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Ailey SH, Molly B, Tichá R, Abery B, Khuu BK, Angel L. Health professionals' education related to people with intellectual and developmental disabilities: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13208. [PMID: 38382496 DOI: 10.1111/jar.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/04/2024] [Accepted: 01/16/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND People with intellectual and developmental disabilities are among the most underserved in an inequitable healthcare system. METHODS Using Arksey and O'Malley's methodology and a social determinants of health framework, we conducted a scoping review of literature on the state of practice in education of healthcare professionals in the health and healthcare needs of this population. RESULTS Searches found 4948 articles, with 182 included in the final review. Themes identified included gaps of not being informed by workforce needs, continued use of the medical model of care, not addressing intersectionality with racial/ethnic and other discriminations, and lack of involvement of the population in developing/evaluating programs and promising trends of development of competency-based interprofessional programs with experiential learning. CONCLUSION We provide recommendations for best practices in a concerted effort to educate a healthcare workforce equipped with the knowledge and skills to address the health needs of this population.
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Affiliation(s)
- Sarah H Ailey
- Department of Community, Systems, and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
| | - Bathje Molly
- Occupational Therapy Program, DePaul University, College of Science and Health, Chicago, Illinois, USA
| | - Renáta Tichá
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brian Abery
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Belle K Khuu
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lisa Angel
- Department of Community, Systems, and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
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Hartsgrove C, DeLauter G, Kirshblum S. Sustained Impact of a Virtual Disability Education Curriculum With Fourth-Year Medical Students in a Mandatory Physical Medicine and Rehabilitation Clerkship. Am J Phys Med Rehabil 2023; 102:780-786. [PMID: 36753447 DOI: 10.1097/phm.0000000000002201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The aim of the study was to measure the short- and long-term impact of a virtual disability education curriculum associated with a 2-wk mandatory physical medicine and rehabilitation clerkship for fourth-year medical students. DESIGN A prospective pre-post intervention survey-based study measuring the impact of a virtual disability education series at 1-wk and 6-mo time points after a mandatory physical medicine and rehabilitation clerkship including 8 hrs of virtual didactics with an emphasis on physical disabilities. The surveys assessed the overall virtual curriculum, perceived benefit of a virtual encounter, and the long-term applicability of the information learned from the clerkship. RESULTS The physical medicine and rehabilitation clerkship was effective in improving medical students' perceived comfort and clinical knowledge regarding treatment of persons with disabilities ( P < 0.01). There were no statistical differences at the 6-mo time point, indicating sustained benefit and integration of knowledge in the long term ( P > 0.05). In addition, 84% of students reported using the information in clinical experiences at 6 mos. CONCLUSIONS The physical medicine and rehabilitation clerkship including a virtual disability education curriculum improved long-term perceived medical student comfort and knowledge of treating persons with disabilities, with a focus on those with physical disabilities. Virtual encounters with persons with disabilities are viable and impactful avenues to provide this education.
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Affiliation(s)
- Caitlin Hartsgrove
- From the Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey (CH, SK); Rutgers New Jersey Medical School, Newark, New Jersey (CH, SK); Kessler Institute for Rehabilitation, West Orange, New Jersey (CH, SK); and Select Medical, Mechanicsburg, Pennsylvania (GD)
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Ali A, Nguyen J, Dennett L, Goez H, Rashid M. A scoping review for designing a disability curriculum and its impact for medical students. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:75-86. [PMID: 37465749 PMCID: PMC10351622 DOI: 10.36834/cmej.74411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Background There is an increasing need for a standardized undergraduate disability curriculum for medical students to better equip students with the proper training, knowledge, and skills to provide holistic care for individuals with disabilities. Objectives The aim of this scoping review was to better understand and analyze the current body of literature focusing on best practice for including disability curricula and its impact on undergraduate medical students. Results Three major components for designing a disability curriculum for undergraduate medical students were obtained from our analysis. The components were: (1) effective teaching strategies, (2) competencies required for disability curriculum, and (3) impact of disability curriculum on medical students. Conclusions Current literature revealed that exposing medical students to a disability curriculum impacted their overall perceptions about people with disabilities. This allowed them to develop a sense of understanding towards patients with disabilities during their clinical encounters. The effectiveness of a disability curriculum is dependent on the extent to which these interventions are incorporated into undergraduate medical education.
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Affiliation(s)
- Abdinasir Ali
- Faculty of science, University of Alberta, Alberta, Canada
| | - Julie Nguyen
- Department of Paediatrics, University of Alberta, Alberta, Canada
| | - Liz Dennett
- Scott Health Sciences Library, University of Alberta, Alberta, Canada
| | - Helly Goez
- Department of Pediatrics, University of Ottawa
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Stretton B, Bacchi S, Thomas J. A scoping review of patient-led teaching of health professions students. Intern Med J 2023; 53:629-634. [PMID: 37186360 DOI: 10.1111/imj.16066] [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: 11/11/2022] [Accepted: 01/04/2023] [Indexed: 05/17/2023]
Abstract
Patients with chronic health conditions may become experts in their own conditions. Thus, utilising patients as teachers, with autonomy over taught content, may better prepare students to deliver patient-centred care. A scoping review following Arksey and O'Malley and Joanna Briggs Institute framework was performed. A total of 2162 articles were identified and 28 unique studies were included. Patient teacher programmes range from single, short 1- to 2-h tutorials to longitudinal community-based programmes. These programmes are mutually beneficial for students, improving awareness of all patient-centred domains, and patients feel empowered by their roles in education.
