Toward Healthcare Parity for Floridians with Disabilities:

Training Healthcare ProvidersSusan M. Havercamp, PhD

The Ohio State University Nisonger Center, UCEDDMyrna Veguilla, MSMS

USF Florida Center for Inclusive Communities, UCEDD

Disability Module Background

Major curricular reform in the 3rd and 4th years

Opportunity to insert new topics previously omitted from the curriculum

Patients with disabilities are encountered by all physicians, regardless of specialty, yet most physicians are not trained in the care of this group

The Surgeon General created a call to action to improve the health and wellness of persons with disabilities in 2005, citing the importance of training physicians

Disability ModuleGoals:• To encourage patient centered

care that allows students to see the patient as an individual

• To help students understand that disability is part of life, through a concept of varying abilities rather than disease model

• To help students develop respectful communication and examination techniques resulting in more effective therapeutic outcomes

• To help students become familiar with some of the more common disabling conditions

Objectives:Students will:1. Demonstrate an adequate comfort

level when interacting with patients with disabilities in the clinical setting

2. Practice and demonstrate appropriate history and physical exam techniques with standardized patients with disabilities

3. Locate and provide adequate community resources for patients with disabilities

4. Participate in service learning projects, behaving respectfully and remaining open-minded toward alternate learning activities

Disability Module Overview

Evaluation and Feedback• Evaluation of student performance

– Log of student activities including online communication

– Disability questions included in clerkship exam

– Patient with disability in final OSCE type exam

• Module evaluation– Student performance and feedback– Home visit patient feedback– Evaluation protocol taken pre- and post-

module• Significant changes in knowledge,

attitude, and comfort with patients who have disabilities

– Long-term follow-up through UCEDD

Evaluation ResultsDifference(Post-Pre) SD t-value (df)

Two-tailed

Knowledge 2.36 2.40 14.76 (224) **

Attitude 4.20 17.27 3.62 (221) **

Cognitive 1.66 6.89 3.70 (234) **

Affective 2.71 11.33 3.60 (225)**

Behavioral .02 6.10 .04 (235)

Comfort 15.00 37.45 5.95 (220)**

Case 1 2.58 13.11 2.99 (230)*

Case 2 4.35 13.11 5.01 (227)**

Case 3 8.29 15.60 8.11 (232)*** p<.01** p<.001

Feedback from Students “I thought this was a wonderful experience. You can learn much

more from a patient in their home than in the clinic and you are able to discuss things that you would not be able to discuss in class. I would definitely continue this experience in the future.”

“What an eye-opening experience! I really enjoyed this portion of the block. Getting to see how a patient with a serious disability goes about their day-to-day activities was very educational and humbling. I really enjoyed having a chance to talk with the pt’s caregiver as well and to better understand what they go through to take care of their loved ones. Textbooks don’t provide the same emotional impact as person-to-person communication!”

“The model patient exercises were very revealing. I would hope that this exercise influenced my approach to patients with disabilities in the future. It was very revealing and demonstrated the importance of taking extra time with these patients.”

“I learned about the significant social discrimination that occurs affecting people with disabilities. I learned about some of the multitude of resources available for these patients as well as some helpful hints for their medical care.”

USF College of Medicine is committed

to sustaining this curricular innovation.

FCIC will help maintain evaluation efforts,

including long-term follow-up.

Recent Publication

• Article describing curriculum and evaluation just accepted for publication in Academic Medicine

– Description of a Required Clerkship Module Focused on Patients with Disabilities

– Laurie J. Woodard, Susan M. Havercamp, Kira K. Zwygart,

and Elizabeth A. Perkins

Healthcare Access for Persons with Disabilities

Part 1: Persons with Physical and Sensory Disabilities

Susan M. Havercamp, PhD

Healthcare Access for Persons with Disabilities

Part II: Persons with Developmental Disabilities

Susan M. Havercamp, Ph.D.The Ohio State UniversityNisonger Center, UCEDD

Toward Healthcare Parity

We hope that training medical

students and healthcare

providers will improve the availability, access, and

appropriateness of healthcare for Floridians with

disabilities.

For more information…Susan M. Havercamp, PhDAssociate Professor of Psychiatry and PsychologyThe Ohio State University Nisonger Center, UCEDD1581 Dodd DrColumbus OH 43210Tel. (614) 247-6629Email: susan.havercamp@osumc.edu

Myrna Veguilla, MSMSFlorida Center for Inclusive Communities Department of Child and Family StudiesCollege of Behavioral and Community SciencesUniversity of South Florida13301 Bruce B. Downs Blvd., MHC 2113ATampa, FL  33612-3807Tel.: 813.974.7008Email: veguilla@usf.edu