Undergraduate medical education for neurodivergent students: a scoping review

Recognition of the importance of the neurodiversity paradigm is growing within medical education, as is understanding of how current practices may create barriers for neurodivergent students. This review aims to explore existing empirical research regarding undergraduate medical education for neurodivergent students, in order to provide practical considerations for educators and inform planning of future research.

Following frameworks outlined by Arksey and O'Malley and the PRISMA Extension for Scoping Reviews, six electronic databases were searched in April 2024 for empirical studies relating to neurodiversity within undergraduate medical education. Quantitative synthesis of article characteristics and a thematic analysis of qualitative studies on student experience were conducted.

Fifteen (n = 15) studies were identified, relating to student experience, assessment, or staff perceptions. Most focussed on dyslexia or specific learning disabilities, with few explicitly referencing the neurodiversity paradigm. Studies of student experience frequently identified discrimination and stigma, and studies of staff perceptions highlighted inadequate training. Barriers to neurodivergent student education were linked to certain teaching modalities and learning environments. Several perceived strengths of neurodivergence were also noted. Studies on assessment focused on the role of accommodations, with an emphasis on written rather than clinical examinations.

This review highlights a lack of empirical studies on neurodiversity within undergraduate medical education, restricting the development of pragmatic guidance. Some adaptations are suggested, but studies are limited to discussing medical education in general with few implementing the neurodiversity paradigm. Future research should explore a greater range of neurodivergent conditions, interrogate assessment practices including clinical examinations, and provide further evidence for inclusive teaching approaches. Explicit utilization of the neurodiversity paradigm is crucial, to amplify neurodivergent voices and better understand existing barriers. This work will have implications for medical educators seeking to understand neurodivergence, with a view to implementing adaptations for neurodivergent students in their educational practice.