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Affiliation(s)
- Brandon Stretton
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Stephen Bacchi
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Josephine Thomas
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
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Hsieh S, Donovan J, Fyffe D, McKay O, Kirshblum S. Effect of Adding a Wheelchair Immersion Program to a Physical Medicine and Rehabilitation Clerkship on Emotions, Behavior, and Attitude: A Prospective Pilot Study. Am J Phys Med Rehabil 2022; 101:782-788. [PMID: 35034065 DOI: 10.1097/phm.0000000000001952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT People with disabilities encounter significant barriers in health care and report that healthcare providers often lack an understanding in caring for them. Currently, there is limited disability awareness training in medical school curricula. This mixed-methods pilot study examined the effects of integrating a short wheelchair immersion program in a physical medicine and rehabilitation clerkship, versus the clerkship alone, on attitudes toward people with disabilities, comfort in treating people with disabilities, knowledge of wheelchair etiquette, and understanding of wheelchair-associated challenges. The standard training group underwent the physical medicine and rehabilitation clerkship, consisting of a 2-wk clinical rotation and didactic program. The intervention group additionally underwent a newly developed 1-hr wheelchair program where they simulated mobility and some activities of daily living as a "wheelchair user" and "caregiver." Quantitative analysis demonstrated that all students who completed the clerkship had significantly improved attitudes toward and comfort in treating people with disabilities, knowledge of wheelchair etiquette, and understanding of wheelchair-associated challenges, whereas students in the wheelchair immersion program had a greater change in understanding wheelchair-associated challenges. Qualitative analysis revealed that the intervention resulted in positive attitudinal changes. These findings suggest that integrating a brief wheelchair immersion program with a physical medicine and rehabilitation clerkship may enhance disability awareness training in medical school curricula.
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Affiliation(s)
- Shelly Hsieh
- From the Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey (SH, JD, DF, OM, SK); Kessler Institute for Rehabilitation, West Orange, New Jersey (SH, JD, SK); Burke Rehabilitation Hospital, White Plains, New York (SH); Montefiore Medical Center, Bronx, New York (SH); Kessler Foundation, West Orange, New Jersey (JD, DF, SK); and Roper Rehabilitation Hospital, Charleston, North Carolina (JD)
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Chardavoyne PC, Henry AM, Forté KS. Understanding Medical Students' Attitudes Towards and Experiences with Persons with Disabilities and Disability Education. Disabil Health J 2022; 15:101267. [DOI: 10.1016/j.dhjo.2021.101267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/07/2021] [Accepted: 12/30/2021] [Indexed: 11/30/2022]
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Lee B, Park SY. Curriculum development on the human rights of people with disabilities for future medical education: using a modified Delphi. BMC MEDICAL EDUCATION 2021; 21:548. [PMID: 34715845 PMCID: PMC8555282 DOI: 10.1186/s12909-021-02961-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In order for doctors to effectively provide medical services to patients with disabilities, an understanding of this population is necessary, along with the knowledge, attitudes, and technical abilities necessary to address health problems associated with each type of disability. One way of doing this is by educating doctors about disabilities and ensuring their frequent contact with people with disabilities while they are in medical school. Therefore, this study aimed to develop a systematic medical education curriculum to enhance doctors' understanding of people with disabilities. METHODS The authors conducted a systematic literature review to develop and verify the basic framework of the educational content and curriculum. Two surveys were also developed using the Delphi method to evaluate the adequacy and necessity of educational topics. Items with a content validity ratio equal to or greater than the minimum value were considered valid. Survey panels comprised academic experts and health care practitioners who were working with people with disabilities. We conducted two surveys, one for a basic and the other for an advanced course, in which 13 to 16 respondents took part. RESULTS The authors selected 13 topics for the 'Basic Introductory Course' and included general educational content on the health rights of people with disabilities focused on improving students' knowledge of disabilities. The authors also selected 12 topics for the 'Care and Communication for Patients with Disabilities Course' designed to improve students' understanding of interviewing and communicating with patients with disabilities. CONCLUSIONS In Korea, disability has received little attention in the medical curriculum to date. The curriculum developed in this study provides preliminary data for guiding future directions in medical education and developing specific support plans for an education that promotes people with disabilities' health rights.
