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Diversity and Inclusion

A work-in-progress resource for faculty, students, and administrators on creating more inclusive and diverse classrooms.

Communicating about health care

Iezzoni, L. I., O'Day, B. L., Killeen, M., & Harker, H. (2004). Communicating about health care: observations from persons who are deaf or hard of hearingAnnals of Internal Medicine140(5), 356-362.

Excerpt:  Patient-centeredness—respect for and responsiveness to patients' preferences, needs, and values—must guide fundamental health care reform (12). This laudable goal poses particular challenges for certain patient populations. Achieving patient-centered care requires complete and effective communication between clinicians and patients. Today, however, communication between clinicians and many persons who are deaf or hard of hearing falls far from this ideal.

Clinical and cultural issues in caring for deaf people

Barnett, S. (1999). Clinical and cultural issues in caring for deaf people. FAMILY MEDICINE-KANSAS CITY-31, 17-22.

Background and Objectives: The clinical practice of family medicine is increasingly crosscultural. Promoting culturally sensitive and competent health care is one of the goals of medical educators in guiding medical students and residents, as well as designing continuing education for family physicians. Working with minority communities is essential to meet that goal. The Deaf community is a linguistic and cultural minority group that is often overlooked. Working with the Deaf community to help develop cultural competency and sensitivity has potential benefits. This article introduces some of the sociocultural experiences of deafness and their relevance in health care settings.

 

Turning the Disability Tide: the importance of definitions

Iezzoni, L. I., & Freedman, V. A. (2008). Turning the disability tide: the importance of definitions. JAMA299(3), 332-334.

Excerpt:  As have others,1 we argue that devising strategies to confront disability must first start by defining disability. Definitions implicitly connote goals, which in turn suggest potential solutions and targets for action. When it comes to preventing or deterring disability, this definition matters.

Not this pig: Dignity, Imagination and Informed Consent (book chapter)

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Willis, M. (2004).  Not this pig: Dignity, Imagination and Informed Consent In Van, C. J. V. (Ed). Genetics, disability, and deafness. Washington, DC: Gallaudet University Press.

Freeing Choices (book chapter)

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Mairs, N. (1996). Freeing Choices In Waist-high in the world: A life among the nondisabled (pp.107-23). Boston: Beacon Press.

Okay so I'm in this bed (book chapter)

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Gramaglia, T. (1996). Okay, so I'm in this bed In I. M. Borger & AIDS Project Los Angeles (Eds.), From a burning house: The AIDS Project Los Angeles writers workshop collection (pp. 196-198). New York: Washington Square Press.  

Normal is a place I visit

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Fiala, SJ. (2004). Normal Is a Place I Visit. JAMA, 291(24):2924-2926. doi:10.1001/jama.291.24.2924.

Excerpt:

I live in a different world. I go through the same motions as others: I wake, relate, and work. But my life plays out in a different theater. The on-stage me is an illusion. The actor is friendly and outgoing, provides good patient care in a group practice, and successfully juggles the rigors of home and career as a single parent. She appears to live a hectic but happy life, and manages to do it with efficiency and grace.

I have bipolar disorder: manic depression. Normal is a place I visit, not one in which I am allowed to remain. I vacillate between recurrent depression and occasional episodes of exuberant, expansive hypomania. After 30 years of living with this illness I have become adept at hiding it. But it continues to be difficult to bear. The pain, fatigue, and loneliness are, at times, overwhelming.

 

Communication with Deaf and Hard-of-Hearing People

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Barnett, S. (2002). Communication with Deaf and Hard-of-hearing People. Academic Medicine, 77(7), 694-700. http://dx.doi.org/10.1097/00001888-200207000-00009 

Abstract: Some physicians may be insufficiently prepared to work with the many patients who have hearing loss. People with hearing loss constitute approximately 9% of the U.S. population, and the prevalence is increasing. Patients with hearing loss and their physicians report communication difficulties; physicians also report feeling less comfortable with these patients. Although communication with patients plays a major role in determining diagnoses and management, little attention is given to teaching medical students and residents the skills necessary to facilitate communication when hearing loss is involved. The need for these skills will increase with the expected rise in the number of such patients. The author presents the rationale for including information about hearing loss in curricula on patient—doctor communication, and suggests curricular content, including background regarding hearing loss and techniques that can enhance the physician's ability to listen to (that is, “hear”) and learn about the stories of these patients.

Structural impairments that limit access to health care for patients with disabilities

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Kirschner KL, Breslin ML, Iezzoni LI. Structural impairments that limit access to health care for patients with disabilities. Journal of the American Medical Association. 2007;297:1121-1125. DOI: 10.1001/jama.297.10.1121 

Excerpt: The following 3 cases represent substandard care for patients with disabilities, yet they occurred recently at US tertiary care medical centers with the latest technologies and well-qualified physicians. These failures resulted from basic, “low-tech” structural deficiencies—lack of accessible call systems, diagnostic equipment, and examination tables.