A systematic review of intellectual and developmental disability curriculum in international pre-graduate health professional education

Abstract

Background Despite the increasing global population of individuals with intellectual and developmental disabilities (IDD), this population remains especially vulnerable to health disparities through several factors such as a lack of access to sufficient medical care and poor determinants of health. To add, numerous studies have shown that healthcare professionals are still insufficiently prepared to support this population of patients. This review synthesizes the literature on current pre-graduate IDD training programs across healthcare professions with the goal of informing the creation of evidence-based curricula. Methods Four major databases were searched for current pre-graduate IDD training interventions for healthcare professionals. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow diagram and the Best Evidence Medical Educations systematic review guide were used to frame our collection and analysis. Results Of the 8601 studies screened, 32 studies were identified, with most studies involving medical students (50%). Of note, 35% of studies were interprofessional. Most interventions utilized multiple pedagogical methods with a majority including clinical experiences (63%) followed by theoretical teaching (59%). Kirkpatrick levels showed 9% were level 0, 6% were level 1, 31% were level 2A, 31% were level 2B, 19% were level 3, 3% were level 4A, and none were level 4B. Conclusions There is a paucity of formally evaluated studies in pre-graduate health professional IDD education. As well, there are a lack of longitudinal learning opportunities and integration into formal curriculum. Strengths identified were the use of multimodal approaches to teaching, including interprofessional approaches to optimize team competencies.

Infusing intellectual and Developmental disability training into Medical School curriculum: a Pilot intervention

“…Using NIH’s 12-point checklist for quality of pre-post studies without controls, we estimate having met ~ 6–8 of listed evaluation strengths, including: clear study question, pre-specified eligibility, sample representativeness, pre-specified outcomes and statistical analysis of pre-post change [ 31 ]. Further, partnering with PWIDDs in the design and implementation of our multi-modal curriculum aligns with recommendations from reviews of prior curricula [ 7 , 32 ].…”

“…Notably, 50% of physicians lack confidence in caring for people with disabilities [ 5 ]. Medical school education on disability often reflect an ableist perspective [ 6 ]; when offered, it is rarely integrated across all years of medical school or fully embedded into the curriculum [ 7 ].…”

The need for co-educators to drive a new model of inclusive, person-centred and respectful co-healthcare with people with intellectual disability

“…Co-production involves collaboration between clinical educators and healthcare recipients, in this case, people with intellectual disability, to design and deliver educational programs ( 39 ) and to ensure that their opinions and preferences are incorporated ( 40 ). Involving people with intellectual disability in the design and delivery of content for medical students and health professionals has been demonstrated to bring transformative change to the individuals involved, as well as to health professionals and health systems ( 41 ). A global systematic review looking at patient engagement across all health services only found a small number of studies that involved patients in the co-production of educational programs ( 42 ).…”

“…Co-production has also been associated with improved attitudes towards and awareness of the needs of people with intellectual disability ( 31 ), improved communication skills ( 33 ), and the sharing of power between patients and health professionals ( 42 ). Finally, learning about people’s lived experiences is enhanced when it is presented by the people themselves (co-education) within a sociocultural framework, as opposed to a purely medicalised perspective ( 41 ). This is crucial to facilitate learning about the importance of reasonable adjustments and adapting health assessments and management practices ( 33 ).…”

Health professionals' education related to people with intellectual and developmental disabilities: A scoping review

“…Literature on intellectual and developmental disability‐focused education for healthcare professionals is reviewed previously; however, previous reviews focused on education around disability in general (Rotenberg et al, 2022), addressing specific age groups such as paediatrics (Ceglio et al, 2019), and specific providers such as physicians (Adirim et al, 2021; Ceglio et al, 2019). A previous integrative review had discussion of the shift to interprofessional education and team competencies as contexts in which health professional education has developed (Vi et al, 2023). None addressed education of healthcare professionals in the contexts of overall workforce needs or the model of care or intersectionality or the participation of people with intellectual and developmental disabilities in the development and evaluation of programs.…”