Effectiveness of an Educational Module on Dental Hygiene Students' Attitudes Towards Persons with Disabilities.

Purpose: Persons with disabilities (PWDs) perceive gaps in health care providers' understanding of their health care needs are more likely to delay or not seek health care as compared to persons without disabilities. Oral health is considered an essential component of overall health, however, disparities exist in the United States, especially for persons with disabilities. Improving the education and training of dentists and dental hygienists may contribute to reducing oral health care barriers for PWDs. The purpose of this study was to investigate whether offering an education module about individuals with disabilities would change dental hygiene students' attitudes and capacity for informed empathy for PWDs.Methods: An educational module utilizing a DVD featuring authentic representation of PWDs, along with student discussions and self-reflection was developed and delivered to 165 (n=165) dental hygiene students attending a 2-year community college and a 4-year university. Students consenting to participate in the study were assessed regarding their attitudes and comfort towards caring for PWDs prior to, and following the educational module. Pre- and post-assessment measures included the validated Attitude Toward Disabled Persons, and Attitudes toward Patient Advocacy Microsocial (AMIA) scale. The Interpersonal Reactivity Index (IRI) was used as a pre-assessment measure.Results: A total of 58 (n=58) dental hygiene students, 35 (n=35) from a 4-year university and 23 (n=23) from a 2-year community college, consented for this study, for an overall participation rate of 35%. Scores increased significantly for both student groups after delivering the education module on the AMIA patient advocacy scale. Differences in IRI scores between the 2-year and 4-year dental hygiene programs approached statistical significance.Conclusion: An education module based on informed empathy with a focus on the experiences of PWDs can result in improved attitudes toward advocacy for this population.

From Impairment to Empowerment: A Longitudinal Medical School Curriculum on Disabilities.

PROBLEM: All physicians will care for individuals with disabilities; however, education about disabilities is lacking at most medical schools. Most of the schools that do include such education exclusively teach the medical model, in which disability is viewed as an impairment to be overcome. Disability advocates contest this approach because it overlooks the social and societal contexts of disability. A collaboration between individuals with disabilities, educators, and physicians to design a medical school curriculum on disabilities could overcome these differences. APPROACH: A curriculum on disabilities for first- and second-year medical students was developed during the 2013-2014 academic year and involved a major collaboration between a medical student, medical educators, disability advocates, and academic disability specialists. The guiding principle of the project was the Disability Rights Movement motto, "Nothing about us without us." Two small-group sessions were created, one for each medical school class. They included discussions about different models of disability, video and in-person narratives of individuals with disabilities, and explorations of concepts central to social perceptions of disability, such as power relationships, naming and stigmatization, and disability as identity. OUTCOMES: According to evaluations conducted after each session, students reported positive feedback about both sessions. NEXT STEPS: Through this curriculum, first- and second-year medical students learned about the obstacles faced by individuals with disabilities and became better equipped to understand and address the concerns, hopes, and societal challenges of their future patients. This inclusive approach may be used to design additional curricula about disabilities for the clinical and postgraduate years.

Fostering informed empathy through patient-centred education about persons with disabilities.

INTRODUCTION: Having a disability can negatively affect provider-patient communication. Persons with disabilities report the need for better communication with their health care providers and argue that education regarding disabilities is lacking for health care professionals. We sought to determine if a patient-centred curriculum focused on individuals with disabilities could foster the development of informed empathy. METHODS: An educational module to enhance health care students' capacity for informed empathy was developed. To assess the development of informed empathy, a qualitative analysis of the post-module question, 'How has your understanding, awareness or perception of individuals with disabilities changed?' was performed. RESULTS: Themes of the qualitative analysis were (a) becoming familiar with the daily life of individuals with disabilities, (b) changing notions of normalcy, (c) seeing discrimination against individuals with disabilities as an issue that impacted them, (d) recognition that disability is not only an issue of the physical body. CONCLUSIONS: Informed empathy can be effectively taught through a patient-centred curriculum focused on persons with disabilities. Health care providers are effective advocates when they understand the physical, emotional, social, and communication issues of persons with disabilities.

A curriculum focused on informed empathy improves attitudes toward persons with disabilities.

Empathy is an important component of the provider-patient relationship. In the United States one in five persons has a disability. Persons with disabilities perceive gaps in health care providers' understanding of their health care preferences and needs. The purpose of this study was to use valid and reliable assessment methods to investigate the association between empathy and attitudes toward persons with disabilities and advocacy. An educational module was developed to enhance health care students' capacity for informed empathy. Pre- and post-assessment measures included the Attitude toward Disabled Persons scale (ATDP), the Attitudes toward Patient Advocacy Microsocial scale (AMIA) and the Interpersonal Reactivity Index (IRI). ATDP (t(94) = -5.95, p = .000) and AMIA (t(92) = -5.99, p = .000) scores increased significantly after the education module. Correlations between the pre- or post-module ATDP or AMIA scores and the IRI scores were not significant. Empathy in general may not be sufficient to ensure optimal attitudes toward persons with disabilities or advocacy in pre-health care professionals. However, a curriculum based on informed empathy and focused on the experiences of persons with disabilities can result in more positive attitudes toward and advocacy for people with disabilities.

A qualitative study of the perspectives of individuals with disabilities about their health care experiences: implications for culturally appropriate health care.

PURPOSE: This study explores the health care experience of individuals with disabilities and how this knowledge can guide health care professionals in providing effective and compassionate care for persons with disabilities. METHODS: Participants' experiences about the health care they received were quantitatively analyzed for common themes. RESULTS: Participants most often discussed the process of how they came to receive their official disability diagnosis. Another recurrent theme was disability etiology, in which participants described the events or process that resulted in a disability. Two other frequent themes, normality and others' perceptions of disability, centered upon what it means to be "normal" or others' assumptions about what it means to be "nor mal" (as opposed to having a disability). Family support and struggles, experiences with medical professionals and hospitals, and barriers to inclusion and accommodations were the other key themes. CONCLUSION: This study provides insights to aspects of living with a disability that individuals with disabilities felt were important for health care professionals to know. Being aware of these topics may help health care providers in establishing good communication with their patients who have a disability.

Popliteal aneurysm as a source of phantom pain: a case report.

A 42-year-old man with a remote history of right transtibial amputation but no history of phantom pain developed severe phantom pain 10 years after amputation. A literature review suggested that his presentation was contrary to the natural history of phantom pain, which is usually most prominent in the early stages after amputation. Diagnostic workup revealed a popliteal artery aneurysm, which was successfully treated with coil embolization. The patient had complete resolution of his phantom pain after treatment of the aneurysm, suggesting it was the source of the pain. As a result of successful diagnosis and treatment, the amputation level did not need to be revised and the patient was able to continue his previously high level of function.