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Bracken RC, Richman KA, Garden R, Fischbein R, Bhambra R, Ragina N, Dawson S, Cascio A. Developing Disability-Focused Pre-Health and Health Professions Curricula. THE JOURNAL OF MEDICAL HUMANITIES 2023; 44:553-576. [PMID: 38099998 PMCID: PMC10733220 DOI: 10.1007/s10912-023-09828-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/21/2023]
Abstract
People with disabilities (PWD) comprise a significant part of the population yet experience some of the most profound health disparities. Among the greatest barriers to quality care are inadequate health professions education related to caring for PWD. Drawing upon the expertise of health professions educators in medicine, public health, nursing, social work, and physician assistant programs, this forum showcases innovative methods for teaching core disability skills and concepts grounded in disability studies and the health humanities. Each of the essays offers practical guidance for developing curricular interventions appropriate for students at various levels of training and familiarity with disability to be implemented in classroom discussions, case-based learning, lectures, panels, and clinical simulations across the full spectrum of pre-health and health professions education.
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Affiliation(s)
| | - Kenneth A Richman
- Center for Health Humanities, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA
| | | | - Rebecca Fischbein
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Raman Bhambra
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Neli Ragina
- College of Medicine, Central Michigan University, Mount Pleasant, MI, USA
| | - Shay Dawson
- College of Education and Human Services, Central Michigan University, Mount Pleasant, MI, USA
| | - Ariel Cascio
- Center for Bioethics and Social Justice, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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Ceglio K, Rispoli MJ, Flake EM. Training Medical Professionals to Work with Patients with Neurodevelopmental Disorders: A Systematic Review. Dev Neurorehabil 2020; 23:463-473. [PMID: 32543301 DOI: 10.1080/17518423.2020.1777217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Patients with neurodevelopmental disorders are not always provided the quality of medical care they deserve. Medical personnel report limited preparation and education in caring for patients with neurodevelopmental disorders. Aim: The purpose of this systematic review is to summarize the research on medical personnel training programs, identify effective training methods, and provide directions for future application and research. Methods: Thirty-four studies met inclusion criteria. The studies were summarized in terms of training components, the medical personnel trained, and the effectiveness of the training in achieving target outcomes. Results: Seventy-nine percent of studies demonstrated improvement in target outcomes. A variety of training components were used in combination throughout the studies, demonstrating a possibility of significant change to medical personnel's abilities for and attitudes about working with patients with neurodevelopmental disorders. Conclusion: Further research is needed to determine specifically which types of training can affect which target outcomes.
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Affiliation(s)
- Katherine Ceglio
- Indiana University School of Medicine - Lafayette , West Lafayette, IN, USA
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Crane JM, Strickler JG, Lash AT, Macerollo A, Prokup JA, Rich KA, Robinson AC, Whalen Smith CN, Havercamp SM. Getting comfortable with disability: The short- and long-term effects of a clinical encounter. Disabil Health J 2020; 14:100993. [PMID: 33012692 DOI: 10.1016/j.dhjo.2020.100993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Physicians report discomfort when interacting with patients with disabilities, which can negatively impact the quality of healthcare they provide. OBJECTIVE/HYPOTHESIS An intervention structured around a formative clinical encounter was assessed for its effectiveness in changing comfort towards treating patients with disabilities. It was predicted that this encounter would have a positive short- and long-term impact on medical students. METHOD During the 2017-2018 academic year, 169 third-year medical students conducted a patient encounter with a person who had a disability. Students met individually with the "patient" and completed a brief social and medical history as if they were meeting a new patient to establish care. A measure of perceived comfort caring for patients with disabilities was administered to students before and after the encounter. One year after the patient encounter, 59 students were surveyed about their satisfaction and the impact of the patient encounter. RESULTS The impact of encountering people with disabilities in a clinical setting was positive, with statistically significant improvements across all items on the measure of perceived comfort. Students were highly satisfied with the experience and anticipated feeling more confident, more comfortable, less awkward, and more skilled and efficacious when encountering a person with a disability in their future practice. A thematic analysis of the one year follow-up data suggest that students valued the encounter and desired more content on disability throughout their education. CONCLUSIONS Medical education should include dedicated exposure to persons with disabilities and a simulated patient experience allowing for a safe environment to gain skills and confidence.
