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Medical Education and Disability Studies

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Abstract

The biomedicalist conceptualization of disablement as a personal medical tragedy has been criticized by disability studies scholars for discounting the difference between disability and impairment and the ways disability is produced by socio-environmental factors. This paper discusses prospects for partnerships between disability studies teaching/research and medical education; addresses some of the themes around the necessity of critical disability studies training for medical students; and examines a selection of issues and themes that have arisen from disability education courses within medical schools globally. The paper concludes that providing there is a commitment from senior management, universities are well positioned to apply both vertical and horizontal approaches to teaching disability studies to medical students.

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Notes

  1. F.Campbell. “Access to Community Health Care Services for Women with Disabilities”. Australian Disability Review 1 (1984):. 30-33; K.Ormond, C.Gill, P. Samark & K. Kirschner. “Attitudes of Health Care Trainees About Genetics and Disability: Issues of Access, Health Care Communication, and Decision Making”, Journal of Genetic Counseling, 12(4), August (2003): 333- 349; K.Piotrowski & L. Snell. “Health Needs of Women with Disabilities across the Lifespan”, JOGNN, 36 (2007): 79-87; S. Smeltzer & V. Zimmerman. “Health promotion interests of women with Disabilities”. Journal of Neuroscience Nursing. 37(2) (2005): 80-86; S.Smeltzer. “Improving the health and wellness of persons with disabilities: A call to action too important for nursing to ignore”. Nursing Outlook. 55(4) (2007): 189-193.

  2. N.Groce. “HIV/AIDS and people with Disability”, The Lancet, 361(26) (2003): 1401 – 1402.

  3. N.Lennox, J. Diggens & A. Ugoni. “The General Practice Care of people with Intellectual Disability: Barriers and Solutions”, Journal of Intellectual Disability research, 41(5) (1997): 380 – 390.

  4. S.Hollins, M.Attard &T, von Fraunhofer. “Mortality of People with Learning Disability: Risk, Causes and death Certification Findings in London”, Developmental Medicine & Child Neurology, 40(1) (1998): 50 – 56.

  5. See also Disability Rights Commission. (2004). Background evidence for the DRC’s formal investigation into health inequalities experienced by people with learning disabilities or mental health problems, Disability Rights Commission, UK, www.library.nhs.uk/SpecialistLibrarySearch/Download.aspx?resID=269518.

  6. G. Di Giulio, “Sexuality and people living with Physical or developmental Disabilities: A Review of key issues”, The Canadian Journal of Human Sexuality, 12(1) (2003): 53 – 88.

  7. G. Melville, “Discrimination and health inequalities experienced by disabled people,” Medical Education 39 (2005): 122–126.

  8. A.M. Biley. “A handicap of negative attitudes and lack of choice. Caring for in-patients with disabilities”. Professional Nurse. 9(12) (1994): 786-788.

  9. M.Duff, Hoghton & M. Scheepers. “More training is needed in health care of people with learning disabilities”, British Medical Journal. August 5; 321(7257) (2000): 385.

  10. Melville, “Discrimination and health”.

  11. J. Loeser, M.& M. Sullivan “Doctors, diagnosis, and disability: a disastrous diversion”. Clinical Orthopedics and Related Research, Mar 336(1997).:61-6.

  12. L.Iezzoni. “Going Beyond Disease to Address Disability”, New England Journal of Medicine, 355(10) (2006): 976 -979.

  13. Lennox,”The General Practice Care”; H.Martin, M.Rowell, S.Reid, M.Marks and D. Reddihough, “Cerebral Palsy: What do medical students know and believe?”, Journal of Paediatric Child Health, 40, (2005): 43–47.

  14. F.Campbell. “Litigation neurosis: Pathological responses or rational subversion?”, Disability Studies Quarterly, Fall, 25 (4) (2006), http://www.dsq-sds.org/article/view/655/832;

    Loeser, “Doctors, diagnosis, and disability”.

  15. G.Engel. “The need for a new medical model: a challenge for science”,. Science. 196 (1977): 129–36.

  16. J.Bishop. “Rejecting Medical Humanism: medical humanities and the metaphysics of medicine”, Journal of Medical Humanities, 19 (2008): 15 -25, p. 16.

  17. L.Iezzoni. “Going Beyond Disease”. See also A. Kvalsvig. “Ask the Elephant”, The Lancet, 362(9401) (2003): 2079 – 2080.

  18. Martin, “Cerebral Palsy”.

  19. F.Campbell. “Exploring Internalized Ableism using Critical Race Theory”, Disability & Society, 23(2) (2008): 151 – 162.