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Affiliation(s)
- Bomyee Lee
- Department of Medical Education and Medical Humanities, Kyung Hee University School of Medicine, Dongdaemun-gu, Seoul, 02447, South Korea
- Department of Policy & Research, Korea National Institute for Bioethics Policy, Jung-gu, Seoul, 04522, South Korea
| | - So-Youn Park
- Department of Medical Education and Medical Humanities, Kyung Hee University School of Medicine, Dongdaemun-gu, Seoul, 02447, South Korea.
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Gilbert C, Hsieh S, Donovan J, Dyson-Hudson T, Cabarle M, Granger S, Kirshblum S. Effect of an interventional educational wheelchair program on medical students' understanding of manual wheelchair use. PM R 2021; 13:1350-1356. [PMID: 33956395 DOI: 10.1002/pmrj.12628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/02/2020] [Accepted: 04/05/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is limited literature exploring the benefits of interactive wheelchair educational programs in medical student curricula. OBJECTIVE To identify the effect of an educational interactive wheelchair program on medical students' understanding of wheelchair use. Researchers hypothesized that the program would increase understanding. DESIGN Repeated-measures survey study with postintervention comparison. SETTING Inpatient acute rehabilitation center. PARTICIPANTS Out of 123 eligible fourth-year medical students on a mandatory physical medicine and rehabilitation clerkship, 79 students participated. INTERVENTION All participants underwent a 2-hour educational wheelchair program consisting of (1) a disability lecture; (2) a video on the importance of proper wheelchair type and fit, wheelchair prescription, as well as recreational wheelchair use; and (3) an interactive wheelchair experience. MAIN OUTCOME MEASURES Pre- and postsurvey Likert scale questions measured medical students' understanding of four main areas: (1) impact of manual wheelchair use, (2) challenges of manual wheelchair use, (3) manual wheelchair skills, and (4) wheelchair etiquette. RESULTS A two-tailed sign test demonstrated a highly significant increase from pre- to postsurvey scores in each survey section (P < .001). Presurvey and postsurvey mean scores for impact of manual wheelchair use, challenges of manual wheelchair use, manual wheelchair skills, and wheelchair etiquette survey sections were 3.9 and 4.4, 3.1 and 4.4, 2.4 and 4.4, and 2.5 and 4.0, respectively. CONCLUSIONS This study demonstrates that an interactive educational wheelchair program effectively increases medical students' understanding of manual wheelchair use. The addition of an educational interactive wheelchair program to medical student curricula is recommended to improve medical students' understanding of manual wheelchair use and its impact on users.
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Affiliation(s)
- Courtney Gilbert
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Shelly Hsieh
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Jayne Donovan
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Trevor Dyson-Hudson
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Foundation, West Orange, New Jersey, USA
| | - Mary Cabarle
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Syndi Granger
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Steven Kirshblum
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA.,Kessler Foundation, West Orange, New Jersey, USA
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Dijk SW, Duijzer EJ, Wienold M. Role of active patient involvement in undergraduate medical education: a systematic review. BMJ Open 2020; 10:e037217. [PMID: 32718925 PMCID: PMC7389514 DOI: 10.1136/bmjopen-2020-037217] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/14/2020] [Accepted: 06/15/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To identify the scope of active patient involvement in medical education, addressing the current knowledge gaps relating to rationale and motivation for involvement, recruitment and preparation, roles, learning outcomes and key procedural contributors. METHODS The authors performed a systematic search of the PubMed database of publications between 2003 and 2018. Original studies in which patients take on active roles in the development, delivery or evaluation of undergraduate medical education and written in English were eligible for inclusion. Included studies' references were searched for additional articles. Quality of papers was assessed using the Mixed Methods Appraisal Tool. RESULTS 49 articles were included in the review. Drivers for patient involvement included policy requirements and patients' own motivations to contribute to society and learning. Patients were engaged in a variety of educational settings in and outside of the hospital. The vast majority of studies describe patients taking on the role of a patient teacher and formative assessor. More recent studies suggest that patients are increasingly involved in course and curriculum development, student selection and summative assessment. The new body of empirical evidence shows the wide range of learning objectives was pursued through patient participation, including competencies as professional, communicator, collaborator, leader and health advocate, but not scholar. Measures to support sustainable patient involvement included longitudinal institutional incorporation, patient recruitment and/or training, resource support and clear commitment by faculty. The importance and advantages of patient involvement were highlighted by students, faculty and patients themselves; however, organisations must continue to consider, monitor and take steps to mitigate any potential harms to patients and students. DISCUSSION This systematic review provides new knowledge and practical insights to physicians and faculty on how to incorporate active patient involvement in their institutions and daily practice, and provides suggested action points to patient organisations wishing to engage in medical education.
