EDI in Action: Texas PA Program Looks at Care for IDD Patients

At Hardin-Simmons University’s PA Program, Kathy Robinson, DHSc, MPAS, PA-C, and Jenni Jamison, MS, MPAS, PA-C, sought to learn if they could teach their PA students to better care for people with intellectual and developmental disabilities (IDD).

Typically, healthcare providers can face communication challenges when caring for people with IDD, such as “lack of a standardized approach to communication, a perception of the patient’s limited decision-making capacity, and a preference for communicating with family or care staff.” These gaps in communication have been noted to result in health disparities for people with IDD.

In fact, a PA who worked at a residential facility for people with intellectual disabilities observed that their residents were not only suffering from communication limitations at the emergency department, but at times were also “discharged from care by outpatient specialists due to behavioral challenges.”

Robinson and Jamison realized that they could help mitigate these challenges by training their students how to effectively care for patients with communication limitations through an experiential learning activity.

Their goals were to:

  1. Instill in students a greater empathy for patients with intellectual developmental disabilities
  2. Give students a better understanding of how to obtain a medical history for patients with communication limitations
  3. Teach students practical tips for obtaining a medical history and physical examination to increase competence in their future practice
  4. Build a relationship with a local organization that serves people with intellectual disabilities

Their first step was to develop a partnership with a residential facility for people with intellectual disabilities. Before students visited the facility, they were provided a detailed overview of intellectual disability topics, including health disparities and health equity, diagnostic factors, and the necessity of developing a therapeutic alliance with patients and caregivers.

Robinson and Jamison saw the importance of utilizing an active educational model to not only teach practical tips for obtaining a medical history and physical examination, but also to improve students’ confidence for their future interactions with patients with IDD.

In total, students participated in three on-site visits at the residential facility. They engaged in interactive discussions and lectures with nurse practitioners, physical therapists, and other nursing staff and direct care professionals, and were also asked to complete a history and physical for one patient. Students were encouraged to work in tandem with the care staff to ask about the patient’s communicational style including vocalizations and gestures while ascertaining their current health status. Back at their program, students wrote a comprehensive history and physical, and presented their patient at the next patient assessment group laboratory session.

Reflecting on the activity, students reported “feeling better prepared to assess people with intellectual disabilities, particularly in obtaining a history and performing a physical examination, and feeling less nervous about doing so.” As an unexpected benefit, the partner residential facility reported that they received valuable feedback from staff participants and would like to continue the partnership with the PA program.

To learn more, read Teaching Physician Assistant Students to Care for People With Intellectual and Developmental Disabilities in JPAE by clicking here.