  20. Ormond,”Attitudes of health care Trainees”.

  21. See C.Goodall. “Preserving Dignity for Disabled People”, Nursing Standard 6(35) 1992). : 25 – 28.

  22. A.Kuper, “The Intersubjective and the Intrasubjective in the Patient Physician dyad: Implications for medical education”, Medical Humanities, 33 (2008): 75 – 80.

  23. Kvalsvig, ” Ask the Elephant”.,

  24. E. Mäenpää. “Sairaalalääkärin jaksaminen työterveyshuollon näkökulmasta [Hospital physicians well-being viewed from their occupational services]”, Acta Universitatis Tamperensis, 729(2000) Tampere: University of Tampere, Finland.

  25. Martin, “Cerebral Palsy”, p. 46.

  26. J.Owoeye & F. Ologe, T. Akande. ”Medical Student’s perspectives of Blindness, Deafness and Deafblindness”, Disability & Rehabilitation, 29(11-12) (2007). 929 – 933, p.929.

  27. Ibid,p. 931.

  28. Ormond, “Attitudes of Health Care Trainees”.

  29. M.Byron, Z. Cockshott, H. Brownett & T.Ramkalawan, “What does ‘disability’ mean for medical students? An exploration of the words medical students associate with the term ‘disability’”, Medical Education; 39: (2005):176–183.

  30. L.Iezzoni. “Going Beyond Disease”.

  31. R.Tervo,S. Azuma, G.Palmer,P.Redinius “Medical students’ attitudes toward persons with disability: a comparative study”. Archives of Physical Medical Rehabilitation, 83,(2002).1537–42.

  32. See Campbell, “Exploring Internalized Ableism”.

  33. United Nations General Assembly, Convention on the Rights of Persons with Disabilities, 6 December 2006, < http://www.un.org/esa/socdev/enable/rights/convtexte.htm> (29 April 2008) at [e].

  34. S.Kahtan, C.Inman , A.Haines, P.Holland “Teaching disability and rehabilitation to medical students. Steering Group on Medical Education and Disability”. Medical Education, Sep;28(5) (1994) :386-93.

  35. Byron,“What does ‘disability’ mean”; M.Byron, C. Howell, P. Bradley, S. Bheenuck, C. Wickham & T. Curran. “Different Differences, Disability Equality Teaching in Healthcare Education A document for action, Partners”, in Practice, Bristol. (2006). Online at http://www.bristol.ac.uk/pip/framework.pdf

  36. Byron,“Different Differences”, p.12.

  37. M.Burgic-Radmanovic. “Medical Student’s Attitudes towards Mental Illness, Abstracts for Poster Sessions”, European Psychiatry, 22: S101 – S220, (2007). : Poster #403.

  38. A.Moroz, D.Stevens, S Waldman, D. Richardson-Heron, B. Dreyer, F. Aull. “Integrated Disability Curriculum: Impact on Students, Faculty and Patients”, Archives of Physical Medicine & Rehabilitation, 876, (2006). : #33.

  39. N.Sharma, J.Lalinde, J. Bosco. “What do residents learn by meeting with families of children with disabilities?: A qualitative analysis of an experiential learning module” Pediatric Rehabilitation, 9(3) (2006). 185 – 189.

  40. T.Vlak, M.Boban, N. Franulovic-Golja, R.Elder.”Teaching Disability and Rehabilitation Medicine at the Medical School in Split, Croatia”, Croatian Medical Journal, 45(1) . (2004): 99 – 102.

  41. L. Saketkoo, D. Anderson, J. Rice, A. Rogan & C. Lazarus. “Effects of a Disability Awareness and Skills Training workshop on Senior Medical Students as Assessed with Self ratings and Performance in a Standardized Patient Scale”, Teaching and Learning Medicine, 16(4) . (2004): 345 – 354, p. 353.

  42. M.Crotty, P.Finucane, M. Ahern.”Teaching medical students about disability and rehabilitation: methods and student feedback”, Medical Education , 34 (8), (2000). :659–664.

  43. S. French, “Simulation Exercises in Disability Awareness training: A Critique”, Disability & Society, 7(3) (1992). : 257 – 266; G.Kiger. “Disability Simulations: Logical, methodological and Ethical Issues”, Disability & Society, 7(1) (1992). : 71 – 78; D.Pfeiffer. “Disability Simulation using a wheelchair exercise”, Journal of postsecondary education and Disability, 7(2) (1989). : 53 – 60.