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Yi YG, Lee JE, Lee SH, Lee JY, Kwon YJ, Shin HI. Development and validation of a scale to assess the attitude of healthcare professionals toward persons with disability. Clin Rehabil 2020; 34:667-676. [PMID: 32164455 DOI: 10.1177/0269215520911968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to develop and validate an instrument that measures the attitudes of healthcare professionals toward persons with disabilities. DESIGN The Delphi survey consensus method was used to compose a preliminary questionnaire for survey. Then, healthcare professionals responded to the questionnaire online, and the results were used for psychometric analysis. SETTING Three tertiary hospitals. SUBJECTS A total of 993 healthcare professionals. INTERVENTIONS Not applicable. MAIN MEASURES Attitudes of healthcare professionals toward persons with disabilities. RESULTS A 28-item preliminary questionnaire was initially developed after a two-round Delphi survey with 16 experts. Through an online survey, the final 20 items were categorized as follows: behaviors in clinical situation, knowledge and skills, emotional response, and responsibility of healthcare professionals. The Cronbach's alpha coefficient for the total score was 0.890 and varied between 0.856 and 0.892 in the four subdomains. The newly developed tool showed an acceptable model fit. Healthcare professionals who participated in an education module showed higher scores in behavior and knowledge/skills subdomains than those who did not, whereas participants who had clinical experience with persons with disabilities demonstrated higher scores in emotional response and knowledge/skills subdomains. CONCLUSIONS We developed a scale to measure the attitudes toward persons with disabilities of healthcare professionals. The scale demonstrated a sensitivity to measure a difference by participation in an education module or clinical experience with persons with disabilities.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.,Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Gyeonggi-do, Republic of Korea
| | - Jeong-Eun Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung Hee Lee
- Department of Medical Education, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jin Yong Lee
- Public Health Medical Service, Seoul Metropolitan Government-Seoul National University, Seoul, Republic of Korea.,Boramae Medical Center, College of Medicine, Seoul National University, Seoul, Republic of Korea.,Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Yong Jin Kwon
- Institute of Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.,Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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McCormack G, Dillon AC, Healy O, Walsh C, Lydon S. Primary Care Physicians’ Knowledge of Autism and Evidence-Based Interventions for Autism: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00189-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Yi YG, Lee JE, Kim YI, Kim E, Shin HI. A validation of the disability attitudes in health care scale using the Rasch analysis on a sample of Korean medical students. Disabil Rehabil 2019; 43:1750-1755. [PMID: 31583917 DOI: 10.1080/09638288.2019.1672215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND PURPOSE The "Disability Attitudes in Health Care" scale contains 17 items and measures attitudes toward persons with disabilities in healthcare settings. This study aimed to analyze the psychometric properties of the Disability Attitudes in Health Care in order to improve its measurement quality. MATERIALS AND METHODS The Disability Attitudes in Health Care scale was administered to 272 students at a medical school. Rasch analysis was conducted to assess the category use, the overall fit of the model, and the person-item fit. RESULTS Compared to the previous 5-point Likert scoring system, the combination of category 1 (strongly disagree) and 2 (disagree), which transformed the Disability Attitudes in Health Care into a 4-point scale, was more appropriate. Items 2 and 13 had a poor fit with the model because of low construct homogeneity and low point-measure correlation, respectively; therefore, they were removed. However, there were not enough questions regarding the difficulty level for distinguishing medical students' attitudes toward persons with disabilities more sensitively. CONCLUSIONS The results of this study suggest that constructing Disability Attitudes in Health Care with 15 items and using a 4-category scoring method could help to increase the scale's reliability and validity. The revised version of Disability Attitudes in Health Care could be of value to those who educate medical students and train rehabilitation professionals. IMPLICATIONS FOR REHABILITATIONConstructing a Disability Attitudes in Health Care scale with 15 items by using a 4-category scoring method could increase the reliability and validity of the scale.To improve the sensitivity of the Disability Attitudes in Health Care, it is necessary to add more difficult items to the scale.The Disability Attitudes in Health Care could be of value to those who educate medical students and train rehabilitation professionals.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Gyeonggi-do, Republic of Korea
| | - Jeong-Eun Lee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ye Il Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eunhae Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Ankam NS, Bosques G, Sauter C, Stiens S, Therattil M, Williams FH, Atkins CC, Mayer RS. Competency-Based Curriculum Development to Meet the Needs of People With Disabilities: A Call to Action. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:781-788. [PMID: 30844926 DOI: 10.1097/acm.0000000000002686] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
People with disabilities constitute 22.2% of the population in the United States, and virtually all physicians have people with disabilities in their clinical practice across a wide range of diagnostic groups. However, studies demonstrate that people with disabilities are inadequately served by the health care system, leading to high costs and poor outcomes. The authors argue that one cause of this discrepancy is that medical students receive limited training in the care of people with disabilities and may therefore not be able to adequately meet the competencies that underlie the Core Entrustable Professional Activities for Entering Residency. To address these gaps, the authors present practical examples of integrating concepts of disability into the curriculum with minimal additional time requirements. A comprehensive disability curriculum is suggested to include active classroom learning, clinical, and community-based experiences. At institutions that do not have a comprehensive curriculum, the authors recommend adding disability-related knowledge and skill acquisition to existing curricula through modifications to current case-based learning, simulated patients, and objective structured clinical examinations. To facilitate curriculum development, they recommend that the World Health Organization International Classification of Functioning, Disability, and Health be used as a tool to build disability concepts into active learning. The goal of these recommended curricular changes is to enhance student performance in the clinical management of people with disabilities and to better train all future physicians in the care of this population.
