Project Description:
People with intellectual/developmental disabilities (I/DD) are an under-recognized group who suffer from health disparities. Due to advances in the medical care of children with I/DD, people with I/DD are living longer and require additional supports for themselves and their families as they age. Changes in policy over the last few decades have meant that the overwhelming majority of people with I/DD live in the community and rely on physicians in their communities for care.
Health care settings are not accessible to people with I/DD. The majority of physicians have limited knowledge regarding the health and psychosocial needs of this population, primarily due from a lack of exposure and training. Despite having higher rates of chronic disease than the neurotypical population, people with I/DD are less likely to receive preventive care and screenings. They are also less likely to be asked preventive health-related questions.
Medical students receive little specific training on providing care to adults with developmental disabilities It is incumbent on medical colleges to teach students about developmentally disabled adults in their community -- concentrating on their lives, culture, history, as well as their medical needs. The goal of this project is ensure that medical students have the information, experiences and skills they need in order to provide caring and competent medical services to individuals with developmental and other disabilities.
In accordance with the principle of nothing about us without us, it is essential to include self-advocates with I/DD in these efforts. Previous contact with people with disabilities, specifically close contact, along with prior knowledge about disabilities, impact the attitudes of medical students towards people with disabilities (Sahin and Akyol, 2010). Results of a survey of UACOM-T medical students suggested students were most interested in social issues surrounding disability in the medical context, and wanted to learn from people with disabilities and their families (Kennedy et al, 2017).
Using initial support from a WISH Foundation grant, the Sonoran UCEDD worked with the University of Arizona College of Medicine-Tucson to establish a AADMD student chapter (Medcats for Developmental Medicine). The chapter receives support form the UACOM-T student council as a student interest group, and sponsors: 1) a lunchtime seminar series for medical students on developmental medicine, 2) opportunities to deliver health promotion activities side-by-side with Special Olympics athletes leaders for athletes and Unified partners at local Special Olympics events. Additionally, Medcats student leaders have worked with Special Olympics Arizona to develop health promotion activities, have developed and implemented surveys of their peers about their interest in developmental medicine, and presented on their work at annual AADMD conferences. Medcats student leaders have also worked with UCEDD faculty to develop curricular projects in developmental medicine.
Introducing new material into medical school curricula has a number of barriers, including curriculum crowding. This generally limits the addition of a stand-alone course in disability medicine to elective time. While electives are an important part of the strategy to enhance medical student education, the addition of disability medicine topics to the required portion of the curriculum increases the level of education among medical students more broadly.
Opportunities for topics in disability medicine occur throughout the four-year medical curriculum. Integration of new curricular topics in an integrated fashion across the medical school curriculum has proven to be effective in nutrition education at the UACOM-T (Taren et al, 2001) and elsewhere (Ball et al, 2014).
With funding through the National Curriculum in Developmental Medicine (NCIDM), Drs. Bassford and Tomasa, working with two Medcats student leaders, implemented sustainable curricular changes at the University of Arizona College of Medicine Tucson,, guided by the NCIDM Medical Student Goals and Objectives/ A primary component of these enhancements is a partnership with self-advocates and with Special Olympics Arizona
These included:
1) Increasing the number of self-advocates working with small inter-professional groups in a required inter-professional teaching activity in disability for first year medical students
2) Introducing positive video introductions (FRAME) to people with specific disabilities to second year medical students
3) Designing and implementing a fourth-year medical school elective in disability medicine
All of these have continued through the present date.
Additionally, for the past 2 years Drs Bassford and Armin have offered a required 90-minute session to first year medical students in the UACOM-T Pathways Curriculum, Caring for Patients with Intellectual and/or Developmental Disabilities, which includes co-teaching by a number of self-advocates with IDD.
Additionally, in Dr Armin's fourth year elective n Health Equity, Dr Bassford presents a pre-recorded session on the history of inequities in health care for people with IDD, and then meets with students in a live Zoom discussion session.
Keyword(s):
Adolescent Health, Preventive Services, Children, Adolescents, and Young Adults with Special Health Care Needs, medical student training, curriculum
Unserved or Under-served Populations:
Racial or Ethnic Minorities, Geographic Areas, Reservation, Rural/Remote, Urban
Primary Target Audience Geographic Descriptor:
Single-County, Mulit-County, State
