Investigating the attitudes of Canadian paramedic students towards homelessness.

IntroductionWhen paramedics are dispatched, it is expected that every patient receives the same level of care regardless of variable factors. Homelessness is a growing social issue across Canada that is particularly prevalent in urban areas. The quality of healthcare delivered to individuals experiencing homelessness may be influenced by negative attitudes held by healthcare professionals. There is an absence of literature quantifying the perspectives of paramedics towards homelessness; therefore, the focus of this study was to identify the attitudes of paramedic students towards homelessness and to continue the conversation in regards to the evolving educational needs of paramedic students. MethodsThis study employed a longitudinal design of a convenience sample of first year paramedic students in a college program in Ontario, Canada. The Health Professionals Attitude Towards the Homeless Inventory (HPATHI) was distributed to participants before and after placement and clinical exposure. The questionnaire includes 19 statements which participants respond to on a Likert scale. Mean scores were calculated, and statements were categorized into attitudes, interest, and confidence. Data were collected post-placement on interactions with persons experiencing homelessness. ResultsA total of 52 first year paramedic students completed the HPATHI pre-placement and 47 completed the questionnaire post-placement. Mean scores for attitudes (pre 3.64, SD 0.49; post 3.85, SD 0.38, p=0.032), interest (pre 3.91, SD 0.40; post 3.84, SD 0.39,p=0.51) and confidence (pre 4.02, SD 0.50; post 3.71, SD 0.67, p=0.004) were largely positive, but there was a demonstrated decreasing trend in confidence with, and interest in, working with those experiencing homelessness. Participants reported an average of 60 hours of placement, during which 15 participants (32%) reported interactions with people experiencing homelessness. ConclusionFirst year paramedic students demonstrate overall positive attitudes towards those experiencing homelessness, and the mean score for attitudes improved over the surveys. However, there were demonstrable decreases in confidence and interest over time, which may be related to the type and frequency of interactions during clinical placement. Paramedic education programs may benefit from the inclusion of focused education on homelessness, specific clinical experiences, and education related to social determinants of health.