Maintaining the focus on people ( not pathology ) in health professional education in

1. Maintaining the focus on people (not pathology) in health professional education in Developmental Disability Health Dr Jane Tracy Centre for Developmental Disability Health Victoria Monash University Melbourne Australia

2. Centre for Developmental Disability Health Academic unit within Monash University Faculty of Medicine, Nursing & Health Sciences – est 1998 Funding:Disability Services, Victorian State Government Department of Human Services Mission:Improve health outcomes for adults with developmental disability by developing the capacity of generic health service systems to better meet their needs. Activities:Educational, Research, Clinical, Advocacy. We are small: ~ 8 EFT positions – incl. 3 PhD Teaching ~ 2 EFT My role there is Education Director and this session will focus on our teaching……… (see website for details of other activities) www.cddh.monash.org

3. In 2000 in Victoria there was little medical education in this area ……We saw the need but lobbying for its inclusion in medical curricula was challenging because: • Competition for teaching time in the medical course is fierce • The population of people with developmental disabilities in practice populations is relatively small We wanted to: • Contribute to education of all medical undergraduates in state (~ 300) • Provide professional development opportunities for medical practitioners in state

4. We knew as doctors we needed to do much better in meeting the complex health and social needs of people with developmental disabilities Vulnerable population with complex health needs and poor health outcomes – More un-recognised health conditions + life expectancy 20 years less than general population Community based population – in the past health care was based in institutions – now in community so all health professionals will see people with developmental disabilities in their practice.

5. And when it didn’t work we thought … Our first strategy was to try and convince decision makers within the medical school that it was important to include Developmental Disability Health within the curriculum …. because we said so! Your greatest disability is your inability to see things my way! (Ashleigh Brilliant) We thought…

6. Over time we have learnt success is about • Timing • Hooks • Persistence

7. Timing • New challenges bring new opportunities • Changes to the course structure • Revision of curriculum • Development of new medical courses and schools • Demand from other health professional courses •  new opportunities for us to contribute to medical education

8. Hooks We needed to listen for the ‘hot topics’in medical education and thought about how to use them as ‘hooks’ for disability health. Those hot topics are currently • Chronic and complex disease management • Interprofessional practice (effective teamwork in health care) • Social inclusion, social justice and equity

9. Persistence • Join committees • Offer to do the work • Sometimes dead ends  Sometimes gold mines of opportunities

10. Educational activities now include: Undergraduate: medicine (5 university medical schools), Monash Uni - Vertically integrated curriculum in disability throughout course:19 hours COMPULSORY + 6 week selective Undergraduate allied health and disability - paramedic, physio, social work, dental, disability studies. Postgraduate: medicine (GPs, psychiatrists, paediatricians), dentists, genetic counselors. Community Health Services: multidisciplinary healthcare teams – physio, OT, speech pathologists, podiatry, social work, psychologists, nurses, practice managers, receptionists .. and others

11. Fundamental to all our teaching is the belief that those living with a disability are the experts on their own experience, and their direct involvement in and contribution to the education of health care professionals is essential.

12. People with disabilities are powerful teachers. Student feedback • “ I previously knew nothing about intellectual disability & how to work with someone who has one - I felt I learnt a lot.” • “Created awareness that everyone has the same feelings, emotions… with or without a disability. I now feel more open and comfortable (I used to feel scared). Thanks!” • “The first time I have been aware of the spectrum of communication differences and how I have to tailor my communication to best fit the patient.” • “A wonderful opportunity to deal with people with disabilities who were willing to help us become more understanding doctors as well as people.”

13. Over the last 5 years here have been new challenges …. Increasing numbers of Victorian medical students (~300  ~800) Increasing number of medical schools in Victoria (2  5) Increasing number of placements across the state (centralised teaching  regionalised) Increasing requests from other health professional courses for contribution to curriculum Increasing focus on interprofessional education and practice But we are a small Centre – limited ability to offer face to face teaching  Need for resources Resource development: for teaching, for health professional and community education Community engagement: supporting people with disabilities to contribute to our teaching program.

14. Teaching and learning resources Textbook: Management Guidelines: Developmental Disability 2. (2005) Melbourne: Therapeutic Guidelines Limited. Interactive CDROM: Healthcare Scenarios in Developmental Disability Medicine (2005) CDDHV: Monash University BUT these have a verymedical focus We wanted students to focus on people ….

15. Need for resource that focused on • People (not pathology): provided students with a personal context for their learning • Interprofessional education: the value of working as part of a team • Disability health: to improve health outcomes The outcome  “Health and Disability: Partnerships in Action” …and that’s another story!

16. Thank you for you attention. Questions and discussion?