Caring for the Deaf and Hard of Hearing

We’re highlighting our Class of 2024 students in advance of Commencement 2024 on May 11. Stay connected with the Miller School of Medicine on social media for more student profiles and to follow along for live Commencement coverage.

Medical student Hannah Ship

Hannah Ship witnessed the health care struggles the Deaf and hard-of-hearing people experience long before she enrolled at the University of Miami Miller School of Medicine.

“I began my journey as an advocate for the Deaf and hard-of-hearing communities when I was in high school and learned American Sign Language, inspired through a friendship with someone who is Deaf,” said Ship, a member of the Miller School’s M.D./M.P.H Class of 2024.

Ship was the first American Sign Language support volunteer at the Ronald Reagan UCLA Medical Center in Los Angeles. Ship would visit the rooms of patients who were Deaf and hard-of-hearing to make sure their communication needs were being met. It was there that Ship witnessed the struggles these patients faced, including misunderstandings about care and being left out of health care decision making.

The more Ship learned, the more she wanted to do something about it.

The Miller School’s M.D./M.P.H. program provided Ship with an avenue for change. Ship said her capstone project, which involved helping to create a curriculum that educates medical students on disability, communication and Deaf culture, allowed her to translate her interest in public health into action.

“That was the start of everything,” Ship said. “I was talking with peers here and getting to know everyone at the beginning of the school year when I realized that a lot of people did not know the Deaf and hard-of-hearing communities or American Sign Language. They had preconceived notions of the different communities.”

In her Miller School research, Ship learned that the discord does indeed impact care access and outcomes. Deaf patients have fewer doctor’s appointments, fewer preventive services, worse cardiovascular health outcomes and higher rates of obesity than the general public. Physical communication barriers increase the risk of a preventable, adverse events by a factor of two.

Ship applied for funding through the M.P.H. program to create a video and community needs assessment featuring researchers, faculty, law center advocates for Deaf culture and, most importantly, people who are Deaf or hard of hearing. Her goal? To make the community’s challenges and needs known.

“I was given a lot of autonomy and recognition for the experiences I brought to the table from prior to medical school,” Ship said. “The faculty at the Miller School are so inclusive and excited about supporting students’ passions.”

Expanding the NextGenMD Curriculum

When Ship proposed incorporating what she had learned into the NextGenMD curriculum, Miller School faculty created an opportunity. Jeffrey Brosco, M.D., Ph.D., professor of developmental and behavioral pediatrics at the Miller School, created a coalition to work on disability education for the curriculum’s Medicine as a Profession course.

“The curriculum is centered on the vital concept of effective patient communication, ensuring we involve patients in medical decision-making according to their values, culture and language,” Ship said.

Ship’s session is one of three in the new longitudinal disabilities curriculum. It includes contributions from faculty, people with disabilities and students. The first session introduces interdisciplinary health professions and how to uplift holistic care for people with disabilities. The second session introduces learners to disability and health disparities, emphasizing medical and social models of care.

“We put together the third part, a three-hour session,” Ship said. “The pre-work involves videos about narratives of people’s experiences and their introduction of Deaf culture. We use a community assessment to help tell the story.”

The students then participate in small-group, patient-scenario discussions that emphasize the importance of medical interpreters and including people with cultural and linguistic diversity in medical decision making.

“This discussion ties many ideas together, including the importance of interpreter use in medical systems and communication necessary for including people with cultural and linguistic diversity in their medical decision making,” Ship said.

The course concludes with a panel of people who have disabilities, including Deaf users of American Sign Language. The panel is facilitated by the Mailman Center for Child Development’s Rochelle Baer and Jairo Arana. Students hear their stories and have the opportunity to ask questions.

“I am grateful to people like Dr. Brosco, who provided me with this foundation and said, ‘Let’s run with it and see what we can come up with,’” Ship said. “Miller School faculty gave me freedom but also support along with way, with grants and this amazing team of people with disabilities associated with the UM Mailman Center for Child Development, who were there with me every step of the way.”

National Exposure for Her Work

Ship’s capstone project has been part of Miller School medical training for three years. In April, the curriculum was published to the Association of American Medical Colleges’ MedEdPortal Journal, giving medical school educators and students nationwide access.

Working alongside the University of Michigan’s Dr. Michael M. McKee, an influential advocate for health equity for Deaf and hard-of-hearing people, Ship published about integrating disability health curricula in medical school curriculum.

“After sharing the curriculum at conferences, my teammate, Sahana Shankar, and I connected with other institutions, creating a network of likeminded scholars across the U.S.,” Ship said. “My heart still flutters when I reflect on the possible impact of the curriculum, the patients that may have better clinical experiences as a result.”

In March, Ship matched to her first-choice residency program, the Internal Medicine Primary Care track at UCLA. She’ll continue to work to create a more effective health care system for Deaf and hard-of-hearing patients.

“I aspire to provide better support for these communities, as well as all communities facing barriers to health care access, through meaningful clinical interactions and public health initiatives,” she said.

Tags: commencement, commencement 2024, Health Equity, medical education, medical students, student research