Access Simulations - Why Employ Simulators with Genuine Disabilities?

Introduction to Access Simulations

Why Employ Simulators with Genuine Disabilities?

The Access Simulations team

What people say...

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Why teach about people with intellectual disabilities at all?
In 2002 the General Medical Council (GMC) of the UK identified 'handicap, disability and rehabilitation' and intellectual disability, as part of the 'core curriculum'.

"Doctors must be good listeners if they are to understand the problems of their patients and they must be able to provide advice and explanations that are comprehensible to patients and their relatives" (italics ours).

Unfortunately, at present, for people whose communication style and behaviour may not correspond to the 'norm', access to fair treatment is severely reduced by the inadequate awareness and skills of service providers. Too often, this leads to inappropriate treatment of symptoms and behaviours - e.g. prescription of unsuitable medication for extended periods, or unjust and unhelpful disciplinary measures which waste time and resources and may constitute abuse.

Few educational institutions or programmes offer direct systematic contact between people with intellectual disabilities and trainees, who therefore do not practise obtaining valid consent and accurate assessment procedures under supervision. Access Simulation aims to remedy this situation.

Can't regular actors do this job?
The involvement of people with intellectual disabilities as trainers of health care professionals has been strongly endorsed by the Department of Health in England.

Experience suggests that employing non-disabled actors to simulate intellectual and language disabilities is ineffective. Such actors often do not detect and challenge terminology which would be incomprehensible to a person with limited receptive language;

E.g.
Student: I'd like to talk to you about your diet.
Simulated Patient: I'm not on a diet - I'm not fat!

and they do not raise problems which are unique to the life experience of disabled adults (e.g. it's all very well to encourage a patient to eat less saturated fat; realistically, a person living in an institution or staffed home will have very little control over their diet).

Finally, we have noticed that some non-disabled actors present inaccurate and offensive stereotypes, e.g. grunting and drooling. This is not helpful to anyone.