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.

Addressing the High Rates of Mortality in People With Intellectual Disability

“…First, train health professionals in recognizing and addressing the health needs of people with ID. Australian research has shown that health care professionals are underequipped to deal with the health needs of people with ID, owing to a lack of appropriate training . Specific education and training for health professionals at all stages, from medical school to specialist training, on providing care for people with ID, can lead to earlier identification and better management of conditions that are amenable to health care.…”

Exploring views on medical care for people with intellectual disabilities: an international concept mapping study

“…Despite the increasing knowledge on the needs for specific skills and knowledge in medical care providers [ 11 , 36 ], authors of recent review articles agree that medical care for people with IDD still lacks adequate support [ 9 – 11 , 37 , 38 ]. This lack can possibly be addressed by systematically increasing the attention/priority for the special medical care needs of people with IDD in medical curricula and education [ 39 , 40 ].…”

Intellectual disability healthcare in Australia: Progress, challenges, and future directions

“…For example, audits of intellectual disability content in medical and nursing curricula across Australian universities found intellectual disability content and teaching methods vary greatly between universities. These audits found only 10% of nursing schools, and 15% of medical schools offered substantial intellectual disability health content, and few universities offered direct clinical contact with people with intellectual disability (Trollor et al, 2020; Trollor, Eagleson, et al, 2016; Trollor, Eagleson, Turner, Salomon, et al, 2018; Trollor, Eagleson, Turner, Tracy, et al, 2018; Trollor, Ruffell, et al, 2016). Research also shows health professionals lack the capacity and confidence to meet the health needs of people with intellectual disability (Weise & Trollor, 2018).…”