Post-graduate Medical Training in Intellectual and Developmental Disabilities: a Systematic Review

Acad Psychiatry. 2021 Jan 12. doi: 10.1007/s40596-020-01378-8. Online ahead of print.

Abstract

Objective: Despite the increasing number of people with autism-spectrum disorder (ASD), intellectual disabilities (ID), and developmental disabilities (DDs), individuals with these conditions continue to have high levels of unmet physical and mental health needs. Robust training of health professionals can help bridge this gap. A systematic review was conducted to describe the features and educational outcomes of existing postgraduate medical education curricula to inform the development of future training to address the growing unmet care needs of people with intellectual and developmental disabilities (IDD) such as ASD and ID.

Methods: Four major databases were searched for peer-reviewed, English-language research focusing on post-graduate training in IDD education. Educational curricula and outcomes were summarized including Best Evidence in Medical Education (BEME) Quality of Evidence and Kirkpatrick training evaluation model.

Results: Sixteen studies were identified with a majority published after 2000 (69%). Pediatric departments were involved in 69%, Psychiatry 19%, Medicine-Pediatrics 19%, and Family Medicine 6.3%. Analysis of Kirkpatrick outcomes showed 31% were level 1 (satisfaction or comfort); 38% level 2 (change in objective knowledge or skills); 13% level 3 (change in behavior); and none at level 4. BEME analysis showed 19% of studies were grade 1 (no clear conclusions), 31% grade 2 (ambiguous results), and half (50%) grade 3 (conclusions can probably be based on findings), with none scoring four or higher.

Conclusions: There is a paucity of objectively evaluated research in the area. Studies reviewed show clear promise for specialized, interdisciplinary, competency-based education which may be foundational for future curriculum development.

Keywords: Autism; Developmental disabilities; Intellectual disabilities; Medical education; Residency.

Publication types

  • Review