Medical students’ perceptions on preparedness and care delivery for patients with autism or intellectual disability
DOI:
https://doi.org/10.36834/cmej.76338Abstract
Introduction: To provide competent care to patients with autism spectrum disorder (ASD) or intellectual developmental disorder (IDD), healthcare professionals must recognize the needs of neurodivergent populations and adapt their clinical approach. We assessed the perceived preparedness of medical students to adapt care delivery for patients with ASD/IDD, as well as their perceptions on neurodiversity education.
Methods: We conducted a sequential explanatory mixed-methods study on undergraduate medical students at McGill University during the academic year 2020-2021. We administered an online survey, followed by semi-structured interviews. We analyzed data using descriptive statistics and thematic analysis. We integrated findings at the interpretation level.
Results: We included two-hundred-ten survey responses (~29% of class), and 12 interviews. Few students felt prepared to adjust care for patients with ASD/IDD despite most indicating doing so was important. Ninety-seven percent desired more training regarding care accommodation for neurodivergent patients. Thematic analysis unveiled the perception of current insufficient education, and the value of experiential learning.
Discussion/Conclusions: This study highlights low perceived preparedness of medical students to accommodate care for neurodivergent patients, and a desire for more instruction. Incorporating interactive training in medical school curricula regarding modifying care delivery for neurodivergent individuals may improve the perceived preparedness of medical trainees to work with these patients and care quality.
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References
Havercamp SM, Scandlin D, Roth M. Health disparities among adults with developmental disabilities, adults with other disabilities, and adults not reporting disability in North Carolina. Public Health Rep. 2004 Aug;119(4):418–26. https://doi.org/10.1016/j.phr.2004.05.006 DOI: https://doi.org/10.1016/j.phr.2004.05.006
Jansen DEMC, Krol B, Groothoff JW, Post D. People with intellectual disability and their health problems: a review of comparative studies. J Intellect Disabil Res. 2004 Feb;48(Pt 2):93–102. https://doi.org/10.1111/j.1365-2788.2004.00483.x DOI: https://doi.org/10.1111/j.1365-2788.2004.00483.x
Vohra R, Madhavan S, Sambamoorthi U. Emergency Department Use among Adults with Autism Spectrum Disorders (ASD). J Autism Dev Disord. 2016 Apr;46(4):1441–54. https://doi.org/10.1007/s10803-015-2692-2 DOI: https://doi.org/10.1007/s10803-015-2692-2
Croen LA, Zerbo O, Qian Y, et al. The health status of adults on the autism spectrum. Autism. 2015 Oct;19(7):814–23. https://doi.org/10.1177/1362361315577517 DOI: https://doi.org/10.1177/1362361315577517
Croen LA, Najjar DV, Ray GT, Lotspeich L, Bernal P. A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics. 2006 Oct;118(4):e1203-1211. https://doi.org/10.1542/peds.2006-0127 DOI: https://doi.org/10.1542/peds.2006-0127
Barber C. Meeting the healthcare needs of adults on the autism spectrum. Brit J Nurs. 2017 Apr 13;26(7):420–5. https://doi.org/10.12968/bjon.2017.26.7.420 DOI: https://doi.org/10.12968/bjon.2017.26.7.420
Shooshtari S, Naghipur S, Zhang J. Unmet healthcare and social services needs of older Canadian adults with developmental disabilities. J Policy Practice Intellect Disabil. 2012;9(2):81–91. https://doi.org/10.1111/j.1741-1130.2012.00346.x DOI: https://doi.org/10.1111/j.1741-1130.2012.00346.x
Liptak GS, Stuart T, Auinger P. Health care utilization and expenditures for children with autism: data from U.S. national samples. J Autism Dev Disord. 2006 Oct;36(7):871–9. https://doi.org/10.1007/s10803-006-0119-9 DOI: https://doi.org/10.1007/s10803-006-0119-9
Vogan V, Lake JK, Tint A, Weiss JA, Lunsky Y. Tracking health care service use and the experiences of adults with autism spectrum disorder without intellectual disability: a longitudinal study of service rates, barriers and satisfaction. Disabil Health J. 2017 Apr;10(2):264–70. https://doi.org/10.1016/j.dhjo.2016.11.002 DOI: https://doi.org/10.1016/j.dhjo.2016.11.002
