Maintenance of learning following teaching communication, disability and diversity to medical students

Objective: Doctors need to communicate with patients, despite disability or cultural differences. This study investigated the effects of teaching these topics together. Method: Communication, disability and cultural diversity were taught to a cohort of medical students beginning their clinical studies in a single three hour session. Participants received theoretical input and discussed diversity issues in small groups. All students talked with both a patient with a communication disability and a non-English speaker via an interpreter. Questionnaire data were collected beforehand, immediately afterwards and an average of 31 weeks later. Additionally, focus group and interview data were collected 27 weeks and an average of 39 weeks after the session respectively. Result: Students’ understanding of diversity issues and their ability to describe disabilities, along with their confidence in interviewing people with a communication disability or where English is not a shared language, all improved and this improvement was sustained up to 39 weeks later. Key communication skills learnt were giving time, positioning during interactions, and using interpreters. Attitudinal changes reported included increased empathy and sensitivity and not making judgments or assumptions. Deeper awareness was also reported of barriers to communication within individual students and external factors such as underlying cultural beliefs. Conclusion: Teaching combining communication, disability and cultural diversity in a single highly experiential three hour session is effective, well-received, and results in long term change (up to 39 weeks) in medical students’ reported skills, attitudes and confidence. Maintenance of skill and attitude change after teaching on disability and diversity has not previously been reported