Learning Objectives for Developmental Disabilities Curriculum University of California, San Francisco

GOAL:

Systematically plan and institutionalize a curriculum in developmental disabilities (DD) across the lifespan and integrate it into the residency curriculum to ensure that every Family Medicine resident graduating from UCSF will have the skills, knowledge, and attitudes necessary to care for patients with developmental disabilities.

LEARNING OBJECTIVES:

At the end of their residency, residents will be expected to achieve and demonstrate the following learning objectives. These are based on the competencies used in all residency programs.

1) Patient Care

Graduates will:

a. Conduct a relevant and focused physical exam on a child and adult patient with developmental disabilities.
b. Demonstrate skills in interviewing patients with DD, their families and caregivers.
c. Document a neurodevelopmental profile of a patient with DD’s etiology and baseline cognitive, sensory, neuromuscular, behavioral, and seizure disorder status.
d. Document an assessment of functional capacity of a child, adolescent and adult patient with DD including activities of daily living (ADLs) and instrumental activities of daily living (IADLs).
e. Perform a standardized developmental/behavioral screening for children to identify developmental delays.
f. Develop an assessment and plan for a focused problem for a child and adult patient with a DD.
g. Demonstrate appropriate exam etiquette when working with both children and adults with DD including assistance with positioning for physical exam.

2) Medical Knowledge

Graduates will:

a. Describe the state and federal definitions of developmental disabilities.
b. Define types of and possible causes of developmental disabilities.
c. Define terminology used to describe cognitive, sensory, neuromuscular, behavioral and seizure disorders in people with DD.
d. Recognize some of the common presentations of developmental disabilities.
e. Recognize some of the common presentations of illness in both children and adults with DD.
f. Identify some of the barriers to accessing health care that children and adults with DD face.
g. Describe the legal rights of both children and adults with developmental disabilities, how to obtain informed consent, and how to make effective referrals.
h. Describe the history of DD, including the disability rights movement and moving people from institutions to community‐based care.
i. Identify key issues around obtaining informed consent and for people with cognitive impairments, including conservatorship and supported and substituted decision‐making.
j. Identify key issues around upholding confidentiality for adults with cognitive impairments.

3) Practice‐Based Learning and Improvement

Graduates will:

a. Evaluate and apply online medical information to people with DD.
b. Apply evidence from scientific studies to patients with DD.
c. Facilitate learning of colleagues about DD.

4) Interpersonal and Communication Skills

Graduates will:

a. Demonstrate appropriate exam room etiquette when working with someone with a DD including using respectful terminology, interacting directly with the patient, and including the patient in the conversation.
b. Identify tools to facilitate communication with patients with DD and respond appropriately to communication barriers that may arise when working with someone with a DD.
c. Elicit needs and preferences of patients, families, and caregivers in their interactions with the health care system.
d. Share information with patients (providing health information or counseling) in a manner that is understandable to patients with DD, their families, and caregivers.

5) Professionalism

Graduates will:

a. Show respect and compassion while interacting with patients with a DD and/or their families and caregivers.
b. Practice ethically, including maintaining confidentiality of patient information, obtaining appropriate informed consent, and understanding appropriate boundaries in the doctor-patient relationship as they relate to patients with a DD.
c. Advocate for children and adults with DD, their families, caregivers, and their communities.
d. Show insight into one’s own personal/professional development through the practice of reflection, and demonstrate awareness of how assumptions and biases about people with DD can influence the doctor‐patient relationship.

6) Systems‐Based Practice

Graduates will:

a. Identify health care delivery systems, and social service, education, vocation and advocacy resources available to both children and adults with DD.
b. Identify members of a patient’s interdisciplinary team, including the role of family members, caregivers, primary care clinicians, medical specialists, social service providers, special therapists, pharmacists, dentists, and durable medical equipment providers.
c. Demonstrate the ability to work effectively as part of an interdisciplinary team, including working collaboratively with representatives from schools, social service agencies and health and advocacy organizations.