FRIEND Residency Pilot Project

Dear Family Medicine Program Directors:

We are very excited to present to you the Family Medicine Residency Inclusion and Engagement of People with Neurodevelopmental Disabilities (FRIEND) Project.  This project exists to provide your programs with models for including caring for people with neurodevelopmental disabilities in your family medicine residency programs.  Through this project, we will provide you with resources to help you in this endeavor.  These include a webinar series which provides 12 hours of physician education on enhancing skills of primary care providers in caring for adults with developmental disabilities.  It also includes written resources, such as “Intellectual Disabilities at Your Fingertips: A Health Care Resource” by Dr. Carl Tyler, and “Developmental Disabilities: Delivery of Medical Care for Children and Adults” by Dr. Rubin and Dr. Crocker.  We will also provide you with models of programs which were created by Family Physicians who are eager to help you create similar programs within your residencies.  Thus, each program comes equipped with a group of physicians and advocates who will happily work with you to make sure your experience incorporating programs into your residencies is met with success.  The programs listed below all allow persons with disabilities (PWDs) to serve as teachers for residency learners.  A strength of this project is that the people participating have authentic disability and students are able to learn from those living with the disability how to effectively provide healthcare.

  1. Patients with Disabilities as Teachers: This is an educational innovation that utilizes the first hand experiences of patients with disabilities and their family members to teach medical students and residents the basics of ‘disability etiquette’. Patients and parents are trained to become teachers to medical professionals. First hand experiences and audiovisual aids are employed for the training. The usual training runs for 3 hours but can be tailored to suit the curriculum. The program also focuses on recognizing the ‘abilities’ and learning ‘person first language’ when interacting with people with disabilities. Tools for training and evaluation of the program have been developed. The program has been presented at national and international conferences and has been recently published. It is also being implemented in all medical schools in Pennsylvania through grant funding.
     
  2. Objective Structured Clinical Exam: A PWD serves as a standardized patient for residency learners to perform a history and physical and develop a therapeutic plan.  An example of an OSCE includes a PWD who has an Intellectual Disability who will need to be diagnosed with hypertension.  A modified OSCE is also a possible program and is being utilized with success at family medicine programs.  In this instance, there are multiple PWDs in different rooms with different impairments.  The resident learner rotates through a series of exam rooms where PWDs have a mobility, communication, sensory, and/or intellectual disability and simply portray themselves.  In both of these OSCE settings, the learner must adapt the history and physical technique for each patient encounter.  The key in all of these learning scenarios is that the standardized patient actually has a disability and not an actor portraying a disability and that the learner receives immediate feedback from the PWD and/or faculty member.
     
  3. Home Visits: Learners often forget that when PWDs are seen in the hospital or clinic they are on our turf and the patient can be at a disadvantage.  Home visits place the learners on the patient’s turf and the visits allow students to see how the patient really lives - many students cannot imagine the quality and richness of life that comprise pts/their families’ lives. Through these often eye opening experiences, learners can better appreciate their role in striving for optimal health and wellbeing in their patients with disabilities. There is a didactic session prior to the home visit, and then a debriefing session afterwards with feedback from the pt and family.
     
  4. PEDD Webinar Series: The Physician Education in Developmental Disabilities (PEDD) Webinar Series was designed to enhance the practice skill of primary care physician and residents in order to provide better quality care to adults with developmental disabilities. Each webinar is accredited by the American Academy of Family Physicians (AAFP) for 1.0 hours of prescribed credit. A total of up to 12.0 credit hours are available. In order to obtain a certificate of completion for each webinar, the learner must pass (with a score of at least 7/10) a related quiz over the material. In order to access the PEDD webinar page please visit: http://aadmd.org/page/pedd-webinar-series

Each of these programs have been evaluated by those who provide this teaching already and noted to meet the ACGME curricular objectives already listed on this website. For a complete listing of the curricular goals and objectives please visit the National Curriculum Initiative in Developmental Medicine (NCIDM) page here: http://aadmd.org/page/ncidm-preamble Please review these materials and feel free to choose a model that will work best for your program. As a next step, please determine which teaching methodology you would like to employ then contact Dr. Matt Holder and he will help you connect with the program leaders who will serve as advisors and will assist you in implementing their program in your residency. 

We are very excited and look forward to working with you soon!

Sincerely,

Matt Holder, MD, MBA
Deb Dreyfus, MD

AttachmentSize
Patients with Disabilities as Teachers.ppt9.2 MB
Objective Structured Clinical Exam.pptx2.62 MB
Home Visits.pptx130.79 KB
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