Abstract
Some highly challenging, seemingly “unsolvable” situations that arise in medical education could be the result of autistic traits (AT) in learners. AT exist in physicians and learners, ranging from profiles compatible with DSM-5’s criteria for autism spectrum disorder (ASD) to more subtle manifestations of ASD’s “broader phenotype.” Often associated with strengths and talents, AT may nonetheless pose significant challenges for learning, teaching, and practising medicine. Since AT remain widely under-recognized and misunderstood by educators, clinicians, and affected individuals alike, they represent a blind spot in medical education. The use of a “neurodiversity lens” to examine challenging situations may help educators consider different pedagogical approaches to address those potentially stemming from AT.This paper aims to raise awareness and understanding of AT-related difficulties in struggling medical learners. To overcome the blind spot challenge and help develop this “neurodiversity lens,” we explore different angles. Beyond any diagnostic consideration, we offer a series of contextual examples, paralleled with explanatory concepts from the field of ASD. We also underline the role of context on functional impact and describe the often ill-defined pattern of challenges encountered, as well as the fertile grounds for interpersonal misunderstandings and disrespect. We propose historical, cultural, and clinical reasons likely contributing to the blind spot. Mindful of the potential risks of prejudice associated with identifying AT-related difficulties, we underline the necessity and feasibility of conciliating diversity and dignity with accountability standards for medical competence.
Highlights
Certain challenging interpersonal situations encountered in medical education leave both learner and teacher frustrated and with a feeling of unfinished business
We can all remember learners who have repeatedly made “surprising” or inappropriate decisions, seemingly unaware of the cues expressed by others and unable to understand their role in creating the problematic situation
When identifying struggling learners’ deficits, medical educators generally overlook cognitive characteristics related to autistic traits (AT)
Summary
Certain challenging interpersonal situations encountered in medical education leave both learner and teacher frustrated and with a feeling of unfinished business. Individuals with AT process information differently and usual remediation strategies may not work. Because of their potential impact on learning, communication, and interactions, AT deserve to be better understood by medical educators and the entire academic medical community. This paper aims to help medical educators identify neurocognitive characteristics in struggling learners that, if unrecognized, are likely to affect the achievement of expected competences. The first step is to acknowledge individual differences in cognitive processes and understand how AT might explain learning challenges. This possibility broadens the scope of hypotheses for performance gaps, may dampen educators’ negative assumptions, and enable comprehensive approaches to support optimal learning. Our aim is to help medical educators consider viewing puzzling situations through a new lens
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