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Towson G, Daley S, Banerjee S. Intellectual disabilities teaching for medical students: a scoping review. BMC MEDICAL EDUCATION 2023; 23:818. [PMID: 37915002 PMCID: PMC10621142 DOI: 10.1186/s12909-023-04766-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND People with intellectual disabilities are a marginalized group whose health experiences and outcomes are poor. Lack of skill and knowledge in the healthcare workforce is a contributing factor. In England, there is a new legislative requirement for mandatory intellectual disability training to be given to the existing healthcare workforce, including doctors. There is a lack of evidence about effective models of educational delivery of such training in medical schools. We undertook a scoping review to assess the range of intellectual disabilities educational interventions and their effectiveness. METHODS We included any study from 1980 onwards which reported an educational intervention on intellectual disability, or intellectual disability and autism, for medical students from any year group. Databases searched included PUBMED, ERIC, Scopus and Web of Science as well as searches of grey literature and hand searching two journals (Medical Education and Journal of Learning Disabilities). 2,020 records were extracted, with 1,992 excluded from initial screening, and a further 12 excluded from full-text review, leaving 16 studies for inclusion. Data was extracted, quality assessed, and findings collated using narrative analysis. RESULTS We found a variety of intervention types: classroom-based teaching, simulation, placement, home visits, and panel discussions. There was substantial variation in content. Most studies involved lived experience input. Across studies, interventions had different learning outcomes which made it difficult to assess effectiveness. Overall study quality was poor, with high use of non-validated measures, making further assessment of effectiveness problematic. CONCLUSIONS There is a need for more consistency in intervention design, and higher quality evaluation of teaching in this area. Our review has drawn attention to the variety in teaching on this topic area and further research should focus on updating this review as curriculum changes are implemented over time.
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Affiliation(s)
- Georgia Towson
- Brighton and Sussex Medical School, Centre for Dementia Studies, University of Sussex, Trafford Building, Room 101, Falmer, BN1 9RY, UK
| | - Stephanie Daley
- Brighton and Sussex Medical School, Centre for Dementia Studies, University of Sussex, Trafford Building, Room 101, Falmer, BN1 9RY, UK.
| | - Sube Banerjee
- Faculty of Medicine and Health Sciences, University of Nottinham, Nottingham, UK
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Trollor JN, Eagleson C, Turner B, Salomon C, Cashin A, Iacono T, Goddard L, Lennox N. Intellectual disability content within pre-registration nursing curriculum: How is it taught? NURSE EDUCATION TODAY 2018; 69:48-52. [PMID: 30007147 DOI: 10.1016/j.nedt.2018.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Despite experiencing higher rates of physical and mental health conditions compared with the general population, people with intellectual disability face inequitable access to healthcare services. Improving education of healthcare professionals is one way to reduce these inequalities. OBJECTIVE To determine how intellectual disability content is taught within Australian nursing schools. DESIGN A two-phase audit of Australian nursing curricula content was conducted using an interview and online survey. SETTING Nursing schools Australia-wide providing pre-registration courses. PARTICIPANTS For Phase 1, course coordinators from 31 nursing schools completed an interview on course structure. Teaching staff from 15 schools in which intellectual disability content was identified completed an online survey for Phase 2. METHODS Methods used to teach intellectual disability content and who taught the content were audited using an online survey. RESULTS Across the 15 schools offering intellectual disability content, lectures were the most common teaching method (82% of units), followed by tutorials (59%), workshops (26%), then other methods (e.g. e-learning; 12%). Approximately three-quarters of intellectual disability teaching used some problem-and/or enquiry-based learning. Only one nursing school involved a person with intellectual disability in delivering teaching content. Six (19%) participating schools identified staff who specialise in intellectual disability, and seven (23%) identified staff with a declared interest in the area. CONCLUSION While some nursing schools are using diverse methods to teach intellectual disability content, many are not; as a result, nursing students may miss out on acquiring the attributes which enable them to address the significant health inequalities faced by this group. A specific deficit was identified relating to inclusive teaching and clinical contact with people with intellectual disability.
