Aitken Debbie, Hodge Grace, Page Michael, Lastmann Ella, Hiller Sebastian, George Riya E
Department of Education, University of Oxford, Oxford, OX2 6PY, UK.
Institute for Academic Development (IAD) Associate, University of Edinburgh, Edinburgh, UK.
BMC Med Educ. 2025 Jul 1;25(1):927. doi: 10.1186/s12909-025-06866-9.
Medical education is inherently demanding, requiring students to navigate academically challenging courses, high-stake assessments, clinical training and interpersonal interactions within high stress environments. Autistic medical students can experience profound differences academically and professionally if their support needs are not identified and addressed by specific pedagogic adaptations. This systematic review aims to explore the experiences and support provision for autistic undergraduate medical students in the United Kingdom, through a critical interpretive review of the literature.
The search strategy involved the use of 6 electronic databases, supplemented by citation tracking, consultation with academic experts and library searches. Of 400 papers, 6 satisfied the inclusion and exclusion criteria. Critical interpretive synthesis (CIS) was used to analyse these papers. The study design assimilated methods adopted in conventional systematic reviews within the format of CIS, to combine the entire body of literature and generate theoretical categories.
Three synthetic constructs (overarching themes) were produced from the analysis; 'reassessing prevailing narratives on autism', 'navigation differences' and the 'absence of meaningful support provision'. Together these constructs generated a theoretical framework ('synthesising argument') defined as 'reframing support for success' for autistic and neurodiverse medical students, which collectively explained the findings of the review. 'Reframing support for success' provided an explanation for the inconsistencies in understanding the lived experiences of autistic medical students and the required adjustments and support provision. It illustrated the distinct challenges experienced by autistic students in navigating medical school as well the necessity to acknowledge the unique strengths autistic medical students bring.
The review calls for enhanced awareness and training within medical schools to foster an inclusive environment that accommodates neurodiversity more broadly. It advocates for legislative compliance and change in offering reasonable adjustments and stresses the potential benefits of viewing autistic traits as strengths in medical practice.
医学教育本身要求很高，需要学生在高压环境中应对学术上具有挑战性的课程、高风险评估、临床培训和人际交往。如果自闭症医学生的支持需求未通过特定的教学调整得以识别和解决，他们在学业和职业方面可能会经历巨大差异。本系统综述旨在通过对文献的批判性解释性综述，探索英国自闭症本科医学生的经历及所获支持情况。
检索策略包括使用6个电子数据库，并辅以引文跟踪、咨询学术专家和图书馆检索。在400篇论文中，有6篇符合纳入和排除标准。采用批判性解释性综合分析（CIS）对这些论文进行分析。该研究设计在CIS的框架内吸收了传统系统综述中采用的方法，以整合全部文献并生成理论类别。
分析得出了三个综合结构（总体主题）；“重新评估关于自闭症的主流叙事”、“导航差异”和“缺乏有意义的支持”。这些结构共同生成了一个理论框架（“综合论点”），定义为为自闭症和神经多样性医学生“重新构建支持以实现成功”，该框架共同解释了综述的结果。“重新构建支持以实现成功”解释了在理解自闭症医学生的生活经历以及所需调整和支持方面存在的不一致之处。它说明了自闭症学生在医学院学习过程中所面临的独特挑战，以及认识到自闭症医学生所具有的独特优势的必要性。
该综述呼吁医学院提高认识并加强培训，以营造一个更广泛包容神经多样性的环境。它主张在提供合理调整方面符合法律规定并进行变革，并强调在医疗实践中将自闭症特质视为优势的潜在益处。
