"
> simulations of short duration.
> For this reason, Grayson and Marini (1996) recommended that educators remind learners of longitudinal studies (e.g., Crewe & Krause, 1990; Marini, Rogers, Slate, & Vines, 1995; Tate, Kewman, & Maynard, 1990) that indicate that persons with physical disabilities experience fulfilling and satisfying lives and report few long-term problems. As reported in these studies, adjustment to disability changes over time as persons learn to deal with and overcome obstacles. For this reason, the experience of understanding and overcoming the challenges that disability sometimes presents is not always available within one short-term disability simulation.
> Ethical and Safety Concerns
> A third important, yet largely excluded, area in the literature involves ethical and safety concerns for learners who participate in disability simulations.
> Because
> of the experience that is simulated for brief periods, disability simulations have no relevance for persons without disabilities to gain useful insight in what it means to incorporate disability as part of one's overall identity. The experience that results from years of living with a disability cannot be condensed within a brief time period. Attempts to approximate this experience raise an important ethical question:
> If persons who participate in a simulation come away from the experience and view people with disabilities as being unfortunate, pitied, or devalued, is it ethical to use this learning method? Perhaps, as Scullion (1996) noted, this ethical dilemma may be avoided if educators pay greater attention to learning objectives, orientation concerns, and debriefing of the experience.
> Within the latter area, Kiger
> (1992)
> contended that disability simulations pose potential emotional risks for participants.
> These risks are heightened in cases where participation is not voluntary.
> Should
> debriefing occur as part of the learning process, Kiger warned that if participants shared personal reactions indicative of prejudice during the debriefing, then sharing such reactions could prove detrimental in other situations outside of the debriefing experience. For this reason, educators must provide a safe debriefing environment where "participants respect one another's privacy" (p. 73).
> Paralleling potential emotional risks are those that involve physical safety. When simulating a functional physical limitation, persons without disabilities are often required to use props or other materials that restrict physical mobility, vision, and/or hearing. Because of the unfamiliarity with sensory loss or physical mobility restrictions, participants may place themselves in physical jeopardy. Kappan
> (1994)
> contended that simulation participants who had no training in blindness skills should avoid environments that contain narrow passageways, overhanging objects, unstable walking surfaces, and stairways. These situations represent potential dangers. The decision as to which environments represent perceived and/or actual risk is one that each educator must consider carefully. Although it is impossible to totally eliminate any chance of injury, no participant should be placed in a situation where serious injury may occur. For this reason, educators must indicate during orientation the potential risks that exist and remind participants to exercise caution when simulating particular disabilities.
> One way to reduce potential risks is to ask participants to work in pairs.
> The person not participating in the simulation serves as a "spotter"
> in the event of potential risk that is not evident to the person with the "disability,"
> or if this person requests assistance. Although there may be concern that the spotter may have a diminished role in the simulation, this role can be enhanced if the "unimpaired"
> partner observes the behavior of the person simulating the disability as well as the reactions of others. These observations can prove useful during subsequent debriefing.
> After a period of time, roles can be reversed so that the spotter simulates the disability.
> This procedure in switching roles has been found to facilitate learning (e.g., Grayson & Marini, 1996).
> Given safety concerns as well as other learning constraints, it may be prudent to use a learning method other than disability simulation. For example, Kappan
> (1994)
> believed it was better for students to engage in a classroom discussion with individuals who are blind or have other sight impairments, rather than to participate in a simulation.
> Recognizing
> that simulations vary across learning environments, refraining from or modifying the simulation may or may not be prudent given learning objectives.
> For instance, wearing a blindfold to simulate visual loss or listening to an audiotape of condescending statements via earphones to simulate mental illness may be very troubling for some individuals. Although there are other ways to simulate aspects of these disabling conditions (e.g., wearing dark glasses that are coated with petroleum jelly, repeating nonsensical phrases aloud), facilitators should indicate to potential participants that some emotional discomfort may occur and, if necessary, learners may discontinue the simulation at any time. In the event that learners do not wish to directly experience any form of disability simulation, they may wish to participate as observers or select one of the other learning methods mentioned earlier.
> Facilitator Role
> Heyman (1975) contended that there was one fundamental rule when directing a simulation, and that was, "Run the simulation, not the learners" (p. 21).
> His basic concern reminds educators that learners should have the necessary information to complete the simulation and, once started, an educator's role should be as an unobtrusive observer.
> Heyman's
> contention was that educators were not there to teach. Rather, it was the simulation that provided the learning. Following this recommendation, the initial role of educators during the simulation is to have minimal interaction with learners. Although this recommendation seems obvious, it is interesting to note that in some disability simulations (e.g., Thatcher, 1990), learners are "harassed and nagged" by "facilitators"
> in order
> to promote empathy about the disability experience. In an effort to duplicate "real world" experiences, this type of intervention seems counterproductive because, as noted earlier, participants learn a succumbing rather than a positive coping framework.
> Facilitator interactions, comments, and/or interpretations about participant behavior should be avoided while persons complete the simulation. Once the simulation has concluded, educators perform an important role as facilitators during the debriefing phase.
> There have been several descriptions regarding how to debrief an experiential activity (e.g., Hammel, 1986; Knapp, 1993; Nadler & Luckner, 1992). Certainly, suggestions contained in these descriptions are applicable to processing a disability simulation experience as well but, within the specific context of disability, Steinwachs (1992) believed facilitators should address additional areas of inquiry. As a guide, participants might be asked to examine: (a) their feelings when the simulation was first introduced,
> (b) their greatest frustration and success during the simulation, (c) whether the simulation raised any parallel real-life experiences, (d) what aspects were missing from the simulation, and (e) who or what else must be confronted regarding disability barriers that was not part of the simulation experience. Such inquiry is useful because it requires learners to consider both negative and positive challenges that the "disability"
> presented as well as how they were overcome. The insight gained as a result of this inquiry also helps learners to reflect on what was learned from the simulation that may generalize to their lives.
> Conclusion
> Disability simulation offers a promising intervention when used in conjunction with other learning methods. Educators who use simulations to develop awareness and facilitate positive attitudes toward persons with disabilities should include orienting activities that increase awareness and provide a proper context in which personal values and biases are examined.
> In particular, educators must address how persons without disabilities often apply a comparative framework when evaluating the capabilities of persons with disabilities. Providing opportunities for learners to appreciate and value the diversity of challenges that may be experienced through disability simulation may promote positive attitudinal changes. When used in combination with other learning methods, simulations represent an intervention to confront and reduce attitudinal barriers that often result in persons being less valued simply because of disability.
> Acknowledgement: The author would like to thank Alan Baehr who provided editorial comment to an earlier draft of the paper. Appreciation to the anonymous reviewers and the Editor is also acknowledged.
> -1-
> Questia, a part of Gale, Cengage Learning.
> www.questia.com
> Publication Information:
> Article Title: Simulation as a Learning Method to Facilitate Disability Awareness.
> Contributors: James T. Herbert - author. Journal Title: The Journal of Experiential Education. Volume: 23. Issue: 1. Publication Year: 2000. Page
> Number: 5+.
> C 2000
> Association for Experiential Education. Provided by ProQuest LLC. All Rights Reserved.
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