Medical Student Experiences in a Four-Week Immersive Disability Elective: A Mixed-Methods Study of Attitudes and Applied Knowledge

Abstract

Despite growing recognition of health disparities affecting people with disabilities (PWD), most medical schools provide limited disability-specific training, and evidence on optimal curricular design is limited. This study aimed to evaluate changes in post-clerkship medical students’ attitudes toward PWD and to characterize their end-of-course disability knowledge following a four-week, immersive disability elective. Using a convergent mixed-methods design, we assessed 64 students across eight cohorts. Attitudes were measured with the Medical Student Attitudes toward Persons with Disabilities Scale (MSA-PWD) administered pre- and post-course (n = 49 matched pairs); knowledge was assessed via end-of-course examinations and a barrier-identification essay exercise. End-of-course debrief transcripts underwent directed content analysis. Students showed significant improvement across all four MSA-PWD factors and the total score (median 50.0 to 58.0, p < 0.001), with 95.9% improving relative to baseline. Mean exam performance was 75.3%, though essays revealed variable ability to identify communication and attitudinal barriers across disability types, particularly for intellectual/developmental conditions. Students attributed attitudinal gains to structured community immersion and engagement with disabled faculty. Participation in an immersive, community-engaged disability elective was associated with improved attitudes toward PWD, and students demonstrated applied disability knowledge at course completion, underscoring the value of longitudinal curricular integration.