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Affiliation(s)
- Nethra S Ankam
- N.S. Ankam is associate professor and director of undergraduate medical education, Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania. G. Bosques is associate professor of physical medicine and rehabilitation, University of Texas Health Science Center at Houston (UTHealth) Medical School, and medical staff, Shriners Hospital for Children, TIRR Memorial Hermann and Children's Memorial Hermann Hospital, Houston, Texas. C. Sauter is assistant professor and director of undergraduate medical education, Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin. S. Stiens was associate professor, Department of Rehabilitation Medicine, University of Washington School of Medicine at the time this article was written, and is curator of education, Stiens' Designs: Personal Enablement, LLC, Seattle, Washington. M. Therattil is clinical assistant professor, Arthur S. Abramson Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, and director of medical education, Clinical Education Program, St. Lawrence Rehabilitation Center and Drexel University College of Medicine, Philadelphia, Pennsylvania. F.H. Williams is chief of physical medicine and rehabilitation, UMass Memorial Medical Center, and clinical professor of orthopedics and physical rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts. C.C. Atkins is adjunct professor of anatomy and physiology, Pomeroy College of Nursing at Crouse Hospital, Syracuse, New York, chief operations officer, MD Grand Rounds, Baltimore, Maryland, and chief executive officer, Cold Fusion Technologies LLC, Carthage, New York. R.S. Mayer is vice chair of education, Department of Physical Medicine and Rehabilitation, and associate professor of physical medicine and rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
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Wheeler AC, Wylie A, Villagomez A, Bishop E, Raspa M. Health care for individuals with fragile X Syndrome: Understanding access and quality. Disabil Health J 2018; 12:269-277. [PMID: 30442576 DOI: 10.1016/j.dhjo.2018.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 09/27/2018] [Accepted: 11/04/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Previous research suggests that individuals with intellectual or developmental disabilities (IDD) may experience challenges accessing quality health care. OBJECTIVE/HYPOTHESIS This study explored parent perceptions of access and quality of health care services for children with fragile X syndrome (FXS), the leading hereditary cause of intellectual/developmental disabilities. METHODS Nearly 600 primary caregivers of at least one child with FXS completed an online survey on access, barriers, and quality of health care for their family member with FXS (N = 731). RESULTS In a convenience sample of well-educated and affluent caregivers, the majority did not report experiencing difficulties with access to services. Caregivers of younger children and those with lower family incomes reported greater challenges with health care access. Nearly 40% of caregivers indicated that their child's PCP was not as knowledgeable about FXS-related needs as they would prefer, indicating a possible knowledge gap on the part of providers. CONCLUSIONS These factors represent potential barriers to quality health care for individuals with FXS, with potential lifelong effects ranging from delayed age of diagnosis to difficulty accessing a PCP in adulthood.
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Affiliation(s)
- Anne C Wheeler
- RTI International 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA.
| | - Amanda Wylie
- RTI International 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Adrienne Villagomez
- Children's Hospital Colorado, Anschutz Medical Campus, 13123 East 16th Avenue, Aurora, CO, 80045, USA
| | - Ellen Bishop
- RTI International 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Melissa Raspa
- RTI International 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
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Effects of a Brief Curricular Intervention on Medical Students’ Attitudes Toward People with Disabilities in Healthcare Settings. Am J Phys Med Rehabil 2016; 95:939-945. [DOI: 10.1097/phm.0000000000000535] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Havercamp SM, Scott HM. National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities. Disabil Health J 2014; 8:165-72. [PMID: 25595297 DOI: 10.1016/j.dhjo.2014.11.002] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 09/29/2014] [Accepted: 11/04/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND People with disabilities experience worse health and poorer access to health care compared to people without disability. Large-scale health surveillance efforts have largely excluded adults with intellectual and developmental disability. This study expands knowledge of health status, health risks and preventative health care in a representative US sample comparing the health of adults with no disability to adults with intellectual and developmental disability and to adults with other types of disability. OBJECTIVES The purposes of this study were (1) to identify disparities between adults with intellectual and developmental disability and adults with no disability and (2) compare this pattern of disparities to the pattern between adults with other types of disability and adults without disability. METHODS This study compares health status, health risks and preventative health care in a national sample across three groups of adults: No Disability, Disability, and Intellectual and Developmental Disability. Data sources were the 2010 Behavior Risk Factor Surveillance Survey and the National Core Indicators Consumer Survey. RESULTS Adults with disability and with intellectual and developmental disability were more likely to report being in poor health compared to adults without disability. Disability and intellectual and developmental disability conferred unique health risks and health care utilization patterns. CONCLUSIONS Significant disparities in health and health care utilization were found for adults with disability and developmental disability relative to adults without disability. Disability training for health care providers and health promotion research that identifies disability as a demographic group is needed.
