Evaluation of Simulated Patient Cases Depicting Patients with Disabilities

Context: People with Disabilities (PWD) face barriers to quality healthcare, including the lack of health professions education focused on caring for PWD. Simulated patient encounters which include individuals with disabilities can increase awareness and reduce stigma among health profession students. However, little work has examined the experience of serving as a simulated patient (SP) as an individual with disabilities. PWD’s voices have been marginalized, their experience is critical to balancing authority and power in the health profession.

Objective: We looked to understand the experience of a patient encounter through the lens of an SP with disabilities.

Study design and analysis: First-year medical students participated and conducted a SP interview with an individual from one of three disability communities: Down syndrome (DS), Blind/visually impaired (BVI), Deaf/hearing impaired (DHI). Focus groups were conducted, and experts consulted to develop, pilot, and refine the case in conjunction with the disability communities. SPs were surveyed after to understand their experience.

Setting: SP interviews were held at a midwestern medical school. SP surveys were completed online, with an option via Zoom or interview. Participants were encouraged to get help to complete the survey as needed.

Population Studied: Thirteen of 17 SPs responded (76.5%) including: 2 BVI; 8 DHI; 3 DS.

Intervention/Instrument: Questions assessed patient case, accessibility, the desire to be a simulated patient again, and areas for improvement.

Results: Most strongly agreed the case was realistic (62%), they had sufficient information to prepare (76.9%), they understood the information provided (82%), and would like to be SPs in the future (85%). BVI participants suggested that students need to be better trained to use the blood pressure cuff. DHI participants suggested reducing the number of cases per day and shared concerns regarding accessibility of the simulation center. DS participants shared that students need to be instructed to use less technical terms.

Conclusions: The overall feedback received was positive. Future implementation including a revised set of directions for the students will emphasize the use of simpler language and ensure participants have sufficient information to conduct their role. Logistical improvements will also be made. The study reports direct experiences of the participants which are crucial to facilitate.