A Medical School Pilot to Teach the Physical Examination for Patients With Mobility Disability: Development, Implementation and Early Assessment of Impact.

BACKGROUND

Despite health disparities and low clinician confidence caring for disabled patients, disability is not routinely included in medical education, with a notable gap in attention to the physical examination. This article examines a novel educational intervention to teach medical and dental students how to perform a physical examination for patients with mobility disability. Disability is the most common disability type in US adults.

APPROACH: A stakeholder-engaged session to teach medical and dental students how to perform a physical examination for patients with mobility disability was developed using Kern's six-step curriculum development approach and provided as a mandatory element of Harvard Medical School's required foundational clinical skills course for first-year students.

EVALUATION: Voluntary pre-/postsession surveys queried student confidence and takeaway lessons. Quantitative analysis was performed using unpaired t-tests. Hybrid inductive-deductive qualitative analysis distilled themes from narrative descriptions of takeaways. Pre-/postsession survey response rate was 121/164 (74%) and 109/164 (66%), respectively. Student confidence to provide care for patients with mobility disability increased significantly following the session (p < 0.001). Lessons learned fell into six themes, including accessible care, clinical humility and collaboration.

IMPLICATIONS: A disability-specific session within a foundational clinical skills course can increase student confidence to provide care for patients with disabilities and stimulate reflection on principles of care relevant to all patients.