Structural ableism in public health and healthcare: a definition and conceptual framework

Lundberg, Dielle J.; Chen, Jessica A.

doi:10.1016/j.lana.2023.100650

Cited by 11 publications

(4 citation statements)

References 37 publications

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“…Further, the need for accommodation in assessment marginalizes students for whom the standard testing environment is unequitable [ 35 ]. As one student reported, “It felt unfair that I had to complete such an extensive application that other test takers who didn’t need accommodations did not have to worry about, just to ensure that I had an equitable test-taking experience.” Others also used language that highlighted their experiences of marginalization and isolation: “[the process]…[m]ade me feel as if a Type 1 diabetic with an insulin pump had never taken Step-1 before.” As other scholars in health professions education have argued, ableism adversely impacts both trainees and the practicing workforce [ 36 – 38 ].…”

Section: Discussion/conclusionmentioning

confidence: 99%

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Barriers to USMLE Step-1 accommodations: Students with Type 1 Diabetes

Serata,

Noonan,

Petersen

2024

PLoS ONE

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Purpose Students who earn their medical doctorate (MD) in the U.S. must pass the United States Medical Licensing Exam (USMLE) Step-1. The application process for students with disabilities who seek Step-1 accommodations can be arduous, barrier-ridden, and can impose a significant burden that may have long-lasting effects. We sought to understand the experiences of medical students with Type-1 Diabetes (T1D) who applied for Step-1 accommodations. Methods A Qualtrics survey was administered to students enrolled in Liaison Committee on Medical Education (LCME)-accredited MD programs who disclosed having a primary diagnosis of T1D. Basic counts and qualitative inductive analyses were conducted. Results Of the 21 surveys sent, 16 (76.2%) participants responded. Of the 16 respondents, 11 (68.8%) applied for USMLE Step-1 accommodations, whereas 5 (31.2%) did not. Of the 11 who applied for accommodations, 7 (63.6%) received the accommodations requested, while 4 (36.4%) did not. Of those who received the accommodations requested, 5/7 (71.4%) experienced at least one diabetes-related barrier on exam day. Of those who did not apply for Step-1 accommodations, 4/5 (80%) participants reported experiencing at least one diabetes-related barrier on exam day. Overall, 11/16 (68.8%) students experienced barriers on exam day with or without accommodations. Qualitative analysis revealed themes among participants about their experience with the process: frustration, anger, stress, and some areas of general satisfaction. Conclusions This study reports the perceptions of students with T1D about barriers and inequities in the Step-1 accommodations application process. Students with and without accommodations encountered T1D-related obstacles on test day.

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Section: Discussion/conclusionmentioning

confidence: 99%

“…[m]ade me feel as if a Type 1 diabetic with an insulin pump had never taken Step-1 before." As other scholars in health professions education have argued, ableism adversely impacts both trainees and the practicing workforce [36][37][38].…”

Section: Discussion/conclusionmentioning

confidence: 99%