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Patients experiencing unsheltered homelessness as educators for physician assistant and medical students: a
Anuva Mittal1, Alexis Coulourides Kogan1, Enya Lowe1
1Family Medicine and Geriatrics, USC Street Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, United States.
Problem:
As of 2024, the nation's homeless population has been steadily growing. However, there is no standardized education in caring for unsheltered populations in higher medical education. Experiential programs have the potential to increase students' knowledge of and confidence in caring for these individuals, but there is a lack of published research on longitudinal programs related to caring for this population. We designed, implemented, and evaluated a longitudinal 12-month educational innovation-Trojan Trainer-from 2021 to 2023 at the Keck School of Medicine at the University of Southern California (USC) on health professions students during their pre-clinical training.
Approach:
Based in constructivist learning theory and intentional redundancy to elevate cognitive, affective, and psychomotor domains, the Trojan Trainer program was created at USC to provide longitudinal experiential learning alongside more static classroom didactics. Emphasizing an interdisciplinary approach, medical (MD) and physician assistant (PA) students were put into small groups to meet weekly with an unhoused or temporarily housed individual, offering non-medical, social support. Pre- and post-surveys assessing students' knowledge of and confidence in caring for unsheltered populations were administered to student participants in the Trojan Trainer program during the 2021-2023 school years.
Outcomes:
108 PA and MD students participated in the program over three years. After the year-long experience, there was a statistically significant increase in the domains of knowledge of- and confidence in caring for people experiencing unsheltered homelessness across the combined MD and PA cohorts (P < .001).
Next Steps:
Education in caring for underserved populations is lacking at the training level for health professionals, leading to discomfort and uncertainty around caring for these patients later in their careers. Service-learning opportunities that focus on caring for unsheltered populations should be implemented early in health professionals' training.
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