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Affiliation(s)
- Susan M Havercamp
- The Ohio State University Nisonger Center, 1581 Dodd Dr, Columbus, OH 43210, USA.
| | - Haleigh M Scott
- The Ohio State University Nisonger Center, 1581 Dodd Dr, Columbus, OH 43210, USA
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Shakespeare T, Kleine I. Educating Health Professionals about Disability: A Review of Interventions. ACTA ACUST UNITED AC 2013. [DOI: 10.11120/hsce.2013.00026] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Genetic counseling for prenatal testing: where is the discussion about disability? J Genet Couns 2012. [PMID: 22898882 DOI: 10.1007/s10897-012-9534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
There are little data revealing how genetic counselors talk about disability in the prenatal setting. We performed a qualitative analysis of 93 existing transcripts from simulated patient (SP) genetic counseling sessions conducted in 2003–4 through the Genetic Counseling Video Project. We found that most genetic counselors (95%) focused on the physical aspects of disability while fewer (27%) discussed the social aspects. In addition, few genetic counselors (38%) asked patients about personal experiences with disability. When discussing options available if a pregnancy were diagnosed with a disability, most genetic counselors mentioned termination (86%) while fewer mentioned the continuation of the pregnancy (37%) or adoption (13%). Only half of the genetic counselors asked the SP if she had thought about how she might use the results of prenatal screening. To better facilitate informed decision-making that is consistent with patient values, we recommend genetic counselors engage prenatal patients in a deeper discussion about their ability and willingness to parent a child with a disability.
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Genetic counseling for prenatal testing: where is the discussion about disability? J Genet Couns 2012; 21:814-24. [PMID: 22898882 DOI: 10.1007/s10897-012-9484-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 07/30/2012] [Indexed: 12/18/2022]
Abstract
There are little data revealing how genetic counselors talk about disability in the prenatal setting. We performed a qualitative analysis of 93 existing transcripts from simulated patient (SP) genetic counseling sessions conducted in 2003–4 through the Genetic Counseling Video Project. We found that most genetic counselors (95%) focused on the physical aspects of disability while fewer (27%) discussed the social aspects. In addition, few genetic counselors (38%) asked patients about personal experiences with disability. When discussing options available if a pregnancy were diagnosed with a disability, most genetic counselors mentioned termination (86%) while fewer mentioned the continuation of the pregnancy (37%) or adoption (13%). Only half of the genetic counselors asked the SP if she had thought about how she might use the results of prenatal screening. To better facilitate informed decision-making that is consistent with patient values, we recommend genetic counselors engage prenatal patients in a deeper discussion about their ability and willingness to parent a child with a disability.
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Woodard LJ, Havercamp SM, Zwygart KK, Perkins EA. An innovative clerkship module focused on patients with disabilities. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:537-42. [PMID: 22361803 DOI: 10.1097/acm.0b013e318248ed0a] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Lack of medical training results in physicians being unprepared to provide care to people with disabilities, which, in turn, contributes to the substantial health disparities that are evident in this population. Few medical schools or primary care residencies address the care of adults with disabilities. Competencies and guidelines to assist American physicians in caring for patients with physical or intellectual disabilities have yet to be established, thus making educational goals unclear. This article describes one novel training module regarding people with disabilities that was developed at the University of South Florida Health, Morsani College of Medicine (USF) and inserted into the primary care clerkship during a major curriculum redesign in 2005. Since then, all USF third-year medical students have been required to participate in this disability-related course component. The authors describe the module's development and integration into the primary care clerkship, as well as the specific elements of their curriculum. By using a variety of teaching modalities in the classroom and community, and especially by involving people with disabilities themselves, the medical students have a very comprehensive learning experience regarding people who have physical, sensory, or intellectual disabilities. The authors have been able to show that USF medical students, on completion of this module, demonstrate improved knowledge, attitudes, and comfort in caring for people with disabilities, which the authors believe will lead to improved health and health care access for this underserved population. Suggestions for program replication, including common challenges, are also discussed.
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Affiliation(s)
- Laurie J Woodard
- Department of Family Medicine, University of South Florida Health, Morsani College of Medicine, Tampa, Florida 33612, USA.
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Long-Bellil LM, Robey KL, Graham CL, Minihan PM, Smeltzer SC, Kahn P. Teaching medical students about disability: the use of standardized patients. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2011; 86:1163-70. [PMID: 21785304 DOI: 10.1097/acm.0b013e318226b5dc] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Standardized patients (SPs), now a mainstay of the undergraduate medical education experience, are beginning to play larger roles in helping students build competencies to better serve patients who have disabilities, in educating students about the lived experiences of persons with disabilities, and in testing students' understanding of disability-related issues. In this article, the authors discuss several U.S. training programs that involve SPs who have disabilities or SPs who do not have disabilities but who portray patients who do. The authors review the goals of each program (e.g., to provide students with opportunities to gain experience with patients with disabilities), describe their commonalities (enhancing students' interview skills) and differences (some programs are educational; some are evaluative), and summarize the evaluative data of each. The authors also explore the benefits and challenges of working with SPs with disabilities and of working with SPs without disabilities. Finally, they consider the practical issues (e.g., recruiting SPs) of developing and implementing such programs.
