Medical Student Self-Efficacy and Attitudes toward Homeless Patients

Buck, David; King, Benjamin T.

doi:10.1001/virtualmentor.2009.11.1.medu1-0901

Cited by 8 publications

(2 citation statements)

References 17 publications

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“…Moreover, burnout rates are higher in residents than medical students but generally improve for early career physicians. 21 In our analysis, PGY4-5 residents who are closer to beginning their careers as staff ophthalmologists did not have more negative attitudes towards the homeless population than PGY1-3s in the majority of items, with the exception of one psychosocial item. Additionally, medical students were more likely to agree with the statement "I feel overwhelmed by the complexity of the problems that homeless people have", which may be impacted by the lack of patient interactions in these early years of medical training.…”

Section: Discussionmentioning

confidence: 54%

The Attitudes of Canadian Ophthalmology Residents and Pre-Clerkship Medical Students at an Ontario Medical School Towards Homeless Individuals: A Cross-Sectional Study

Sayal

Popović

Mustafa

et al. 2020

Ophthalmic Epidemiology

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Purpose: This cross-sectional study assessed the attitudes of Canadian ophthalmology residents (PGY1-5) and pre-clerkship medical students (year 1 and 2) at the University of Toronto towards individuals experiencing homelessness. Methods: Residents and students were invited to complete the Health Professionals' Attitudes Towards the Homeless Inventory (HPATHI) tool to assess attitudes, interests and confidence in working with the homeless population on a 5-point Likert scale. Comparisons were made between residents and pre-clerkship learners and between junior and senior residents using the Fisher exact test and Mann-Whitney U test. Results: Responses were received from 114 of 220 ophthalmology residents (52%) and 315 of 534 (59%) pre-clerkship medical students. Ophthalmology residents had significantly more negative overall attitudes (pre-clerk median = 4.4, resident median = 4.1, both still indicating positive attitudes) and interests (pre-clerk median = 4.0, resident median = 3.3, residents with more neutral interests) towards working with the homeless population compared to pre-clerkship medical students. Using both statistical methods, beliefs were significantly more negative in 7 of 9 'Attitude' items, 5 of 5 'Interest' items and 1 of 4 'Confidence' items. Ophthalmology residents were only more positive in 1 of 4 of the 'Confidence' items. Attitudes were similar across PGY1-5 training years, except PGY4 and PGY5 residents were more negative than PGY1-3 residents on 1 of 5 'Interest' items. Conclusions: Ophthalmology residents have an at least neutral perception of individuals experiencing homelessness, while medical students have a more positive opinion. Studies exploring optimal ways to advocate for this population are needed for Canada's eye-care trainees.

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Section: Discussionmentioning

confidence: 54%

The Attitudes of Canadian Ophthalmology Residents and Pre-Clerkship Medical Students at an Ontario Medical School Towards Homeless Individuals: A Cross-Sectional Study

Sayal

Popović

Mustafa

et al. 2020

Ophthalmic Epidemiology

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“… 19 – 21 , 38 , 45 , 72 Data suggest the phenomenon of negative counter-transference in caring for PEH can develop as early as during training. 124 , 125 If left unchecked, negative stereotypes, bias, and perceptions can affect patient care, research, and advocacy efforts for this population. Thus, action must be taken to educate clinicians and researchers on implicit bias and counter-transference, and tools to address these are needed to reduce the impact on future research, perceptions of the interaction between surgical care and PEH, and consequently the health outcomes of PEH.…”

Section: Discussionmentioning

confidence: 99%

A scoping review of surgical care for people experiencing homelessness: prevalence, access, and disparities

Hircock,

Huan,

Pizzola

et al. 2024

cjs

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Background: Numerous studies have highlighted the inequitable access to medical and psychiatric care that people experiencing homelessness (PEH) face, yet the surgical needs of this population are not well understood. We sought to assess evidence describing surgical care for PEH and to perform a thematic analysis of the results. Methods: Ovid MEDLINE, Embase, and Web of Science were searched using the terms “surgery” AND “homelessness.” Grey literature was also searched. We used a stepwise scoping review methodology, followed by thematic analysis using an inductive approach. Results: We included 104 articles in our review. Studies were included from 5 continents; 63% originated in the United States. All surgical specialties were represented with varying surgical conditions and procedures for each. Orthopedic surgery (21%) was the most frequently reported specialty. Themes identified included characteristics of PEH receiving surgical care, homeless-to-housed participants, interaction with the health care system, educational initiatives, barriers and challenges, and interventions and future strategies. Conclusion: We identified significant variation and gaps, representing opportunities for further research and interventions. Further addressing the barriers and challenges that PEH face when accessing surgical care can better address the needs of this population.

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Bringing Health Professions Education to Patients on the Streets

2021

AMA Journal of Ethics

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This article considers strategies for illuminating health systems' structural violence toward people experiencing homelessness and for resisting incursion of moral injury to health professional learners. This article also canvasses the nature and scope of educators' obligations to teach in patient-focused ways that motivate equity and students' capacity to serve some of the country's most vulnerable residents in clinical settings or on the streets.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity. Resisting Education Embedded in ViolenceMedical education is at a threshold for much-needed change. Although academic health learning models in the United States have standardized and improved health professional training, the patients served (particularly excluded populations) often just don't get their health needs met by clinicians and organizations. 1,2,3,4,5,6 Medical education is embedded in structurally violent systems in which the well-being of many patients (eg, those suffering domestic violence, addiction, or homelessness) is largely ignored. Patients experience dehumanization and students may too easily become coconspirators. 2,3,6,7 The process through which students are desensitized has been referred to as the hidden curriculum and is a form of moral injury. 8 Medical educators have made efforts to bridge the reality gap between traditional health systems and the real lives of patients through an emphasis on patient-centered care, the social determinants of health, health disparities and equity, narrative medicine, and other frameworks that shift the focus from the health system to those it should serve. 1,3,7,8,9 However, these efforts still fail to provide the transformative experience that a truly immersive setting might provide. In this article, we will discuss how street medicine can serve that role in medical education.A Classroom of the Streets Street medicine is an emerging field of practice throughout the world. It is defined as the direct provision of health care to those experiencing unsheltered homelessness. 4 Teams of health and social service experts regularly visit rough sleepers where they live in

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Medical Student Self-Efficacy and Attitudes toward Homeless Patients

Cited by 8 publications

References 17 publications

The Attitudes of Canadian Ophthalmology Residents and Pre-Clerkship Medical Students at an Ontario Medical School Towards Homeless Individuals: A Cross-Sectional Study

The Attitudes of Canadian Ophthalmology Residents and Pre-Clerkship Medical Students at an Ontario Medical School Towards Homeless Individuals: A Cross-Sectional Study

A scoping review of surgical care for people experiencing homelessness: prevalence, access, and disparities

Bringing Health Professions Education to Patients on the Streets

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