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Has teaching about intellectual disability healthcare in Australian medical schools improved? A 20-year comparison of curricula audits.

ABSTRACT: BACKGROUND:People 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. METHODS:Identical 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. RESULTS:There 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%). CONCLUSIONS:Overall, 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.

SUBMITTER: Trollor JN

PROVIDER: S-EPMC7507627 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Has teaching about intellectual disability healthcare in Australian medical schools improved? A 20-year comparison of curricula audits.

Trollor Julian N JN Eagleson Claire C Ruffell Beth B Tracy Jane J Torr Jennifer J JJ Durvasula Seeta S Iacono Teresa T Cvejic Rachael C RC Lennox Nicholas N

BMC medical education 20200921 1

<h4>Background</h4>People 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 amoun ...[more]

PMID: 32958040

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Project description:BackgroundThe Australian Medical Council, which accredits Australian medical schools, recommends medical leadership graduate outcomes be taught, assessed and accredited. In Australia and New Zealand (Australasia) there is a significant research gap and no national consensus on how to educate, assess, and evaluate leadership skills in medical professional entry degree/programs. This study aims to investigate the current curricula, assessment and evaluation of medical leadership in Australasian medical degrees, with particular focus on the roles and responsibilities of medical leadership teachers, frameworks used and competencies taught, methods of delivery, and barriers to teaching leadership.MethodsA self-administered cross-sectional survey was distributed to senior academics and/or heads or Deans of Australasian medical schools. Data for closed questions and ordinal data of each Likert scale response were described via frequency analysis. Content analysis was undertaken on free text responses and coded manually.ResultsSixteen of the 22 eligible (73%) medical degrees completed the full survey and 100% of those indicate that leadership is taught in their degree. In most degrees (11, 69%) leadership is taught as a common theme integrated throughout the curricula across several subjects. There is a variety of leadership competencies taught, with strengths being communication (100%), evidence based practice (100%), critical reflective practice (94%), self-management (81%), ethical decision making (81%), critical thinking and decision making (81%). Major gaps in teaching were financial management (20%), strategic planning (31%) and workforce planning (31%). The teaching methods used to deliver medical leadership within the curricula are diverse, with many degrees providing opportunities for leadership teaching for students outside the curricula. Most degrees (10, 59%) assess the leadership education, with one-third (6, 35%) evaluating it.ConclusionsMedical leadership competencies are taught in most degrees, but key leadership competencies are not being taught and there appears to be no continuous quality improvement process for leadership education. There is much more we can do as medical educators, academics and leaders to shape professional development of academics to teach medical leadership, and to agree on required leadership skills set for our students so they can proactively shape the future of the health care system.

Project description:BackgroundIntellectual Disability (ID) is characterized by significant limitations that affect intellectual functioning, adaptive behavior, and practical skills which directly interfere with interpersonal relationships and the environment. In Western countries, individuals with ID are overrepresented in the health system, often due to associated comorbidities, and its life-time cost places ID as one of the most expensive conditions of all diagnoses in the International Classification of Diseases. Most of the people affected (75%) live in low-income countries, suffer from malnutrition, lack health care, and do not have access to adequate treatment. The aim of this study was to obtain an estimate of the diagnostic status as well as the prevalence of familial ID among individuals with serious (moderate or severe) ID in a region of the State of Santa Catarina, investigating attendees of special education schools of the Florianópolis Macroregion.MethodsThis was a cross-sectional study conducted between August 2011 and August 2014, through a semi-structured screening questionnaire for the collection of relevant developmental, clinical, familial and educational data, applied in an interview to guardians of students of special education schools of the macroregion of Florianópolis.ResultsThe participant special schools enrolled close to 1700 students during the study period and the questionnaire was applied to 849 (50.5%). The male to female ratio of the participants was 1.39:1. Clear etiologic explanations were relatively scarce (24%); most diagnoses referring only to the type and the degree of impairment and for the majority (61.4%) the cause was unknown. About half were sporadic cases within their families (considering three generations). For 44.2% at least one other case of an ID-related condition in the extended family was mentioned, with 293 (34.5%) representing potential familial cases.ConclusionHere we describe the epidemiological profile, the available diagnostics, etiology, family history and possible parental consanguinity of participants with ID of special education schools in the South of Brazil. The main results show the need for etiological diagnosis and uncover the relevance of potential hereditary cases in a population where consanguineous unions have a relatively low frequency (0,6%) and highlight the need for public health actions.

