Huddled around a table, a group of second-year medical students watches a woman’s frustration play out on the screen in front of them. She went to the radiology clinic for a mammogram, her first in 25 years. But the visit didn’t go as planned.
The clinic staff wouldn’t let her operate her own wheelchair during the exam, even though the motorized chair rises and tilts. Aggravated, she vents about the situation.
The story is part of an audio slideshow called a Photomap, a new research methodology that UF College of Public Health and Health Professions researchers developed, in part, to educate health-care providers (and future ones) about the barriers patients with disabilities face.
College of Public Health and Health Professions researchers Ellen Lopez, Ph.D., M.P.H., and Eva Egensteiner, M.A., C.P.H., worked with four women living with disabilities to create the Photomaps, detailing their experiences obtaining a mammogram or visiting the doctor. The photos, which the women and researchers took, were paired with each woman’s recorded thoughts about her experience.
In March, first- and second-year UF medical students watched the Photomaps as part of a new training module designed to better prepare them for treating patients with disabilities. The half-day session included a lecture, an expert panel and a small-group session where students viewed and discussed the Photomaps, which gave them a bird’s-eye view of what it’s like to live with a disability. First-years also began “seeing” patients with disabilities during role-playing sessions at the college’s Harrell Professional Development and Assessment Center.
Currently, 62 million have some form of disability that limits their physical or mental function, according to the National Center for Health Statistics. Laws such as the Americans with Disabilities Act have improved life for people with disabilities, yet physical and social barriers still limit their access to health care and education.
In the Photomaps, the women face barriers that seem painfully obvious when looking at their encounters from their perspective but might go unnoticed by someone without a physical limitation — such as doors that don’t open automatically. One woman described her technique for opening doors while seated in her wheelchair; she wedges her foot in to keep it from closing. She’s broken her foot this way but says it’s the only way she can get in without help.
After Melanie Hagen, M.D., a UF physician who co-directs the College of Medicine course, Essentials of Patient Care, viewed the Photomaps, she and course co-director Rebecca Pauly, M.D., teamed with Lopez and Egensteiner to develop the training module for medical students. The researchers received a College of Medicine grant for the project.
“Being able to empathize with a patient is, to me, the most important thing in medicine,” Hagen says. “That is something I try to improve in my own practice.”
For Lopez, the goal of the session was less an overview of disabilities and more a lesson in empathy.
“The goal is not only that they be aware of disability issues, but also that they use their knowledge and power to be advocates. I want these students to realize that they can be the catalysts for positive change,” says Lopez, now a research associate at the Center for Alaska Native Health Research. “If they can understand, just a little bit, what it is like to have a disability, it will change their practice.”
Before and after the session, medical students completed surveys about their perceptions of people with disabilities and their thoughts on the session.
Although the data from these surveys has not been analyzed yet, one student wrote that the session taught them “how much of a burden it can be to simply go to the doctor when people have significant disabilities.”
Hagen says they will probably conduct a similar session for students next year with more advanced information for the students who already took part this year.
“There was so much to talk about,” Hagen says. “This was definitely a worthwhile activity.”