Increasing disability awareness of future spinal cord injury physicians.

OBJECTIVE: This prospective study was designed to evaluate a disability awareness training program for medical students. METHODS: First- and second-year medical school students participated in an interactive disability awareness program consisting of 6 sessions spaced across 1 year. The Modified Issues in Disability Scale (MIDS), administered at program commencement and completion, was used to measure attitudes toward people with a disability. The paired t test was used to compare pre- and posttest data on the MIDS. In addition, gain scores on content-based tests were used to measure learning for each session. Participants also completed evaluation forms for each session. RESULTS: Two hundred and six students completed the MIDS forms at program commencement and completion. Analysis revealed a significant average increase (P = 0.033) in positive attitudes toward people with disabilities between the pre- and posttest data. Content learning also was evidenced by an average 34% gain from pretest to posttest. The participant evaluation summary for the sessions averaged 3.95 on a Likert-type scale of 5, which was characterized as "very good." Subjective evaluations were extremely favorable, as evidenced by requests for more information and exposure. CONCLUSION: This project illustrates the effectiveness of disability awareness training among medical school students during the early period of their training.

Sexual health after spinal cord injury: a longitudinal study.

OBJECTIVES: To clarify sexuality issues after spinal cord injury (SCI) and to identify the appropriate timing of sexual health interventions. DESIGN: Longitudinal analysis of the survey responses of persons with SCI at 4 intervals between initial inpatient rehabilitation and 18 months postdischarge. SETTING: Spinal Cord Injury Model Systems inpatient center and home-based setting. PATIENTS: A volunteer sample of 40 individuals (32 men, 8 women) from a consecutive population of persons with recent SCI admitted for initial inpatient rehabilitation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Responses to the Sexual Health Needs Survey. RESULTS: By 6 months postdischarge, individuals in the study group had made the significant changes in sexual activity and sexual interest that they would achieve during the study period. The respondents' greatest concerns remained their partners' and their own sexual satisfaction. A more realistic recognition of decline in their sexual activity, function, and interest corresponded with more requests for sexual health interventions during the interval from inpatient rehabilitation and 6 months postdischarge. CONCLUSIONS: The interval between inpatient rehabilitation to 6 months postdischarge appeared to be the critical period for function and realization about sexuality. Readily accessible sexual health interventions at about 6 months after inpatient rehabilitation and the inclusion of sexual partners in the intervention process appear warranted.

The challenge of teaching rehabilitative care in medical school.

Rehabilitative care has gained importance because the population is aging, and improved acute and chronic medical care saves and prolongs lives but leaves some patients with temporary or permanent physical impairments. However, despite its importance, the teaching and learning of rehabilitative care in medical school lag behind medical education relating to acute and chronic care. The authors analyze the broad scope of rehabilitative care and the need to include it in the medical school curriculum. They also discuss advantages for students and their patients of learning rehabilitative care in the undergraduate curriculum and suggest methods to improve teaching it.