National consensus on disability competencies for health care education

Although access to health care is improving in the United States, the growing population of patients with disabilities faces barriers to care at multiple levels of the health care system. Most students in health professional programs report that they did not receive any clinical training about caring for patients with disabilities. Students, as well as experienced health care professionals, report bias and discomfort with patients with disabilities. Lack of training and bias contribute to heath care inequities for patients with disabilities and complex care needs. People with disabilities report receiving lower quality treatment and less preventive care.

Fixing the problem

Though the need for disability training has been widely established, a set of disability standards for health training programs didn’t previously exist. Consensus was recently reached on the Core Competencies on Disability for Health Care Education, a set of disability education standards consisting of fundamental standards, competencies and learning outcomes, through a partnership with The Ohio State University Wexner Medical Center and the Alliance for Disability in Health Care Education. The competencies were designed to improve training across a diverse field of health care providers and improve the care provided to people with all types of disabilities throughout the health care system.

“Health care providers are committed to providing quality care to their patients, but are often unprepared to address the needs of patients with disabilities,” says Susan Havercamp, PhD, professor of Psychiatry at The Ohio State University College of Medicine, director of the CDC-funded Ohio Disability and Health Program at The Ohio State University Nisonger Center and the leader of the competency effort. “Creating educational standards on disability is important because it will give students the opportunity to learn about disability as part of their professional training program.”

Using an iterative, consensus-building approach

In 2017, the alliance drafted the first set of core disability competencies, 73 educational standards highlighting key elements of quality health care, including professionalism, disability rights, team-based care and effective clinical care. Aiming to encompass the perspectives of all disability stakeholders, Dr. Havercamp and her team then went through the process to gain consensus on whether the draft competencies addressed what health care providers need to know to provide quality care to patients with disabilities. Over 150 people with disabilities, disability advocates and professionals, family members and health educators representing many disciplines developed educational standards of quality care for people with disabilities. Using an iterative consensus-building process, these disability stakeholders provided feedback and suggestions for improving the competencies.

Dr. Havercamp’s team revised the competencies based on stakeholder feedback and sent them back to the group. After two rounds of feedback, the group overwhelmingly agreed that the competencies addressed the range of knowledge, attitudes and skills necessary for health care students to appropriately and effectively care for patients with disabilities. Stakeholders also agreed that the competencies were relevant across disability types and for health care professionals across a range of disciplines (e.g., physicians, nurses, social workers, etc.). The standards—Core Competencies on Disability for Health Care Education—are the first interprofessional competencies to address health care needs of patients with all types of disabilities.

Creating a disability-competent health care workforce

“These competencies will provide a framework for educators to help them better prepare future doctors, nurses and other health professionals to provide quality care to people with disabilities,” says Linda Long-Bellil, PhD, JD, vice president of the Alliance for Disability in Health Care Education.

As recognition of the importance of disability training standards has increased, so has the amount of required curricular content in training for future health providers at academic institutions such as Harvard University, University of Connecticut and The Ohio State University. To meet the disability standards outlined in the Core Competencies, programs can work to update current curricular content to be more inclusive of disability, instead of adding curriculum to already content-heavy programs.

Dr. Havercamp stresses the importance of acknowledging disability as an aspect of diversity, parallel to that of race or ethnicity. “This work represents an important milestone in the creation of a disability competent health care workforce. We hope that it will guide the development and evaluation of disability content in interprofessional health education, as well as create better health outcomes for people with disabilities.”

Learn more about the consensus process in the Disability and Health Journal.