title: Presence with purpose: attitudes of people with developmental disability towards health care students.
abstract: BACKGROUND
  Early clinical encounters help medical and nursing students build professional competencies. However, there is a necessary emphasis on patient autonomy and appropriate consent. Although most individuals do not object to student involvement in clinical encounters, there are occasions when personal preference and health care education conflict. Many studies have evaluated patient attitudes towards students across a variety of specialties.
  
  
  OBJECTIVE
  The purpose of this study was to identify the attitudes, comfort level and preferences of individuals with developmental disability (DD) towards the presence and involvement of medical and nursing students during clinical encounters.
  
  
  METHODS
  Adults with DD across the Hamilton-Niagara region were invited to participate. Focus groups were moderated by two students with a health care facilitator and physician-educator. Participants were provided with focus group questions in advance and encouraged to bring communication aids or care providers. Data were analysed for emerging themes by two independent reviewers, who then compared results.
  
  
  RESULTS
  Twenty-two individuals participated. A wide range of opinions were expressed. Some participants were positively disposed towards students and perceived better care and improved communication with the health care team. Others were indifferent to students in a clinical setting. The final group was opposed to the presence of health care students, expressing confusion over their role and purpose, uneasiness with deviation from the norm, and concerns about confidentiality. Informative introductions with confidentiality statements and the presence of a supervising clinician were seen as helpful.
  
  
  CONCLUSIONS
  People with DD are affected by above-average health care needs. Their input into health care planning has been limited. Their opinions on health care learners varied considerably. Themes relating to attitudes, comfort and preferences about student involvement provide impetus for health care training practices that promote person-centred approaches and improvements to the quality of care received by people with DD.
authors.affiliation: Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Ginette
authors.initials: G
authors.lastname: Moores
authors.affiliation: Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Lidster
authors.affiliation: Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.|Bethesda Services, St Catharine's, Ontario, Canada.
authors.forename: Kerry
authors.initials: K
authors.lastname: Boyd
authors.affiliation: Bethesda Services, St Catharine's, Ontario, Canada.|Southern Networks of Specialized Care, Hamilton, Ontario, Canada.
authors.forename: Tom
authors.initials: T
authors.lastname: Archer
authors.affiliation: Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Nick
authors.initials: N
authors.lastname: Kates
authors.affiliation: Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Karl
authors.initials: K
authors.lastname: Stobbe
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003142:Communication; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D005791:Patient Care / Q000523:psychology; D011361:Professional Competence; D013337:Students, Medical; D013338:Students, Nursing