Accommodating a Student with Hearing Loss in the Medical Curriculum: A Case Study

Abstract

Despite legislative advancements like the Americans with Disabilities Act (ADA)1, Deaf and Hard of Hearing (DHH) individuals remain underrepresented in medical education2 as many institutions lack adequate support systems to accommodate their needs.3 This case study documents the comprehensive support strategies implemented to address the challenges faced by a DHH learner throughout the entirety of undergraduate medical education, spanning both didactic and clinical settings. The student, with severe hearing loss in one ear and profound loss in the other, utilized a combination of oral communication, lip-reading, a Bluetooth-enabled hearing aid, and a cochlear implant. The student successfully navigated both foundational and clinical phases of medical education, overcoming barriers such as poor acoustics, overlapping communications, background noise, and the need for clear visual cues. Key strategies included the use of speech-to-text services such as Communication Access Real-Time Translation (CART) services, assistive listening devices such as microphones and amplifying stethoscopes, minimizing background noise, strategic positioning in classrooms or patient rooms, and utilizing the teach-back strategy. The study spans from pre-matriculation disclosure and accommodation planning, classroom teaching of foundational sciences to the completion of clinical clerkships and individualized career exploration electives. By detailing our approach and the successful integration of tailored and proactive accommodations, we provide valuable insights for educators aiming to support DHH students. This case study contributes to the literature by being the first to document such extensive accommodations across both didactic and clinical curricula. Our experience underscores the importance of creating an equitable and accessible environment, paving the way for a more diverse physician workforce and enhancing healthcare for the DHH community. The student's successful completion of the program and subsequent residency match underscores the potential for DHH individuals to thrive in medical education with appropriate support.