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Affiliation(s)
- Julian N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Claire Eagleson
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Beth Turner
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, 34 Botany Street, Randwick, NSW 2052, Australia
| | - Carmela Salomon
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Andrew Cashin
- School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia.
| | - Teresa Iacono
- La Trobe Rural Health School, La Trobe University, 102 Arnold Street, Bendigo, VIC 3550, Australia.
| | - Linda Goddard
- School of Nursing, Midwifery & Indigenous Health, Charles Sturt University, P.O. Box 789, Albury, NSW 2640, Australia.
| | - Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute, The University of Queensland, Level 2 Aubigny Place, Mater Hospitals, South Brisbane, QLD 4101, Australia.
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Trollor JN, Eagleson C, Turner B, Tracy J, Torr JJ, Durvasula S, Iacono T, Cvejic RC, Lennox N. Intellectual disability content within tertiary medical curriculum: how is it taught and by whom? BMC MEDICAL EDUCATION 2018; 18:182. [PMID: 30071847 PMCID: PMC6090866 DOI: 10.1186/s12909-018-1286-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 07/19/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Individuals with intellectual disability experience higher rates of physical and mental health conditions compared with the general population, yet have inequitable access to health care services. Improving the workplace capacity of medical professionals to meet the needs of this population is one way to reduce barriers to care and improve health outcomes. Using diverse pedagogy appropriate to learning outcomes to teach medical students about intellectual disability is a necessary step in improving future workplace capacity. However, there is a lack of research into how, and by whom, medical students are taught about intellectual disability. The aim of this study was to investigate this through an audit of Australian medical school curricula. METHODS The Deans of Australian universities that provide accredited medical degrees (n = 20) were invited by email to participate in a two-phase audit of intellectual disability content in the curricula. Phase 1 (n = 14 schools) involved the Dean's delegate completing a telephone interview or questionnaire regarding medical course structure. If intellectual disability content was identified, a unit coordinator was invited to complete a survey regarding how this content was taught and by whom (Phase 2; n = 12 schools). RESULTS There was considerable variability across Australian medical schools regarding methods used to teach content about intellectual disability. Didactic teaching methods were most frequently used (62% of units included some form of lecture), but workshops and tutorials were reasonably well represented (34% of units contained one or both). Thirty-six percent of units included two or more teaching methods. Almost all schools (83%) used some problem- and/or enquiry-based learning. Educator backgrounds included medicine, nursing, and allied health. A majority of schools (n = 9, 75%) involved people with intellectual disability designing and teaching content, but the extent to which this occurred was inconsistent. CONCLUSIONS Renewing curricula around intellectual disability across all medical schools by introducing varied teaching methods and the inclusion of people with intellectual disability would assist students to develop knowledge, skills, attitudes, and confidence in intellectual disability health. Such renewal offers the potential to reduce barriers to service this population regularly face, thereby improving their health outcomes.
