How Medical Students Conceptualize Disability: Implications for Interprofessional Practice and Education

摘要

Background: This study explored whether medical students at a Canadian university conceptualize health and disability from a biomedical or biopsychosocial perspective. The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) served as the theoretical basis for this exploration. Methods: A written survey was administered to capture medical students' conceptualizations of health and disability. The survey included questions explicitly related to the constructs of universalism, nonlinearity, social and environmental factors, personal factors, participation, aspects of language and biopsychosocial health perspectives. The survey was also designed to include both theoretical and scenario-based questions related to biopsychosocial concepts of disability. The survey was distributed to and completed by a senior medical school class at a Canadian university. Results: In total, 82 out of 131 medical students completed the survey. Observed trends suggested that for theory-based questions, respondents exhibited close agreement with biopsychosocial perspectives of health and disability. Scenariobased questions resulted in more variability among respondents compared to theory-based questions. When students who previously had been introduced to the ICF were compared with students who had not, those familiar with the ICF more consistently exhibited a biopsychosocial perspective of health and disability; however these differences were not statistically significant. Conclusion: Overall, senior medical students in this study were generally found to conceptualize disability using a biopsychosocial orientation. This result was more pronounced among students who were previously familiar with the ICF. Interestingly, a biopsychosocial orientation was not consistently maintained for scenario-based questions for all respondents. Our current healthcare climate requires that the concept of health move beyond a biomedical perspective to a more holistic biopsychosocial perspective. This change in perspective is of particular importance as movement towards team-based models of care continues to gain momentum. Closing conceptual and language-based gaps related to concepts of health and disability among all healthcare professionals is pertinent to improving interprofessional collaboration and service provision. The ICF presents a framework and language that is relevant across all health professions. Increased use of the ICF in health professional education and training could significantly contribute to increased interdisciplinary success.