A clinical rehabilitation course for college undergraduates provides an introduction to biopsychosocial interventions that minimize disablement.

Abstract

A two-credits per semester clinical medicine course was established in the Department of Physical Medicine and Rehabilitation (PM&R) in cooperation with the Johns Hopkins University undergraduate Human Biology faculty to present the variety of inpatient consultation personnel, units, patient diagnostic groups, and functional problems. College students spend 4 hr weekly on the PM&R consultation service as team members under resident supervision. The curriculum emphasizes student understanding of the roles of rehabilitation team members. Objectives include demonstration of working knowledge of the Biopsychosocial Model, the World Health Organization Model of disablement and interdisciplinary rehabilitation intervention. The course includes simulations of physical impairments, demonstrations of adaptive equipment, interactive chart reviews, readings, and audio lectures. A retrospective sequential review was made of the last 100 physical medicine and rehabilitation consultations with student attendance. The results confirm student exposure to many ward settings (surgery, 30%; neurology/neurosurgery, 28%; medicine, 24%; intensive care, 15%; oncology, 2%; and psychiatry, 1%), patient complexity (averaging 10 problems), and multiple ICD-9 diagnosis categories (circulatory, 36%; neurologic, 22%; musculoskeletal, 17%; neoplasms, 10%; injury, 5%; endocrine, 4%; infections, 3%; and others, 3%). The rehabilitation consultation service is particularly effective as an introduction to hospital-based medical practice due to the diagnostic variety of the patients, the functional approach of rehabilitation, and student exposure to multiple hospital settings. The Biopsychosocial Model of medical practice is demonstrated through multiple interdisciplinary perspectives of needs and interventions for patients with obvious functional deficits. This process develops a rudimentary understanding of the effect of illness on the person and the variety of medically effective therapeutic modalities.