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Amplifying Marginalised Voices Through Advocacy: Community-Informed Curriculum Development for Cultural Safety in
Clare Puddifoot1, Eleanor Cape1, Leanne C Doherty2
1Ulster University School of Medicine, Derry-Londonderry, UK.
Background:
People experiencing homelessness face significant health inequities, yet their voices remain largely absent from medical education. Partnering with community-based advocates enables the integration of lived experience and advocacy expertise into curriculum design and delivery. This study aimed to develop and evaluate a medical education module on homeless health that embeds community-based advocacy and lived-experience expertise to advance cultural safety.
Approach:
A homelessness health module was collaboratively developed by clinical teachers, researchers, educators and community advocates with lived and professional experience of homelessness. Guided by Kern's Six Steps of Curriculum Development, a targeted needs assessment was conducted through a focus group with community advocates. Insights informed six learning objectives and the design of interactive teaching sessions. The module was delivered to second-year graduate-entry medical students and evaluated using open-ended questionnaires exploring students' understanding of cultural safety and advocacy in homeless health.
Evaluation:
Fifty-three students (33%) submitted open-ended questionnaires. Deductive content analysis confirmed alignment with themes identified during the needs assessment, with most students recognising life experiences (69%), demographic hardship (65%) and healthcare access barriers (69%) as central to homelessness. Inductive thematic analysis revealed additional themes related to survival priorities and medication adherence barriers.
Implications:
Embedding community voices and patient perspectives shaped curriculum content, delivery and evaluation. Students developed compassion, reflexivity and a deeper awareness of inequities. This accessible, scalable model demonstrates how cultural safety can be embedded in inclusion health education.
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