Austriaco, K., Aban, I., Willig, J., & Kong, M. Contemporary trainee knowledge of autism: How prepared are our future providers? Frontiers Peds. 2019; 7. https://doi.org/10.3389/fped.2019.00165 DOI: https://doi.org/10.3389/fped.2019.00165
Rhoades RA, Scarpa A, Salley B. The importance of physician knowledge of autism spectrum disorder: results of a parent survey. BMC Ped. 2007 Nov 20;7(1):37. https://doi.org/10.1186/1471-2431-7-37 DOI: https://doi.org/10.1186/1471-2431-7-37
Walsh C, Lydon S, O’Dowd E, O’Connor P. Barriers to healthcare for persons with autism: A systematic review of the literature and development of a taxonomy. Development Neurorehabil. 2020;23(7):413–30. https://doi.org/10.1080/17518423.2020.1716868 DOI: https://doi.org/10.1080/17518423.2020.1716868
Zerbo O, Massolo ML, Qian Y, Croen LA. A Study of Physician Knowledge and Experience with Autism in Adults in a Large Integrated Healthcare System. J Autism Dev Disord. 2015 Dec;45(12):4002–14. https://doi.org/10.1007/s10803-015-2579-2 DOI: https://doi.org/10.1007/s10803-015-2579-2
Burge P, Ouellette-Kuntz H, Isaacs B, Lunsky Y, University UME in IDG at Q. Medical students’ views on training in intellectual disabilities. Can Fam Phys. 2008 Apr;54(4):568-571.e6. Available from: https://www.cfp.ca/content/54/4/568 [Accessed May 1, 2022]
Hong QN, Fàbregues S, Bartlett G, et al. The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Educ Inform. 2018;34(4):285–91. https://doi.org/10.3233/efi-180221 DOI: https://doi.org/10.3233/EFI-180221
Braun V, Clarke V. Thematic Analysis. APA handbook of research methods in psychology, Vol 2: Research designs: Quantitative, qualitative, neuropsychological, and biological. 2012;:57–71. https://doi.org/10.1037/13620-004 DOI: https://doi.org/10.1037/13620-004
Pluye P, Bengoechea E, Granikov V, Kaur N, Tang D. A World of Possibilities in Mixed Methods: Review of the Combinations of Strategies Used to Integrate Qualitative and Quantitative Phases, Results and Data. Int. J. Mult. Res. Approaches. 018; 10. 41-56. https://doi.org/10.29034/ijmra.v10n1a3. DOI: https://doi.org/10.29034/ijmra.v10n1a3
Muskat B, Burnham Riosa P, Nicholas DB, Roberts W, Stoddart KP, Zwaigenbaum L. Autism comes to the hospital: The experiences of patients with autism spectrum disorder, their parents and health-care providers at two Canadian paediatric hospitals. Autism. 2015 May 1;19(4):482–90. https://doi.org/10.1177/1362361314531341 DOI: https://doi.org/10.1177/1362361314531341
Burge P, Ouellette-Kuntz H, McCreary B, Bradley E, Leichner P. Senior residents in psychiatry: Views on training in developmental disabilities. Can J Psych. 2002 Aug;47(6):568–71. https://doi.org/10.1177/070674370204700610 DOI: https://doi.org/10.1177/070674370204700610
Reinblatt SP, Rifkin A, Castellanos FX, Coffey BJ. General Psychiatry residents' perceptions of specialized training in the field of mental retardaon. Psych Serv. 2004 Mar 1;55(3):312–4. https://doi.org/10.1176/appi.ps.55.3.312 DOI: https://doi.org/10.1176/appi.ps.55.3.312
Smith SE, McCann HP, Urbano RC, Dykens EM, Hodapp RM. Training Healthcare Professionals to work with people with intellectual and developmental disabilities. J Intellect Dev Disabil. 2021 Dec 1;59(6):446–58 https://doi.org/10.1352/1934-9556-59.6.446 DOI: https://doi.org/10.1352/1934-9556-59.6.446
Jaworsky D, Gardner S, Thorne JG, et al. The role of people living with HIV as patient instructors - reducing stigma and improving interest around HIV care among medical students. AIDS Care 2017;29:524–31. https://doi.org/10.1080/09540121.2016.1224314 DOI: https://doi.org/10.1080/09540121.2016.1224314
Gordon M, Gupta S, Thornton D, et al. Patient/service user involvement in medical education: a best evidence medical education (BEME) systematic review: BEME guide No. 58. Med Teach 2020;42:4–16. https://doi/org/10.1080/0142159X.2019.1652731 DOI: https://doi.org/10.1080/0142159X.2019.1652731
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