THE PROBLEM
Most physicians do not develop the appropriate knowledge, skills, and attitudes during medical school and residency training to care for patients with intellectual and developmental disabilities which can exacerbate health care disparities in this population.
BACKGROUND
Although >20% of the United States population has a disability, fewer than 3% of medical students report having a disability which indicates that physicians lack shared life experiences with patients with disabilities. Regarding exposure of medical students to diverse populations during clinical rotations at the University of Colorado School of Medicine (CUSOM), only 40% of students encounter 20 or more patients with disabilities while almost 90% of students encounter >20 patients from racial/ethnic minorities or who are medically underserved or socioeconomically disadvantaged. Given underrepresentation of medical students with disabilities and the lack of defined curricula and competencies in caring for patients with disabilities in most medical schools, including CUSOM, future physicians are ill-prepared to care for patients with intellectual and developmental disabilities.
Ideally, medical schools should partner with community organizations that support people with intellectual and developmental disabilities to develop competencies, curricula, and clinical experiences to help students learn best practices on how to care for patients with intellectual and developmental disabilities. As CUSOM established a new regional medical campus in Colorado Springs, this created an opportunity to implement pilot educational programs to address current gaps in medical education and to serve the needs of the local community. The Colorado Springs Branch partnered with The Resource Exchange (TRE) to obtain funding and develop relationships in the community to provide educational and clinical experiences for medical students to improve their knowledge, skills, and attitudes toward caring for patients with intellectual and developmental disabilities.
The National Curriculum Initiative in Developmental Medicine (NCIDM) supports multiple medical schools to implement curriculum about health care for people with intellectual disabilities through a multi-year partnership between the American Academy of Developmental Medicine and Dentistry and Special Olympics International, with resources from a cooperative agreement funded by the Centers for Disease Control and Prevention. CUSOM was selected as part of the first cohort of NCIDM Medical School Partners.
SOLUTION
In 2017, CUSOM implemented an intellectual and developmental disabilities curriculum for 21 medical students during their core clinical year at the Colorado Springs Branch (CSB) regional medical campus. CUSOM partnered with The Resource Exchange (TRE) , a community-based organization in Colorado Springs that supports people with intellectual and developmental disabilities across the lifespan. Curricular interventions included completion of knowledge-based modules through the Physician Education in Development Disabilities (PEDD) webinar series, participation in a Patients with Disabilities as Teachers (P-DAT) session where students could interact with and improve their communication skills from a series of patients with intellectual and developmental disabilities and their caregivers, attendance at a pediatric physical medicine and rehabilitation clinic to participate in the interdisciplinary care with children with cerebral palsy, and accompanying a nurse for visits to patients with intellectual and developmental disabilities in group, host, and individual home settings. Student communication skills were assessed through standardized patient scenarios that included a patient with intellectual and developmental disabilities and their caregiver. For more information, read the complete case study here.