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Fagerstrom JM, Eliason G, Al-Hallaq H, Taylor BA, Ashraf MR, Viscariello N. Improving access in medical physics residency programs for physicists with disabilities. J Appl Clin Med Phys 2024; 25:e14518. [PMID: 39284579 DOI: 10.1002/acm2.14518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/21/2024] [Accepted: 08/05/2024] [Indexed: 10/12/2024] Open
Abstract
Within the landscape of medical physics education, residency programs are instrumental in imparting hands-on training and experiential knowledge to early-career physicists. Ensuring access to educational opportunities for physicists with disabilities is a legal, ethical, and pragmatic requirement for programs, considering that a significant proportion of the United States population has a disability. Grounded in conceptual frameworks of competency-based medical education and the social model of disability, this work provides an introduction to some practical recommendations for medical physics residency programs. Strategies include embracing universal design principles, fostering partnerships with disability service offices, using inclusive language, developing and publicizing clear procedures for disclosing disabilities and requesting accommodations, and maintaining an overall commitment to equitable access to education. This work urges medical physics residency leadership to proactively move towards training environments that support the needs of residents across the spectrum of disability, highlighting why disability inclusion fundamentally enriches diversity.
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Affiliation(s)
- Jessica M Fagerstrom
- Department of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Grace Eliason
- Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Hania Al-Hallaq
- Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA
| | - Brian A Taylor
- Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Natalie Viscariello
- Department of Radiation Oncology, University of Alabama Birmingham, Birmingham, Alabama, USA
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Kessler A, Schroth SL, Rydberg L. Disability's absence from admissions nondiscrimination and recruitment initiatives in Top-Tier US allopathic medical schools. Disabil Health J 2024:101679. [PMID: 39153941 DOI: 10.1016/j.dhjo.2024.101679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/25/2024] [Accepted: 08/04/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Diversity in medical school students is essential to ensure that future physicians can care for a range of patients from different backgrounds. However, disability is often overlooked and there are potential examples of discrimination in US medical schools. OBJECTIVE To determine if students with disabilities are included in online recruitment, diversity equity and inclusion (DEI), or nondiscrimination materials for US allopathic medical schools. METHODS In this descriptive study, the authors reviewed publicly available data from websites of the top ranked 51 US allopathic medical schools to assess inclusion of disability in recruitment efforts or antidiscrimination statements. RESULTS The results showed that just under one third of these schools (31 %) mention disability within their DEI or published recruitment efforts. Most commonly (27.5 %), disability is mentioned in a general diversity statement. CONCLUSIONS These findings suggest that there is a need for greater inclusion of disability in US medical schools' recruitment efforts. This is essential to ensure that people with disabilities are not discriminated against in medical school applications and is one of many factors that will contribute to future physicians being prepared to care for patients with disabilities.
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Affiliation(s)
- Allison Kessler
- Physical Medicine and Rehabilitation, Feinberg School of Medicine, USA; Spinal Cord Injury Medicine, Shirley Ryan Abilitylab, USA.
| | | | - Leslie Rydberg
- Physical Medicine and Rehabilitation, Feinberg School of Medicine, USA; Henry and Monika Betts Medical Student Education Chair, USA
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Brown-Young D, Papich TA, Jhaveri S, Nielsen C, Pardee M, Betchkal R, Porter E, Meeks LM. Informed Inclusion Model: Medical Student Wheelchair User in an Obstetrics and Gynecology Clerkship. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:828-832. [PMID: 38639603 DOI: 10.1097/acm.0000000000005743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
ABSTRACT Students with physical disabilities are underrepresented in medicine, driven in part by ableist beliefs about the ability of individuals with disabilities to complete procedure-based or surgically oriented clerkships, including obstetrics and gynecology (Ob/Gyn). There is a growing commitment to disability inclusion by medical and specialty training associations. Yet published case studies and accommodation protocols for medical student wheelchair users navigating an Ob/Gyn clerkship are absent in the literature. This article describes successful disability inclusion for an Ob/Gyn clerkship, including accommodations for medical student wheelchair users. The authors share mechanisms to address and combat ableist assumptions and facilitate access for future medical students by working collaboratively with student and key stakeholders to develop an inclusive and accessible training experience.These recommendations are shared through the story of a third-year medical student who rotated through the longitudinal clerkships at the Cleveland Clinic Lerner College of Medicine. The student, an individual with osteogenesis imperfecta who uses a power wheelchair with a seat elevator, completed third-year rotations and thrived in her clinical experiences. The authors describe her journey through a robust 4-week Ob/Gyn clerkship, in which she fulfilled the required clinical core conditions and observation skills with reasonable accommodation. Given the high acuity, surgery, and outpatient demands in Ob/Gyn-and the transferrable skills to other clerkships-the student's experience is an excellent exemplar for demonstrating disability inclusion and reasonable accommodation.Ob/Gyn clerkship directors and clinical faculty can broadly use the recommended timelines and communication protocols to create accessible training environments. With student input, minor scheduling adjustments, ongoing communication, reasonable accommodations, and an open mind, medical students on the clinical wards who are wheelchair users can successfully navigate the required expectations of medical training.
