Leadership academy for excellence in disability services: evaluation of outcomes for state employees.

As the United States' first disability-specific leadership academy in state government, the Leadership Academy for Excellence in Disability Services is a year-long competency-based training experience designed for employees who manage programs that impact the lives of Tennesseans with intellectual and developmental disabilities and their families. The Tennessee Department of Human Resources, in collaboration with the Tennessee Council on Developmental Disabilities, began implementing this program in 2017. The lasting impact of such a training experience on the practices of state employees once they complete the program is not known; this was the aim of the study. A follow-up survey examining graduate perceptions and outcomes was sent to 71 graduates; 48 completed the measure. The results reveal an increase in knowledge of disability service systems and a perceived ability to lead and advocate for others. Leadership competencies deemed most important to graduates' current efforts in state government included developing direct reports, managing diversity, organizational agility, and innovation management. Graduates' written comments cited the variety of subject matter experts, networking opportunities, and small group projects as fundamental in breaking down barriers to cross-agency collaboration in their disability work. The impact of this experience continues to be seen years after completing the leadership academy.

A Novel Disability Advocacy and Awareness Program for Training Future Healthcare Professionals on Care for Patients with Disabilities.

In a poll of 714 US physicians, it was revealed that only 40.7% felt very confident in their ability to provide the same quality of care, overall, to patients with disabilities (PWDs) compared with patients without disabilities. It was also found that only 56.5% strongly agreed that they welcomed PWDs into their practice as healthcare providers. This suggests a systemic issue of inequity in medicine, which affects both physicians and patients. If this problem is not corrected, our healthcare system will continue to lack in providing adequate care to PWDs. A key component of this issue is that the lack of confident care for PWDs appears to be a result of insufficient exposure to PWDs during the formative years in medical schools. Although medical students are taught extensive clinical skills and bedside manners, there appears to be little mention of how to make adaptations to basic patient encounters to accommodate PWDs. Further, the lack of representation of PWDs in the medical community results in minimal experience among trainees and the perpetuation of unjust biases in the healthcare system. Changes to the medical field must start with shaping future physicians and filling the void in medical education. As a solution, we at Florida State University (FSU) College of Medicine (COM) propose a program called the Disability Advocacy and Awareness Program (DAAP). Two interactive sessions were designed, and students were offered an immersive experience in which they were not only provided with information through well-crafted presentations but also encouraged to engage in direct interactions with PWDs and a myriad of assistive devices. We believe a great deal of the program's success stemmed from the two-phase interactive model that allowed students to undergo a truly immersive experience that a textbook cannot endow. Although we cannot expect every provider to be an expert on all disabilities, all physicians should have an understanding of how a disability may impact a patient's life and medical care. Improved knowledge and awareness surrounding disability and the barriers faced by the PWD population will provide insights that will allow for the most equitable, patient-centered care for the disabled community.

Comparative effects of disability education on attitudes, knowledge and skills of baccalaureate nursing students.

AIM: This study aimed to examine if participation in a required clinical course or elective fellowship pertaining to care of people with disabilities (PWD) had an impact on attitudes, knowledge and skills of nursing when compared with those with no clinical exposure to PWD. BACKGROUND: Worldwide, over 1 billion people live with a disability, 93 million are children and an estimated 1-3% have an intellectual disability; 6.9 billion live with 'impairment producing health condition'. (WHO, 2011; Maulik et al., 2011; Roscigno, 2013 p.21). Barriers that contribute to health disparities in PWD are numerous; repeated themes of inadequate education of nursing students and faculty, deficient communication skills and negative attitudes are pervasive in the literature (Alshammari et al., 2018; Anyinam et al., 2019; Cervasio et al., 2010; Ilkhani et al., 2015; Lyon & Houser, 2018; Polikandrioti et al., 2020; Temple & Murdoch, 2012; Werner & Grayzman, 2011; WHO, 2011). STUDY DESIGN: A singular institution descriptive quantitative design using a purposive sample of student volunteers explored differences among pre-licensure senior nursing students which examined perceptions prior to and following a clinical experience specific to the care of PWD. METHODS: Analyses of the change in scale scores by student type and experience working with PWD were evaluated using one-way ANOVA. Spearman correlations were used to test for an association between the change in scale scores and birth year. RESULTS: There was no statistical evidence of differences between the elective fellowship (n = 9), clinical (n = 13), or control (n = 24) groups for change in attitudes (p = 0.1383), scenario 1 (p = 0.1996), or knowledge scores (p = 0.2854) (Table 3). Mean pre- and post-test scores for attitudes within the fellowship (69.78, 75.11) and clinical (67.62, 74) group increased more than the control (66.92, 68.29). There was evidence of a difference detected in the attitude questions, scenario 2 scores, with the fellowship and clinical groups showing a larger increase in scores compared with the control group (p < 0.0001) (Table 3). Also, the clinical group experienced a larger increase in skill scores compared with the control group (p = 0.0154). CONCLUSIONS: Results from pre-post surveys exemplify the need for disability specific undergraduate education. Students will experience confidence and competence in their transition to practice because at anytime, anywhere, they will encounter someone with a disability. Further research is needed to determine the amount and type of education that translates to quality care of PWD.

