October 18-21, 2010 Service Learning to Enhance Cross Cultural - PowerPoint PPT Presentation

Kim Bullock, M.D. Associate Professor, Community Health Division Director, Service-Learning Assistant Director, Beverly Roberson Jackson, Ed. D. Adjunct Professor, Department of Family Medicine Georgetown University Medical Center Washington, DC Pooja Sodha, Georgetown Medical School student Seventh National Conference on Quality Health Care for Culturally Diverse Populations Baltimore, MD October 18-21, 2010

 Service Learning to Enhance Cross Cultural Communication What is the potential for synergy in Service Learning? Structured intentional reflection before, during and after Service Learning experiences often builds a bridge between the concrete and the abstract; between practice and theory. It utilizes health to frame the problems into solutions and a practical action strategy. In this case; it involves interactive developments with the families who illuminate and frame the issues surrounding immunization. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Project Goals Long-term Georgetown University Medical School/ MACECD Service Learning Partnership Goal: To increase community health literacy among parents of preschool children and increase awareness of and involvement in public health policy for medical students and parents through campus community service learning projects. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

Course Overview  The Service Learning course at the School of Medicine provides an opportunity for the students to examine the environmental and social context in which a targeted group of the city’s population makes health decisions. Service Learning experiences challenge student's assumptions about community issues, and marginalized communities. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Health literacy has recently been infused in the medical school curriculum in order to promote awareness and sensitivity by future doctors as part of a social- determinant framework. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Students come to an appreciation of the strengths, capacities, and assets of diverse people groups that are often considered at-risk or displaced.  Service Learning is an opportunity for students to move from their comfort zones to their contact zones , and thus redefine what is "comfortable and/familiar to them.  This addresses the sense of connectedness, the nexus that binds all humanity. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Added to this approach is the use of student reflection which when linked to knowledge enriches student response and responsiveness.  Reflection brings out "cognitive dissonance," and allows students to explore through reflective assignments and exercises how to resolve or dispel these often erroneous beliefs. This is part of the cornerstone of effective Service Learning pedagogy and stimulates cognitive growth and inquiry about people, cultures, nationalities, and differences. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Effective Service Learning classes are those which allow service and civic engagement to become integrated and enhanced as part of the academic learning experience; not take the place of it. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Process for Immunization Experience  At the beginning of the course the students created a community asset map and learned to recognize health resources and health impediments in targeted communities.  Students studied general factors related to various neighborhoods within the city (e.g., income, housing patterns, environmental toxins and the availability of fresh whole foods) and then selected a critical problem and target neighborhoods for exploration. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Research Methods  Within the course module, the community study was followed by an introduction to qualitative research methods with a community based social science researcher.  The students in the team assigned to the Mayor’s Advisory Committee on Early Childhood Development learned and practiced conducting focus groups and key informant interviews and were matched with Head Start parent groups to study a health issue/problem that the students selected.  Students develop a deeper understanding of the community-decision-making processes, ethical and critical reflection and practical utilization in practice. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 The problem selected in 2007 was the recent decline in early childhood immunizations as noted in the 2007 Child Trends report below. Figure 2. The students selected a Health Literacy project in health promotion that encouraged targeted parents to get their children immunized on schedule and reverse the declining trend shown. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 The medical students completed additional research on the topic before applying qualitative research strategies. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

Qualitative Research with Community Partners enhances Synergy  Service Learning allows students, teachers and community leaders to dialogue and deliberate together as a primary mode of developmental learning. In curricular terms, it draws upon student experiences, creative ideas and "funds of knowledge" that are diverse in order to improve the diversification of intellectual resources. Faculty integration or synergy promotes meaningful engagement, commitment to teaching and a greater connection to the community-based experience. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Lessons Students Learned - Public policy development regarding child health care involves many branches of government and civil servants. There is no clearly defined role for each player. - Ineffective methods to monitor the immunization deficiencies. - Immunization deficits are due primarily to presumed lack of affordability. Citizens believe that insurance is required in order to access vaccines. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Lessons Students Learned from parents - Dangerous mentality: "If I didn't get them, {shots} my kids don't need them." - Parents would like to get information about the vaccines: What do vaccines protect against? i. Physician involvement is vital. ii. Parents express concern over potential side effects. iii. Assistance with language barriers Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

 Service Learning Lessons Learned ◦ How to apply textbook knowledge of health literacy to encounters with parents who need to access the health system ◦ How to work with parents and community leaders in problem solving ◦ Relating to parents with different cultural backgrounds ◦ Perspective taking to resolve community problems  In an unplanned part of the course, the students developed a number of strategies to try to bridge the gap between the parent perspectives and the health policy approaches Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

Class Product The students designed an information brochure for parents based on the issues uncovered in the focus groups. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755

THE IRB ( Institutional Review Board) Parents and child care providers who participated in focus group sessions completed a 6-page IRB form adapted for parent use from traditional Georgetown University forms. The first 30 minutes of each focus group session focused on an explanation of the form. Special attention was paid to the voluntary aspect of participation in the focus group. Service-Learning as a Strategy to Enhance Collaborative Cross-Cultural Learning, Understanding and Synergy Presentation ID#: 2755