Amplifying Marginalised Voices Through Advocacy: Community-Informed Curriculum Development for Cultural Safety in Homeless Health

Clare Puddifoot, Eleanor Cape, Leanne Doherty, Ayesha Younas, Suzanne Manning, Michelle Doyle, Gary Rutherford

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Abstract

Background
People experiencing homelessness face significant health inequities, yet their voices remain largely absent from medical education. Partnering with community-based advocates enables the integration of lived experience and advocacy expertise into curriculum design and delivery.

This study aimed to develop and evaluate a medical education module on homeless health that embeds community-based advocacy and lived-experience expertise to advance cultural safety.

Approach
A homelessness health module was collaboratively developed by clinical teachers, researchers, educators and community advocates with lived and professional experience of homelessness. Guided by Kern's Six Steps of Curriculum Development, a targeted needs assessment was conducted through a focus group with community advocates. Insights informed six learning objectives and the design of interactive teaching sessions. The module was delivered to second-year graduate-entry medical students and evaluated using open-ended questionnaires exploring students' understanding of cultural safety and advocacy in homeless health.

Evaluation
Fifty-three students (33%) submitted open-ended questionnaires. Deductive content analysis confirmed alignment with themes identified during the needs assessment, with most students recognising life experiences (69%), demographic hardship (65%) and healthcare access barriers (69%) as central to homelessness. Inductive thematic analysis revealed additional themes related to survival priorities and medication adherence barriers.

Implications
Embedding community voices and patient perspectives shaped curriculum content, delivery and evaluation. Students developed compassion, reflexivity and a deeper awareness of inequities. This accessible, scalable model demonstrates how cultural safety can be embedded in inclusion health education.
Original languageEnglish
Article numbere70314
Pages (from-to)1-12
Number of pages12
JournalThe Clinical Teacher
Volume23
Issue number1
Early online date16 Nov 2025
DOIs
Publication statusPublished online - 16 Nov 2025

Bibliographical note

© 2025 The Author(s). The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.

Funding

The authors have nothing to report.

Keywords

  • case-based learning
  • cultural humility
  • homelessness health
  • inclusion health
  • medical curriculum
  • patient and public involvement
  • case‐based learning
  • Cultural Competency - education
  • Students, Medical - psychology
  • Humans
  • Focus Groups
  • Male
  • Patient Advocacy
  • Ill-Housed Persons
  • Curriculum
  • Female
  • Needs Assessment
  • Cultural Competency/education
  • Students, Medical/psychology

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