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Affiliation(s)
- Linda M Long-Bellil
- Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, USA.
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Minihan PM, Robey KL, Long-Bellil LM, Graham CL, Hahn JE, Woodard L, Eddey GE. Desired educational outcomes of disability-related training for the generalist physician: knowledge, attitudes, and skills. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2011; 86:1171-1178. [PMID: 21785313 DOI: 10.1097/acm.0b013e3182264a25] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The problems adults with disabilities face obtaining quality primary care services are persistent and undermine national efforts to improve the health status of this group. Efforts to address this issue by providing disability-related training to physicians are hampered by limited information about what generalist physicians need to know to care for patients with disabilities. The authors consider the desired outcomes of disability-related training for generalists by exploring the contributions of the domains of knowledge, attitudes, and skills to patient-directed behavior and summarizing the empirical data.Because disability reflects a complex interplay among individual, interpersonal, institutional, community, and societal factors, generalist physicians can promote and protect the health of adults with disabilities by interventions at multiple levels. Thus, the authors use the social-ecological framework, an approach to health promotion that recognizes the complex relationships between individuals and their environments, to delineate the recommended knowledge, attitudes, and skills in the context of primary care. The importance of role models who demonstrate the three domains, the interactions among them, and issues in evaluation are also discussed. This clear delineation of the recommended educational outcomes of disability-related training in terms of knowledge, attitudes, and skills will support efforts to better prepare generalist physicians-in training and in practice-to care for adults with disabilities and to evaluate these training strategies.
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Affiliation(s)
- Paula M Minihan
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
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Smith WT, Roth JJ, Okoro O, Kimberlin C, Odedina FT. Disability in cultural competency pharmacy education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2011; 75:26. [PMID: 21519416 PMCID: PMC3073100 DOI: 10.5688/ajpe75226] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 10/25/2010] [Indexed: 05/12/2023]
Abstract
Improving health care providers' knowledge and ability to provide culturally competent care can limit the health disparities experienced by disadvantaged populations. As racial and ethnic cultures dominate cultural competency topics in education, alternative cultures such as disability have consistently been underrepresented. This article will make the case that persons with disabilities have a unique cultural identity, and should be addressed as an important component of cultural competency education in pharmacy schools. Examples of efforts in pharmacy education to incorporate cultural competency components are highlighted, many of which contain little or no mention of disability issues. Based on initiatives from other health professions, suggestions and considerations for the development of disability education within pharmacy curricula also are proposed.
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Affiliation(s)
- W Thomas Smith
- University of Florida College of Pharmacy, PO Box 100496, Gainesville, FL 32610, USA.
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Lam WY, Gunukula SK, McGuigan D, Isaiah N, Symons AB, Akl EA. Validated instruments used to measure attitudes of healthcare students and professionals towards patients with physical disability: a systematic review. J Neuroeng Rehabil 2010; 7:55. [PMID: 21062438 PMCID: PMC2987969 DOI: 10.1186/1743-0003-7-55] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 11/09/2010] [Indexed: 12/02/2022] Open
Abstract
Background Instruments to detect changes in attitudes towards people with disabilities are important for evaluation of training programs and for research. While we were interested in instruments specific for medical students, we aimed to systematically review the medical literature for validated survey instruments used to measure attitudes of healthcare students and professionals towards patients with physical disability. Methods We electronically searched Medline, EMBASE, PsycINFO, Health and Psychosocial Instruments. We included papers reporting on the development and/or validation of survey instruments to measure attitudes of healthcare students and professionals towards patients with physical disability. We excluded papers in which the attitudes were not measured in a provider-patient context. Two reviewers carried out titles and abstracts screening, full texts screening, and data abstraction in a duplicate and independent manner using standardized and pilot tested forms. Results We identified seven validated survey instruments used for healthcare students and professionals. These instruments were originally developed for the following target populations: general population (n = 4); dental students (n = 1); nursing students (n = 1); and rehabilitation professionals (n = 1). The types of validity reported for these instruments were content validity (n = 3), criterion-related validity (n = 1), construct validity (n = 2), face validity (n = 1), discriminant validity (n = 1), and responsiveness (n = 1). The most widely validated and used tool (ATDP) was developed in the late 1960s while the most recent instrument was developed in the early 1990s. Conclusion Of the seven identified validated instruments, less than half were specifically designed for healthcare students and professionals and none for medical students. There is a need to develop and validate a contemporary instrument specifically for medical students.
