Developing attitudes in developing doctors: Addressing attitudinal health care barriers for homeless children and families S/A

Objective: Effective patient care must address the negative attitudes of health professionals that act as a barrier to health services for homeless children and families. Prior research has revealed that medical students' attitudes towards homeless populations may become increasingly negative over the course of medical school. An effective method to counteract this negative trend is to provide meaningful exposure to this population through service learning. Unlike prior studies, this unique investigation assesses attitudes towards homeless children and youth. Methods: This study conducts qualitative interviews with first year pediatric residents at Children's Hospital and Research Center Oakland participating in the Community, Advocacy and Primary Care rotation curriculum on homelessness to understand attitudes towards homeless children and families. Results: The results of the study consider the effects of cognitive, affective, and behavioral exposure on medical residents as they formulate opinions, feelings, and practices. Contrary to expectations, the interviews reveal that attitude does not simply progress in a uni-linear trajectory, but instead is comprised of often conflicting feelings and thoughts not easily dichotomized into “positive” and “negative” terms. Conclusions: Therefore, while curriculum and rotation may better equip residents to deliver more appropriate services, additional interventions need to be developed to help residents overcome their frustrations at the limitations of their ability to “fix” homeless children's medical problems. These results have important social justice implications for homeless and health care policies, medical education and residency, and multi-disciplinary collaborations towards health care provision that may improve the effectiveness of health services for all homeless populations.