title: Medical residents reflect on their prejudices toward poverty: a photovoice training project.
abstract: BACKGROUND
  Clinicians face challenges in delivering care to socioeconomically disadvantaged patients. While both the public and academic sectors recognize the importance of addressing social inequities in healthcare, there is room for improvement in the training of family physicians, who report being ill-equipped to provide care that is responsive to the living conditions of these patients. This study explored: (i) residents' perceptions and experience in relation to providing care for socioeconomically disadvantaged patients, and (ii) how participating in a photovoice study helped them uncover and examine some of their prejudices and assumptions about poverty.
  
  
  METHODS
  We conducted a participatory photovoice study. Participants were four family medicine residents, two medical supervisors, and two researchers. Residents attended six photovoice meetings at which they discussed photos they had taken. In collaboration with the researchers, the participants defined the research questions, took photos, and participated in data analysis and results dissemination. Meetings were recorded and transcribed for analysis, which consisted of coding, peer debriefing, thematic analysis, and interpretation.
  
  
  RESULTS
  The medical residents uncovered and examined their own prejudices and misconceptions about poverty. They reported feeling unprepared to provide care to socioeconomically disadvantaged patients. Supported by medical supervisors and researchers, the residents underwent a three-phase reflexive process of: (1) engaging reflexively, (2) break(ing) through, and (3) taking action. The results indicated that medical residents subsequently felt encouraged to adopt a care approach that helped them overcome the social distance between themselves and their socioeconomically disadvantaged patients.
  
  
  CONCLUSIONS
  This study highlights the importance of providing medical training on issues related to poverty and increasing awareness about social inequalities in medical education to counteract prejudices toward socioeconomically disadvantaged patients. Future studies should examine which elective courses and training could provide suitable tools to clinicians to improve their competence in delivering care to socioeconomically disadvantaged patients.
authors.affiliation: Family Medicine Department, Faculty of Medicine, Université de Sherbrooke (Longueuil Campus), 150 Place Charles Lemoyne, Room 200, Longueuil, QC, J4K 0A8, Canada. Christine.Loignon@usherbrooke.ca.
authors.forename: Christine
authors.initials: C
authors.lastname: Loignon
authors.affiliation: Department of Anthropology, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada. alexbf@uvic.ca.
authors.forename: Alexandrine
authors.initials: A
authors.lastname: Boudreault-Fournier
authors.affiliation: Center for Oral History and Digital Storytelling (COHDS), Concordia University, 1455 de Maisonneuve Blvd W, Montreal, QC, H3G 1 M8, Canada. karoline.truchon@gmail.com.
authors.forename: Karoline
authors.initials: K
authors.lastname: Truchon
authors.affiliation: Academic Primary Care Unit Charles-LeMoyne, 299, boulevard Sir-Wilfrid-Laurier, bureau 201, Saint-Lambert, QC, J4R 2 L1, Canada. yanoulabrousse@hotmail.com.
authors.forename: Yanouchka
authors.initials: Y
authors.lastname: Labrousse
authors.affiliation: Academic Primary Care Unit Charles-LeMoyne, 299, boulevard Sir-Wilfrid-Laurier, bureau 201, Saint-Lambert, QC, J4R 2 L1, Canada. bruno.fortin@usherbrooke.ca.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fortin
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D005194:Family Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D011203:Poverty; D011287:Prejudice; D013337:Students, Medical / Q000523:psychology*