Andrew Roberts, MD
Medical Resident
MedStar Health - Georgetown/National Rehabilitation Hospital
BALTIMORE, Maryland, United States
.jpg "Laura J. Malmut, MD photo")
Laura J. Malmut, MD
Medical Director of Transplant Rehabilitation, Assistant Professor, Associate Clerkship Director
MedStar National Rehabilitation Hospital and Georgetown University School of Medicine
Washington, District of Columbia, United States
To explore how frequently Physical Medicine & Rehabilitation (PM&R) residency programs use standardized patients (SPs) for simulation-based learning experiences and how many of them employ persons with disabilities to act as SPs with physical disabilities.
Design:
In this cross-sectional study, PM&R residency program directors were surveyed on their program’s use of SPs for simulation-based learning experiences, on whether persons with disabilities are employed to act as SPs with disabilities, and on perceived barriers to employing actors with disabilities. Participants were invited via email using the AAP program director listserv. Data were analyzed using descriptive statistics.
Results:
Out of 32 (40%) total responses, six programs reported using SPs for simulation-based learning experiences. Four use SPs to teach residents medical management of disabling conditions, and two use SPs for teaching procedural skills. Three programs reported sometimes and one program reported never employing actors without disabilities to act as SPs who have disabilities. In two instances, actors with disabilities were not used in the simulation curricula because they were not provided or available through the medical school. In one case, actors without disabilities were used when the purpose of the activity was to learn standard anatomy. Barriers to employing actors with disabilities were increased effort, actor availability, and mismatch of interest and need.
Conclusions:
Our study found that PM&R programs employ nondisabled actors to act as SPs who have disabilities at least some of the time. By casting non-disabled actors as SPs with disabilities, portrayals may lack authenticity, perpetuate negative stereotypes, stigmas, and ableism. Furthermore, it potentially limits or displaces potential work opportunities for disabled actors who may already face a number of accessibility barriers in gaining employment. The purposeful hiring and integration of persons with disabilities into SP encounters would improve the fidelity of the simulated learning experiences and promote disability-conscious care.
