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Abstract: As a form of discrimination, ableism impacts access to and the experience of clinical care for patients with disabilities as well as the daily experiences of learners and clinicians with disabilities. Ableist beliefs and practices conflict with physicians' professional responsibilities and legal obligations to provide care that is nondiscriminatory and accessible. An actionable pedagogical approach within medical education is needed to prepare a physician workforce that is able to meaningfully identify and mitigate ableism at all levels of the health care system.In this article, the authors propose a 3-pronged approach to ableism-aware medical education, building on frameworks that have been articulated for addressing other forms of discrimination to set forth a practical framework easily adopted by educators who may not be experts in ableism and its impact. The 3-pronged approach aligns with American Medical Association and Association of American Medical Colleges perspectives on advancing health equity and is inclusive of priority areas articulated by stakeholders, including those living with disability, those teaching about disability, and those advancing equity within medicine more broadly. The authors provide strategies relevant to medical students, faculty, and institutions, recognizing that ableism exists-and can be addressed-on multiple levels., (Copyright © 2024 the Association of American Medical Colleges.)

Disability is a large and growing minority population worldwide. People with disabilities continue to experience health and healthcare disparities. Despite multiple calls to action to provide disability education within undergraduate medical education as a strategy to mitigate ongoing inequities, robust disability education is not routinely provided across medical schools. This article provides twelve tips that any medical school faculty can utilize to integrate meaningful disability education within existing core medical education.

Abstract: One in four noninstitutionalized adults in the United States lives with a disability. People with disabilities have frequent interactions with the medical community and the healthcare system yet experience disparities in access and outcomes. The Association of American Medical Colleges has included disability in its definition of diversity as one of the aspects of patient care that may affect health equity. However, training in the lived experience of disability is not always included in medical education. Physiatrists make excellent disability champions in medical schools, given their training and experience in the care of individuals with disabilities. Here, we describe strategies for physiatrists to increase disability education in medical schools and an overview of standards and tools (Liaison Committee on Medical Education standards; Commission on Osteopathic College Accreditation standards; International Classification of Functioning, Disability and Health language; and the Core Competencies on Disability for Health Care Education published by the Alliance for Disability in Health Care Education) physiatrists can use to facilitate interactions with medical school educational leadership. Specific examples are provided along with a framework to guide the development of disability champions in medical schools., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The aim of the study was to describe the current physiatrist workforce in the United States., Design: An online, cross-sectional survey of board-certified physiatrists in 2019 (N = 616 completed, 30.1% response) collected information about demographic and practice characteristics, including age, sex, practice area, practice setting, hours worked, patient characteristics, staffing, and work responsibilities. Physiatrists were stratified by substantive practice patterns using a cluster analysis approach. Survey responses were arrayed across the practice patterns and differences noted., Results: The practice patterns identified included musculoskeletal/pain medicine, general/neurological rehabilitation, academic practice, pediatric rehabilitation, orthopedic/complex conditions rehabilitation, and disability/occupational rehabilitation. Many differences were observed across these practice patterns. Notably, primary practice setting and the extent and ways in which other healthcare staff are used in physiatry practices differed across practice patterns. Physiatrists working in musculoskeletal/pain medicine and disability/occupational rehabilitation were least likely to work with nurse practitioners and physician assistants. Physiatrists working in academic practice, general/neurological rehabilitation, and pediatric rehabilitation were most likely to have primary practice settings in hospitals., Conclusions: Physiatry is an evolving medical specialty affected by many of the same trends as other medical specialties. The results of this survey can inform policy discussions and further research on the effects of these trends on physiatrists and physiatry practice in the future., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

People with disabilities constitute 22.2% of the population in the United States, and virtually all physicians have people with disabilities in their clinical practice across a wide range of diagnostic groups. However, studies demonstrate that people with disabilities are inadequately served by the health care system, leading to high costs and poor outcomes. The authors argue that one cause of this discrepancy is that medical students receive limited training in the care of people with disabilities and may therefore not be able to adequately meet the competencies that underlie the Core Entrustable Professional Activities for Entering Residency. To address these gaps, the authors present practical examples of integrating concepts of disability into the curriculum with minimal additional time requirements. A comprehensive disability curriculum is suggested to include active classroom learning, clinical, and community-based experiences. At institutions that do not have a comprehensive curriculum, the authors recommend adding disability-related knowledge and skill acquisition to existing curricula through modifications to current case-based learning, simulated patients, and objective structured clinical examinations. To facilitate curriculum development, they recommend that the World Health Organization International Classification of Functioning, Disability, and Health be used as a tool to build disability concepts into active learning. The goal of these recommended curricular changes is to enhance student performance in the clinical management of people with disabilities and to better train all future physicians in the care of this population.

This study sought to evaluate the effects of a brief curricular intervention on medical students' attitudes toward physical disability in healthcare settings. Students participated in a focused curriculum about people with disabilities (PWDs), which included 2.5 hours of lectures, panel discussions, and video presentations. After the curricular sessions, students were surveyed (n = 237), and their attitudes toward PWDs in healthcare settings were compared with those of students who did not undergo the intervention (n = 251) using the Disability Attitudes in Health Care (DAHC) scale. Thematic analysis of the students' comments regarding the session was performed to supplement the DAHC scale. The intervention group responded with significantly more positive attitudes on 6 of the 17 items on the DAHC scale, and multiple linear regression analysis confirmed the independent effect of the curriculum on higher DAHC scale scores. Female students had more positive attitudes on the survey than did male students, although the effect of the curriculum was independent of gender. Previous experiences with PWDs did not correlate to higher attitude scores. These results suggest that a brief curricular intervention on disability can engender more positive attitudes in medical students toward PWDs.