Disability Competencies in Medical Education (DISCO-MED): Qualitative Study of Unmet Needs.

Abstract

Objective: To explore the lived experiences of persons with disabilities and compare to current disability medical education guidelines, and to identify gaps in medical professionals' preparedness to provide appropriate care.

Design: A qualitative pilot study using semi-structured interviews with eight individuals with disabilities. Interview transcripts were analyzed using thematic analysis in Dedoose and compared to established medical education guidelines: the Core Competencies on Disability for Health Care Education (CCDHE) and the expanded Framework to End Health Disparities of People with Disabilities.

Results: Six major themes emerged: (1) conceptualizing disability, (2) patient challenges and empowerment, (3) provider traits and professionalism, (4) provider-patient relationship dynamics, (5) social determinants of health and accessibility, and (6) therapeutic importance and follow-up. Prominent subthemes included empathy and support, communication and consideration, advocacy and acceptable language, accessibility and support, and differing needs. Findings largely aligned with the CCDHE and the expanded framework while revealing gaps with the patient's lived experiences.

Conclusion: Despite existing competency frameworks, significant gaps remain in how medical professionals are trained to meet the needs of persons with disabilities. These findings underscore the urgent need to revise and expand disability-related education within medical curricula to improve healthcare accessibility and quality for this population.