Improving the Attitudes to Homeless Persons in a Family Medicine Residency

Abstract

Introduction: Family medicine providers are at the forefront of serving homeless persons. It is important to prepare family medicine residents for this responsibility during residency. In the current study, we aimed to assess the effect of a series of enrichment activities on the attitudes toward homeless persons held by residents, faculty, and staff in a rural family medicine residency program. Methods: The residency program implemented a 6-month enrichment activities series that provided various educational experiences and aimed to improve the participants’ knowledge of and attitudes toward homeless persons. Participants completed 2 anonymous online surveys before and after the enrichment series: (1) the Health Professional’s Attitude Toward the Homeless Inventory (HPATHI) and (2) a short survey assessing the understanding of local issues that affected homeless persons. Two-tailed Student t tests were used to compare the survey results. Results: Of the 48 eligible participants, 42 (88%) completed the surveys before enrichment activities and 41 (85%) completed the surveys afterward. Engagement in the enrichment series was associated with a significant improvement in attitudes supporting social advocacy, but it did not affect self-reported levels of cynicism or personal advocacy. Participant knowledge of local homelessness issues improved, but the difference was not statistically significant. Conclusions: The longitudinal enrichment activities series, which was implemented in a rural family medicine residency program and aimed to provide experiences working with homeless individuals, was effective in improving attitudes supporting social advocacy among participants.

Prioritizing homelessness in emergency medicine education: A concept paper

“…Reinforcement of negative cognitive biases by physicians has been speculated to lead to missing treatable pathologies 12 . In multiple studies, dedicated training of physicians on homelessness and the connection between social factors and health reframed how participants viewed patients clinically, improved confidence in recognizing social barriers to health, improved attitudes toward homelessness, and made participants feel more connected to original motivations for entering the health professions 17,19–21 . This connection between education, provider morale, and patient care offers a glimpse into the benefits of further developing EM education and training on homelessness.…”

A Street Psychiatry Rotation for Medical Trainees: Humanizing the Care of People Experiencing Homelessness

“…The Health Professionals Attitudes Toward the Homeless Inventory (HPATHI) assesses healthcare professionals' attitudes, interests, and confidence about working with individuals experiencing homelessness through a series of validated 5-point Likert scale questions. Family medicine residents demonstrated significant increases in the "social advocacy subscale" of the HPATHI after participation in clinical and enrichment activities related to homelessness [5]. Health professionals and trainees with more than 1 year of experience working with people experiencing homelessness had significantly higher HPATHI scores [6].…”