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A group of clinicians and academics came together with a commitment to working on and improving Inclusion Health. Julie Broderick and Clíona Ní Cheallaigh tell us more about this unique initiative as they go into detail about the steps they and their team are taking to update the undergraduate curriculum, so that it addresses the complex societal challenges in health education, as covered in their open letter published on HRB Open Research, a partner platform with the Health Research Board.

Tackling health inequality

Inclusion health is an approach that aims to address the extreme health inequalities experienced by socially excluded, such as people experiencing homelessness, Travellers and Aboriginal/First Nation people, people with substance disorders, sex workers and prisoners. We know that people who are socially excluded are among the most vulnerable in our society and have often experienced adversity and trauma throughout their lives since childhood. Many experience complex health issues as well as other problems related to addiction and social exclusion, which results in a much lower life expectancy.

By formally integrating the topic of inclusion health into the undergraduate curriculum we are taking positive steps to ensure graduates will be equipped with the skills to adapt services as well as their approach to meet the complex needs of these groups. Our aim is that our graduates will be skilled, empathetic, non-judgemental and innovative clinicians to help drive better health outcomes for these vulnerable groups.

We put some time into the organisation of this placement and ensured a comprehensive orientation took place. The main client group assessed and treated by students were in-patients of St. James’s Hospital who were experiencing homelessness.

Another facet of the placement was the design, set-up and delivery of a student led exercise class in a residential hostel for homeless adults in the local area. Students also attended GP-led clinics for refugees in the direct provision system and observed a dedicated clinic for Roma people.

A quality learning environment

The success of this placement can be attributed to the students themselves, including Sofia Hodalova and Sorcha Feehan from the Discipline of Physiotherapy, Trinity College, who engaged positively and were highly motivated and committed to this placement. Dr. Julie Broderick and Lucy Alpine were also engaged from an academic standpoint from the Discipline of Physiotherapy, Trinity College.  The lead Consultant in this area Dr. Clíona Ní Cheallaigh and Physiotherapy Manager, Niamh Murphy, were key players in this initiative and were also hugely supportive. The support of the Physiotherapy Clinical Tutors in St. James’s Hospital who supervised the students was also crucial as they provided a quality learning environment and ensured that learning objectives were met.

We have already incorporated this topic into the formal undergraduate physiotherapy curriculum. The focus so far has been on homelessness and migrant health. We have plans to extend this further in the next academic year.

Learning from our experience

We chose to publish in HRB Open Research as we believe this initiative was unique and was worth sharing, so others may learn from our experience. Some of the authors had experience of the impressive speed of publication and reach of HRB Open Research, so were keen to use this platform again. We also appreciated the open transparent peer-review. Our experience was very positive and we hope to work with HRB Open Research in the future.