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Affiliation(s)
- Julian N. Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), 34 Botany Street, UNSW, Sydney, NSW 2052 Australia
| | - Claire Eagleson
- Department of Developmental Disability Neuropsychiatry (3DN), 34 Botany Street, UNSW, Sydney, NSW 2052 Australia
| | - Beth Turner
- Department of Developmental Disability Neuropsychiatry (3DN), 34 Botany Street, UNSW, Sydney, NSW 2052 Australia
| | - Jane Tracy
- Centre for Developmental Disability Health Victoria (CDDHV), Monash Health, 122 Thomas Street, Dandenong, VIC 3175 Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168 Australia
| | - Jennifer J. Torr
- Department of Psychiatry, Monash University, Monash Medical Centre, Block P, Level 3 246 Clayton Rd, Clayton, VIC 3168 Australia
| | - Seeta Durvasula
- Centre for Disability Studies, Sydney Medical School, The University of Sydney, Level 1, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW 2050 Australia
| | - Teresa Iacono
- La Trobe Rural Health School, La Trobe University, 102 Arnold Street, Bendigo, VIC 3550 Australia
| | - Rachael C. Cvejic
- Department of Developmental Disability Neuropsychiatry (3DN), 34 Botany Street, UNSW, Sydney, NSW 2052 Australia
| | - Nicolas Lennox
- Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute, The University of Queensland, Level 2 Aubigny Place, Mater Hospitals, South Brisbane, QLD 4101 Australia
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Trollor JN, Ruffell B, Tracy J, Torr JJ, Durvasula S, Iacono T, Eagleson C, Lennox N. Intellectual disability health content within medical curriculum: an audit of what our future doctors are taught. BMC MEDICAL EDUCATION 2016; 16:105. [PMID: 27066776 PMCID: PMC4827238 DOI: 10.1186/s12909-016-0625-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 04/02/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND There is a high burden of unmet health needs for people with intellectual disability. Despite experiencing significantly higher rates of morbidity and mortality compared with the general population, this group faces greater barriers to accessing healthcare. While increasing workplace capacity is one way to reduce this inequitable access, previous research indicates a scarcity of undergraduate teaching in intellectual disability. The aim of the study was to determine the extent and nature of intellectual disability content currently offered within medical degree curricula. METHODS All Australian universities (n = 20) providing accredited medical training were invited to participate in a two-phase audit via an email invitation to the Dean of each medical school. The Dean's delegate from 14 medical schools completed Phase 1, which involved a questionnaire or telephone interview about the overall medical course structure. Unit coordinators and/or teaching staff from 12 medical schools completed Phase 2, which involved an online survey about intellectual disability content within the curriculum. RESULTS In Australia, medical school curricula contain a median of 2.55 h of compulsory intellectual disability content. The majority of universities only offer a small amount of compulsory content. Of compulsory units, intellectual disability teaching is minimal in sexual health and emergency medicine (only one unit offered in one school for each). Topics of key relevance in intellectual disability health such as human rights issues, interdisciplinary team work and preventative health are poorly represented in intellectual disability teaching. Elective content varies markedly across universities (1 to 122 h), but emergency medicine, women's health, men's health and many other specialist medicine areas are not represented. Inclusive practice is inconsistent in degree and nature, but a majority of universities (nine) involve people with intellectual disability in the development or delivery of content. CONCLUSIONS There is a mismatch between the considerable unmet health needs of people with intellectual disability and the inconsistent teaching within medical schools. Future doctors will be better equipped to support the health and wellbeing of people with intellectual disability if curricula are enhanced in this area.
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Affiliation(s)
- Julian N. Trollor
- />Department of Developmental Disability Neuropsychiatry (3DN), UNSW Australia, 34 Botany Street, Randwick, NSW 2052 Australia
| | - Beth Ruffell
- />Department of Developmental Disability Neuropsychiatry (3DN), UNSW Australia, 34 Botany Street, Randwick, NSW 2052 Australia
| | - Jane Tracy
- />Centre for Developmental Disability Health Victoria (CDDHV), Monash Health, 122 Thomas Street, Dandenong, VIC 3175 Australia
- />Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, 3800 Australia
| | - Jennifer J. Torr
- />Centre for Developmental Disability Health Victoria (CDDHV), Monash Health, 122 Thomas Street, Dandenong, VIC 3175 Australia
- />Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, 3800 Australia
| | - Seeta Durvasula
- />Centre for Disability Studies, Sydney Medical School, The University of Sydney, Level 1, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW 2050 Australia
| | - Teresa Iacono
- />La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, VIC 3552 Australia
| | - Claire Eagleson
- />Department of Developmental Disability Neuropsychiatry (3DN), UNSW Australia, 34 Botany Street, Randwick, NSW 2052 Australia
| | - Nicolas Lennox
- />Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute, The University of Queensland, Level 2 Aubigny Place, Mater Hospitals, South Brisbane, QLD 4101 Australia
