Education Research: Predictors of Resident Physician Comfort With Individuals With Intellectual and Developmental Disabilities

Abstract

Background and ObjectivesIndividuals with intellectual and/or developmental disabilities (IDD) experience worse health outcomes compared with peers without a disability partly due to difficulties accessing age-appropriate health care. Provider discomfort with interacting and caring for individuals with IDD is a primary barrier to accessing care. The objectives of this study were to describe resident physicians' education, experiences, and comfort levels regarding individuals with IDD and to identify predictors of higher comfort levels with this patient population.MethodsIn this cross-sectional study, we surveyed medical trainees in 7 residency programs in Boston, Massachusetts on their education, experiences, and comfort levels regarding individuals with IDD. The comfort level was assessed directly on a 6-point Likert scale. The relationship between comfort regarding people with IDD and several candidate explanatory variables was explored with Spearman and partial Spearman correlations (rs).ResultsThe estimated survey response rate was 49%. Of 423 resident physicians included in the study, 96% reported they had treated a patient with IDD, while only 25% reported having formal education on caring for this population. On a scale of 1–6, with higher numbers corresponding to greater comfort, the mean comfort level treating individuals with IDD was 3.73 (CI 3.61–3.85). In bivariant analyses, the amount of prior experience with people with IDD had a moderate, positive correlation with increased comfort levels treating individuals with IDD (rs= 0.42,p< 0.01). The following characteristics had a weak, positive correlation with increased comfort levels: training in a pediatric-focused residency specialty (rs= 0.18,p< 0.01), number of hours of formal education on caring for people with IDD (rs= 0.15,p< 0.01), and age (rs= 0.12,p= 0.03). Only the amount of prior experience with this patient population remained positively correlated with higher comfort levels when the other variables were controlled for (rs= 0.38,p< 0.01).DiscussionPrior experience with individuals with IDD predicted higher comfort levels with this population. This study supports the need for increased opportunities for medical trainees to engage with people with IDD to improve resident physicians' comfort caring for this patient population.

An Issue on Innovation: What Makes Curricula Innovative and New Approaches to Neurology Education

“…In this second section of articles, authors' report on approaches to teaching neuro-ophthalmology, comfort with treating patients with intellectual disability, and team-based learning. [11][12][13] Neurologic Education Across Professions and Disciplines Neurology faces a critical physician shortage. Patientcentered care requires interprofessional collaborative practice where providers across varying disciplines and professions work together to deliver team-based care.…”

New Frontier: The First Year of an Adult Neurodevelopmental Disabilities Clinic

“…The adult NDD clinic provides a unique opportunity for adult neurology residents to gain clinical experience with adults with NDDs. Other studies have shown that many residents in adult medical specialties do not see the population of adults with NDDs as a regular part of their specialty, likely due to lack of exposure (Shapiro et al, 2023). Because the University of Colorado Neurology Department now includes the adult NDD clinic as part of the clinical rotations for residents who are rotating in behavioral neurology, our hope is that these residents will graduate with more comfort and confidence in caring for adults with NDDs.…”