87 Developing Skills for Developmental Disabilities: Does clinical experience improve preclinical student confidence in interacting with pediatric patients with developmental disabilities?

Abstract

Medical students feel they have inadequate training in caring for patients with developmental disabilities (PWDD) and behavioural co-morbidities (Troller et al. 2016; Salvador-Carulla et al. 2015). Inadequate education regarding care of PWDD can lead to frustration and negative attitudes toward this complex patient population. Consequently, PWDD may not receive timely and empathetic care in pediatric and family practice (Sahin & Akyol, 2010). Our preclinical 12-hour elective, “Developing Skills with Developmental Disabilities” (DSDD), has a primary learning objective of improving students’ knowledge of and attitudes toward childhood developmental disabilities. Our objective was to compare confidence outcomes of DSDD students to those exposed only to the standard developmental pediatrics curriculum. Content in the pre-clinical Neurosciences block includes didactic lectures on developmental disabilities, a problem-based learning case on developmental delay, and small-group clinical skills sessions with typically developing children and their parents. Elective students received 6 hours of didactic teachings from developmental pediatricians and physiatrists on child development, estimating developmental age, assistive technologies, and breaking bad news. Students spent 6 hours at a rehabilitation hospital, where they attended a intake session, conducted a brief interview with the family, observed school-aged PWDD in a modified classroom, and interacted with the interdisciplinary team. Participating DSDD students were given pre- and post-elective self-assessment surveys administered on a 5-point Likert scale. Questions pertained to students’ self-perceived comfort and knowledge regarding PWDD. Control students received the same surveys at the beginning and end of the Neurosciences block. Scores pre- and post-elective were used to calculate relative improvement of controls and elective participants. T-tests were then used to compare these cohorts. Data was collected from 2 consecutive years, including 35 students who completed DSDD and 18 control students from the same academic classes. Statistically significant (p<0.05) relative improvements were present in 4 of 10 self-reported scores, with the statistically significant scores pertaining to confidence interacting with PWDD, taking histories, recommending appropriate resources to families, and estimating developmental age. DSDD appears to teach skills that may not be learned from the standard Neurosciences curriculum. Improvement in confidence is a first step in implementing a new skill or changing a behaviour. Reported improved skills included interacting with PWDD, approach to histories, recommending resources, and estimating developmental age. Next steps would be to see if these changes translate into improved clinical skills and ultimately better care for this population.