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.

Keywords

medical education graduate medical education homelessness community inter-professional training reflective practice

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References

Smith RL. Ohio still years away from economic recovery, study shows, The Plain Dealer, http://www.cleveland.com/business/index.ssf/2013/07/ohios_economic_recovery_could.html (accessed 22 April 2016).

Poverty in Cuyahoga county, http://www.neoch.org/poverty-stats-2017/ (accessed 23 March 2017).

Bossaller J. Service learning as an innovative pedagogy in online learning. Education for Information 2016; 32 (1), 35–53.

Brainard

et al.

Learning professionalism: a view from the trenches. Acad Med 2007; 82: 1010–1014.

Cruess

. Teaching professionalism: general principles. Med Teach 2006; 28: 205–208.

Gillis

Dickerson

Hanson

. Recovery and homeless services: new directions for the field. Open Health Serv Pol J 2010; 3: 71–79.

Benston

. Housing Programs for homeless individuals with mental illness: effects on housing and mental health outcomes. Perspect Med Educ 2016; 5: 154–162. DOI: 10.1007/s40037-016-0270-8.

Baribeau D, Ramji N, Slater M, et al. An advocacy experience for medical students. Clin Teach 2017; 14: 15–19. DOI:10.1111/tct.12495.

Kim

et al.

Healthcare barriers among severely mentally ill homeless adults: evidence from the five-site health and risk study. Admin Pol Ment Health 2007; 34: 363–375.

10.

Six things I want you to understand about being homeless in America, nationalhomeless.org (accessed 24 August 2017).

11.

Asgary

et al.

A collaborative clinical and population-based curriculum for medical students to address primary care needs of the homeless in New York City shelters. Psychiatr Serv 2015; 66: 806–816. DOI:10.1176/appi.ps.201400294.

12.

Clifasefi

et al.

Exposure to project-based housing first is associated with reduced jail time and bookings. Int J Drug Policy 2013; 24: 291–296. DOI: 10.1016/j.drugpo.2012.10.002.

13.

Dornan

et al.

How can experience in clinical and community settings contribute to early medical education? A BEME systematic review. Adm Policy Ment Health 2007; 34: 363–75.

14.

Baribeau

et al.

An advocacy experience for medical students. Med Teach 2006; 28: 3–18.

15.

Jarrell

et al.

Constructing the foundations for compassionate care: How service-learning affects nursing students’ attitudes towards the poor. Nurse Educ Pract 2014; 14: 299e303.

16.

Kasl

Yorks

. Do I really know you? Do you really know me? Empathy amid diversity in differing learning contexts. Adult Educ Q 2016; 66: 1–21. DOI:10.1177/0741713615606965.

17.

Knight

et al.

Service learning as a component of physician assistant education: the development of a compassionate practitioner. J Physician Assist Educ 2007; 18: 48–52.

18.

Langstraat

. Service-learning and critical emotion studies: on the perils of empathy and the politics of compassion. Mich J Community Serv Learn 2011; 17: 5–14.

19.

Adelman

et al.

Simulations and social empathy: domestic violence education in the new millennium. Violence Against Women 2016; 22: 1451–1462. DOI: 10.1177/1077801215625850.

20.

Gray

et al.

Social work students confront poverty’s impact in the community: a service learning project. J Baccalaureate Soc Work 2013; 18: 217–233.

21.

Hutchison M. The empathy project: Using a project-based learning assignment to increase first-year college students' comfort with interdisciplinarity. Interdisciplinary Journal of Problem-Based Learning 2016; 10(1). DOI: 10.7771/1541-5015.1580.

22.

Stratman

. Toward a pedagogy of hospitality: empathy, literature and community engagement. J Educ Christ Belief 2013; 17: 25–59.

23.

Trothen

. Engaging the borders: empathy, religious studies, and pre-professional fields. Theology and Religion 2016; 19: 245–263.