Physician collaboration involving students with Autism Spectrum Disorders

Medical student perceptions of autism education: A qualitative study

Background

The global prevalence of autism is reported to be at least 1% and is rising. Autistic people have a range of comorbidities resulting in a high use of health services. Doctors of nearly all specialties are likely to encounter autistic people in their practice. Autistic people report dissatisfactory care and encounter disproportionately worse health-related outcomes than non-autistic people, which in part has been attributed to a lack of skill and awareness in the medical workforce. At present, autism education is not always included in undergraduate medical curricula. In England, the Department of Health and Social Care has mandated that autism education should be included in all undergraduate medical curricula but current evidence relating to the delivery and receipt of autism education is poor. A greater understanding of medical student perceptions of autism education is required to inform curriculum development. This qualitative study sought to explore the perceptions of autism education in final year medical students at a medical school in South-East England by 1) assessing their perceived preparedness to care for autistic people once they have graduated from medical school and 2) determining their perceived acceptability of a new undergraduate education programme, Time for Autism (TfA).

Materials and methods

A purposeful sample of ten final-year medical students were recruited. Students completed in-depth, individual interviews. Data was analysed using thematic analysis.

Results

Four key themes were identified: Learning environment, Exposure, Relevance and Curricular priority. The findings of this study indicate that medical students perceived greatest value in autism education when it was directly relevant to developing preparedness for practice. Value was influenced by the perceived curricular priority attached to autism education. The new autism programme, Time for Autism was perceived to add relevance and priority to autism education in the existing curriculum in this medical school setting.

Discussion

The study findings shed new light on medical education literature, emphasising the importance of congruence between the provision of autism education and the prioritisation of autism education within the curriculum. Consideration of relevance and curricular priority can be used to support the development of autism education in future medical curricula.

Linking the Medical and Educational Home to Support Children With Autism Spectrum Disorder: Practice Recommendations

Children with autism spectrum disorder (ASD) present with complex medical problems that are often exacerbated by a range of other intellectual and psychiatric comorbidities. These children receive care for their physical and mental health from a range of providers within numerous child-serving systems, including their primary care clinic, school, and the home and community. Given the longitudinal nature in which care is provided for this chronic disorder, it is particularly necessary for services and providers to coordinate their care to ensure optimal efficiency and effectiveness. There are 2 primary venues that serve as a "home" for coordination of service provision for children with ASD and their families-the "medical home" and the "educational home." Unfortunately, these venues often function independently from the other. Furthermore, there are limited guidelines demonstrating methods through which pediatricians and other primary care providers (PCPs) can coordinate care with schools and school-based providers. The purpose of this article is 2-fold: (1) we highlight the provision of evidence-based care within the medical home and educational home and (2) we offer practice recommendations for PCPs in integrating these systems to optimally address the complex medical, intellectual, and psychiatric symptomology affected by autism.

Interprofessional education during an autism session

Interprofessional education (IPE) gained a strong foothold in the beginning of the twenty-first century as an effort to improve care to patients through enhanced teamwork. The aim of this study was to compare attitudes and experiences of the learners, which included graduate students, physicians in training, and practicing healthcare professionals, before and after an interprofessional clinical practice (IPCP) six-h autism didactic and experiential training session. The training session consisted of a 1-h lecture on Autism Spectrum Disorder (ASD), a 2-h behavior review meeting consisting of four different case study discussions among the learners, a 1-h lunch, a 1-h therapy session with children diagnosed with ASD, and a 1-h discussion among the learners. The IPCP learners (n = 63) completed a pre- and post-learning questionnaire of the Readiness for Interprofessional Learning Scale (RIPLS) and 12 Statements instruments and both showed an overall significant improvement in the learners interprofessional education after completing the training session. This study was able to show that students, professional trainees, and practicing professionals from different backgrounds led by an expert in the field can exchange ideas and role perceptions in an interprofessional didactic and experiential session, and develop improved attitudes toward IPCP. Moving forward, interprofessional education research needs to focus more on professional trainees and practicing professionals working together in combined didactic and experiential environments for children diagnosed with ASD.

How physicians support children with disabilities and their families: Roles, responsibilities and collaborative partnerships

BACKGROUND

The American Association of Pediatricians (AAP), in collaboration with the Council for Children with Disabilities and the Council on School Health, recommends that physicians learn special education law and practices in order to increase their ability to work with schools to support children with disabilities and their families. However, there is limited research that examines how doctors perceive their role as collaborators with families and school personnel.

OBJECTIVE

The purpose of this study was to explore the perceptions and collaborative experiences of doctors treating children with disabilities in order to develop an initial understanding of how doctors collaborate within the doctor/family/school triad.

METHOD

Semi-structured interviews with doctors (n = 13) from two states in the North Eastern United States were collected and analyzed using grounded theory methodology. Doctor specialty areas included general pediatrics, developmental pediatrics, rehabilitation pediatrics, and neurology.

RESULTS

Analysis of the data revealed four key categories: (a) what doctors do with regard to children with disabilities and schools, (b) elements that interfere with doctor/family/school collaboration, (c) what doctors know and understand about topics related to special education, and (d) how doctors learned about topics related to special education. Doctors disclosed they learned about these topics through mentorship and on-the job training, not formally during medical school or residency.

CONCLUSIONS

This research presents powerful evidence in support of a paradigm shift with regard to infusing a focus on doctor/family/school collaboration for children with disabilities into the medical school curriculum.