Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes Toward Homeless Persons

Abstract

Results suggest that medical students showed small differences in their attitudes toward homeless people following clerkships in Psychiatry but not in Emergency Medicine. Regarding resident and faculty results, significant differences between specialties were noted, with Psychiatry residents and faculty exhibiting more favorable attitudes toward homeless persons than residents and faculty in Emergency Medicine. Given that medical student competencies should be addressing the broader social issues of homelessness, medical schools need to first understand the attitudes of medical students to such issues, and then develop curricula to overcome inaccurate or stigmatizing beliefs.

What Are We Communicating When We Present the Diagnosis of PNES?

“…Education is a powerful tool for change. It has been shown to decrease negative attitudes for psychiatric or other stigmatized conditions (11). Modifying residency curricula to train on these issues may lead to improvement in patient care and healthcare delivery.…”

Teaching Medical Students and Residents about Homelessness: Complex, Evidence-Based, and Imperative

“…In addition to assisting residents and staff, the students in this program learned about the barriers to care for the homeless population and what kinds of leadership skills were necessary to address them. Morrison et al [17] reported that experiences with homeless patients in the context of the psychiatry clerkship can result in an increase in positive attitudes of medical students toward this population, possibly related to the implicit attitudes of the faculty and residents they worked with. Recently, Fleisch et al [18] reported on a street psychiatry rotation for residents, which focused on learning to engage homeless people on the street in order to connect them with case management.…”

“…These experiences can test the limits of one's identity as a physician and healer and can exhaust one's wellspring of compassion, leading to the adoption of self-protective attitudes and behaviors (e.g., distancing from patients psychologically or dedicating less time to the care of homeless patients) [22]. As with other difficult patients, educators should incorporate supervisory systems to monitor and to rapidly respond to student reactions that might distort clinical judgment and care [17,23]. The professional virtue of self-effacement is critical to this work [24].…”

Critical Appraisal of Emergency Medicine Education Research: The Best Publications of 2012

“…The sources of funding were as follows: five federal (two NIH, one Canada, and one Taiwan), five universitysponsored, two industry-supported, and two organizationally funded. Research methodology included 17 surveys (36%), 17,19,21,25,30,31,33,37,40,42,46,[50][51][52]54,60,61 15 (31%) observational analyses, [14][15][16]22,23,27,32,33,38,44,47,49,56,57,59 and three (6%) qualitative methodology studies. 19,28,45 There were only 12 (25%) with an experimental or quasi-experimental study design, 20,24,26,35,36,39,41,43,48,53,55,57 with five of the highlighted articles using this rigorous design.…”

“…Three (6%) appeared in medical education journals, and nine (19%) were published in journals ranging from surgery 33,42,44,54 to psychiatry. 31,52 Others included palliative medicine, 26 critical care, 56 and simulation. 38 Most articles (81%) had authors with an EM affiliation.…”