Chandan Priya, Noonan Emily J, Brody Kayla Diggs, Feller Claire, Lauer Emily
Division of Physical Medicine and Rehabilitation, School of Medicine, University of Louisville, Louisville, KY.
Undergraduate Medical Education, School of Medicine, University of Louisville, Louisville, KY.
Med Care. 2025 Jan 1;63(1 Suppl 1):S25-S30. doi: 10.1097/MLR.0000000000002079. Epub 2024 Dec 6.
The lack of physician training in serving patients with intellectual and developmental disabilities (IDDs) has been highlighted as a key modifiable root cause of health disparities experienced by this high-priority public health population. To address gaps in medical education regarding the lack of IDD curriculum, lack of evaluation/assessment, and lack of coordination across institutions, the American Academy of Developmental Medicine and Dentistry created the National Inclusive Curriculum for Health Education-Medical (NICHE-MED) Initiative in 2016. The aims of NICHE-MED are to: (1) impact medical students' attitudes and/or knowledge to address underlying ableism and address how future physicians think about disability; (2) apply a lens of health equity and intersectionality, centering people with IDD, but fostering conversation and learning about issues faced by other disability and minoritized populations; and (3) support community-engaged scholarship within medical education. As of 2024, the NICHE-MED initiative consists of close to 40 Medical School Partners, each with their own community-engaged disability curriculum intervention paired with a rigorous evaluation that ties centrally to coordinated program evaluation. The NICHE-MED initiative demonstrates implementation success at scale and is a successful community-engaged curriculum change model that may be replicated regarding disability more broadly and regarding necessary medical education efforts that center other marginalized populations.
医生在为智力和发育障碍(IDD)患者提供服务方面缺乏培训,这已被视为这一重点公共卫生人群所经历的健康差距的一个关键可改变根本原因。为了解决医学教育中关于IDD课程缺失、缺乏评估以及机构间缺乏协调等问题,美国发育医学与牙科学会于2016年发起了“全国健康与医学包容性课程(NICHE - MED)倡议”。NICHE - MED的目标是:(1)影响医学生的态度和/或知识,以消除潜在的能力主义,并探讨未来医生对残疾的看法;(2)运用健康公平和交叉性视角,以IDD患者为中心,但促进关于其他残疾和少数群体所面临问题的对话与学习;(3)支持医学教育中的社区参与式学术研究。截至2024年,NICHE - MED倡议由近40个医学院合作伙伴组成,每个合作伙伴都有自己的社区参与式残疾课程干预,并配有与协调项目评估紧密相关的严格评估。NICHE - MED倡议展示了大规模实施的成功,是一个成功的社区参与式课程变革模式,在更广泛的残疾领域以及以其他边缘化人群为中心的必要医学教育努力方面都可能被复制。