Project description:BackgroundAccurate knowledge of the relationship between craniofacial anomalies (CFA), intellectual disability (ID) and autism spectrum disorder (ASD) is essential to improve services and outcomes. The aim is to describe the association between CFA, ID and ASD using linked population data.MethodsAll births (1983-2005; n = 566,225) including CFA births (comprising orofacial clefts, craniosynostosis, craniofacial microsomia and mandibulofacial dysostosis) surviving to 5 years were identified from the birth, death, birth defects and midwives population data sets. Linked data from these data sets were followed for a minimum of 5 years from birth until 2010 in the intellectual disability database to identify ID and ASD. These associations were examined using a modified Poisson regression.ResultsPrevalence of ID and ASD was higher among CFA (especially with additional anomalies) than those without [prevalence ratio 5.27, 95% CI 4.44, 6.25]. It was higher among CFA than those with other gastrointestinal and urogenital anomalies but lower than nervous system and chromosomal anomalies. Children with CFA and severe ID had a higher proportion of nervous system anomalies.ConclusionsFindings indicate increased ID and ASD among CFA but lower than nervous system and chromosomal anomalies. This population evidence can improve early identification of ID/ASD among CFA and support service planning.ImpactOur study found about one in ten children born with craniofacial anomalies (CFA) are later identified with intellectual disability (ID). Prevalence of ID among CFA was higher than those with other gastrointestinal, urogenital, and musculoskeletal birth defects but lower than those with the nervous system and chromosomal abnormalities. Most children with craniofacial anomalies have a mild-to-moderate intellectual disability with an unknown aetiology. On average, intellectual disability is identified 2 years later for children born with non-syndromic craniofacial anomalies than those with syndromic conditions. Our findings can improve the early identification of ID/ASD among CFA and support service planning.

Project description:Importance:Researchers have published surveys on health professionals' perceptions of the possible association between climate change and health (climate-health) and assessed climate-health or planetary health curricula in medical schools. However, curricula on climate-health are still lacking and gaps in knowledge persist. Objective:To understand the state of climate-health curricula among health professions institutions internationally. Design, Setting, and Participants:A survey of 160 institutional members of the Global Consortium on Climate and Health Education, which includes international health professions schools and programs, was conducted from August 3, 2017, to March 1, 2018. The survey, hosted by Columbia University Mailman School of Public Health, used an online survey tool for data collection. Main Outcomes and Measures:The survey assessed climate-health curricular offerings across health professions institutions internationally, including existing climate-health educational offerings, method of teaching climate-health education, whether institutions are considering adding climate-health education, whether institutions received a positive response to adding climate-health curricula and/or encountered challenges in adding curricula, and opportunities to advance climate-health education. Results:Overall response rate to the survey was 53%, with 84 of 160 institutional responses collected; 59 of the responses (70%) were from schools/programs of public health, health sciences, or health professions; 15 (18%) were from medicine; 9 (11%) were from nursing; and 1 (1%) was from another type of health profession institution. Among respondents, 53 (63%) institutions offer climate-health education, most commonly as part of a required core course (41 [76%]). Sixty-one of 82 respondents (74%) reported that climate-health offerings are under discussion to add, 42 of 59 respondents (71%) encountered some challenges trying to institute the curriculum, and most respondents have received a positive response to adding content, mainly from students (39 of 58 [67%]), faculty (35 of 58 [60%]), and administration (23 of 58 [40%]). Conclusions and Relevance:Current climate-health educational offerings appear to vary considerably among health professions institutions. Students, faculty, and administration are important groups to engage when instituting curricula, and awareness, support, and resources may be able to assist in this effort.

