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Building Disability Competency in Osteopathic Medical Students in Rural Ohio Pilot Study
Hughes, A. [1]
Barrett, J. [1]
Dillman, O. [1]

Journal: Journal of Osteopathic Medicine Date: 2024/12, 124(12):Pages: A119-A120. doi: Subito , type of study: pretest posttest design

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2024-2000/html)

Keywords:

disability [40]
empathy [59]
knowledge [62]
medical students [647]
osteopathic medicine [2025]
pilot study [194]
pretest posttest design [217]
USA [1656]

Abstract:

Context: Appalachian based care for individuals with intellectual and developmental disabilities (I/DD) has fallen behind the standard of care. The largest proportion of Ohioans with disabilities live in Ohio’s rural Appalachian counties (1). The Appalachian region falls below the national average in both mental and physical health outcomes. Contributing factors to these trends include systemic issues such as socioeconomic disparities and barriers to healthcare access, including shortages of healthcare providers due to the relative remoteness of many Appalachian communities. Compared to Ohio adults with disabilities, those in the Appalachian region are more likely to live below the poverty line (34.8%), have lower educational attainment (68.1% have a high school education or less), and be unemployed (68.5%) (2). Addressing these issues is crucial for improving health outcomes in this region. Currently, individuals with I/DD must travel over an hour to Columbus or Cincinnati for specialty care from disability-competent clinicians. Training the next generation of physicians in I/DD competence will help reduce these disparities and minimize the need for long-distance travel for care. This project addresses the needs of the adult population with I/DD by aiming to improve the healthcare that they will receive in their local community, encouraging future physicians to be advocates for this population, and increasing empathy for individuals with I/DD and their caregivers. This project provides training to medical students to improve competency and training in disability. Objective: To determine whether focused I/DD education and training can improve future physicians’ understanding of I/DD, increase empathy, and reduce bias towards this patient population. Methods: This study utilized surveys as the primary methodology. Participants completed three pre-test surveys that evaluated general knowledge, empathy, and bias towards I/DD. The Jefferson Scale of Empathy (JSE) was used to assess empathy, and the Attitudes Towards Disabled Persons (ATDP) scale was used to assess bias. Surveys were administered on participant’s personal technology devices using a Qualtrics survey link. Following the pre-test surveys, participants completed a three hour in-person training session on I/DD. After the training, the same three surveys were administered to participants with the addition of three quality improvement questions pertaining to the training session. Participants in this study included first and second year medical students at Ohio University Heritage College of Osteopathic Medicine (OU-HCOM) located in Athens, OH. All first- and second-year students at OU-HCOM were invited to participate without exclusion criteria, and student participation was voluntary. To recruit participants, flyers were distributed in the OU-HCOM medical building as well as electronically via the student newsletter and medical student organizations. In total, nine students participated in the training session and completed the pre-test measure. Six students completed the post-test measures. Students were offered a $10 Tango gift card in exchange for their participation. Due to the small sample size and nature of the study, no randomization or grouping procedures were done. All participants completed the same training and surveys on the same day and in the same order. Components of the training included a brief informational session on I/DD led by Dr. Allyson Hughes, a Q&A panel that included both people with I/DD and their caregivers, and two research presentations from established social scientists who have conducted research in the field of I/DD health disparities. Paired t-tests were used to determine if there were significant differences between the pre- and post-test scores on attitudes, empathy, and knowledge of I/DD. Osteopathy is focused on a holistic view of medicine that considers the entire person when managing medical conditions and considering avenues of treatment. Every physician will encounter I/DD in their respective practice. In order to maintain a person-centered view of care, it is imperative that osteopathic physicians understand the nuances of conditions that affect this population. Results: The majority of participants identified as female (83.3%). Half of participants identified as Black or African American. Half of participants identified as white. The average age of participants was 26 years old. The majority of participants were first year osteopathic medical students (66.6%). Two students reported having a family member with I/DD. The response rate for this study was 66.6%. The final number of participants was six medical students located at the Ohio University Heritage College of Osteopathic Medicine. A paired-samples t-test was conducted to compare knowledge levels in pre- and post-test conditions. There was a significant difference in the knowledge scores for pre- and post-test (p = .001, n=6). A paired-samples t-test was conducted to compare empathy levels in pre- and post-test conditions. There was a significant difference in the empathy scores for pre- and post-test (p = .041, n=6). Differences between pre- and post-test for ATDP were not statistically significant. Conclusion: This study investigated whether focused education and training on I/DD would improve future healthcare professionals’ understanding of I/DD, increase empathy, and reduce bias towards this patient population. The intervention demonstrated statistically significant improvements in both knowledge about I/DD and empathy towards patients with I/DD among the medical students following the intervention. Importantly, the intervention did not show a significant change in attitudes toward disabled persons. Limitations of this study included the small sample size and selection of participants from a single rural medical school. Although results should be generalized with caution, this pilot study provides preliminary evidence that focused education and training on I/DD may be beneficial for future healthcare physicians and their patients, as it has the potential to improve knowledge and empathy in this population.

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