“After this presentation, I feel more confident caring for autistic patients”: The impact of neurodivergent doctors educating hospital staff about neurodiversity

Authors

Abstract

Guidelines for professionals practising in healthcare settings recommend that autistic people seeking care should receive neurodiversity-affirming support. However, education on neurodiversity is not widely included in health professional training in Australia. With a focus on health equity for autistic, neurodivergent people, we conducted a healthcare improvement initiative addressing the need for neurodiversity education in an Australian tertiary hospital through a change process. This project was conducted from May to November 2022, led by neurodivergent, disabled doctors who developed neurodiversity education for two hospital departments, refined through Plan-Do-Study-Act cycles and feedback surveys. The feedback survey, which included an opportunity to provide comments, was completed by 29 of 44 attendees, a response rate of 66%. Respondents agreed the education was relevant to their work (97%, n = 28), and reported more confidence (83%, n = 24) and acceptance (90%, n = 26) of autistic patients and colleagues. Themes identified in the analysis of the open-ended questions included reducing negative attitudes (biases), recognizing unmet neurodiversity learning needs, and a shift in perspective. Neurodivergent doctors led this healthcare improvement project to educate hospital clinicians about neurodiversity. The theme of reducing bias emerged from the open-ended responses, highlighting the importance of this work, given bias contributes significantly to health inequity. Lay abstract Barriers to autistic people accessing healthcare include health professionals with negative attitudes (biases). This study created training for hospital doctors and nurses about reducing healthcare barriers so autistic people can be included. We taught about neurodiversity affirming support, which means accepting and valuing neurodivergent people because they belong in our diverse society. The team included two neurodivergent, disabled doctors, and two research experts. The training was based on guidelines about quality hospital care, supporting autistic people, and the experiences of neurodivergent doctors. Meetings were held with hospital education leaders to find out what kinds of training doctors and nurses preferred. A feedback survey was created to find out about experiences within the training. Three groups received the training. First was Junior Medical Officers in the Emergency Department, who are qualified doctors training to become specialists. The second was specialists and doctors in the final stage of training before becoming specialists in the Geriatric Medicine department. The third was nurses in the Emergency Department. The majority of the survey responses said the training was relevant and made them feel more confident in supporting and more accepting of autistic people. Themes from the open-response questions were “bias,” “neurodiversity knowledge” and “perspective shifts.” These describe becoming aware of biases and stigma and having these challenged; wanting to know more about supporting neurodivergent people; and changing their point of view to understand neurodivergent people. These findings can support other hospitals to train staff about neurodiversity-affirming support.

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