Making the Case for Including Standardized Patients with Disabilities in Medical Education

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Background: Research indicates that physicians and medical students often do not feel prepared to address the healthcare needs of individuals with disabilities. Patients with disabilities are more likely to report being treated badly by physicians and left out of the clinical decision-making process. Medical schools have adopted disability-focused curricula to address these disparities. Studies have revealed that learning experiences led by individuals with disabilities have the greatest impact on students' knowledge and attitudes. Consequentially, some programs have incorporated standardized patients with disabilities into their clinical teaching curriculum. In these exercises, individuals with disabilities are paid to simulate an acute illness, allowing medical students to practice clinical skills and receive direct feedback. 

Objective: The purpose of this study is to assess medical students' attitudes, experiences, and interest in caring for patients with disabilities. Results inform the design of a teaching module that includes standardized patients with disabilities, with a goal of making medical education more inclusive of disabilities.

Design/Methods: A 19-question survey was developed to assess medical students' attitudes, experiences, and interest in caring for patients with disabilities. The survey was distributed via email and Facebook to 697 medical students at Robert Wood Johnson Medical School (RWJMS); 137 students (19.6%) responded. The instrument included several open-ended and multiple choice questions that elicited information on students' attitudes toward disabilities, prior experiences with disabilities, and preparedness to care for patients with disabilities as physicians. These results informed the design of a teaching module that features acute-care encounters with standardized patients with disabilities.

Results: While most students reported personal experience with disabilities and occasional exposure to disabilities through medical education, the majority of students reported feeling somewhat or not at all prepared to care for patients with disabilities in clinical practice. Further, students reported uncertainty about quality of life and understanding of what it would be like to live with a disability, suggesting that more direct interaction with individuals with disabilities is needed. Students preferentially ranked learning experiences that offer opportunities to practice interview and physical exam skills with standardized patients and to discuss an individual's real-life experience living with a disability.

Conclusions: Including standardized patients with disabilities in medical education is increasingly important to address the comfort and preparedness of prospective physicians to care for individuals with disabilities. Finally, involvement of the disability community in training and education efforts is considered essential to the Disability Rights Movement, embodied by the conviction "Nothing about us without us."

Rutgers Robert Wood Johnson Medical School
Rutgers Robert Wood Johnson Medical School, The Boggs Center on Developmental Disabilities

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