Community-Engaged Medical Student Elective to Improve Knowledge and Attitudes Toward Individuals With Intellectual...

Individuals with intellectual and developmental disabilities (IDD) face multiple barriers to inclusion throughout life. One barrier is the medical knowledge and biases of adult healthcare providers with diagnoses traditionally associated with childhood. Medical school curricula have limited content related to IDD, and students have limited opportunities to engage with community organizations during their clinical years.  Methods: We created a one-month clinical elective to address medical students' attitudes and knowledge regarding individuals with IDD using experiential learning. Students saw adult patients in our primary care clinic with a variety of IDD diagnoses and spent 30% of their time at community sites engaging with individuals with IDD in nonmedical settings. A survey of 38 attitudinal questions (Likert-scale) and a 48-item knowledge exam were administered before and after the elective.  Results: Of the 47 participants, 42 (89%) completed the paired instruments between 2018 and 2022. Of the attitudinal items, nine resulted in a more positive direction post-elective (p < 0.05). Respondents indicated receiving adequate training so that they felt increased comfort, p < 0.001, r = 0.86 (large effect), and more competent to care for a person with IDD (p < 0.001, r = 0.85). Based on a composite score of a 48-question knowledge exam, post-scores were higher than pre-scores (p < 0.001) and Cohen's d = 0.90 (large effect).  Conclusion: The creation and implementation of a medical student elective that combines clinical experience with community engagement had a significant impact on knowledge and attitudes toward individuals with IDD. Community engagement should be considered as a mechanism to enhance other clinical electives and break down attitudinal barriers.