  44. D.May, S. Phillips, J Miller, J. “Changing attitudes: a teaching initiative in the medical school. British Journal of Learning Disabilities, 22, (1994):104–108.

  45. J. Piachaud. “Teaching learning disability to undergraduate medical students”, Advances in Psychiatric Treatment, 8 (2002): 334-341.

  46. J.Tracey & T.Iancono. People with Developmental Disabilities teaching Medical Students- Does it make a difference?” Journal of Intellectual & Developmental Disability, 33(4) 2008:345 – 348.

  47. P.Dieppe, E. Anderson, M.Byron, L.Marks. “Teaching Doctors about Disability”, BMJ Careers, 23 September(2006).: 113 – 115.

  48. I.Richard, V. Compain, J. Mouillie, F. Ades, F. Garnier, F. Dubas, J. Saint-Andre. « Évaluation de L’attitutdue vis-à vis des personnes handicapées des étudiants en médicine de 3e and 4e année par le questionnaires “Attitude towards disabled person”. Effects de I’enseignement théorique et de stages dans les services de medicine physique et réadaptation, Annales de Réadaptation et de Médecine Physique, 48(2005). : 662 – 667. (French only).

  49. J.Scott. ”Experience'”, in Feminists Theorize the Political. eds. J.Butler and J.Scott (New York: Routledge, 1992). pp.22-40.

  50. G.Rubin “The Traffic in Women: Notes on the Political Economy of Sex'“, in Towards and Anthropology of Women,, ed.R. Reither (New York: Monthly review Press, 1975): 157 - 210.

  51. P.McDonagh, Idiocy A Cultural History, (Liverpool: Liverpool University Press, 2008).

  52. (Richards et al, 2005: 665, my translation) < <… considèrent les personnes handicapées comme porteuses d’un manqué, qui met en cause leur competence collective à < <guérir> > . > > .

  53. Richards, »Évaluation de L’attitutdue », p.:666,) < <…quels sont les moyens pédagogiques pertinents pour y parvenir ? Si l'attitude vis-à-vis des personnes handicapées est d'abord une affaire de concepts, de prise de conscience des mécanismes de discrimination et de préjugés sociaux, cet enseignement doit alors trouver sa place dans le corpus de sciences humaines et d'initiation à l'éthique : discussion des modèles médicaux et sociaux du handicap, parallèle avec d'autres formes de discrimination, réflexion sur la part des attitudes dans les décisions médicales. Si le comportement final est la résultante de l'attitude et de l'expérience, notamment des contacts vécus avec des personnes handicapées, les enseignements théoriques et pratiques de MPR peuvent y contribuer, mais doivent probablement être modifiés.>>

  54. M.Byron, & P. Dieppe.”How to handicap medical Students?”, Letters to the Editor, Medical Education, 35 . (2001): 83; M.Crotty, P. Finucane & M. Ahern. “Author’s Reply”, Letters to the Editor, Medical Education, 35(2001). : 84.

  55. Crotty, .”Teaching medical students”.

  56. ,Byron, “What does ‘disability’ mean”.

  57. Crotty,.”Teaching medical students”., p. 84.

  58. Ibid, p. 84.

  59. D. Were, “Insurgent Multiculturalism: Rethinking How and Why We Teach Culture in Medical Education”, Academic Medicine, Volume 78(6), June (2003):549–554

  60. T.Wells, M. Byron, S. McMullen, M. Birchall. “Disability teaching for Medical Students: Disabled people contribute to curriculum development, Letters to the Editor”, Medical Education, 36 (2002): 788 – 792, p.788.

  61. DSU web page, “Guiding Principles”, Disability Studies Unit, DSU. (2007). Disability Studies Unit, DSU, Faculty of Medicine, University of Kelaniya (Sri Lanka) Home page, Online at http://www.med.kln.ac.lk/dsu/Dsu.htm.

  62. N.Lennox, & J.Diggens. “Medical Education and Intellectual Disability: A Survey of Australian Medical Schools”, Journal of Intellectual and Developmental Disability, 24(4) (1999). : 333- 340; and Kahtan. “Teaching disability and rehabilitation”.

  63. Melville, “Discrimination and Health”.

  64. L.Iezzoni. “Going Beyond Disease”.

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  1. School of Human Services & Social Work, Logan Campus University Drive, Griffith University, Meadowbrook, Qld 4131, Australia

    Fiona Kumari Campbell

  2. Adjunct Professor in Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

    Fiona Kumari Campbell

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Campbell, F.K. Medical Education and Disability Studies. J Med Humanit 30, 221–235 (2009). https://doi.org/10.1007/s10912-009-9088-2

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