The Columbia-Harlem Homeless Medical Partnership: A New Model for Learning in the Service of Those in Medical Need

Batra, Priya; Chertok, Judy Sara; Fisher, Carl Erik; Manseau, Marc; Manuelli, Victoria; Spears, James M.

doi:10.1007/s11524-009-9386-z

Cited by 44 publications

(50 citation statements)

References 11 publications

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“…SL also supports students' professional identity formation, a core component of "professionalism", and a key strand in health care curricula (Woollard, 2006;Bentley & Ellison, 2007;Batra et al, 2009). North…”

Section: R MC Menamin Et Al 2014mentioning

confidence: 87%

Training socially responsive health care graduates: Is service learning an effective educational approach?

McMenamin¹,

McGrath²,

Cantillon³

et al. 2014

Medical Teacher

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Section: R MC Menamin Et Al 2014mentioning

confidence: 87%

Training socially responsive health care graduates: Is service learning an effective educational approach?

McMenamin¹,

McGrath²,

Cantillon³

et al. 2014

Medical Teacher

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“…Given that primary care of the marginalized is often fragmented (delivered by student-or volunteerrun clinics) and takes place in locations where people's living situations may be transient (eg, shelters), [35][36][37][38] quantitative research comparing the impact of continuity of care in marginalized populations as compared with the general population would be important. This research may help determine if continuity of care has a greater impact on the health of drug-using women as compared with women in the general population.…”

Section: Discussionmentioning

confidence: 99%

'Meeting People Where They're At': Experiences of Family Physicians Engaging Women Who Use Illicit Drugs

Woolhouse¹,

Brown²,

Thind³

2011

The Annals of Family Medicine

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PURPOSE There is little research exploring the experiences of family physicians caring for women who use illicit drugs. This study explores the experiences of these physicians in order to better understand the process of engaging these women in the patient-physician relationship. METHODSWe conducted a phenomenologic, qualitative study using individual, in-depth interviews with 10 family physicians working in inner-city Toronto and Ottawa, Ontario. An iterative and interpretive analysis was used.RESULTS Three broad themes emerged from the analysis. The predominant theme was that of the patient-physician relationship, which consisted of 2 phases: the engagement phase and the maintenance phase. During the engagement phase, issues such as access and women's experiences of trauma and violence were evident and impeded participants' ability to engage with this population. As such, the patient-physician relationship during the engagement phase was tenuous. Trust and presence were paramount during this phase. Once a family physician engaged a woman, the transition to the maintenance phase was made. Within the maintenance phase, 2 subthemes were identifi ed: continuity of care and "meeting people where they're at" (fi nding common ground). CONCLUSIONSThis study identifi ed a 2-phase process of the patient-physician relationship from the perspective of family physicians caring for women using illicit drugs: the engagement and maintenance phases. Our fi ndings identifi ed strategies to support the patient-physician relationship during each of these phases that have implications for improving the health of these women. Ann Fam Med 2011;9:244-249. doi:10.1370/afm.1225. INTRODUCTIONH aving a strong patient-physician relationship is good for one's health. Such a relationship may be especially important for marginalized women, such as those who use illicit drugs. Despite high use of emergency departments and walk-in clinics, 1-3 some studies have found marginalized women have low rates of outpatient visits and poor follow-up. [4][5][6] This pattern is contrary to that of women in the general population, who access the health care system more than men.7-9 Barriers these women face include spending time fi nding drugs, participation in sex work, homelessness, lack of health care coverage (eg, through loss of identifi cation), mental illness, lack of transportation, discrimination from health care clinicians, and distrust of the health care system. 4,[10][11][12][13][14][15][16][17] This lack of continuity is of particular concern given the high morbidity and mortality in this population. 11,15,17,[18][19][20][21][22][23] Just as a woman's health care needs are highest, her likelihood of accessing care is lowest.There is very little research studying the active role that family physicians can play in reducing the morbidity of women who use illicit drugs, particularly within the context of the patient-physician relationship. We speculate that higher rates of engagement in the patient-physician relationship will result in inc...

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“…Students reported that they were more confident at tackling the various steps of the care pathway: first screening, then clinical procedures, and finally encouraging compliance and providing non-medical assistance, eventually leading to better management of chronic disease. Clearly, bringing the student into the resident's home made for a better learning outcome; this beneficial approach could be replicated in similar service learning programs (Batra et al 2009). The reasons for this could possibly be due to differences in how the patients were seen, as well as the structure of the programs.…”

Section: Discussionmentioning

confidence: 99%

Doctors-to-be at the doorstep – Comparing service-learning programs in an Asian medical school

2011

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Background: Service-learning is a powerful, but underutilized, educational tool in Asian medical schools. Aim: We compared the ability of two programs providing medical care to low-income populations (clinic-based versus homebased approach) to teach community medicine skills in an Asian medical school. Methods: We conducted a cross-sectional study using a self-administered anonymized questionnaire on medical students who participated in the programs using the Fund for the-Improvement of Postsecondary Education Survey Instrument. Participants also gave an overall score for their learning experience in the programs. Results: Participation rates were 97.4% (760/780) and 95.8% (230/240) across the two programs. A majority of participants in either program felt that the experience helped them to improve in all domains surveyed. Regardless of whether one compared those who participated in either program or both programs, the home-based approach was superior at teaching communication skills, teamwork, identifying social issues, gaining knowledge, and applying knowledge. Improved knowledge on long-term management of chronic diseases ( ¼ 1.25, 95% CI, 0.55-1.96) was strongly associated with the overall score for those participating in the home-based program. Conclusions: Service-learning programs, in the Asian context, have potential educational value for medical students in a wide range of domains. The home-based approach is superior at teaching certain aspects of community care.

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The Columbia-Harlem Homeless Medical Partnership: A New Model for Learning in the Service of Those in Medical Need

Cited by 44 publications

References 11 publications

Training socially responsive health care graduates: Is service learning an effective educational approach?

Training socially responsive health care graduates: Is service learning an effective educational approach?

'Meeting People Where They're At': Experiences of Family Physicians Engaging Women Who Use Illicit Drugs

Doctors-to-be at the doorstep – Comparing service-learning programs in an Asian medical school

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