The impact of autism-related training programs on physician knowledge, self-efficacy, and practice behavior: A systematic review

Abstract

One in 44 children in the United States is diagnosed with autism spectrum disorder. Despite this, physicians receive little clinical training, inclusive of autistic patients. It is therefore not surprising that physicians report low levels of confidence in their ability to provide care to autistic individuals. This review examines the impact of specialized training programs on physicians’ knowledge of autism and their self-efficacy and practice behavior related to caring for autistic patients. A search of MEDLINE, PsycINFO, PubMed, ERIC, Web of Science, and Scopus was performed to identify studies evaluating specialized autism training programs for physicians or physician trainees. Seventeen studies were found to meet the inclusion criteria. The Medical Education Research Study Quality Instrument was utilized to objectively measure the quality of the included studies. Based on the results reported in these studies, specialized autism training programs were associated with positive changes in physician knowledge and self-efficacy related to the care of autistic patients. Other than short-term increases in screening for autism, no other changes in physician behavior were studied. These results call for the development and evaluation of autism training programs that focus on improving physician behavior and patient outcomes. Lay abstract Autism spectrum disorder is estimated to impact 1.5 million children and almost 5.5 million adults. However, most physicians do not receive training on how to provide care to this increasingly large group of people. After performing a systematic review of the literature and screening over 4,500 unique articles focused on the effectiveness of autism-specific training programs designed for physicians and physician trainees, we determined that 17 studies met the pre-determined criteria for inclusion in this systematic review. The results reported by these studies suggest that by completing specialized training programs related to autism, physicians were more knowledgeable on topics related to the condition, more confident in their ability to provide care to autistic individuals, and more likely to screen their patients for autism spectrum disorder. However, further studies with higher quality data are needed to validate these findings and provide additional insight on the ability of these programs to improve physician behavior and patient outcomes. We are therefore advocating that medical educators develop and evaluate specialized autism training programs with an increased focus on improving physician behavior related to all aspects of providing care to autistic people.

Virtual Training of Medical Students to Promote the Comfort and Cooperation of Patients with Neurodevelopmental Disabilities

“…The study extends the current literature by evaluating the effectiveness of brief virtual BST when teaching health care students to apply a set of practical behavior management strategies that should be effective for at least a portion of patients with NDD. The majority of prior studies on autism-specific training for health care professionals evaluated lecture-based, educational programs, a format that is unlikely to produce changes in practices, and none evaluated changes in actual trainee behavior (for reviews, see Clarke & Fung, 2022 ; Walsh et al, 2021 ). Furthermore, few prior studies on BST have examined its efficacy when conducted solely in a virtual environment (see Lloveras et al, 2022 , for a notable exception).…”

“…Research suggests that this type of training is ineffective for preparing caregivers and professionals to work with this population (e.g., Hudson, 1982 ; Ward-Horner & Sturmey, 2012 ). A recent review of studies on autism-specific training for physicians and physician trainees also noted a lack of evidence that existing programs produce changes in physician behavior when interacting with this patient population (Clarke & Fung, 2022 ). Furthermore, surveys of health care providers indicate that they prefer hands-on training (e.g., Smith et al, 2021 ).…”

Evaluating the Impact of an Online Autism Training on Employers’ Autism Knowledge and Commitment to Inclusion in the Workplace

“…Beyond university students, online autism training has also been shown to have an impact on professional groups. Training improved autism knowledge and autism screening and diagnosis rates in medical physicians (see review by Clarke & Fung, 2022), and improved post-secondary educators' autism knowledge and reduced stigmachanges that were maintained (albeit with some attenuation) one month after online training (Waisman et al, 2023). Such training was also more effective at increasing autism knowledge compared to an active control training, or compared to groups who received no training (Ha et al, 2022;Jones et al, 2021).…”

“Autism is everyone’s business”: Autism knowledge and self-efficacy amongst NHS Scotland mental health professionals

“…Such findings align with previous research (8,21,23), with confidence potentially built through experience with autistic people (which was also noted in our qualitative findings). Training could build self-efficacy and studies testing training have evidenced this relationship (24). Indeed, mandatory, evidence-based autism/neurodiversity training for mental health professionals has been suggested as a way forward to address the mental health needs of autistic people (25).…”