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Caring for Patients with Physical Disabilities

Assessment of an Innovative Spinal Cord Injury Session that Addresses an Educational Gap

John, Janice Thomas DO, MS, MPH1; Block, Lauren MD, MPH2; Stein, Adam MD3; Vasile, Elizabeth MPH4; Barilla-LaBarca, Maria-Louise MD5

American Journal of Physical Medicine & Rehabilitation: June 19, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001251
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Despite the fact that one-fifth of Americans live with disability, caring for these patients is not routinely part of the undergraduate medical student curriculum. An innovative session addressing care of patients with spinal cord injury (SCI) was developed for medical students and led by physiatrists, faculty experts in communications and individuals with SCI. A mixed-method design was utilized in evaluating students’ knowledge, skills and attitudes following this curriculum. Quantitative evaluation was performed with a written essay question and checklist items from an objective structured clinical examination (OSCE) station. The session was given to 296 students from 2016 to 2018. On the OSCE, 94% asked about sexual function, 85% asked about activities of daily living (ADL), 77% asked about instrumental activities of daily living (IADL) and 47% of students evaluated skin health. Students demonstrated respectful (99%) and non-judgmental (99%) attitudes with SCI standardized patients (SPs) and 91% interacted with the SP’s caretaker appropriately. Themes emerged from the student survey including: the value of having real patients present during the session, exposure to physical medicine and rehabilitation (PM&R) as a specialty, and the advantage of a small group format. This session provided students with tools necessary to care for patients with SCI.

1Department of Science Education and Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Drive Hempstead, NY 11549

2 Department of Science Education and Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Drive Hempstead, NY 11549

3 Department of Physical Medicine and Rehabilitation, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Drive Hempstead, NY 11549

4 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Drive Hempstead, NY 11549

5 Department of Science Education and Rheumatology, Allergy and Clinical Immunology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

Corresponding author: Janice Thomas John, DO, MS, MPH, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY 11549, Phone: 516-463-7577 Fax: 516-463-5631; email: janice.t.john@hofstra.edu

Author disclosures:Janice Thomas John DO, MS, MPH- nothing to disclose. Lauren Block MD, MPH - nothing to disclose. Adam Stein MD- nothing to disclose. Elizabeth Vasile, MPH- nothing to disclose. Maria-Louise Barilla-LaBarca MD-nothing to disclose

Sources of funding: None

Previous presentations: 2017 data was presented at: 1. Directors of Clinical Skills (DOCS) Annual Meeting, 2017. Boston, MA (poster). 2. Association of Academic Physiatrist (AAP) Annual Meeting, 2018 Atlanta, GA (platform presentation)

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