Project description:BackgroundThere have been a few but not precise surveys of the current status of traditional Japanese Kampo education at medical schools in Japan. Our aim was to identify problems and suggest solutions for a standardized Kampo educational model for all medical schools throughout Japan.MethodsWe surveyed all 80 medical schools in Japan regarding eight items related to teaching or studying Kampo medicine: (1) the number of class meetings, target school year(s), and type of classes; (2) presence or absence of full-time instructors; (3) curricula contents; (4) textbooks in use; (5) desire for standardized textbooks; (6) faculty development programmes; (7) course contents; and (8) problems to be solved to promote Kampo education. We conducted descriptive analyses without statistics.ResultsEighty questionnaires were collected (100%). (1) There were 0 to 25 Kampo class meetings during the 6 years of medical school. At least one Kampo class was conducted at 98% of the schools, ≥4 at 84%, ≥8 at 44%, and ≥16 at 5%. Distribution of classes was 19% and 57% for third- and fourth-year students, respectively. (2) Only 29% of schools employed full-time Kampo medicine instructors. (3) Medicine was taught on the basis of traditional Japanese Kampo medicine by 81% of the schools, Chinese medicine by 19%, and Western medicine by 20%. (4) Textbooks were used by 24%. (5) Seventy-four percent considered using standardized textbooks. (6) Thirty-three percent provided faculty development programmes. (7) Regarding course contents, "characteristics" was selected by 94%, "basic concepts" by 84%, and evidence-based medicine by 64%. (8) Among the problems to be solved promptly, curriculum standardization was selected by 63%, preparation of simple textbooks by 51%, and fostering instructors responsible for Kampo education by 65%.ConclusionsJapanese medical schools only offer students a short time to study Kampo medicine, and the impetus to include Kampo medicine in their curricula varies among schools. Future Kampo education at medical schools requires solving several problems, including curriculum standardization.

Project description:IntroductionPostgraduate education is transitioning to a competency-based curriculum in an effort to standardize the quality of graduating trainees. The learning experiences and opportunities in each institution are likely variable, as no standard exists regarding the teaching curriculum offered through residency. The objective of this study is to examine the various teaching curricula among different Canadian urology residency programs and to identify which teaching modalities are prioritized by program directors.MethodsA 10-question anonymous survey was sent electronically to program directors at all 12 urology residency programs across Canada. Questions were designed to quantify the time allotted for teaching and to assess the various teaching session types prioritized by programs to ensure the successful training of their graduates. We assessed each program's perceived value of written exams, oral exams, didactic teaching session, and simulation sessions. Responses were assessed using a Likert-scale and a ranking format. Descriptive statistics were performed.ResultsOverall survey response rate from residency program directors was 75% (9/12). Sixty-seven percent of programs designated one day of teaching per week, whereas 33% split resident teaching over two days. Review of chapters directly from Campbell-Walsh Urology textbook were deemed the most valuable teaching session. Practice oral exams were also prioritized, whereas most programs felt that simulation labs contributed the least to residency education. All programs included review of the core urology textbook in their weekly teaching, while only 67% of programs included faculty-led didactic sessions and case presentations. Forty-four percent of programs included resident-led didactic sessions. Practice oral exams and simulation labs were the least commonly included teaching modalities.ConclusionsAlthough most program directors prioritize the review of chapters in the core urology textbook, we found significant heterogeneity in the teaching sessions prioritized and offered in current urology residency curricula. As we move to standardize the quality of graduating trainees, understanding the impact of variable educational opportunities on residency training may become increasingly important.

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Has teaching about intellectual disability healthcare in Australian medical schools improved? A 20-year comparison of curricula audits.

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Has teaching about intellectual disability healthcare in Australian medical schools improved? A 20-year comparison of curricula audits.

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