Meeting Challenges in Caring for Patients with Disabilities: An Interclerkship Course

Abstract

Purpose: People with disabilities use healthcare services more than those without disabilities, yet healthcare systems often fail these individuals. Understanding the needs of those with physical and cognitive disabilities is crucial in providing them with appropriate healthcare. A one-day Interclerkship introduced third-year medical students to key challenges for physicians who care for disabled patients: (1) building trust and confidence, (2) communication, (3) anticipating secondary medical conditions, (4) appropriately modifying clinical encounters, and (5) identifying appropriate community resources. Methodology: Essential elements of patient-centered care for disabled individuals were presented in plenary sessions. In small groups, students met with individuals with physical or development disabilities, their families and their community advocates, discussing healthcare and access concerns. Other workshops, taught by clinical and community experts, addressed assistive technology, parenting challenges, mental health, community resources, sexuality, and end-of-life care. Sixty-seven (69%) students completed pre-and post-Interclerkship self-assessments that rated knowledge, skills, and attitudes about medical care for disabled patients, using a 14-item 5-point Likert scale; means were compared by paired t-test. Students also provided course feedback. Results: There was a highly significant (p80% of the students agreed or strongly agreed that the Interclerkship addressed a topic essential to physician training, providing knowledge and skills not obtained elsewhere. Conclusions: A single-day Interclerkship successfully improved third year medical students self-assessed knowledge, attitudes and skills on providing appropriate medical care for disabled patient. Presented at the AAMC (Association of American Colleges) Annual Meeting, RIME (Research in Medical Education) Program, November 2006.