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Bulk LY, Franks A, Stephens L, Smith H, Baljko M, Dadashi N, Epstein I. The invisible work of co-creating disability access in work integrated learning. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023; 28:1391-1408. [PMID: 37093331 DOI: 10.1007/s10459-023-10216-z] [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] [Received: 06/09/2022] [Accepted: 02/04/2023] [Indexed: 05/03/2023]
Abstract
Promoting health equity necessitates the diversification of healthcare workforces. Disability is one aspect of diversity that is increasing in healthcare. While the number of Disabled students in health professions increases, barriers in their work integrated learning (WIL), such as placements in hospitals or clinics, persist. While literature has addressed some of these barriers, there is less known about the social processes that enable access in work integrated learning when it does occur. Therefore, an interdisciplinary team from design, geography, occupational science, nursing, occupational therapy, critical disability studies, and knowledge mobilization explored questions regarding social processes involved in WIL accessibility in clinical settings. The team conducted twenty-five in-depth interviews with 4 placement coordinators, 8 placement supervisors, 6 access professionals, 4 education leaders (e.g. Deans) and 3 healthcare leaders (e.g. site education leaders) from two hospitals and two universities in eastern Canada. The team's collaborative thematic analysis of participant narratives constructed four themes regarding the invisible work clinical and academic educators engage in to create access: putting in extra time, doing emotional labour, engaging in relational work, and navigating complexities. This labour is unrecognized and optional, and therefore its result-access to education-is inequitably distributed. Educators, policy makers, and institutions need to know how access is created in WIL to promote diversity within health professions and systems.
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Affiliation(s)
- Laura Yvonne Bulk
- School of Nursing, York University, Toronto, Canada.
- Centre for Accessibility, University of British Columbia, xʷməθkʷəy̓əm (Musqueam) Territory, 1203 Brock Hall, 1874 East Mall, Vancouver, BC, V6T 1Z1, Canada.
| | | | | | - Hilda Smith
- School of Nursing, York University, Toronto, Canada
| | | | | | - Iris Epstein
- School of Nursing, York University, Toronto, Canada
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Jarus T, Krupa T, Mayer Y, Battalova A, Bulk L, Lee M, Nimmon L, Roberts E. Negotiating legitimacy and belonging: Disabled students' and practitioners' experience. MEDICAL EDUCATION 2023; 57:535-547. [PMID: 36516022 DOI: 10.1111/medu.15002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 05/12/2023]
Abstract
INTRODUCTION People with disabilities are underrepresented in health professions education and practice. Barriers for inclusion include stigma, disabling discourses, discriminatory programme design and oppressive interactions. Current understandings of this topic remain descriptive and fragmented. Existing research often includes only one profession, excludes particular types of disability and focuses on one aspect of the career journey. To expand understanding, we examined the recurrent forms of social relations that underlie the participation of disabled individuals in learning and practice contexts across five health professions. METHOD We analysed 124 interviews with 56 disabled health practitioners and students. Participants were interviewed up to three times over 1.5 years. Using constructivist grounded theory, authors used a staged analytic approach that resulted in higher level conceptual categories that advance interpretations of social processes. Finally, the authors compared and integrated findings among students and practitioners. RESULTS Participants experience challenges to their sense of legitimacy and belonging as health providers. They describe tensions within the health education and practice between the commitment to inclusion and the day-to-day realities experienced by disabled participants. We identified six distinct, but related, conditions underlying these tensions: (i) validity and transparency of competencies' evaluation; (ii) the social and physical contexts; (iii) integration of inclusive practices; (iv) boundaries between personal and professional identities; (v) vulnerability to authority figures; and (vi) dynamic person-level factors. DISCUSSION If we are to commit to health practitioners and students with disabilities experiencing an overall sense of legitimacy and belonging, priority needs to be given to system-level practices and policies to support inclusion. Attention to the day-to-day marginalisation of students and practitioners with disabilities in the health professions is also needed. Additionally, inclusive and transparent delineation of competency requirements is needed. Finally, educational actions are needed to increase understanding of disability in the health professions, with particular attention to promoting social relations that foster collective responsibility for supporting inclusion.
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Affiliation(s)
- Tal Jarus
- Department of Occupational Science & Occupational Therapy, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Terry Krupa
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Yael Mayer
- Department of Occupational Science & Occupational Therapy, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
| | - Alfiya Battalova
- Department of Occupational Science & Occupational Therapy, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Laura Bulk
- Department of Occupational Science & Occupational Therapy, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- The Centre for Accessibility, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Lee
- Department of Occupational Science & Occupational Therapy, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Laura Nimmon
- Department of Occupational Science & Occupational Therapy, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Centre for Health Education Scholarship, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Earllene Roberts
- Disability Resource Centre and AVP Students, University of British Columbia, Kelowna, British Columbia, Canada
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Lawson ND. Reconciling LCME Diversity With Federal Law Mandates for Affirmative Action on the Basis of Disability, Gender, Race/Ethnicity, and Veteran Status. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:156. [PMID: 36696293 DOI: 10.1097/acm.0000000000005081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Nicholas D Lawson
- Georgetown law scholar, Georgetown University Law Center, Washington, DC;
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