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Ailey SH, Molly B, Tichá R, Abery B, Khuu BK, Angel L. Health professionals' education related to people with intellectual and developmental disabilities: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13208. [PMID: 38382496 DOI: 10.1111/jar.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/04/2024] [Accepted: 01/16/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND People with intellectual and developmental disabilities are among the most underserved in an inequitable healthcare system. METHODS Using Arksey and O'Malley's methodology and a social determinants of health framework, we conducted a scoping review of literature on the state of practice in education of healthcare professionals in the health and healthcare needs of this population. RESULTS Searches found 4948 articles, with 182 included in the final review. Themes identified included gaps of not being informed by workforce needs, continued use of the medical model of care, not addressing intersectionality with racial/ethnic and other discriminations, and lack of involvement of the population in developing/evaluating programs and promising trends of development of competency-based interprofessional programs with experiential learning. CONCLUSION We provide recommendations for best practices in a concerted effort to educate a healthcare workforce equipped with the knowledge and skills to address the health needs of this population.
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Affiliation(s)
- Sarah H Ailey
- Department of Community, Systems, and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
| | - Bathje Molly
- Occupational Therapy Program, DePaul University, College of Science and Health, Chicago, Illinois, USA
| | - Renáta Tichá
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brian Abery
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Belle K Khuu
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lisa Angel
- Department of Community, Systems, and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
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Edelman EA, Logan K, Ingram Nissen T, Reed EK, Wicklund C, Duquette D, Dellefave-Castillo L. A team-based approach to cardiogenomic education. J Genet Couns 2024; 33:216-221. [PMID: 37849384 DOI: 10.1002/jgc4.1798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 08/07/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023]
Abstract
While many genetic professionals are involved in the education of lay and professional audiences, most do not have formal training in education theory and program design. Partnerships with adult education experts can provide additional resources and improve the level of instruction, thereby increasing the impact of an educational intervention. This report discusses the experience of a multidisciplinary team of educators, clinicians, and researchers partnering to develop evidence-based education for cardiology practitioners. It includes practical advice for how clinicians and educators can develop more effective education through collaboration, needs assessment, instructional design, and iterative content development.
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Affiliation(s)
- Emily A Edelman
- Clinical Education Program, Genomic Education, The Jackson Laboratory, Farmington, Connecticut, USA
| | - Kalisi Logan
- Clinical Education Program, Genomic Education, The Jackson Laboratory, Farmington, Connecticut, USA
| | - Therese Ingram Nissen
- Clinical Education Program, Genomic Education, The Jackson Laboratory, Farmington, Connecticut, USA
| | - E Kate Reed
- Clinical Education Program, Genomic Education, The Jackson Laboratory, Farmington, Connecticut, USA
| | - Catherine Wicklund
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Debra Duquette
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Lisa Dellefave-Castillo
- Center for Genetic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Meredith S, Weiss S, Kleinert HL, Tyrrell CA. The impact of implicit and explicit bias about disabilities on parent experiences and information provided during prenatal screening and testing. Disabil Health J 2024; 17:101514. [PMID: 37633732 DOI: 10.1016/j.dhjo.2023.101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Prenatal screening technology has consistently raised concerns regarding the conversations and information provided about disabilities, particularly given that research shows trauma related to negative prenatal screening and diagnosis experiences among parents of children with Down syndrome.1 OBJECTIVE: To determine what information obstetric medical providers (OB/MFMs) are most and least likely to provide when delivering prenatal screening/testing results about Down syndrome (DS), the subsequent impact of bias on prenatal screening experiences, and how these issues can be addressed through training, resources, and professional guidelines. METHODS Online surveys were distributed to parents of children with DS born between 2016 and 2021 via local DS organizations and the national DS Diagnosis Network (April 2020-December 2021). RESULTS Of the 242 parents who completed the survey, a majority indicated that OB/MFMs were most likely to discuss medical issues and reproductive options while less than 40% reported that OB/MFMs discussed psychosocial outcomes, supports, and services. Respondents reported that the 61.3% of OB/MFMs who delivered the diagnosis as bad news or said "I'm sorry" were significantly less likely than their counterparts to provide information about life outcomes, supports and services, condition-specific resources, or more comprehensive prenatal care. Qualitative responses about screening/diagnosis experiences provided further context about the impact of implicit and explicit bias on the provision of accurate, up-to-date information. CONCLUSION To meet information needs during prenatal screening, OB/MFMs need access to accurate, balanced, and up-to-date information about disabilities and more training on disability cultural competency and how to deliver prenatal screening/testing results without implicit or explicit bias.
