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Original article
peer-reviewed

An Inner City Emergency Medicine Rotation Does Not Improve Attitudes toward the Homeless among Junior Medical Learners



Abstract

Introduction

Learners in the emergency department (ED) frequently encounter individuals who are homeless. We sought to evaluate the effect of an inner city emergency medicine rotation at the Royal Alexandra Hospital (RAH) on the attitudes of medical students and residents towards this population.

Methods

Data were collected both pre- and post-rotation using an electronic survey. Data collected included demographic information and as well as scores on the Health Professionals’ Attitudes Towards the Homeless Inventory (HPATHI). Pre- and post-survey results were compared using Wilcoxon tests.

Results

Ninety-eight students completed the rotation. A total of 40 (41%) students completed both pre- and post-surveys. Demographic information was available for 66 respondents. Most participants were male (42 {64%}), single (47 {71%}), and 30 years of age or younger (59 {89%}). Most participants were of a Caucasian or East/South Asian background (61 {92%}) and grew up in an urban setting (51 {77%}). Overall, 43 (90%) participants saw at least one person who was homeless during their rotation. There was no significant difference between pre- and post-aggregate scores (z = -0.78, p = 0.44), or any of its three subscales (Personal Advocacy, Social Advocacy, and Cynicism).

Conclusion

First year residents and medical students are frequently exposed to patients who are homeless during an inner city ED rotation. Attitudes towards these patients did not significantly change following the rotation. Educational objectives should be set to improve attitudes of learners towards those with unstable housing throughout the ED rotation.



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Original article
peer-reviewed

An Inner City Emergency Medicine Rotation Does Not Improve Attitudes toward the Homeless among Junior Medical Learners


Author Information

Aaron Sibley Corresponding Author

Emergency Medicine, Dalhouse University, Halifax, NS.

Kathryn A. Dong

Department of Emergency Medicine, School of Community Based Medicine, University of Alberta

Brian H. Rowe

Department of Emergency Medicine, School of Community Based Medicine, University of Alberta


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Health Research Ethics Board of the University of Alberta issued approval. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Acknowledgements

Acknowledgements: This study was funded by the Kingsway Emergency Agency (Edmonton, AB). The authors would like to thank Christine Vandenberghe for her assistance with the statistical analysis. Dr. Rowe’s research was supported by a Tier I Canada Research Chair in Evidence-based Emergency Medicine from the Canadian Institutes of Health Research (CIHR) through the Government of Canada (Ottawa, ON). The funders take no responsibility for the execution, analysis, and interpretation of the study.


Original article
peer-reviewed

An Inner City Emergency Medicine Rotation Does Not Improve Attitudes toward the Homeless among Junior Medical Learners


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Original article
peer-reviewed

An Inner City Emergency Medicine Rotation Does Not Improve Attitudes toward the Homeless among Junior Medical Learners

Aaron Sibley">Aaron Sibley , Kathryn A. Dong">Kathryn A. Dong, Brian H. Rowe">Brian H. Rowe

  • Author Information
    Aaron Sibley Corresponding Author

    Emergency Medicine, Dalhouse University, Halifax, NS.

    Kathryn A. Dong

    Department of Emergency Medicine, School of Community Based Medicine, University of Alberta

    Brian H. Rowe

    Department of Emergency Medicine, School of Community Based Medicine, University of Alberta


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Health Research Ethics Board of the University of Alberta issued approval. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements

    Acknowledgements: This study was funded by the Kingsway Emergency Agency (Edmonton, AB). The authors would like to thank Christine Vandenberghe for her assistance with the statistical analysis. Dr. Rowe’s research was supported by a Tier I Canada Research Chair in Evidence-based Emergency Medicine from the Canadian Institutes of Health Research (CIHR) through the Government of Canada (Ottawa, ON). The funders take no responsibility for the execution, analysis, and interpretation of the study.


    Article Information

    Published: October 05, 2017

    DOI

    10.7759/cureus.1748

    Cite this article as:

    Sibley A, Dong K A, Rowe B H (October 05, 2017) An Inner City Emergency Medicine Rotation Does Not Improve Attitudes toward the Homeless among Junior Medical Learners. Cureus 9(10): e1748. doi:10.7759/cureus.1748

    Publication history

    Received by Cureus: August 04, 2017
    Peer review began: September 19, 2017
    Peer review concluded: October 03, 2017
    Published: October 05, 2017

    Copyright

    © Copyright 2017
    Sibley et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction

Learners in the emergency department (ED) frequently encounter individuals who are homeless. We sought to evaluate the effect of an inner city emergency medicine rotation at the Royal Alexandra Hospital (RAH) on the attitudes of medical students and residents towards this population.

Methods

Data were collected both pre- and post-rotation using an electronic survey. Data collected included demographic information and as well as scores on the Health Professionals’ Attitudes Towards the Homeless Inventory (HPATHI). Pre- and post-survey results were compared using Wilcoxon tests.

Results

Ninety-eight students completed the rotation. A total of 40 (41%) students completed both pre- and post-surveys. Demographic information was available for 66 respondents. Most participants were male (42 {64%}), single (47 {71%}), and 30 years of age or younger (59 {89%}). Most participants were of a Caucasian or East/South Asian background (61 {92%}) and grew up in an urban setting (51 {77%}). Overall, 43 (90%) participants saw at least one person who was homeless during their rotation. There was no significant difference between pre- and post-aggregate scores (z = -0.78, p = 0.44), or any of its three subscales (Personal Advocacy, Social Advocacy, and Cynicism).

Conclusion

First year residents and medical students are frequently exposed to patients who are homeless during an inner city ED rotation. Attitudes towards these patients did not significantly change following the rotation. Educational objectives should be set to improve attitudes of learners towards those with unstable housing throughout the ED rotation.



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Aaron Sibley, M.D., Assistant Professor

Emergency Medicine, Dalhouse University, Halifax, NS.

For correspondence:
asibley@ualberta.ca

Kathryn A. Dong

Department of Emergency Medicine, School of Community Based Medicine, University of Alberta

Brian H. Rowe

Department of Emergency Medicine, School of Community Based Medicine, University of Alberta

Aaron Sibley, M.D., Assistant Professor

Emergency Medicine, Dalhouse University, Halifax, NS.

For correspondence:
asibley@ualberta.ca

Kathryn A. Dong

Department of Emergency Medicine, School of Community Based Medicine, University of Alberta

Brian H. Rowe

Department of Emergency Medicine, School of Community Based Medicine, University of Alberta