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Affiliation(s)
- Jill M Crane
- Ohio State University Nisonger Center, 1581 Dodd Drive, Columbus, OH, 43210, United States.
| | - Jesse G Strickler
- Ohio State University Nisonger Center, 1581 Dodd Drive, Columbus, OH, 43210, United States.
| | - A Todd Lash
- The Ohio State University Wexner Medical Center, United States.
| | | | | | - Kelly A Rich
- Ohio State University Nisonger Center, 1581 Dodd Drive, Columbus, OH, 43210, United States.
| | - Ann C Robinson
- Ohio State University Nisonger Center, 1581 Dodd Drive, Columbus, OH, 43210, United States.
| | | | - Susan M Havercamp
- Ohio State University Nisonger Center, 1581 Dodd Drive, Columbus, OH, 43210, United States.
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Wu J, Zhang J, Mitra M, Parish SL, Minama Reddy GK. Provision of Moderately and Highly Effective Reversible Contraception to Insured Women With Intellectual and Developmental Disabilities. Obstet Gynecol 2019; 132:565-574. [PMID: 30095771 DOI: 10.1097/aog.0000000000002777] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To estimate provision of moderately and highly effective reversible contraceptives to women with intellectual and developmental disabilities. METHODS We used data from the Massachusetts All-Payer Claims Database to identify women aged 15-44 years with and without intellectual and developmental disabilities who were continuously enrolled in a private commercial insurance plan, Medicaid, or Medicare in 2012. We calculated the percentage of women aged 15-44 years who were not medically or surgically sterile and were provided 1) highly effective, long-acting reversible contraception (LARC, the intrauterine device or subdermal implant); or 2) prescriptions for moderately effective methods (pill, patch, ring, shot, or diaphragm). Logistic regression models estimated the odds of LARC and moderately effective method provision by disability status, adjusted for age, income, and Medicaid receipt. RESULTS Among 915,561 women who were not medically or surgically sterile, 13,059 women (1.4%) had at least one intellectual and developmental disability. Women with intellectual and developmental disabilities were less likely to be provided LARC (2.1% vs 4.2%, P<.001, adjusted odds ratio [OR] 0.43, 95% CI 0.38-0.48, P<.001) and moderately effective methods (21.1% vs 29.9%, P<.001, adjusted OR 0.68, 95% CI 0.65-0.71, P<.001) than women without intellectual and developmental disabilities. The one exception was the progestin shot, which was provided more often to women with intellectual and developmental disabilities than women without these disabilities (14.7% vs 4.3%, P<.001). Among a subset of women who only received moderately effective methods or LARC (n=310,344), women with intellectual and developmental disability had lower odds of receiving LARC than moderately effective methods (adjusted OR 0.59, 95% CI 0.52-0.67). CONCLUSION The study findings raise concerns that the provision of LARC and moderately effective methods differs based on the presence of intellectual and developmental disabilities. Greater understanding is needed regarding factors that underlie lower provision of LARC in comparison with moderately effective methods, especially the progestin shot, among women with intellectual and developmental disabilities.
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Affiliation(s)
- Justine Wu
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan; the Lurie Institute for Disability Policy, Brandeis University, Waltham, and the Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts; and Mt. Sinai Downtown Residency in Urban Family Medicine, New York, New York
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Herrmann-Werner A, Loda T, Wiesner LM, Erschens RS, Junne F, Zipfel S. Is an obesity simulation suit in an undergraduate medical communication class a valuable teaching tool? A cross-sectional proof of concept study. BMJ Open 2019; 9:e029738. [PMID: 31383708 PMCID: PMC6688692 DOI: 10.1136/bmjopen-2019-029738] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE With the growing prevalence of overweight and obesity, medical students should be prepared to engage in weight management and obesity-related communications in order to prevent patients from having stigmatising experiences. In addition, medical students should have training to reduce anti-fat prejudices. DESIGN Cross-sectional proof of concept study. SETTING University Hospital Tuebingen, Germany. PARTICIPANTS 246 participants (207 second-year medical students, 13 standardised patients (SPs) and 22 teachers) took part in the study. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the assessment of degree of reality of the encounter with the SP wearing an obesity simulation suit (OSS). The secondary outcome was the evaluation of students' awareness and prejudice against patients with obesity in a simulated role play. Additionally, a description of the advantages and disadvantages when using such a teaching tool is delivered. RESULTS The OSS contributed to a realistic perception of the patient group depicted in a role play according to students, teachers and SPs. OSS body mass index estimation by students, teachers and SPs correctly was over 30 kg/m2-thus in the range of obesity. In a selected subscale of the Anti-Fat Attitudes Test, students showed significantly stronger anti-fat stigmatisation compared with teachers and SPs. CONCLUSIONS An OSS worn by an SP is a valuable teaching tool to raise awareness about patients with obesity. It gives a realistic picture of the encounter. Stigmatisation was low in general but was especially present in the students. Further research should include intervention studies to address this issue.
