Educating Students about the Care of Patients with Disabilities Kira Zwygart, MD Laurie Woodard, MD University of South Florida College of Medicine Department of Family Medicine

Background –Major curricular reform in the 3rd and 4th years –Opportunity to insert new topics previously omitted from the curriculum –Patients with disabilities are encountered by all physicians, regardless of specialty, yet most physicians are not trained in the care of this group –The Surgeon General created a call to action to improve the health and wellness of persons with disabilities in 2005, citing the importance of training physicians

Goals and Objectives of Curriculum GOALS To encourage patient centered care that allows students to see the patient as an individual To help students understand that disability is part of life, through a concept of varying abilities rather than disease model To help students develop respectful communication and examination techniques resulting in more effective therapeutic outcomes To help students become familiar with some of the more common disabling conditions OBJECTIVES 1.Improve the comfort level of students when in patient care situations 2.Demonstrate and practice history and physical exam techniques with standardized patients with disabilities 3.Expose students to community resources for patients with disabilities 4.Involve students in service learning projects

Structure – Improving Students’ Comfort Didactic sessions –Panel of college students with developmental disabilities meet with medical students –Panel of patients or parents of patients with physical disabilities meet with students –Sensitivity training – students are assigned disabilities and must complete tasks with the disabilities in place Home visits to patients with disabilities –Students write a reaction paper regarding this experience

Structure – Demonstrating Exam Techniques Didactics –Overview of various disabilities, and specific exam and preventive care issues –Special Considerations for Special Athletes – the preparticipation exam for patients with disabilities Training session –Students interview and examine several model patients with disabilities Clinical work –Students attend Shriners clinic (patients with various orthopedic conditions) and learn how to provide care

Structure – Exposure to Community Resources Students attend rehabilitation centers and work with therapists or physiatrists Students visit spinal cord injury center and learn about services provided there Visitation of group homes for people with developmental disabilities

Structure – Service Learning Students team teach to a group of college students with developmental disabilities Students team teach at a local training center for people with disabilities Assisting in Special Olympics events and other structured sports activities

Feedback from Students “I thought this was a wonderful experience. You can learn much more from a patient in their home than in the clinic. I would definitely continue this experience in the future.” “What an eye-opening experience! I really enjoyed this portion of the block. Getting to see how a patient with a serious disability goes about their day-to-day activities was very educational and humbling. Textbooks don’t provide the same emotional impact as person-to-person communication!” “I learned about the significant social discrimination that occurs affecting people with disabilities. I learned about some helpful hints for their medical care.” “The model patient exercises were very revealing. I would hope that this exercise influenced my approach to patients with disabilities in the future. It was very revealing and demonstrated the importance of taking extra time with these patients.”

Future Directions Partnering with physical therapy students for home visits and perhaps therapy for patients Partnering with speech therapy for further educational experience Providing education regarding disabilities in different cultures, so students might understand more specialized needs Increasing involvement in Special Olympics and local outreach activities for people with disabilities Increasing involvement with newly created UCEDD (University Center for Excellence in Developmental Disabilities)

Contact Information Kira Zwygart, MD Laurie Woodard, MD Department of Family Medicine USF College of Medicine Bruce B Downs Blvd, MDC 13 Tampa, Florida 33612