Formative Evaluation of PREPARE for Autistic Adults: An Adult Autism Training for Resident Physicians Designed with Autistic Adults and Family Members

Efforts are intensifying across the U.S. to better prepare physicians to deliver high-quality, patient-centered care for adults with disabilities like autism. To address this need, we partnered with autistic adults and their families to develop a training program for resident physicians called Promoting Residents' Excellence in Patient-centered cARE (PREPARE) for Autistic Adults. Here, we describe an evaluation of the feasibility, acceptability, and appropriateness of PREPARE for Autistic Adults to inform content and format revisions before efficacy pilot testing. We recruited residents (n=14) at one large academic medical center in the Midwestern U.S. to participate in the eight-week virtual training, which included six pre-recorded lectures, six facilitator-led case studies, and two standardized patient encounters. Participants rated feasibility, acceptability and appropriateness of the training, and participated in qualitative interviews to identify improvement opportunities. We analyzed quantitative data with descriptive statistics and qualitative interviews with an inductive rapid qualitative analysis. Participants' median completion rate was 76.9% of training components. Participants rated feasibility, acceptability, and appropriateness highly. We identified four main qualitative themes: 1) Flexibility facilitates feasibility, 2) High-value experiences increase acceptability, 3) Practicalities affecting participation, and 4) High clinical practice relevance enhances appropriateness. We revised the training based on feedback, including clarifying or adding content, modifying standardized patient encounter logistics, and adding optional components for residency programs to supplement core PREPARE content. These results provide information for continued refinement of the training. Our next steps include pilot testing the efficacy of the revised training at one large academic medical center.