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Affiliation(s)
- Anne Herrmann-Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Teresa Loda
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Lisa M Wiesner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Rebecca Sarah Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
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Abstract
The education of doctors shapes their professional identity: who they are and how they practise. Where does the issue of learning disability fit in? What is it and of what factors should doctors in training be aware?
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Havercamp SM, Ratliff-Schaub K, Macho PN, Johnson CN, Bush KL, Souders HT. Preparing Tomorrow's Doctors to Care for Patients With Autism Spectrum Disorder. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 54:202-216. [PMID: 27268475 DOI: 10.1352/1934-9556-54.3.202] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
People with autism spectrum disorder (ASD) and other developmental disabilities have poorer health and face unique barriers to health care compared to people without disabilities. These health disparities can be partially attributed to physicians' limited knowledge about caring for patients with developmental disabilities. The purpose of this study was to determine the effectiveness of ASD training for medical students. Our training included a lecture and a panel presentation that featured people with ASD and family members. Students reported improved knowledge, skills, confidence, and comfort in caring for patients with ASD.
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Affiliation(s)
- Susan M Havercamp
- Susan M. Havercamp, The Ohio State University Nisonger Center, Columbus, Ohio; Karen Ratliff-Schaub, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus, Ohio; Patricia Navas Macho, Department of Personality, Assessment and Psychological Tratment, INICO, University of Salamanca, Salamanca, Spain; Cherelle N. Johnson, Kelsey L. Bush, and Heather T. Souders, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus Ohio
| | - Karen Ratliff-Schaub
- Susan M. Havercamp, The Ohio State University Nisonger Center, Columbus, Ohio; Karen Ratliff-Schaub, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus, Ohio; Patricia Navas Macho, Department of Personality, Assessment and Psychological Tratment, INICO, University of Salamanca, Salamanca, Spain; Cherelle N. Johnson, Kelsey L. Bush, and Heather T. Souders, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus Ohio
| | - Patricia Navas Macho
- Susan M. Havercamp, The Ohio State University Nisonger Center, Columbus, Ohio; Karen Ratliff-Schaub, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus, Ohio; Patricia Navas Macho, Department of Personality, Assessment and Psychological Tratment, INICO, University of Salamanca, Salamanca, Spain; Cherelle N. Johnson, Kelsey L. Bush, and Heather T. Souders, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus Ohio
| | - Cherelle N Johnson
- Susan M. Havercamp, The Ohio State University Nisonger Center, Columbus, Ohio; Karen Ratliff-Schaub, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus, Ohio; Patricia Navas Macho, Department of Personality, Assessment and Psychological Tratment, INICO, University of Salamanca, Salamanca, Spain; Cherelle N. Johnson, Kelsey L. Bush, and Heather T. Souders, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus Ohio
| | - Kelsey L Bush
- Susan M. Havercamp, The Ohio State University Nisonger Center, Columbus, Ohio; Karen Ratliff-Schaub, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus, Ohio; Patricia Navas Macho, Department of Personality, Assessment and Psychological Tratment, INICO, University of Salamanca, Salamanca, Spain; Cherelle N. Johnson, Kelsey L. Bush, and Heather T. Souders, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus Ohio
| | - Heather T Souders
- Susan M. Havercamp, The Ohio State University Nisonger Center, Columbus, Ohio; Karen Ratliff-Schaub, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus, Ohio; Patricia Navas Macho, Department of Personality, Assessment and Psychological Tratment, INICO, University of Salamanca, Salamanca, Spain; Cherelle N. Johnson, Kelsey L. Bush, and Heather T. Souders, The Ohio State University Nisonger Center and Nationwide Children's Hospital, Columbus Ohio
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Teaching health care students about disability within a cultural competency context. Disabil Health J 2013; 6:271-9. [DOI: 10.1016/j.dhjo.2013.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/06/2013] [Accepted: 05/08/2013] [Indexed: 11/22/2022]
