Abstract
Background People with learning disabilities (LD) and autism face significant health inequalities, partly due to clinicians' limited confidence and lack of training in inclusive care. Undergraduate curricula often emphasise theory over practical skills. This project aimed to improve final-year medical students' confidence through a combined lecture and immersive simulation using actors with lived experience. Methods Thirty-two students from Queen Mary University of London attended an introductory lecture, and eight participated in small-group simulation sessions. Scenarios were co-designed with actors with LD and autism, supported by communication aids and hospital passports. Debriefing involved actors, carers, and faculty. Confidence was assessed using pre- and post-intervention Likert-scale surveys, with qualitative feedback collected. Results Students reported improved confidence across all measured domains (p < 0.001). All simulation participants strongly agreed that the teaching should be mandatory. Qualitative feedback highlighted authenticity, safe practice opportunities, and the value of direct lived experience. Conclusion The innovation provided both knowledge transfer and experiential practice. Simulation offered a safe environment for communication and skill development, aligning with Kolb's experiential learning cycle. Involving actors with lived experience met Allport's conditions for meaningful intergroup contact, supporting attitudinal change. The intervention aligns with the GMC Outcomes for Graduates, the Equality Act 2010, and the National Health Service (NHS) Long-Term Plan to reduce health inequalities. Simulation with actors with lived experience improved medical students' confidence in caring for patients with LD and autism, although the sample size of students attending could limit the power of these results. The approach is replicable with adaptations and may contribute to addressing healthcare inequalities.