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June 3, 2026Academic Medicine0 citationsOpen Access

Patients experiencing unsheltered homelessness as educators for physician assistant and medical students: a longitudinal program

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AMAnuva MittalAKAlexis Coulourides KoganELEnya Lowe

Key Points

  • The aim was to evaluate the effectiveness of a longitudinal program designed to educate health professions students about caring for unsheltered populations.
  • Implemented the Trojan Trainer program at the Keck School of Medicine over a 12-month period from 2021 to 2023.
  • Engaged medical (MD) and physician assistant (PA) students in small groups weekly with unhoused individuals to provide non-medical social support.
  • Administered pre- and post-surveys to assess changes in knowledge and confidence related to unsheltered populations.
  • 108 students participated in the program over three years with a significant increase in knowledge and confidence levels (P < .001).
  • The experiential learning approach significantly enhanced students' understanding and ability to care for unsheltered populations.
  • Findings indicate a pressing need for similar service-learning opportunities in medical education to prepare health professionals.

Abstract

Abstract 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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Cite This Study

Mittal et al. (2026) studied this question.

synapsesocial.com/papers/6a1fc47adee9eb8c0dce6088https://doi.org/10.1093/acamed/wvag167
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