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Wilkinson J, Dreyfus D, Cerreto M, Bokhour B. "Sometimes I feel overwhelmed": educational needs of family physicians caring for people with intellectual disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 50:243-50. [PMID: 22731973 PMCID: PMC3708475 DOI: 10.1352/1934-9556-50.3.243] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Primary care physicians who care for adults with intellectual disability often lack experience with the population, and patients with intellectual disability express dissatisfaction with their care. Establishing a secure primary care relationship is particularly important for adults with intellectual disability, who experience health disparities and may rely on their physician to direct/coordinate their care. The authors conducted semistructured interviews with 22 family physicians with the goal of identifying educational needs of family physicians who care for people with intellectual disability. Interviews were transcribed and coded using tools from grounded theory. Several themes related to educational needs were identified. Physician participants identified themes of "operating without a map," discomfort with patients with intellectual disability, and a need for more exposure to/experience with people with intellectual disability as important content areas. The authors also identified physician frustration and lack of confidence, compounded by anxiety related to difficult behaviors and a lack of context or frame of reference for patients with intellectual disability. Primary care physicians request some modification of their educational experience to better equip them to care for patients with intellectual disability. Their request for experiential, not theoretical, learning fits well under the umbrella of cultural competence (a required competency in U.S. medical education).
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Affiliation(s)
- Joanne Wilkinson
- Boston University, Family Medicine, 1 BMC Place, Dowling 5, Boston, MA 02118, USA.
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Balandin S, Hines M. The involvement of people with lifelong disability and communication impairment in lecturing to speech-language pathology students. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2011; 13:436-445. [PMID: 20964515 DOI: 10.3109/17549507.2011.513738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In order to provide appropriate service and support to people with lifelong disability, including those who use augmentative and alternative communication (AAC), speech-language pathologists need to develop positive attitudes to people with disability and a holistic approach. The aim of this paper was to explore final year students' and new graduates' perceptions of the impact of lectures by people with lifelong disability on their attitudes and learning. Fourteen final year speech-language pathology students and nine graduates who had been practising for a year participated in four focus groups to discuss their perceptions of four 50-minute lectures by people with lifelong disability and communication impairment. A content analysis of the focus group transcripts revealed five themes; understanding the perspectives of people with disability, seeing the person as a whole, attitudes, working in the field, and gaps in the lectures. Overall there were few differences between the groups that were not accounted for by clinical experience. Participants agreed that the lectures were interesting and informative and provided new insights into lifelong disability, but were an adjunct to a learning process that also required theoretical lectures or clinical practice.
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Brown RS, Graham CL, Richeson N, Wu J, McDermott S. Evaluation of medical student performance on objective structured clinical exams with standardized patients with and without disabilities. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:1766-1771. [PMID: 20881817 DOI: 10.1097/acm.0b013e3181f849dc] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE To investigate whether medical students' performance on a family medicine clerkship objective structured clinical exam (OSCE) differed when the standardized patient (SP) had a disability versus when the SP did not have a disability. METHOD SPs with spinal cord injury (SP-SCI), SPs with intellectual disability (SP-ID), and SPs without a disability participated separately in two OSCE scenarios that were administered by the University of South Carolina School of Medicine's Department of Family and Preventive Medicine from 2007 to 2009. OSCE scores were determined based on the number of critical actions completed by the student, and scores were analyzed to determine differences among scenarios. RESULTS Students scored lower in history, physical exam, lab tests, and interpersonal skills with an SP-SCI, and lower in history, physical exam, and lab tests with an SP-ID than did students interacting with SPs without a disability. The odds ratio for ordering a hemoglobin A1c in one scenario was 4.16 times higher in cases when the SP did not have a disability (95% confidence interval [CI] 1.78-9.17, P = .001). In the second scenario, the odds ratio was 3.08 times higher for ordering a urinalysis (95% CI 1.34-7.08, P = .006) and was 2.15 times higher for providing lifestyle counseling (95% CI 1.04-4.44, P = .038) in students interacting with SPs without a disability. CONCLUSIONS Students performed better when the SP did not have a disability. This suggests that greater emphasis should be placed on teaching appropriate care of patients with a disability.
