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医学教育中的残疾健康:斯坦福医学院试点课程的开发、实施与评估

Disability health in medical education: development, implementation, and evaluation of a pilot curriculum at Stanford School of Medicine.

作者信息

Sapp Richard W, Lee Edmund, Bereknyei Merrell Sylvia, Schillinger Erika, Lau James N, Feldman Heidi M, Poffenberger Cori McClure

机构信息

Stanford University School of Medicine, Stanford, CA, United States.

Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States.

出版信息

Front Med (Lausanne). 2024 Sep 4;11:1355473. doi: 10.3389/fmed.2024.1355473. eCollection 2024.

Abstract

BACKGROUND

People with disabilities face significant healthcare disparities due to barriers to accessing care, negative attitudes of providers, and lack of education on disabilities for healthcare professionals. Physicians report discomfort when interacting with patients with disabilities, adding to the disparity, warranting research on medical school education.

OBJECTIVE

Two educational interventions were structured: (1) a brief 2-h intervention in the mandatory curriculum and (2) a 9-week elective course which included interactions with individuals with disabilities through workshops and partner programs. We predicted that both of these interventions would result in improvements in attitude and empathy toward individuals with disabilities and reduce student anxiety.

METHODS

During the 2018-2019 academic year, 54 students completed the surveys for the 2-h intervention and 8 students completed the 2-h intervention and elective course. Pre-, post-, and delayed post-intervention surveys (3 months after post survey) measured students' attitudes, using validated surveys on attitudes, empathy and anxiety toward individuals with disabilities.

RESULTS

Both educational interventions resulted in improved attitudes toward individuals with disabilities. However, students reported only feeling prepared to care for patients with disabilities after the elective course. The elective course, but not the 2-h course, significantly decreased student anxiety levels, likely due to more individual time working with individuals with disabilities. Delayed analysis after 3 months showed that both interventions had a lasting impact on attitudes and behavior change when caring for individuals with disabilities.

CONCLUSION

Medical education is effective at improving medical students' attitudes and behaviors toward individuals with disabilities. A 2-h session can lead to a modest improvement in attitudes. However, more dedicated time and exposure to persons with disabilities results in a greater improvement in students' attitudes, anxiety and preparedness.

摘要

背景

由于就医障碍、医疗服务提供者的消极态度以及医疗专业人员缺乏有关残疾的教育,残疾人面临着显著的医疗保健差距。医生报告称,与残疾患者互动时会感到不适,这加剧了这种差距,因此有必要对医学院教育进行研究。

目的

构建了两种教育干预措施:(1)在必修课程中进行为期2小时的简短干预;(2)为期9周的选修课程,其中包括通过工作坊和合作项目与残疾人互动。我们预计这两种干预措施都将改善对残疾人的态度和同理心,并减少学生的焦虑。

方法

在2018 - 2019学年,54名学生完成了2小时干预的调查,8名学生完成了2小时干预和选修课程。干预前、干预后以及干预后延迟调查(干预后调查3个月后)使用经过验证的关于对残疾人态度、同理心和焦虑的调查来测量学生的态度。

结果

两种教育干预措施都改善了对残疾人的态度。然而,学生们表示只有在选修课程后才感觉为照顾残疾患者做好了准备。选修课程而非2小时的课程显著降低了学生的焦虑水平,这可能是因为与残疾人有更多的个人互动时间。3个月后的延迟分析表明,两种干预措施在照顾残疾人时对态度和行为改变都有持久影响。

结论

医学教育在改善医学生对残疾人的态度和行为方面是有效的。2小时的课程可以使态度有适度改善。然而,更多专门的时间以及与残疾人接触会使学生的态度、焦虑和准备情况有更大改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bdb/11408233/86a69f1ab8eb/fmed-11-1355473-g001.jpg

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