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Teaching Culture and Community in Primary Care: The Community as Teacher. Teaching Culture and Community: The Community as Teacher. After this session, you will be able to: Address knowledge needs regarding cultural issues in the community setting - PowerPoint PPT Presentation
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©2003 Community Faculty Development Center
Teaching Culture and Community in Teaching Culture and Community in Primary Care:Primary Care:
The Community as TeacherThe Community as Teacher
©2003 Community Faculty Development Center
Teaching Culture and Community: Teaching Culture and Community: The Community as TeacherThe Community as Teacher
After this session, you will be able to:
• Address knowledge needs regarding cultural issues in the community setting
• Augment the GNOME planning process to include service-learning methodologies
• Use the principles of service-learning to plan a community-based learning experience for incorporation into your practice
©2003 Community Faculty Development Center
Where have we been?Where have we been?
©2003 Community Faculty Development Center
Needs AssessmentNeeds Assessment
• Self-assessment• Assess level of ethno-
sensitivity• Assess skill level of
learner in the context of trans-cultural interviewing
CULTURALLY EGOCENTRICCULTURALLY EGOCENTRIC
CULTURALLY SENSITIVECULTURALLY SENSITIVE
MINIMIZATION
©2003 Community Faculty Development Center
• Attitudes and values:– Celebration of diversity
– Recognition of cultural biases
– Respect for all health beliefs
– Avoid assumptions and stereotypes
• Skills: – Patient Centered Interviewing
– Social Context Review of Systems
– LEARN model
ObjectivesObjectives
©2003 Community Faculty Development Center
MethodsMethods
• Appropriate Use of Teaching Styles Reflection
• Modeling• Role Play
©2003 Community Faculty Development Center
EvaluationEvaluation
• Characteristics feedback in context of cultural learning objective
• Encourage self-assessment– Facilitates self-reflection
– Promotes self-awareness
• Refer to specific, observed behaviors– No presumption of attitude
– Provides opportunity for change and growth
©2003 Community Faculty Development Center
• Knowledge Objectives– Population health
– Outcome disparities
– Exploring history and cultural norms of specific groups
– Explore the culture of the community in which you are practicing
What’s missing?What’s missing?
©2003 Community Faculty Development Center
A Little Knowledge is …A Little Knowledge is …
• ENLIGHTENING!– Historical context
– Geography
– Cultural Norms
• Facilitate asking pertinent positive and negative questions
• Leads to efficiency
©2003 Community Faculty Development Center
A Little Knowledge is A Little Knowledge is ……
• DANGEROUS!– Context needs to be
seen as general
– To avoid stereotype, still must get patient’s perspective
©2003 Community Faculty Development Center
ScenarioScenario
• A student from your practice in Worcester, MA is seeing a Mexican American with Type II diabetes mellitus. The student comments on the apparent frequency of diabetes in Hispanics and wonders if this is a problem for Mexican-Americans as well as Puerto Ricans (the majority Latino culture). To what resources would you point your learner?
©2003 Community Faculty Development Center
Population HealthPopulation Health
- HHS Race and Health Home Page
- Census Bureau Home Page
- CDC Diabetes Resource
- CDC's Diabetes Program - Statistics
Links
©2003 Community Faculty Development Center
Scenario, Part 2Scenario, Part 2
Now that the student knows about the increased prevalence of diabetes, she is interested in knowing if there is specific help with dietary counseling available.
©2003 Community Faculty Development Center
Latinos and DiabetesLatinos and Diabetes
- Welcome to DiversityRx-March- Mexican American Diets and Diabetes- Nutritional Materials in Spanish- Latin American Food Pyramid
Links
©2003 Community Faculty Development Center
Other Reference MaterialsOther Reference Materials
• Bibliographies for web sites• “Pocket texts”• Its in your handout!
©2003 Community Faculty Development Center
But, is knowledge enough???But, is knowledge enough???
• General information– May not apply in your community
– Acculturation: Process of adapting from one culture to another.
• Expertise– Doctors are “experts”
– May not be the expert on this.
• Solution– Draw on expertise of others
– Structure community experiences for deep learning
©2003 Community Faculty Development Center
The Community as Teacher: The Community as Teacher: How have you done it?How have you done it?
Please think for a minute of an educational experience in which you were sent out into a non-medical community setting?
What did you learn? How?
©2003 Community Faculty Development Center
CONCEPT: SERVICE- LEARNING
"A structured learning experience that combines community service with preparation and reflection. Service-learning students not only provide community service, but also learn about the context in which the service is provided”
S. Saefer, 2002
The Community as TeacherThe Community as Teacher
©2003 Community Faculty Development Center
Service-LearningService-Learning
Volunteerism Practicum
Community Service Field Education
Service-Learning
Community Beneficiary Provider
Service Activity Learning
©2003 Community Faculty Development Center
• Include more community sites and build long term relationships.
• Develop a service learning experience using service-learning objectives
• Develop an orientation component• Develop a reflection component • Integrate an evaluation component• Promote the professional ethic of service
Service Learning Protocol for Service Learning Protocol for Health Professionals SchoolsHealth Professionals Schools
©2003 Community Faculty Development Center
• IS:Partnership: educators and
communityLearning objective connected
to service.Real service, meeting an
unmet need.Reflection component.Applicable in future personal
and professional life.Equitable
• IS NOTNot just volunteering.Not just a clinical experience
Not a chance to show how
much you know.Not a chance to hone your
skills.Not just an individual
relationship* *(although it can start there)
What is Service-Learning?What is Service-Learning?
©2003 Community Faculty Development Center
WHAT NEXT?Abstract
Conceptualization
SO WHAT? Reflective Observation
WHAT?Concrete
Experience
ACTION!Active
Experimentation
Reflection is the hyphen in Reflection is the hyphen in Service-LearningService-Learning
©2003 Community Faculty Development Center
Reflective MethodsReflective Methods
• Before:– Briefing, essay(pre), self evaluation(pre), writing goals/
learning contract, on-line journal
• During:– Self-evaluation, community partner or faculty review.
• After:– Essay(Post), Self-Evaluation(Post), essay based on on-
line journal, review of learning contract.
©2003 Community Faculty Development Center
How to make it work?How to make it work?
Medical student has just seen a 6 y/o well child whose mother is deaf, and for whom the child is the interpreter. The student doesn’t know ASL, available resources for deaf persons nor much about deaf culture. You don’t know much about it either.
What can you do?How could you structure the experience?
Please discuss with your neighbor for 2 minutes.
©2003 Community Faculty Development Center
• Surveys and Scavenger Hunts• Community reading day• Visit a home with a home
visitor• Writing newspaper articles.• Consulting with HeadStart on
lead poisoning• Interviewing the family of a
CSHCN
Service-Learning in PracticeService-Learning in Practice
©2003 Community Faculty Development Center
Practical Aspects of Service-Practical Aspects of Service-LearningLearning
• Build on existing relationships
• Negotiate the objectives
• Empower partners to teach
• Reflect with your learner
©2003 Community Faculty Development Center
What about Culture?What about Culture?
• S-L enables growth in the empathic stages:– Models collaboration and power-sharing– Demands reflection and insight– Values all participants
• S-L requires time and energy– Need to establish and maintain relationships– Need time and expertise to reflect
©2003 Community Faculty Development Center
SummarySummary
• Knowledge about culture is available, but requires context.
• Service-learning is a teaching method that can provide that context.
• Preceptors can incorporate service-learning into their precepting by building on existing relationships.