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Affiliation(s)
- Rachel S Brown
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina, USA.
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May W, Park JH, Lee JP. A ten-year review of the literature on the use of standardized patients in teaching and learning: 1996-2005. MEDICAL TEACHER 2009; 31:487-92. [PMID: 19811163 DOI: 10.1080/01421590802530898] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND Although there is a growing body of literature on the educational use of standardized patients (SP) in teaching and learning, there have been no reviews on their value. OBJECTIVE To determine whether the educational use of SPs has an effect on the knowledge, skills, and behaviour of learners in the health professions. METHODS English-language articles covering the period 1996-2005 were reviewed to address the issue of to what extent has the use of SPs affected the knowledge, skills and performance of learners. Out of 797 abstracts, 69 articles, which met the review criteria, were selected. An adaptation of Kirkpatrick's model was used to classify and analyse the articles. RESULTS Most of the learners were students in medicine and nursing. SPs were used mostly to teach communication skills and clinical skills. The study designs were case-control (29%), pre-test/post-test (24.6%), post-test only (26.1%) and qualitative studies (20.3%). METHODOLOGICAL ISSUES: Most of the studies had weak research designs. More rigorous designs with control or comparison groups should be used in future research. CONCLUSIONS Most studies reported that the educational use of SPs was valuable. More rigorous studies would support the evidence-based use of SPs in teaching and learning.
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Affiliation(s)
- Win May
- Division of Medical Education, Keck School of Medicine, KAM 211B, Los Angeles, CA 90033, USA.
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Eddey GE, Robey KL. Considering the culture of disability in cultural competence education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2005; 80:706-12. [PMID: 15980092 DOI: 10.1097/00001888-200507000-00019] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Cultural competence extends beyond understanding those values, beliefs, and needs that are associated with patients' age or gender or with their racial, ethnic, or religious backgrounds. People hold many simultaneous cultural associations, and each have implications for the care process. The "culture of disability" is a pan-ethnic culture for which a set of physician competencies are required to ensure appropriate, culturally sensitive care to persons with congenital or acquired disabilities. Such competencies include communicating with patients who have deficits in verbal communication and avoidance of infantilizing speech; understanding the values and needs of persons with disabilities; the ability to encourage self-advocacy skills of patients and families; acknowledging the core values of disability culture including the emphasis on interdependence rather than independence; and feeling comfortable with patients with complex disabilities. Medical schools have developed programs to increase students' exposure to persons with disabilities and it is suggested that such programs are most effective when they are the result of collaboration with community-based facilities or organizations that serve persons with disabilities in the natural environment. Combining lecture-based instruction and structured experiences with the opportunity for students to interact with patients in their natural environments may facilitate development of competencies with respect to patients with disabilities. The culture of disability should be included as one of the many cultures addressed in cultural competence initiatives in medical school and residency curricula.
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Affiliation(s)
- Gary E Eddey
- Matheny Center of Medicine and Dentistry, Matheny Medical and Educational Center, Matheny School and Hospital, P.O. Box 339, Peapack, NJ 07977, USA.
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Freer JP, Zinnerstrom KL. The palliative medicine extended standardized patient scenario: a preliminary report. J Palliat Med 2001; 4:49-56. [PMID: 11291394 DOI: 10.1089/109662101300051988] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
An extended standardized patient scenario (ESPS) is described that utilizes standardized patients (SPs) in palliative care education of medical students and residents. The goals of the ESPS will be to: (1) improve physician communications skills in regard to breaking bad news and end-of-life care; (2) integrate evidence-based medicine into patient recommendations; and (3) enhance clinical skills in the practice of palliative medicine, particularly the evaluation and management of total suffering. The main features of the ESPS include a single SP scenario that is presented over several sessions, portraying an extended period in the patient's life. The ESPS requires little in the way of equipment, but is labor intensive. The ESPS is a promising modality that deserves further scrutiny and outcomes research.
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Affiliation(s)
- J P Freer
- Department of Medicine, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, New York, USA
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