The impact of autism-related training programs on physician knowledge, self-efficacy, and practice behavior: A systematic review

Abstract

One in 44 children in the United States is diagnosed with autism spectrum disorder. Despite this, physicians receive little clinical training, inclusive of autistic patients. It is therefore not surprising that physicians report low levels of confidence in their ability to provide care to autistic individuals. This review examines the impact of specialized training programs on physicians’ knowledge of autism and their self-efficacy and practice behavior related to caring for autistic patients. A search of MEDLINE, PsycINFO, PubMed, ERIC, Web of Science, and Scopus was performed to identify studies evaluating specialized autism training programs for physicians or physician trainees. Seventeen studies were found to meet the inclusion criteria. The Medical Education Research Study Quality Instrument was utilized to objectively measure the quality of the included studies. Based on the results reported in these studies, specialized autism training programs were associated with positive changes in physician knowledge and self-efficacy related to the care of autistic patients. Other than short-term increases in screening for autism, no other changes in physician behavior were studied. These results call for the development and evaluation of autism training programs that focus on improving physician behavior and patient outcomes. Lay abstract Autism spectrum disorder is estimated to impact 1.5 million children and almost 5.5 million adults. However, most physicians do not receive training on how to provide care to this increasingly large group of people. After performing a systematic review of the literature and screening over 4,500 unique articles focused on the effectiveness of autism-specific training programs designed for physicians and physician trainees, we determined that 17 studies met the pre-determined criteria for inclusion in this systematic review. The results reported by these studies suggest that by completing specialized training programs related to autism, physicians were more knowledgeable on topics related to the condition, more confident in their ability to provide care to autistic individuals, and more likely to screen their patients for autism spectrum disorder. However, further studies with higher quality data are needed to validate these findings and provide additional insight on the ability of these programs to improve physician behavior and patient outcomes. We are therefore advocating that medical educators develop and evaluate specialized autism training programs with an increased focus on improving physician behavior related to all aspects of providing care to autistic people.