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Affiliation(s)
| | - Sierra Weiss
- University of Kentucky Human Development Institute, USA
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Kammes RR, Lachmar EM, Douglas SN, Schultheiss H. "Life-altering": A qualitative analysis of social media birth stories from mothers of children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:919-937. [PMID: 35898186 DOI: 10.1177/17446295211025960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Perinatal depression/anxiety is a significant concern for mothers of children with Down syndrome. This is influenced by the way the Down syndrome diagnosis is shared with parents. This study examined social media posts from mothers regarding experiences of the birth of their child with Down syndrome. Forty-three total stories were coded using thematic content analysis. Results highlighted the experiences of mother's who received a diagnosis of Down syndrome for their newborn. Two themes were found with relevant subthemes (i.e., receiving the diagnosis-mother's intuition, confirmation of the diagnosis, influence of potential health concerns, initial emotions, impact of the medical professional; Processing the diagnosis-life-altering, child not meeting expectations, reframing the diagnosis, impact of partner and others). Findings highlight the need for medical personnel to understand this identity-changing process, as perinatal depression/anxiety looks different for these mothers. There is also a need to help them engage in services accordingly.
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Recommendations to Improve the Patient Experience and Avoid Bias When Prenatal Screening/Testing. Disabil Health J 2022; 16:101401. [PMID: 36463093 DOI: 10.1016/j.dhjo.2022.101401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
While prenatal screening and testing have expanded substantially over the past decade and provide access to more genetic information, expectant parents are more likely to describe the diagnosis experience as negative than positive. In addition, the conversations that take place during these experiences sometimes reflect unconscious bias against people with disabilities. Consequently, an interdisciplinary committee of experts, including people with disabilities, family members, disability organization leaders, healthcare and genetics professionals, and bioethicists, reviewed selected published and gray literature comparing the current state of the administration of prenatal testing to the ideal state. Subsequently, the interdisciplinary team created recommendations for clinicians, public health agencies, medical organizations, federal agencies, and other stakeholders involved with administering prenatal screening and testing to create better patient experiences; conduct training for healthcare professionals; create, enforce, and fund policies and guidelines; and engage in more robust data collection and research efforts.
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Vincent A, Urben T, Becker C, Beck K, Daetwyler C, Wilde M, Gaab J, Langewitz W, Hunziker S. Breaking bad news: A randomized controlled trial to test a novel interactive course for medical students using blended learning. PATIENT EDUCATION AND COUNSELING 2022; 105:105-113. [PMID: 33994021 DOI: 10.1016/j.pec.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/07/2021] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Breaking bad news (BBN) is challenging for physicians and patients and specific communication strategies aim to improve these situations. This study evaluates whether an E-learning assignment could improve medical students' accurate recognition of BBN communication techniques. METHODS This randomized controlled trial was conducted at the University of Basel. After a lecture on BBN, 4th year medical students were randomized to an intervention receiving an E-learning assignment on BBN or to a control group. Both groups then worked on an examination video and identified previously taught BBN elements shown in a physician-patient interaction. The number of correctly, misclassified and incorrectly identified BBN communication elements as well as missed opportunities were assessed in the examination video. RESULTS We included 160 medical students (55% female). The number of correctly identified BBN elements did not differ between control and intervention group (mean [SD] 3.51 [2.50] versus 3.72 [2.34], p = 0.58). However, the mean number of inappropriate BBN elements was significantly lower in the intervention than in the control group (2.33 [2.57] versus 3.33 [3.39], p = 0.037). CONCLUSIONS Use of an E-learning tool reduced inappropriate annotations regarding BBN communication techniques. PRACTICE IMPLICATIONS This E-learning might help to further advance communication skills in medical students.
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Affiliation(s)
- Alessia Vincent
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Tabita Urben
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Christoph Becker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Emergency Department, University Hospital Basel, Basel, Switzerland
| | - Katharina Beck
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | | | - Michael Wilde
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Wolf Langewitz
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Sabina Hunziker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland.
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