DEVELOPING SKILLS FOR DEVELOPMENTAL DISABILITIES PRE-CLINICAL ELECTIVE: DIFFERENT SETTING AND POPULATION PRODUCES CONSISTENT IMPROVEMENT IN STUDENT CONFIDENCE

Abstract

Abstract BACKGROUND Medical students feel they are inadequately trained in caring for patients with developmental disabilities (PWDD) (Troller et al. 2016; Salvador-Carulla et al., 2015). Consequently, PWDD may not receive timely, empathetic care from their future clinicians (Sahin and Akyol, 2010). We developed a preclinical elective, “Developing Skills with Developmental Disabilities” (DSDD), to improve student knowledge, skills, and attitudes toward paediatric PWDD. The first cohorts worked with pre-schoolers; DSDD was effective in improving student confidence working with PWDD (Penner et al. 2017). The current project compared the efficacy of DSDD using a hospital-based day-school for elementary-aged children, to previous cohorts. OBJECTIVES Our goal was to determine if changing the population being observed and the setting in which they are being observed could reproduce improvement in student confidence as seen in past cohorts. DESIGN/METHODS The DSDD module was an elective offered to preclinical medical students for credit. Students were given 6 hours of didactics on child development, assistive technologies, and breaking bad news. Students also participated in 6 clinical hours at the Glenrose Rehabilitation Hospital, where they observed school-aged PWDD in a classroom and interacted with an interdisciplinary team. Students also interviewed children’s families during medical intakes. Students completed pre- and post-elective surveys administered on a 5-point Likert scale. Questions pertained to students’ self-perceived comfort and knowledge regarding PWDD. Scores pre- and post-elective were compared using t-test analysis. This data was compared to data collected from previous cohorts, which used the same survey. RESULTS 24 students registered for DSDD, and 21 surveys were able to be analysed. Statistically significant (p<0.01) increases were present in 9/10 self-reported scores, with the statistically insignificant score pertaining to confidence using positive reinforcement. There was no significant difference in pre- and post-elective score improvement when comparing this cohort with past cohorts, across all scores. The critical components of DSDD were maintained across setting changes with significant (p<0.01) increases in students’ self-reported confidence and knowledge in working with PWDD. CONCLUSION This elective demonstrates effectiveness in different settings and ages. The general structure and principles of this elective may be applied by Paediatricians to improve medical education. Examples include having students attend developmental programmes they might provide support for, using a short set of parent interview questions and/or a child observation to improve developmental teaching, and allocating time for interaction with other allied health professionals to better understand their roles in the management of paediatric PWDD.