Paramedic student empathetic attitudes towards homelessness: a mixed methods pilot study

Abstract

PurposeCurrent statistics highlight the increasing prevalence of homelessness in Australia, however, there is scant research regarding empathy and homelessness in the paramedic literature. Research in other areas of healthcare demonstrates that interaction with the homeless can positively impact empathetic attitudes and also highlights the opportunity to examine if these results are consistent or generalisable to the Australian paramedic profession. Therefore, the aim of our study was to explore paramedic students' empathetic attitudes towards homelessness.Design/methodology/approachA sequential mixed method design study was undertaken using a repeated measures and focus group approach. Paramedic students participated in clinical experience, involving interactions with the homeless. This entailed participating in at least four shifts (11 pm – 5 am) where students gained experience at the Salvation Army Health Café or with the Youth Street Teams in Melbourne, Australia. Empathy levels of the paramedic students toward homelessness, both pre- and post- were measured using the Medical Condition Regard Scale (MCRS) and the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI). A focus group with student participants was also conducted to obtain further detailed information about their perceptions of the experience.FindingsA total of 20 students participated (100% response rate). Statistically significant (p < 0.05) increases were observed on the MCRS pre- to post- data with total mean scores of 48.35 (SD ± 8.33) and 51.65 (SD ± 5.56), respectively. On the HPATHI a statistically significant (p < 0.0001) increase in Personal Advocacy was observed. Eight of these students took part in a subsequent focus group. Following thematic analysis of the focus group, a number of common themes were identified that included: communication, empathy and rapport, and a change in perception and attitude.Originality/valueThe results of this pilot study demonstrate that through participation in a project involving experience interacting with the homeless population, paramedic students showed a greater level of empathy towards the homeless. Increases in empathetic regard, social advocacy and personal advocacy were also found.

Undergraduate paramedic students and interpersonal communication development: a scoping review

“…In 12 interviews, Ross and Kabidi ( 2017 ) discovered that this opportunity to practice communication led to an increased confidence and the development of new communication strategies. Similarly, the focus groups conducted by Prakash et al ( 2020 ) highlighted that students immersed in this environment were afforded the opportunity to practice and hone communication skills such a rapport building. Furthermore, semi-structured interviews conducted by Credland et al ( 2020 ) regarding a hospital-based WIL placement, highlighted that students were able to observe and practice various communication strategies with multiple patients, as well as gain experience with inter-disciplinary communication.…”

“…Non-ambulance work-integrated learning (WIL) experiences within the community (Ross & Kabidi, 2017 ; Prakash et al, 2020 ), and in hospital (Credland, et al, 2020 ) were examined in 3 publications. Whilst communication was not the primary outcome under investigation, it was an area of development reported by students.…”

“…Whilst communication was not the primary outcome under investigation, it was an area of development reported by students. On community-based WIL placements, students were exposed to areas of the community they had not interacted with before and this led to the development of empathy and led students to recognising unconscious biases that they may have held prior to the placement (Prakash et al, 2020 ; Ross & Kabidi, 2017 ). In 12 interviews, Ross and Kabidi ( 2017 ) discovered that this opportunity to practice communication led to an increased confidence and the development of new communication strategies.…”

“…Practise in this manner appears to build students comfort and confidence in their interpersonal communication skills (Credland et al, 2020 ; Furseth et al, 2016 ; Johnston et al, 2014 ; Lucas et al, 2015 ; Ross & Bertucci, 2014 ; Ross & Williams, 2014 ; Stratton et al, 2015 ). Through this interaction, students are able to discover their own weaknesses and strengths in their current communication ability (Ford et al, 2014 ; Prakash et al, 2020 ; Ross & Kabidi, 2017 ; Ross et al, 2018 ) and students consider more opportunities to obtain practical experience as a way to develop their communication ability further (O’Brien et al, 2013 ; Twinley, 2012 ). Additionally, in the literature review by Ross ( 2013 ), a similar conclusion was drawn, that the use of ‘real patients’ to develop interpersonal communication skills, when introduced early and purposefully within a HCP training, can lead to an increased confidence and ability to build rapport thus supporting the findings from this review.…”

“…Additionally, in the literature review by Ross ( 2013 ), a similar conclusion was drawn, that the use of ‘real patients’ to develop interpersonal communication skills, when introduced early and purposefully within a HCP training, can lead to an increased confidence and ability to build rapport thus supporting the findings from this review. Furthermore the research shows that practising communication with specific patient groups, or with new groups of people that students had not interacted with before, appears to highlight unconscious biases that students may have held and encourages them to question stereotypical ideas they may have felt (Prakash et al, 2020 ; Ross & Kabidi, 2017 ; Stratton et al, 2015 ). These interactions lead to students developing empathy (Lucas et al, 2015 ; Prakash et al, 2020 ; Ross & Williams, 2014 ; Ross et al, 2018 ).…”