Creating Change Classroom Conversations Einstein Buddies Einstein Buddies

Creating Change: Classroom Conversations Einstein Buddies

Einstein Buddies: Shifting Medical Students’ Attitudes toward People with Disability Elizabeth Ridgway, OTD, OTR, C/NDT (Faculty Mentor) Carol Terilli, PT, DPT (Faculty Mentor) Jordan Stumph, MS 3 Elizabeth. ridgway@einstein. yu. edu Carol. terilli@einstein. yu. edu RFK CERC

Best Healthcare for All • • 18. 7% of the U. S. population has a disability (2010 Census) Physician attitudes and lack of training reported barriers to people with disabilities receiving health care services (Symons, Morley, Mc. Guigan, & Akl, 2014) Persons with disabilities: ⇑risk of experiencing ineffective patient-physician communication, compromising current health status and ⇑ possibility of secondary health conditions (Smith, 2009) Exposure of medical students to curriculum including caring for people with disabilities led to significant ⇑ in comfort and attitudes (Symons et. al, 2014) First year medical students with background or experiences with people with disabilities were more comfortable dealing with situations (Tervo, Azuma, Palmer & Redinius , 2002) ⇑ in levels of comfort and ⇑ awareness of attitudinal factors that influence patient care in 3 rd year medical students who participated in clinical experience with people with developmental disabilities (Karl, Mc. Guigan, Withiam, Leitch, Akl & Symons, 2013) Need for specific educational experience in medical school to promote more positive physician attitudes and comfort with people with disabilities ( Tervo et. al, 2002 & Symons et. al, 2014)

Einstein Buddies Innovative experiential learning program created to join together: • Medical students at Albert Einstein College of Medicine • Pediatric occupational and physical therapists at Rose F. Kennedy Children’s Evaluation and Rehabilitation Center’s (CERC) • Individuals with developmental disabilities and their families To build collaborative relationships while engaged in shared learning experiences

Medical Students’ Attitudes Toward People with Disability Research Aims: • • Measure first year Einstein medical students’ attitudes toward people with disabilities Examine the effect participation of first year medical students in Einstein Buddies has on their attitudes toward people with disabilities. Methods: • Survey of First Year Einstein medical students at start and end year via Survey Monkey Measure: • Medical Students’ Attitudes Toward Persons with Disability Questionnaire (Symons, Fish, Mc. Guigan, Fox &. Akl, 2012)

Results: Class as a Unit • First year Einstein medical students to assess their attitudes and comfort toward people with disabilities (n=80) • • • 50% had previous structured experiences working with people with disabilities 63% had relative or friend with a disability 47% female/ 53% male • End of the year to assess change in the class as a unit (n=23) • The medical students showed more positive attitudes and comfort at follow up. The comparison of the group differences in mean scores on the instrument using t-tests approached significance (p= 0. 05675) from initial to follow up.

Results: Einstein Buddies at Follow Up • We examined further the effect participation of Einstein Buddies (n=8) with non Einstein Buddies (n=15) had at follow up: • Einstein Buddies • • • younger (23. 5 y compared to Non Buddies 25. 9 y) More males (63% vs 38%) Fewer friends and family with a disability (25% vs 63%) • We compared these two groups looking at twenty questions that elicited a higher quantitative value for a positive answer and found a significant difference between the groups (p=0. 0267) with Einstein Buddies more comfortable and with a more positive attitude toward disability.

All About Buddies Intro Night: Slide show emphasizing the fun factor Tour: Orientation to the space and program in context Sessions: All Buddies are asked to commit 2 hours per month Case Presentations: Two to three diagnoses are presented Special Event: Activities planned for Halloween or Earth Day as an example Passing the torch: Leadership is shifted to new Board

INTRO NIGHT 1 st year Medical Students • Eager, Hungry Community Based Service Learning (CBSL) • Voluntary: Meaningful - Educational - FUN • Leadership Buddie status: upon sign-up • Working with minors: mandatory module • Commitment: 2 hrs/month

CLINIC TOUR • Clinician’s creative canvas: opportunity to plan and collaborate • Volunteers roles and expectations: • Attestation Form: Always under supervised contact with the clientele • Pizza

Sessions and Special Events Self advocates as teachers and future Doctors as play partners Bi-directionally bending the perception of “ABILITY”

Passing the Torch Emerging Leaders: Picking future board members Evolution: Brainstorming for the following year CBSL as curriculum: 2017 -2018 Einstein changes • Compulsory participation • Graded by assessment – faculty roles

