Aside from simulations in which the "learner" is asked to engage in
activities that somehow simulate the experience of having a disability,
there are also simulations in which the learner does not step into the role
of one who has a disability, but rather the role of one who interacts in a
specific or specialized situation with persons who have disabilities.
I've been working with third-year medical students in building their
comfort/skill in conducting clinical interviews with persons who are
nonverbal due to cerebral palsy or other developmental condition. We
started the program at the urging of several frustrated people who, when
going to the local emergency room, found all questions to be directed to the
driver or personal care assistant who brought them there. We use the same
"standardized patient" model that med students are quite familiar with.
Persons who are nonverbal serve as patient simulators, portraying
appendicitis, pneumonia, otitis media, temporomandibular joint disorder,
etc. The medical students are asked, in this instance, to abandon the
standard (and sometimes exclusionary) "open-ended questioning" that they are
so throughly trained to rely upon, and to conduct the interview in a manner
that capitalizes on nonverbal responses. In the process, the students gain
an appreciation for the tremendous value (and ethical responsibility) in
directly addressing the patient, i.e. the person who has the greatest stake
in the outcome of the encounter and who is likely to be the best source of
information to guide their care. They also begin to question their implicit
assumption that physical disability is necessarily accompanied by cognitive
impairment, as well as their tendency to simply take what they believe to be
the easiest route in gathering information. (See Eddey, Robey & McConnell
(1998), Increasing medical students' . . ., Academic Medicine, 73 (October
Supplement), 106-108.)
There's a wealth of literature that demonstrates the need for direct
exposure in altering attitudes about disability. While these exposures are
usually unplanned contacts in uncontrolled contexts, there is a place for
more controlled and perhaps simulated contacts as well.
Ken Robey, Ph.D.
Matheny Institute for Research in Developmental Disabilities
Matheny School & Hospital
Peapack, NJ
USA
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