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Competency-Based Curriculum Development to Meet the Needs of People With Disabilities

A Call to Action

Ankam, Nethra S., MD; Bosques, Glendaliz, MD; Sauter, Carley, MD; Stiens, Steven, MD, MS; Therattil, Maya, MD, MS; Williams, Faren H., MD, MS; Atkins, Caleb C., MD; Mayer, R. Samuel, MD

doi: 10.1097/ACM.0000000000002686
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People with disabilities constitute 22.2% of the population in the United States, and virtually all physicians have people with disabilities in their clinical practice across a wide range of diagnostic groups. However, studies demonstrate that people with disabilities are inadequately served by the health care system, leading to high costs and poor outcomes. The authors argue that one cause of this discrepancy is that medical students receive limited training in the care of people with disabilities and may therefore not be able to adequately meet the competencies that underlie the Core Entrustable Professional Activities for Entering Residency. To address these gaps, the authors present practical examples of integrating concepts of disability into the curriculum with minimal additional time requirements. A comprehensive disability curriculum is suggested to include active classroom learning, clinical, and community-based experiences. At institutions that do not have a comprehensive curriculum, the authors recommend adding disability-related knowledge and skill acquisition to existing curricula through modifications to current case-based learning, simulated patients, and objective structured clinical examinations. To facilitate curriculum development, they recommend that the World Health Organization International Classification of Functioning, Disability, and Health be used as a tool to build disability concepts into active learning. The goal of these recommended curricular changes is to enhance student performance in the clinical management of people with disabilities and to better train all future physicians in the care of this population.

N.S. Ankam is associate professor and director of undergraduate medical education, Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.

G. Bosques is associate professor of physical medicine and rehabilitation, University of Texas Health Science Center at Houston (UTHealth) Medical School, and medical staff, Shriners Hospital for Children, TIRR Memorial Hermann and Children’s Memorial Hermann Hospital, Houston, Texas.

C. Sauter is assistant professor and director of undergraduate medical education, Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin.

S. Stiens was associate professor, Department of Rehabilitation Medicine, University of Washington School of Medicine at the time this article was written, and is curator of education, Stiens’ Designs: Personal Enablement, LLC, Seattle, Washington.

M. Therattil is clinical assistant professor, Arthur S. Abramson Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, and director of medical education, Clinical Education Program, St. Lawrence Rehabilitation Center and Drexel University College of Medicine, Philadelphia, Pennsylvania.

F.H. Williams is chief of physical medicine and rehabilitation, UMass Memorial Medical Center, and clinical professor of orthopedics and physical rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts.

C.C. Atkins is adjunct professor of anatomy and physiology, Pomeroy College of Nursing at Crouse Hospital, Syracuse, New York, chief operations officer, MD Grand Rounds, Baltimore, Maryland, and chief executive officer, Cold Fusion Technologies LLC, Carthage, New York.

R.S. Mayer is vice chair of education, Department of Physical Medicine and Rehabilitation, and associate professor of physical medicine and rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland.

Funding/Support: None reported.

Other disclosures: This task force report represents the conclusions of the Task Force on Disability Education for Medical Students established by the Association of Academic Physiatrists. This manuscript has been reviewed by the board of trustees of the Association of Academic Physiatrists.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Nethra S. Ankam, Department of Rehabilitation Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, 25 S. 9th St., Philadelphia, PA 19107; telephone: (215) 955-1213; e-mail: nethra.ankam@jefferson.edu.

© 2019 by the Association of American Medical Colleges