Abstract
BackgroundPeople with intellectual disability (ID) have multiple and complex health needs, more frequent healthcare episodes, and experience poorer health outcomes. Research conducted two decades ago showed that medical professionals were lacking in the knowledge and skills required to address the complex needs of this patient group. The aim of the current study was to determine whether Australian undergraduate medical schools that offer ID health education content had changed the amount and nature of such teaching over this period.MethodsIdentical or equivalent questionnaire items were compared across eight Australian medical schools that participated in curricula audits conducted in 1995 (referred to as T1) and 2013/14 (T2). The audits were of the nature of the ID content, methods used to teach it, and who taught it.ResultsThere was no significant difference in the number of hours of compulsory ID content offered to medical students at T2 (total = 158.3 h; median = 2.8 h per ID unit) compared with T1 (total = 171 h; median = 2.5 h). At T2 compared with T1, units with ID content taught in the area of general practice had increased (2 units; 3.6% to 7 units; 16.3%), while decreases were seen in paediatrics (22 units; 40.0% to 10 units; 23.3%) and psychiatry (10 units; 18.2% to 4 units; 9.3%). The number of schools using problem- and/or enquiry-based learning rose to six at T2 from one at T1. Inclusive teaching practices (people with ID develop or deliver content) in compulsory/elective units had increased at T2 (10 units; 23.3%) compared with T1 (6 units; 10.9%), but direct clinical contact with people with ID had decreased (29 units; 52.7% to 11 units; 25.6%).ConclusionsOverall, little progress has been made to address the gaps in ID education for medical students identified from an audit conducted in 1995. Renewal of ID content in medical curricula is indicated as a key element in efforts to improve workforce capacity in this area and reduce barriers to care, with the aim of reversing the poor health outcomes currently seen for this group.
Highlights
People with intellectual disability (ID) have multiple and complex health needs, more frequent healthcare episodes, and experience poorer health outcomes
Intellectual disability content within the course program Compulsory intellectual disability units Across the eight medical schools, there was no significant difference in the number of compulsory ID units offered at T2 compared with T1
There was no significant difference in the number of hours of compulsory ID content taught at T2 versus T1, nor the number of hours of ID content taught across all compulsory units offered by each school
Summary
People with intellectual disability (ID) have multiple and complex health needs, more frequent healthcare episodes, and experience poorer health outcomes. Almost two thirds of Australian general practitioners responding to a survey on the standards of healthcare for people with ID and educational needs reported a lack of adequate training to care for people with ID, and almost all indicated an interest in receiving further education in this area [13]. Health needs of people with ID vary depending on the influence of social determinants, including access to effective healthcare services, level of social inclusion, poverty, and support for a healthy lifestyle [18]. They vary by the level of ability and cause of the ID. To reduce barriers to access, specific adaptations to practice are often required, such as tailoring communication [21]
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