P3.Q331: A Disability-Focused Medical Education Curriculum to Foster Trainee Advocacy

Background: Physicians have a distinctive role in utilizing their expertise and position to advocate for improved accessibility and better outcomes for patients with disabilities through direct observation of the diverse experiences and barriers to care they face. However, most trainee education programs lack a standardized and structured educational framework specifically aimed at fostering disability advocacy beyond the traditional curriculum (1). To fill this gap, we designed a trainee-led curriculum at UC Riverside School of Medicine, aiming to equip trainees with the knowledge, skills, and insight to become advocates for disability-inclusive healthcare. Structured upon the biopsychosocial model, our curriculum engages trainees through multi-media educational modules, clinical practice, community programs, healthcare professional interviews, and narrative medicine discussions with a focus on pediatric disabilities.

Methods: Using the biopsychosocial model as a framework, our 2-4 week curriculum offers three modes of learning: disability-based multimedia didactic modules, visits to disability-focused clinical centers and community organizations, and narrative medicine. The course includes six modules covering topics like transitioning from pediatric to adult disability care, advocacy, disability law, disability first-person stories, and accessible technology. The curriculum provides clinical experiences at Autism care centers, neurology clinics, and traumatic brain injury centers. Trainees are also immersed in community-based programs including public health departments, health insurance disability programs, and pediatric disability multidisciplinary team meetings. Discussions on these modules, clinicals, and immersive experiences occur through narrative medicine sessions woven around reflective pieces and interviews with health care professionals and caregivers. Using Kirkpatrick's model for program evaluation, trainees take pre- and post-curriculum surveys, assessing changes in their knowledge, attitudes, and confidence in care and advocacy for patients with disabilities (2). These surveys, featuring Likert scales, multiple-choice questions, open-ended responses, and a written reflective piece, also gather student feedback on the course.

Results: Data collection is ongoing. Preliminary results show that trainees report increased awareness of health barriers and the complexities of disability care after completing the curriculum. In narrative responses and reflective essays, learners expressed increased awareness of the complex intersections of disability, self-determination, and vulnerability. Specifically, learners emphasized wanting to incorporate disability-competent care into their future practice.

Conclusion: Pediatricians are often the first resource for families discussing their child's disability. This important role requires additional training in culturally competent care to meet diverse needs, improve communication, and provide more inclusive care in pediatrics and beyond. This trainee-led, multimodal curriculum focusing on disability healthcare shows promising results in enhancing competency and advocacy readiness among trainees. By integrating narrative medicine as an avenue to synthesize trainee’s thoughts and experiences, the curriculum addresses critical gaps in medical education and empowers future physicians to advocate for disability-inclusive healthcare. This curriculum may be adapted by other training programs to promote standardized and advocacy-driven disability focused care.