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Social Issues in Medicine

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  1. Social Issues in Medicine Bridging Community and Medicine Mohan Nadkarni, MD, Course Director DarciLieb, MEd, Director, Instructional & Clerkship Support Dela Alexander, MSW, Course Administrator

  2. Course Purpose To introduce medical students to the complex socio-economic, cultural and policy issues that impact the practice of medicine and to promote an ethic of service.

  3. Social Issues in Medicine Learning Objectives • To address how social and cultural issues, gender, economics and policyimpact both the delivery of medical care and the health of populations. • To address how we understand humanism and professionalism in medicine. • To reflect on one’s practice and thereby increase the comfort level of future physicians in working with people different from themselves. • To develop partnerships between the University and community through which students may further their ethic of service.

  4. Course Highlights • Content talks • Curricular threads • Pre-clinical patient experience • Exposure to diverse populations • Student-initiated proposals for placements • Development of original health-related educational materials for particular populations • Ethic of service • Reflection and self-evaluation through written exercises, case reviews & discussions to achieve personal growth

  5. Service - Learninga pedagogical model • A structured, experiential learning activity that ties academic content to service in the community • Utilizes self reflection and evaluative exercises to • Link the service experience to the curriculum • Promote personal growth • Permits learner to make a contribution to the community AND develop new insights

  6. Course Format • In-class Content Talks by Community Experts & Faculty e.g. Poverty & Homelessness; Health Care Policy; Chronic Illness; Mental Health, LGBTQ Issues; Health Disparities • Community Service with a Partner Agency 30 hours in the field at a school, social service agency or health-related program • Reflection Exercises & Small Group Discussions in CPD (Clinical Performance Development) Class

  7. The Service in Service-Learning • Offering Concrete or Material Assistance (e.g. research; administrative tasks; delivering material resources to clients) • Advocacy (helping clients access services; directing clients to other services in the community) • Health Education • Outreach • Tutoring • Listening, Offering Empathy/Support • “Being” With Another; Affirming the Other’s Humanity & Pain

  8. TheLearningin Service-Learning Learning About… • The conditions & challenges faced by the target population • Agency services – How might they be helpful to future patients? • The network of social services • Helping strategies employed by agencies: i.e. counseling; material support; case management; financial assistance; etc.

  9. Community Partner Visits Talking with at-risk children about visiting a doctor.

  10. Community Experiences Talking about nutrition with a young patient at the children’s dental clinic. Community Children’s Dental Center

  11. Community Experiences Meeting with parents of preschool children in a local pre-school to discuss nutrition and behavior management.

  12. Community Experiences Tutoring a child in an after-school program

  13. Community Experiences Chatting with a senior in the local adult care center

  14. Community Experiences Medical student assists therapist in Horses as Healers therapy program.

  15. Community Experiences Assisting a senior with therapeutic exercises

  16. Community Experiences Learning about homelessness in Charlottesville by talking with guests in a homeless shelter program.

  17. Agencies & Schools & Community Partners Schools • Walker Upper Elementary School • Charlottesville High School ESOL Program • Charlottesville Adult Education Program -Adult Learning Center • Virginia Institute of Autism • Virginia School for the Deaf & Blind At-risk Children • Salvation Army Children’s Advocacy Program & Homeless Shelter • Community Attention- Teens Give • Big Brothers Big Sisters • Boys & Girls Club of Charlottesville/Albemarle • Blue Ridge Care Connection for Children • YMCA After-School Program • Hope Community Center After School Program

  18. Agencies & Schools & Community Partners cont’d Senior & Hospice Settings • Jefferson Area Board for the Aging (JABA) • Alzheimer’s Association • Hospice of the Piedmont • Legacy Hospice • The Senior Center, Inc. Social Services & Mental Health • Legal Aid Justice Center • Love INC • Region Ten Community Services Board – Substance Use Disorders • Region Ten – Intensive Services Team • Region Ten – Blue Ridge House • CreciendoJuntos Lay Health Promoters

  19. Agencies & Schools & Community Partners cont’d • Shelter for Help in Emergencies (SHE) • PACEM Homeless Shelter • On Our Own • Piedmont House Medically-related Settings • UVA Children’s Fitness Clinic • UVA Healthy Appalachia • UVA Teen Health Center • UVA Ryan White Clinic • UVA Hospitality House • Planned Parenthood of the Blue Ridge • Blue Ridge Medical Center Rural Health Outreach Program • Charlottesville Free Clinic • CADA (Community Children’s Dental Center)

  20. Agencies & Schools & Community Partners cont’d • Horses As Healers • Jefferson Area CHIP • Women’s Health Virginia • CARS Charlottesville/Albemarle Rescue Squad • Midway Manor UVA University medical Associates Clinic • Virginia Neurocare

  21. SIM Statistics 2005-06 142 Students placed  almost 5,000 hours of service 2006-07 140 Students placed 4200 hours of community service 2007-08 143 Students placed  4300 hours of community service 2008-09 145 Students placed  4350 hours of community service 2009-10 142 Students placed  4260 hours of community service 20010-11 155 Students placed  4650 hours of community service

  22. Reflection Exercises and Discussions are Opportunities for Raising Awareness of Social Issues in Medicine and For Deepening Self-Awareness of One’s Role as a Professional & Humanistic Physician

  23. Written Reflections • Make connections between current & past experiences • Examine personal prejudices, preferences and misconceptions • Explore the meaning of humanism & professionalism in medicine • Give evidence of the transfer of learning from classroom into the community and vice-versa

  24. Clinical Professional Development Small Group Discussions • Discusscontent talk issues • Integrate SIM issues into cases • Makeconnections between talks and community experiences • Hearwhat others are doing at other sites • Challenge misconceptions • Grapplewith pressing societal issues that impact the practice of medicine

  25. SIM: A Different Kind ofLearning Experience • Open-ended, exploratory course that focuses on learning about the community & oneself • No memorization of data; No pat answers to questions; No easy solutions to problems • Encourages the development of the practice of self-reflection and personal growth through better self-understanding