Medical students, like all learners, bring a range of cognitive styles and needs to their training. When those needs aren’t met, it can hinder progress in both the classroom and the clinic, speakers said at a recent Stanford Medicine symposium.
Today, most medical schools’ curricula don’t take into consideration the unique cognitive, sensory and social challenges that neurodiverse learners experience, said Daphne Darmawan, MD, a postdoctoral scholar in neonatology.
With the number of neurodiverse learners — which includes those with dyslexia, autism, attention deficit disorder, obsessive-compulsive disorder, among other conditions — on the rise, she and other presenters said there is a need for greater flexibility in training to accommodate individual learning styles.
“Medical education needs an overhaul because the way we have been incorporating information has changed in 50 years,” said Nkechi Okoro, MD, a postdoctoral scholar in psychiatry. “If we could be more inclusive, we could encourage people with a lot of different talents and strengths.”
The opportunities to better support neurodiverse learners was one of 10 projects highlighted at the School of Medicine’s Eighth Annual Diversity and Inclusion Forum on May 9. About 150 residents and postdoctoral scholars attended the event.
Darmawan said that many as 3% of medical students in the United States and the United Kingdom have a specific learning difficulty, such as dyslexia or dyscalculia, a disorder that affects mathematical ability.
“But there are so many other neurodiverse medical conditions,” she said.
She said the number of these diagnoses is rapidly increasing, especially among women and girls, due to greater awareness and understanding of neurodiversity. An estimated 15% to 20% of the world’s population exhibits some characteristics of neurodivergence, she said.
Most medical schools have a fixed, uniform curriculum that follows the same rules and schedules in a way that detracts from personalized learning, said Franziska Miller, MD, a postdoctoral scholar in anesthesiology.
She noted that exams are written, multiple-choice tests that involve quick recall, problem- solving or social interactions, all of which can be challenging for those with anxiety disorders and other neurodiverse conditions. She said most medical schools accommodate people with learning differences only on an individual, case-by-case basis, not as a systemwide approach.
If we could be more inclusive, we could encourage people with a lot of different talents and strengths.”
In a workshop at the conference, trainees offered strategies that could aid neurodiverse learners and be relatively easy to implement.
For instance, instead of giving lectures, teachers could present material in a variety of formats, such as text, audio, video and graphics, Okoro said. Instead of rigid testing methods, students could be allowed to express what they have learned in different ways, whether it’s through writing, speaking, drawing or use of multimedia, she said.
Many students could also benefit from more kinesthetic learning — gaining knowledge through hands-on experience. For instance, in a simulation lab, a surgical trainee can develop a feel for how a scalpel interacts with tissue. In a cadaver lab, they can understand the texture and structure of internal organs in a tangible way.
Miller said simple changes, including noise reduction, removal of visual clutter and other environmental adjustments, could benefit neurodiverse learners. For those with dyslexia, changes in type font could be beneficial, as some have difficulty distinguishing characters in certain fonts.
Minimizing distraction and providing frequent breaks and quiet spaces also could improve the learning experience, she said.
With recent advancements in artificial intelligence, Okoro suggested that this technology be woven into the curriculum to enhance learning.
“AI can be used as a positive tool to support students in different ways,” she said.
Above all, it’s important to treat those with learning differences with sensitivity, said Thamanna Nishath, MD, a resident in emergency medicine.
“There is a real stigma and lack of understanding of what neurodiverse learning looks like,” Nishath said. “Being able to allow for empathy is important to decreasing that stigma.”