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Affiliation(s)
- Wai Yim Lam
- School of Medicine and Biomedical Sciences, State University of New York at Buffalo, NY, USA
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Sahin H, Akyol AD. Evaluation of nursing and medical students' attitudes towards people with disabilities. J Clin Nurs 2010; 19:2271-9. [PMID: 20522157 DOI: 10.1111/j.1365-2702.2009.03088.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study is to assess the attitudes of students towards disabled people and provide suggestions to make necessary changes in the curricula. BACKGROUND Disabled people suffer from rejection, exclusion and discrimination. The undergraduate education of future health professionals should include processes of critical thinking towards and analysis of the disabled. DESIGN Cross-sectional design was used. METHODS All the preclinical medical and nursing students in our institution were included in study. Data were collected using the Turkish Attitudes towards Disabled Person Scale (TATDP) and demographical variables. TATDP Scale was scored according to five-point Likert Scale. RESULTS Students' mean attitude score is 120.57 (SD 15.24). Subscale mean scores are 53.61 (SD 7.25) for compassion (CP), 50.47 (SDS 7.26) for social value (SV) and 16.49 (SD 2.89) for resource distribution (RD). Whilst nursing students had less contact with the disabled, medical students had a closer contact with them. Medical students acquired more prior knowledge about attitudes towards the disabled. Total attitude scores of female students were above the students' mean attitude score when compared to those of male students. CONCLUSION Only if early contact is established with patients and the disabled, practical educational strategies are adopted, and the students are provided with information on attitudes about the disabled, will a social model of disability be introduced into the curriculum. RELEVANCE TO CLINICAL PRACTICE This study results were presented to curriculum planning committees of nursing and medical schools, so that they should use them as needs assessment data in developing a disability awareness curriculum. The curriculum will be implemented in cooperation with not only schools but also other social institutions. For instance, clerkship applications will be accomplished by cooperating with nursing homes and organisations of disabled people.
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Affiliation(s)
- Hatice Sahin
- Ege University, School of Medicine, Department of Medical Education, Bornova-Izmir, Turkey 35100.
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Duggan A, Bradshaw YS, Altman W. How do I ask about your disability? An examination of interpersonal communication processes between medical students and patients with disabilities. JOURNAL OF HEALTH COMMUNICATION 2010; 15:334-350. [PMID: 20432112 DOI: 10.1080/10810731003686630] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Medical student behaviors were examined through digital recordings of interpersonal skills communication training framed around a brief curriculum on disability within a family medicine clerkship. This analysis focuses on interpersonal communication processes and ways medical students ask standardized patient educators about visually apparent disability (N = 142). Primary themes of asking about or avoiding disability were identified with regard to language and nonverbal communication in how medical students asked and whether they integrated chronic disability with new musculoskeletal pain complaints. Secondary themes related to timing and communication further contextualized the primary themes. Seventy-four percent of students asked about the disability. Analysis of feedback sessions immediately following the interactions revealed that more than half the students who did not ask about disability spontaneously recognized that they avoided disability language. Results suggest that some ways of asking about disability may inhibit patient disclosure and restrict relationship building. In particular, asking about disability, but then avoiding integrating disability disclosure into the treatment plan, or responding to disability-related disclosure with overly positive, infantilizing-type communication, may pose more difficult dilemmas than never asking about the disability. On the contrary, students who ignored disability altogether often also recognized they missed disability cues, thus providing a learning experience of considerable value. Underlying student attitudes and possibilities for integrating biomedical concerns with social-psychological impacts of disability are addressed.
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Affiliation(s)
- Ashley Duggan
- Communication Department, Boston College, Chestnut Hill, Massachusetts, USA.
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Duggan A, Bradshaw YS, Carroll SE, Rattigan SH, Altman W. What can I learn from this interaction? A qualitative analysis of medical student self-reflection and learning in a standardized patient exercise about disability. JOURNAL OF HEALTH COMMUNICATION 2009; 14:797-811. [PMID: 20029712 DOI: 10.1080/10810730903295526] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Patients with disabilities receive fewer health services than the general population, yet they have greater health needs. Similarly, physicians report limited training in disability. The current project examines medical students' learning about disability in a project using individuals with disabilities as medical educators. Family medicine clerkship students (N = 138) across an academic year were videotaped during interviews with standardized patient educators with disabilities and during feedback sessions following the interactions. Qualitative analysis of feedback transcripts identifies three primary areas of integrating learning, reflective practice, and disability: (1) learning how disability impacts the treatment plan, (2) self-reflection and recognizing attitudes about disability, and (3) learning about the practice of medicine generally from the disability exercise. Themes are identified within each of the primary learning areas. Medical student reflection provides evidence of learning to connect disability with pain, everyday life, and treatment. Medical students learned to recognize patients' expertise in their own condition and in health care navigation. Medical students also examined how their language implies attitude. The current investigation provided evidence of the ways examining disability can serve as a cornerstone for building relationship-centered patient care and encouraging reflective practice overall.
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Affiliation(s)
- Ashley Duggan
- Communication Department, Boston College, Chestnut Hill, Massachusetts 02467, USA.
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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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