Teaching health-care trainees empathy and homelessness IQ through service learning, reflective practice, and altruistic attribution

Abstract

This article describes a novel inter-professional curriculum designed to address the needs of homeless patients in a Midwestern region of the United States which has high rates of poverty. The curriculum is intended for healthcare trainees coming from undergraduate pre-medical programs, nursing, pharmacy, social work, clinical psychology, medical school and post-graduate medical training in family medicine, medicine-pediatrics, and psychiatry. The clinical component is specifically designed to reach destitute patients and the curriculum is structured to reverse commonly held myths about homelessness among the trainees, thereby improving their Homelessness Information Quotient, the ability to more fully understand homelessness. Participants across all disciplines and specialties have shown greater empathy and helper behavior as determined by qualitative measures. Learners have also developed a greater understanding of health-care systems allowing them to more consistently address social determinants of health identified by the authors as their Disparity Information Quotient. This article outlines the process of initiating a homeless service program, a curriculum for addressing common myths about homelessness and the effective use of narrative methods, relational connections, and reflective practice to enable trainees to process their experience and decrease burnout by focusing on the value of altruism and finding meaning in their work.

Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study

“…This research builds on past work to understand how medical students and the institutions they are a part of can better care for people who are houseless, including through the development of socially-conscious medical schools as a whole [30][31][32][33]. Medical students have pushed to improve didactic [20,[23][24][25][26] and clinical [25,[27][28][29] opportunities to care for people who are houseless. These programs have helped support the professional development and education of other medical students, but have not always given space to community members to make their needs, preferences, and experiences heard.…”

“…Extensive research from medical schools and students across the country has sought to take advantage of each of these role-characteristics to improve care for people who are homeless within institutions. This research focused primarily on improving attitudes and knowledge around houselessness among medical students [17][18][19][20][21][22]; altering didactic medical education to include training on caring for people who are houseless or otherwise excluded from care [20,[23][24][25][26]; facilitating opportunities to care for people who are houseless in clinical settings [25,[27][28][29]; and more broadly improved the social accountability of medical schools and the institutions they are a part of [30][31][32][33]. These efforts are significant not only for enacting change at the institutional level, but also for preparing the next generation of physicians to provide full-spectrum and empathic care to people who are houseless.…”

Understanding Homelessness: A Call to Action and Curriculum Framework for Psychiatry Residencies

“…Some training sites have developed educational initiatives designed to improve provider empathy toward patients who are homeless. One interprofessional clinical curriculum incorporated narrative work and reflective practices, which led to improvements in trainee empathy and helper behavior toward patients who were homeless [69].…”

Improving the Attitudes to Homeless Persons in a Family Medicine Residency

“…For instance, the Doctors-On-The-Street program was started by the Metro Health Medical Center Family Medicine Residency in Cleveland, Ohio. 10 The program trains learners to offer “doctor-mom/dad” skills to homeless persons—they give hugs and listen to them, provide over-the-counter medications and supplies, and provide limited skin and foot care and basic health screenings. Qualitative data showed improved empathy and understanding of homelessness by student learners.…”