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Tracy J, McDonald R. Health and Disability: Partnerships in Health care. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2014; 28:22-32. [DOI: 10.1111/jar.12135] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Jane Tracy
- Centre for the Developmental Disability Health Victoria; Monash University; Notting Hill Vic. Australia
| | - Rachael McDonald
- Centre for the Developmental Disability Health Victoria; Monash University; Notting Hill Vic. Australia
- Department of Occupational Therapy; Monash University; Notting Hill Vic. Australia
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Ryan TA, Scior K. Medical students' attitudes towards people with intellectual disabilities: a literature review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2316-2328. [PMID: 24952372 DOI: 10.1016/j.ridd.2014.05.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 05/29/2014] [Accepted: 05/29/2014] [Indexed: 06/03/2023]
Abstract
The present paper provides a review of research on medical students' attitudes to people with intellectual disabilities. The attitudes of medical students warrant empirical attention because their future work may determine people with intellectual disabilities' access to healthcare and exposure to health inequalities. An electronic search of Embase, Ovid MEDLINE(R), PsycINFO, Scopus, and Web of Science was completed to identify papers published up to August 2013. Twenty-four studies were identified, most of which evaluated the effects of pedagogical interventions on students' attitudes. Results suggested that medical students' attitudes to people with intellectual disabilities were responsive to interventions. However, the evidence is restricted due to research limitations, including poor measurement, self-selection bias, and the absence of control groups when evaluating interventions. Thus, there is a dearth of high-quality research on this topic, and past findings should be interpreted with caution. Future research directions are provided.
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Affiliation(s)
- Travis A Ryan
- Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom.
| | - Katrina Scior
- Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom.
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Moyle JL, Iacono T, Liddell M. Knowledge and Perceptions of Newly Graduated Medical Practitioners in Malaysia of Their Role in Medical Care of People With Developmental Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2010. [DOI: 10.1111/j.1741-1130.2010.00252.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The biomedicalist conceptualization of disablement as a personal medical tragedy has been criticized by disability studies scholars for discounting the difference between disability and impairment and the ways disability is produced by socio-environmental factors. This paper discusses prospects for partnerships between disability studies teaching/research and medical education; addresses some of the themes around the necessity of critical disability studies training for medical students; and examines a selection of issues and themes that have arisen from disability education courses within medical schools globally. The paper concludes that providing there is a commitment from senior management, universities are well positioned to apply both vertical and horizontal approaches to teaching disability studies to medical students.
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Affiliation(s)
- Fiona Kumari Campbell
- School of Human Services & Social Work, Logan Campus University Drive, Griffith University, Meadowbrook, Qld 4131, Australia.
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Gibbs SM, Brown MJ, Muir WJ. The experiences of adults with intellectual disabilities and their carers in general hospitals: a focus group study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:1061-1077. [PMID: 18466292 DOI: 10.1111/j.1365-2788.2008.01057.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) have higher levels of health needs compared with the general population, many of which are unrecognised and unmet. While there has been interest and research into the primary health provision for this group, there has been a more limited focus on addressing their care received in general hospitals. Access to health care has predominated in the literature, with less attention being paid to the experiences of people with ID as users of general hospital care. METHOD A qualitative focus group methodology was used. Eleven adults with ID, nine parents and five paid carers of adults with ID participated. The focus groups were audiotaped and transcriptions were analysed using principles of grounded theory. RESULTS The analysed data highlighted key themes identified from the experiences of participants. These were the interrelated issues of feelings, particularly anxiety and fear, communication and behaviour problems; the practicalities of being in or attending hospitals, including the role played by carers; and issues around perceived discrimination and negative comments. CONCLUSIONS The experiences of participants in this study concur with and add to concern expressed in recent reports and published research. Wide ranging implications are discussed for further research, wider policy development, clinical practice, local health service provision and education of health professionals.
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Affiliation(s)
- S M Gibbs
- Learning Disability Service, NHS Fife, Lynebank Hospital, Dunfermline, UK.
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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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