Need for Education in the Health Professions

1
Need for Education in the Health Professions

• Wendy M. Nehring, RN, PhD, FAAN, FAAIDD

2
Medical and Nursing Education in I/DD

• In some institutions, the nurses were the
  higher functioning patients and were trained by
  the physicians.
• Modern education in I/DD came about in the 1960s
  with the Kennedy administration and the advent of
  UAP/UAFs.
• Continuing education and post-graduate programs.

3
Medical and Nursing Education in I/DD-2

• Federal funding for education.
• Most education today for nurses and physicians
  comes in pediatric courses, followed by
  psychiatric and community health courses.

4
Scope and Standards of Practice

• Exist for nurses AAMR and DDNA
• Intellectual Developmental Disabilities
  Nursing Scope Standards of Practice (Nehring
  et al., 2004).
• Aspirational Standards of Developmental
  Disabilities Nursing Practice (Willis, 2008)
• None available for physicians and other health
  disciplines

5
Need for More Education

• Closing the Gap A National Blueprint to Improve
  the Health of Persons with Mental Retardation
  (2002).
• The Surgeon Generals Call to Action to Improve
  the Health and Wellness of Persons with
  Disabilities (2005).

6
Closing the Gap (2002)

• 6 major goals with goal 4 specific to the
  training of health care providers in the care of
  adults and children with mental retardation
• Professional education
• Interdisciplinary education and training
• Provider competence
• Continuing education

7
Call to Action (2005)

• Principle that good health is necessary for
  persons with disabilities to secure the freedom
  to work, learn and engage in their families and
  communities (p. 21).
• 4 major goals with the second goal focusing on
  health care providers, specifically their
  knowledge and expertise in using tools to screen,
  diagnose, and treat persons with a disability.

8
Call to Action Strategies for Goal 2

• Appropriate communication skills
• State-of-the-art health services and supports
• Include persons with disabilities across the life
  span in clinical and health research
• Knowledge of laws affecting persons with
  disabilities
• Identify available curriculums focusing on EBP

9
Strategies-2

• Equipment and devices that allow universal access
• Increase available educational and training
  materials
• Handbooks to include best practices and resources
  for wellness promotion
• Increase clinical experiences and continuing
  education

10
Strategies-3

• Increase opportunities for persons with
  disabilities to be members of the research team
• Increase research to enhance best practices
• Promote interdisciplinary collaboration in
  research and clinical best practices
• Evaluate available resources used in health care
  settings (pp. 22-23).

11
Preservice

• How much focus in didactic and clinical courses
  is given to intellectual and developmental
  disabilities?
• Use of clinical sites
• Outcome criteria for minimal competence
• Few opportunities for specialization
• Few academic specialists

12
Continuing Education

• Entry into the care of persons with intellectual
  and developmental disabilities.
• Availability of resources
• Handout
• Declaration of Health Parity and others
• Join state, regional, and/or national
  organizations
• Online resources
• Offerings from area UCEDDs

13
Available Resources

• Nehring (ed.). (2005). Health Promotion for
  Persons with Intellectual and Developmental
  Disabilities (AAMR) followed conference.
• Rubin Crocker (eds.). (2006). Developmental
  Disabilities Delivery of Medical Care for
  Children and Adults (2nd ed.) (Mosby).
• HealthSofts internet modules/DDNA
• Healthy People 2010 (US DHHS, 2000).

14
Available Resources-2

• Lakin Turnbull (ed.). (2005). National Goals
  and Research for People with Intellectual and
  Developmental Disabilities. (AAMR). followed
  conference.
• Nehring (ed.). (2005). Core Curriculum for
  Specializing in Intellectual and Developmental
  Disability A Resource for Nurses and Other
  Health Care Professionals. (Jones Bartlett).

15
International Efforts

• Healthy Ageing (joint report between WHO/IASSID,
  2000)
• Pomona Project (Walsh, Kerr, Lantman-De Valk,
  2003)
• European Manifesto on Basic Standards of Health
  Care for People with Intellectual Disabilities
  (Meijer, Carpenter, Scholte, 2004)
• People with Learning Disabilities in Scotland.
  Health Needs Assessment Report (NHS and Health
  Scotland, 2004)
• Colloquium on the Primary Care of Adults with
  Developmental Disabilities (Ontario, Canada,
  2005)
• Lennox, N. Management guidelines Developmental
  disability (2nd ed.) (2005)

16
WHO/IASSID

• Life-span approach to care
• Availability of expert care
• Access to preventive health care practices
• Know difference between intellectual disabilities
  and older-age onset medical conditions review
  affect of both
• Identify appropriate screening

17
WHO/IASSID-2

• Eliminate attitudes and barriers
• Enhanced training in assessment and communication
• Interdisciplinary approach
• Educational and clinical practice supports
  available to primary care providers
• Medical education

18
European Manifesto

• Health professionals in mainstream health
  services will have competencies in intellectual
  disabilities
• Health professionals who are specialized in the
  specific health needs of individuals with
  intellectual disabilities are available as a
  backup to mainstream health services.
• Health care needs a multidisciplinary approach
  (p. 14).

19
European Manifesto-2

• Basic standards of health care
• Standard care and care of condition
• Training in attitudes and communication
• Practice guidelines
• Access to expert consultants
• Virtual centers of expertise
• Pre-service and continuing education
  opportunities
• Ongoing research by experts
• Interdisciplinary education
• Creation of academic chairs

20
Ontario Guidelines

• Provide specific training guidelines (minimum of
  22 hours 2 didactic and 20 clinical) for all
  applicable disciplines
• Mandatory instruction for family medicine and
  nursing
• Development of graduate programs in nursing
• Clinical experts should be given joint
  appointments
• Continuous evaluation of training programs
• Use of best practices and evidence based practice
• Development of a Clinical Support Network

21
The Future

• Quality of programs and information
• Keeping the information up-to-date with
  appropriate evidence
• Involving people of all ages with I/DD in the
  research and program development process

22
The Future-2

• Leadership includes making a contribution.
• Maintaining visibility of this specialty.
• Disseminating information to and for
  professionals, persons with IDD and their
  families, the health care system, public policy,
  and the general public.