What does "disability" mean for medical students? An exploration of the words medical students associate with the term "disability".
BACKGROUND
Disability teaching is a core theme in undergraduate medical education. Medical students bring a range of experiences of disability to their medical training.


OBJECTIVE
The principal aim of this study was to explore the words that medical students associate with the term "disability" and to consider how the resulting information could inform teaching. A secondary aim was to see if a short disability course changed the word associations.


METHODS
Students were asked to write down 2 words that came to mind when they heard the word "disability", before and after a 4-day course in disability. Words from 4 cohorts were analysed by frequency and the following word dichotomies: visual icons/personal attributes; loss/enabling, and medical model/social model. A random sample of students took part in focus groups at the beginning and end of the course.


RESULTS
A total of 381 students provided 667 before-course words and 189 students provided 336 after-course words. Before the course, words denoting visual icons of disability, and loss were prominent, accounting for 85% of the words, and 74% of the words describing personal attributes were negative. Focus group responses at this stage reflected an eagerness to help but patronising terms were prominent, along with concern about political correctness. Students also expressed nervousness about encountering disabled people. In response, teaching was adapted to make it more learner-focused, to offer a safe environment in which students can test out their language, to build on the positive associations and to develop a range of pre-course creative activities with disabled people. After the course a considerable and significant shift in emphasis was observed, with a reduction in the use of visual icon words, an increase in words denoting enablement, and an increase in words relating to the social model of disability and to positive personal attributes (P < 0.001). Focus group participants at this stage reported greater confidence in approaching disabled people but continued to question political correctness.


CONCLUSIONS
Medical students associate disability predominantly with depersonalised or negative words. A short disability course appears to change these associations. Reasons for this and implications for teaching are discussed.
Byron
Margaret
M
Department of Clinical Medicine, University of Bristol, c/o Centre for Medical Education, 39-41 St. Michael's Hill, Bristol BS8 8DZ, UK. Margaret.Byron@bristol.ac.uk
Cockshott
Zoë
Z
Brownett
Hilary
H
Ramkalawan
Tina
T
D001291:Attitude of Health Personnel; D003142:Communication; D003479:Curriculum; D006233:Persons with Disabilities / Q000523:psychology; D004504:Education, Medical, Undergraduate / Q000379:methods*; D017144:Focus Groups; D006801:Humans; D013337:Students, Medical / Q000523:psychology*; D009626:Terminology as Topic