‘Understanding Disability’: Evaluating a contact-based approach to enhancing attitudes and disability literacy of medical students Julie Lynch a, * , Jason Last b , Philip Dodd c , Daniela Stancila d , Christine Linehan e a School of Psychology, University College Dublin, Belfield, Ireland b School of Medicine, University College Dublin, Belfield, Ireland c Consultant Psychiatrist/Director of Psychiatry at St. Michael's House, Dublin 9, Ireland d National Rehabilitation Hospital, Dublin, Ireland e Director of UCD Centre for Disability Studies, University College Dublin, Ireland article info Article history: Received 22 January 2018 Received in revised form 15 July 2018 Accepted 19 July 2018 Keywords: Attitudes Disability Medical students Education Intergroup contact abstract Background: Health disparities and disparities in the provision of healthcare to people with disabilities remains a topic of concern. Research demonstrates that attitudes of healthcare providers contribute to this disparity. The approach to disability education and training in medical school warrants evaluation. Objectives: This study sought to investigate the efficacy of an educational intervention in cultivating positive attitudes towards disability in medical students, and determine the specific impact of an interaction-based hospital visit to patients undergoing neurological rehabilitation. Methods: Web-based questionnaires were distributed to medical students undertaking a 12-week ‘Un- derstanding Disability’ module. Measures of anxiety, attitude, competency and empathy were obtained from 65 students at the beginning (T1), middle (T2) and end (T3) of the module. At T2, approximately half of the students had completed a hospital visit and half had not. Results: Scores changed significantly across all constructs between the beginning and end of the module suggesting a positive overall module effect. Findings confirmed a significant difference in anxiety and empathy levels between the group of students who had completed the visit to the rehabilitation hospital by the middle survey wave and those who had not, indicating a specific placement effect. Conclusions: Our findings suggest that interpersonal contact with individuals with disabilities has a distinct impact on the affective variables of anxiety and empathy. Previous research suggests that this contributes towards improved attitudes to disability. Overall, we provide strong evidence for the in- clusion of contact-based educational interventions in medical school to enhance students' attitudes to disability. © 2018 Elsevier Inc. All rights reserved. Introduction Determining disparity in the provision of healthcare to various populations is a complex task. Within the context of disability, this process is complicated further by having to distinguish between health differences that are avoidable, and those that are unavoid- able and possibly related to the underlying health condition that initiated the disability. Researchers have defined health disparities for this population as differences in health status that cannot be solely attributed to the presence of disability, and/or the provision of disparate healthcare that is solely attributed to the presence of disability. 1,2 Contemporary research evidencing the disparities experienced by people with disabilities suggests that inadequate health coverage, limited access to care and poor quality care contribute to unfavourable health outcomes for this population. 3,4 An inquiry into the premature deaths of people with intellectual disabilities in the UK, for example, suggests that 37% of deaths in this population were avoidable and due to poor quality healthcare, compared to just 13% in the general population. 5 Research indicates that attitudes of healthcare providers can impact the quality of care * Corresponding author. School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland. E-mail addresses: julie.lynch@ucdconnect.ie (J. Lynch), Jason.last@ucd.ie (J. Last), Philip.dodd@smh.ie (P. Dodd), Daniela_stancila@yahoo.com (D. Stancila), Christine. linehan@ucd.ie (C. Linehan). Contents lists available at ScienceDirect Disability and Health Journal journal homepage: www.disabilityandhealthjnl.com https://doi.org/10.1016/j.dhjo.2018.07.007 1936-6574/© 2018 Elsevier Inc. All rights reserved. Disability and Health Journal xxx (2018) 1e7 Please cite this article in press as: Lynch J, et al., ‘Understanding Disability’: Evaluating a contact-based approach to enhancing attitudes and disabilityliteracy of medical students, Disabilityand Health Journal (2018), https://doi.org/10.1016/j.dhjo.2018.07.007