St George’s and Leonard Cheshire teach medical students how to deal with disabled patients

Disabled people in south london are working with medical students to challenge discrimination and inform the trainee doctors about the social model of disability. Amy Taylor reports

Many of us will have experienced doctors talking down to us and automatically rattling off a prescription for antibiotics no matter what our complaint. But for disabled people the problem can be even more acute as doctors often assume that whatever is wrong with them is related to their disability.

A project being run in partnership between the medical school at St George’s, University of London, in Tooting, south London, and charity Leonard Cheshire Disability is tackling this issue.

Under the scheme, disabled people who attend the charity’s Randall Close Resource Centre in Battersea, south London, work with first and second year medical students to challenge stereotypes of disabled people and improve future practice.

The scheme began last September after William J Gallagher, service manager at Randall Close, was approached by the university. Gallagher was clear that it had to be beneficial for both groups.

The disabled people and the students work together in different ways depending on whether the students are on the university’s foundation year medicine programme, a pre-entry course, the five-year undergraduate programme or the four-year programme for graduates. Although not all the students on the courses take part in the project, the numbers involved are in the hundreds.

Both the disabled people and the students go into each others’ environments as part of the work. This involves students shadowing disabled people and staff at Randall Close for one afternoon a week for a term, and another group visiting the centre to attend a presentation by disabled people about the social model of disability.

Experiences

Disabled people in turn go to the university to talk about their experience of health care and take part in role plays, playing out situations such as when a doctor diagnoses someone, so that they can give students feedback. Twice a year disabled people also take part in role plays in which the students are assessed in terms of their clinical and communication skills.

Gallagher says that bringing the students into the centre is invaluable in terms of getting them to understand how disabled patients feel. “In the earlier days they were quite uncomfortable with being in the environment (of the centre), which to me shows that they need to be in places like this. If you experience disempowerment it makes you feel uncomfortable and that’s a good thing. It makes you know how people in your care feel,” he says.

Veronica Thomas, assistant service user co-ordinator for the project, who has been involved in the role plays, says: “Sometimes doctors start writing their prescription before you start talking and that’s saying ‘I haven’t got time to talk to you’. Also they don’t listen to the patient when they are making a diagnosis. They shouldn’t presume it’s something to do with your existing disability but they very often do. We look at the way the students speak and we look at their body language.”

Thomas says that many of the students do not realise how disabled people feel they are treated by doctors and are grateful to be given the opportunity to see it from the other perspective. She adds that while they are aware of the medical model of disability many don’t know about the social model.

Proper training

All disabled people who take part in the project receive training in what will be expected of them and are accompanied to the university by a member of staff from Randall Close. Leonard Cheshire Disability receives a financial contribution from the university for the disabled people’s time, which is spent on activities at the centre.

Gallagher says that St George’s recognises that disabled people are the experts on their conditions and gives the group the status they deserve as soon as they arrive at the university. He explains how the disabled people are in control of the role play scenarios from the start, deciding whether or not to share their information with the students.

As well as improving students’ practice, Gallagher says the scheme also benefits disabled people: “It’s a real confidence builder for the service users. Those [who have taken part in the project] can now go to their own GPs and question them,” he says.

Gallagher and Thomas feel the project is working well for both groups. Gallagher says St George’s should be congratulated for trying to tackle an issue that is often overlooked: “St George’s has completely recognised that if you empower people and if you know how to effectively communicate with them then that’s what makes a good nurse or a good doctor,” he says.

Further information

The Randall Close Centre: 020 7223 0422