1. Using Experiential Learning to Educate Students to Better Serve People with Disabilities The University of Texas at El Paso Kiersten Garrand, SPT; Liliana Jimenez, SPT Celia Pechak, PT, PhD, MPH Non-presenting collaborator: Nancy Gell, PT, MPH, PhD- University of Vermont

2. Background  People with disabilities (PWD) face healthcare disparities that are not experienced by people without disabilities. 1  Research suggests that healthcare providers are ineffectively meeting the needs of our nation’s largest minority population.  This may be attributable to inadequate skills and experience. 2  These barriers may be resolved by integrating disability education into a cultural competence framework. 2-4

3.  Disability competence is defined as the awareness, beliefs, attitudes, knowledge, skills, and behaviors necessary to effectively serve people with disabilities.  Emerged from a cultural competence framework. 5  “We suggest that the disability experience be included under the cultural competence umbrella in the Doctor of Physical Therapy curriculum.” 5 Disability Competence?

4. Study Purpose Identify evidence-based disability competence teaching strategies. Explore which strategies are currently being used to promote disability competence in entry-level physical therapist education in the United States.

5. Methods Four investigators independently searched the literature for evidence related to disability competence education. An online survey was then developed, and an email invitation sent to program directors/chairs of all 217 entry- level physical therapist education programs in the US to complete it.

6. Literature Review Findings The investigators identified articles across health disciplines (medical, nursing, dental, pharmacy, occupational therapy, and physical therapy education) and disability studies. Three of four key categories of disability competence education seen in the literature were experiential: Simulation training Community engagement Clinical experience

7. Shields N, Taylor NF. Contact with young adults with disability led to a positive change in attitudes toward disability among physiotherapy students. Physiother Can. 2014;66(3):298-305.  Shields and Taylor paired 16 second to fourth year physical therapist students with adults with Down Syndrome.  Pairs were randomized to jointly attend a walking program 2 times per week or a social activity program 1 time per week for 8 weeks.  Discomfort subscale of the Interaction with Disabled Persons Scale.

8. Summary of Literature Review  The literature suggests that early, targeted educational interventions focusing on students’ knowledge of, skills with, and attitudes about individuals with disabilities can encourage skillful, culturally- sensitive, client-centered healthcare. 6  The majority of health disciplines used a hybrid approach involving real-world examples and constant reflection (eg, community volunteer programs, restaurant-accessibility assessments, and service-learning opportunities).

9. Preliminary Survey Results  40% of programs (87 of 217) completed all or part of the survey.  95% (73) of respondents agree with our working definition of disability competence.  78% (59) of respondents believe that disability-related competencies should be explicitly defined for entry-level physical therapist education.  37% (28) of respondents stated that their programs define specific disability-related competencies.

10. Preliminary Survey Results  79%-100% (58-75) of respondents agreed that the core competencies listed in the survey should be demonstrated by entry-level physical therapists.  49%- 93% (36-70) of respondents stated that the core competencies listed in the survey are addressed in their program.  74% (56) of respondents believe their programs adequately prepare entry-level physical therapists to effectively serve people with disabilities.

11. Preliminary Survey Results

13. Survey Limitations  The online survey was disseminated to program directors/chairs in the summer.  No way to guarantee that the survey participant was the person with the most knowledge of disability-related content in the physical therapist education program.  If a program member selected his or her affiliated institution on the drop-down list and then discontinued the survey, another member of that program could not take the survey.

14. Discussion PWD are the largest minority group in the US, suggesting that individuals in all fields of study, not just health professionals, are likely to benefit from disability competence training. Integrating evidence-based experiential learning techniques into current didactic teaching methods has the potential to better prepare any student to more optimally serve PWD.

15. Next Steps  Future research - Control group: Class of 2017 - Intervention group: Class of 2018  To incorporate experiential learning by pairing a student with a member of the community with a disability (community faculty).  Outcome measures -Multidimensional Attitudes Scale Toward Persons with Disabilities (MAS) -Attitudes Towards Disabled Persons Scale (Form A)  Questionnaire scores will be compared.

16. Comments or Questions? THANK YOU FOR ATTENDING! We would to thank the UTEP Graduate School for supporting this research through the Graduate Student Research Assistant Award presented to Kiersten Garrand.

17. References 1Sharby N, Martire K, Iversen MD. Decreasing health disparities for people with disabilities through improved communications strategies and awareness. Int J Environ Res Public Health. 2015;12:3301-3316. doi:10.3390/ijerph120303301. 2Symons AB, McGuigan D, Akl EA. A curriculum to teach medical students to care for people with disabilities: development and initial implementation. BMC Med Educ. 2009;9(78). doi: 10.1186/1472-6920-9-78. 3Rapport MJ, Rodriguez J, Bade M. Use of a community volunteer program to develop value for patient-centered care in physical therapist professional education. J Phys Ther Educ. 2010;24(2):53-59. 4Morgan PE, Lo K. Enhancing positive attitudes towards disability: evaluation of an integrated physiotherapy program. Disabil Rehabil. 2013;35(4):300-305. doi:10.3109/09638288.2012.691941. 5Roush SE, Sharby N. Disability reconsidered: the paradox of physical therapy. Phys Ther. 2011;91:1715–1727. 6Shields N, Taylor NF. Contact with young adults with disability led to a positive change in attitudes toward disability among physiotherapy students. Physiother Can. 2014;66(3):298-305.doi:10.3138/ptc.2013-61. doi: 10.3138/ptc.2013-61.