title: Medical education for equity in health: a participatory action research involving persons living in poverty and healthcare professionals.
abstract: BACKGROUND
  Improving the knowledge and competencies of healthcare professionals is crucial to better address the specific needs of persons living in poverty and avoid stigmatization. This study aimed to explore the needs and expectations of persons living in poverty and healthcare professionals in terms of medical training regarding poverty and its effects on health and healthcare.
  
  
  METHODS
  We conducted a participatory action research study using photovoice, a method using photography, together with merging of knowledge and practice, an approach promoting dialogue between different sources of knowledge. Nineteen healthcare professionals and persons from an international community organization against poverty participated in the study. The first phase included 60 meetings and group sessions to identify the perceived barriers between persons living in poverty and healthcare teams. In the second phase, sub-committees deployed action plans in academic teaching units to overcome barriers identified in the first phase. Data were analysed through thematic analysis, using NVivo, in collaboration with five non-academic co-researchers.
  
  
  RESULTS
  Four themes in regard to medical training were highlighted: improving medical students' and residents' knowledge on poverty and the living conditions of persons living in poverty; improving their understanding of the reality of those people; improving their relational skills pertaining to communication and interaction with persons living in poverty; improving their awareness and capacity for self-reflection. At the end of the second phase, actions were undertaken such as improving knowledge of the living conditions of persons living in poverty by posting social assistance rates, and tailoring interventions to patients' reality by including sociodemographic information in electronic medical records. Our findings also led to a participatory research project aiming to improve the skills and competency of residents and health professionals in regard to the quality of healthcare provided to persons living in poverty.
  
  
  CONCLUSIONS
  Medical training and residency programs should aim to improve students' and residents' relational skills, more specifically their communication skills, as well as their awareness and capacity for self-reflection, by helping them to identify and recognize their biases, and limitations.
authors.affiliation: Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, 3001 12e avenue Nord, Sherbrooke, QC, Canada. catherine.hudon@usherbrooke.ca.
authors.forename: Catherine
authors.initials: C
authors.lastname: Hudon
authors.affiliation: Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, 3001 12e avenue Nord, Sherbrooke, QC, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Loignon
authors.affiliation: Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, 3001 12e avenue Nord, Sherbrooke, QC, Canada.
authors.forename: Cristina
authors.initials: C
authors.lastname: Grabovschi
authors.affiliation: Department of Family Medicine, McGill University, 5858 chemin de la Côte des Neiges, Montreal, QC, Canada.
authors.forename: Paula
authors.initials: P
authors.lastname: Bush
authors.affiliation: Centre de santé et de services sociaux de Chicoutimi, 305 rue Saint-Vallier, Chicoutimi, QC, Canada.
authors.forename: Mireille
authors.initials: M
authors.lastname: Lambert
authors.affiliation: Charles-LeMoyne Research Centre, 150 Place Charles-LeMoyne, Longueuil, QC, Canada.
authors.forename: Émilie
authors.initials: É
authors.lastname: Goulet
authors.affiliation: ATD (All Together in Dignity) Fourth World Movement, an international community organization against poverty, 6747 rue Drolet, Montreal, QC, Canada.
authors.forename: Sophie
authors.initials: S
authors.lastname: Boyer
authors.affiliation: ATD (All Together in Dignity) Fourth World Movement, an international community organization against poverty, 6747 rue Drolet, Montreal, QC, Canada.
authors.forename: Marianne
authors.initials: M
authors.lastname: De Laat
authors.affiliation: Academic Primary Care Unit Charles-LeMoyne, 299 boulevard Sir-Wilfrid-Laurier, Saint-Lambert, QC, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Fournier
mesh_terms: D003142:Communication; D003479:Curriculum; D004501:Education, Medical; D006297:Health Services Accessibility; D006302:Health Services Research; D054625:Healthcare Disparities; D006801:Humans; D020380:Needs Assessment; D011203:Poverty
keywords: Equity; Medical education; Participatory research; Poverty; Primary healthcare