Medical Student Experience • Importance of exposure • Familiarity with conditions • Comfort level • Change in attitude towards those with disabilities

Personal Experiences in the Clinical Setting • Interaction with a young man with cerebral palsy • Knowing the importance of different rehabilitation settings • Advocating for patients with disabilities

Experiences of other Buddies • “The buddies program has helped me build a better understanding of other facets of clinical medicine, namely physical and occupational therapy, and their broad applications to treating patients. The program also consistently reminded me that I applied to medical school because I wanted to spend my life working with patients. A necessary reminder during the first two years of medical school which contain little clinical experience. ”- MS 2 • “I really enjoy spending time with Buddies at CERC! In addition to the fulfillment I gain from assisting clients in their therapy, buddies has supplemented my medical education by allowing me to observe physical and occupational therapy techniques that I have not learned about in class (at least up until this point). I have also gained a valuable, deeper understanding of the patient perspective through spending time with Buddies!” -MS 2 • “As an aspiring pediatrician, I joined Buddies not only because of the opportunity to work with kids, but also to learn about the many crucial components of a child's health care outside of a medical office. Upon volunteering, I was blown away by the variety of activities at the facility and how they were specifically tailored to the current patients. Moving forward, I hope to emphasize the importance of each patient's individuality and specific needs in my care for them as a student and beyond. ”- MS 3

Moving Forward • Better questionnaires and assessment tools • Experiential learning involving persons with disabilities embedded in medical education • Continuing education engaging persons with disabilities collaboratively with health care providers

Conclusion Einstein Buddies program results supports collaboration of medical students, multidisciplinary clinicians, individuals with disabilities and their families , to improve attitudes and comfort of medical students preparing future physicians to ensure equitable and inclusive health care for all people.

References • • • Best Buddies International, http: //www. bestbuddies. org. July 1, 2015. • Lam, W. Y. , Gunukula, S. K. , Mc. Guigan, D. , Isaiah, N. , Symons, A. B. , & Akl, E. A. (2010). Validated instruments used to measure attitudes of healthcare students and professionals towards patients with physical disability: A systematic review. Journal of Neuroengineering and Rehabilitation, 7, 55 -0003 -7 -55. doi: 10. 1186/1743 -0003 -7 -55 [doi] • Smith, D. L. (2009). Disparities in patient-physician communication for persons with a disability from the 2006 medical expenditure panel survey (MEPS). Disability and Health Journal, 2(4), 206 -215. doi: 10. 1016/j. dhjo. 2009. 06. 002 [doi] • Symons, A. B. , Fish, R. , Mc. Guigan, D. , Fox, J. &. Akl, E. A. (2012) Development of an instrument to measure medical students' attitudes toward people with disabilities. Intellectual and Developmental Disabilities, 50, (3), 251 -260. • Symons, A. B. , Morley, C. P. , Mc. Guigan, D. , & Akl, E. A. (2014). A curriculum on care for people with disabilities: Effects on medical student self-reported attitudes and comfort level. Disability and Health Journal, 7(1), 88 -95. doi: 10. 1016/j. dhjo. 2013. 08. 006 [doi] • Symons, A. B. , Swanson, A. , Mc. Guigan, D. , Orrange, S. , & Akl, E. A. (2009). A tool for self-assessment of communication skills and professionalism in residents. BMC Medical Education, 9, 1 -6920 -9 -1. doi: 10. 1186/1472 -6920 -9 -1 [doi] • Tervo, RC, Azuma, S, Palmer, G. & Redinius, P. (2002). Medical students’ attitudes toward persons with disability: A comparative Study. Arch Phys Med Rehabil, 83, 1537 -42. • • • U. S. Department of Commerce, Economics and Statistical Administration, U. S. Census Bureau. Berg, B. L. (2009). Qualitative research methods for the social sciences. Allyn & Bacon. NY Karl, R. , Mc. Guigan, D. , Withiam-Leitch, M. L. , Akl, E. A. , & Symons, A. B. (2013). Reflective impressions of a precepted clinical experience caring for people with disabilities. Intellectual and Developmental Disabilities, 51(4), 237 -245. doi: 10. 1352/1934 -955651. 4. 237 [doi] Americans with Disabilities 2010. http: //www. census. gov/prod/2012 pubs/p 70 -131. pdf; July 5, 2015. Wozencroft, A. J. , Pate, J. P. & Griffiths, H. K. (2015). Experiential learning and its impact on students’ attitudes toward youth with disabilities. Journal of Experiential Education. 38(2) 129– 143.