Understanding medical students' attitudes towards and experiences with persons with disabilities and disability education.

BACKGROUND: In the United States, approximately one quarter of individuals are living with disabilities and receiving healthcare services. The undergraduate medical school curriculum provides an opportunity to improve the attitudes and skills of physicians working with persons with disabilities (PWD). OBJECTIVE/HYPOTHESIS: The purpose of this study was to gain an understanding about fourth-year medical students' self-reported attitudes towards and experiences with PWD and disability education. We hypothesized that medical students would recall having education about disabilities, would be able to identify a pivotal disability education experience, and would report being less comfortable working with PWD than persons without disabilities. METHODS: This mixed methods observational study was conducted via an online survey distributed to medical students during Winter 2020/2021. It contained an adapted instrument and a few short answer questions. RESULTS: Our survey had 44 respondents, a 28% response rate. Though 98% of students reported receiving disability education during one or more courses, 80% felt their disability education during medical school has been inadequate. Additionally, 64% reported having an influential learning experience involving PWD. Despite their attitudes, education, and experiences, respondents reported feeling less comfortable obtaining a history, performing a physical exam, and establishing a differential diagnosis when working with PWD. CONCLUSIONS: This study highlights the need for continued development of disability curricula, which likely extends beyond the studied institution. Additional educational elements could be added to humanities sessions, as well as other courses and clerkships.

Afrontamiento espacial de estudiantes con discapacidad física / Enfrentamento espacial de alunos com deficiências físicas / Mobility of students with physical disabilities

Resumen Para conocer las formas de apropiación territorial cotidiana de estudiantes con discapacidad física y visual en la ciudad de Bucaramanga, Colombia, se realizó un estudio desde un enfoque cualitativo, en donde se combinan técnicas etnográficas, entrevistas y análisis cartográfico con la participación de seis estudiantes de una universidad pública. Se concluyó que existen grandes limitaciones de movilidad, incrementadas por la falta de conciencia ciudadana y la discontinuidad espacial de las acciones implementadas, destacando la capacidad de afrontamiento y resiliencia de los jóvenes en situación de discapacidad y su interpretación sobre las barreras culturales que les impide el derecho a la educación y la participación social. Finalmente se llama la atención sobre la efectividad y sostenibilidad de ordenamiento urbano para la inclusión, el cual se logra cuando se trasciende la gestión pública instrumental para convertirse en ejercicio de reflexión y acción basado en la comprensión del ser humano, más allá del control y explicación del comportamiento.

Abstract In order to know the forms of daily territorial appropriation of students with physical and visual disabilities in the city of Bucaramanga, Colombia, a study is carried out from a qualitative approach, where ethnographic techniques, interviews and cartographic analysis are combined with the participation of six students of a public university It is concluded that there are great mobility limitations, increased by the lack of citizen awareness and the spatial discontinuity of the actions implemented, highlighting the capacity of coping and resilience of young people with disabilities and their interpretation of the cultural barriers that prevent them from right to education and social participation. Finally, attention is drawn to the effectiveness and sustainability of urban planning for inclusion, which is achieved when instrumental public management is transcended to become an exercise in reflection and action based on the understanding of the human being, beyond control and explanation of behavior

Resumo Para conhecer as formas de apropriação territorial diária de estudantes com deficiência física e visual na cidade de Bucaramanga, Colombia, foi realizado um estudo de abordagem qualitativa, onde técnicas etnográficas, entrevistas e análises cartográficas são combinadas com a participação de seis estudantes de Uma universidade pública. Concluiu-se que existem grandes limitações de mobilidade, aumentadas pela falta de conscientização do cidadão e pela descontinuidade espacial das ações implementadas, destacando a capacidade de enfrentamento e resiliência dos jovens com deficiência e sua interpretação das barreiras culturais que os impedem de direito à educação e participação social. Finalmente, chama-se atenção para a eficácia e sustentabilidade do planejamento urbano para a inclusão, o que é alcançado quando a gestão pública instrumental é transcendida para se tornar um exercício de reflexão e ação com base na compreensão do ser humano, além de controle e explicação de comportamento.