From: morris@zodiac.rutgers.edu
Newsgroups: sci.med
Subject: Re: A Question/Proposal for "Health Care Consumers"
Date: 22 Jul 92 22:45:06 GMT
Organization: Rutgers University Computing Services

In article <1992Jul22.152557.7831@athena.mit.edu>, jgnassi@athena.mit.edu (John Angelo Gnassi) writes:
> 
> As part of the Family Practice residency at Chestnut Hill Hospital in
> Philadelphia, senior residents are required to spend just 5 half days
> in an elementary, junior, or high school talking about health.  I spent
> one of those half days giving a lecture I prepared on testicular cancer
> to 9th graders.  I don't know if it did any good (i.e. will change
> outcomes), but it at least made most of them aware of a disease
> that strikes beginning in their age group and which most previously
> had been unaware of.  They weren't very excited, and asked few
> questions.

They probably "were not excited" because they were 9th graders and you
were talking to them about about an embarrassing topic.  It would have
been very uncool to have appeared interested.  My guess is that you did
some good because you were an outside expert who provided them with
information which they did not have.  You provided an awareness - you
cannot be interested in something in which you are unaware.  You did
not say whether this was all males or coed.  If it was coed even a very
well trained, skilled instructor would have had a hard time getting them
to appear interested.  However, they would have known this and not been
disappointed.  Did the medical school give any kind of preparation so that
you had some idea of how to present your information?  I hope you told
the students where to go for more information - my guess is that if you
did and this was a place where they would feel comfortable they went for
more info.  Despite the public image, school-based clinics do their 
biggest business in just talking to the kids indvidually or in small 
groups. Ninth grade is a time when you are not supposed to appear
interested in sex when adults are around. 
Remember these were 9th graders you were talking to - a very
embarassing time of life and you chose a particularly embarassing
topic.  It sounds to me like you did a great job, you just had
unrealistic expectations.

> I spent the other half days at an elementary/junior high school
> without prepared lectures, just wandering from classroom to classroom.
> Big difference.  The kids there were *starved* for simple knowledge
> that I had.  I am not a trained educator, but I doubt that one has to
> be in order to teach people who really want to know something.

You were successful because you were an outside expert - you would quickly
lose that effect if you were in the classroom every day.  Also elementary
and junior high students are very eager to learn.  You also provided a 
diversion from the regular classroom activities.

I love going into other professors' classes to teach because I am the
outside expert who is disrupting the regular routine.  The same
students who would not give me the time of day in my own class are
suddenly fascinated with what I have to say.  They are really interested
in both classes but it is okay to show it in one and not the other.
I use outside experts in my classes because they are effective if used
on a limited basis.  However, there is such a thing as overkill.  I know
colleagues who have done it.  When I was doing community education I
used experts in appropriate places.  The key is knowing when and where to
use outside resources like you. 
> What did they want to know?  .......

All are typical questions.
 
> In each class it was easy to maintain relevance, i.e. in the science
> class I talked about Doppler sound frequency shifts (which they
> already knew something about from earlier that week) and how they can
> be used to measure cardiac output.  In math, where they had been
> covering probability, we talked about uncertainty and some ways to
> deal with it.  In English I talked about the autoimmune damage
> to heart valves following strep infection (OK, so I missed the
> relevance boat there, but that's what they wanted to know about,
> so that's what we talked about!).

Did you know what they had covered in class before you went in or did
you discover it as you went along?  How much pre-coaching did you get
from the classroom teachers?  Good teachers will have prepped you if there
was the opportunity.  What you did is the coordinated method of health
education - where health is integrated into other subjects.
 
> When I returned I brought illustrative materials ...

All great teaching materials and ones that are often very difficult for
classroom teachers to obtain.
 
> These kids weren't just looking for someting to break up their
> day.  They really wanted to know things that were easier for
> me than their teachers to talk about without extra preparation.

It takes incredible preparation to be able to teach what it sounds like you
taught, particularly with the additional materials.

> The residents and teachers uniformly applauded this approach.
> Perhaps others who've had similar experiences would care to comment
> on them.

Teachers really do like outside experts who have a good rapport with
their students - you would not believe how difficult it is to find these
people sometimes.  I always thought the dud guest speakers were the
teacher's fault until I had to start obtaining them.  I hope you will
continue volunteering your time to your local school system.  The
teachers need you on two scores - 1) you show that there are people
out there who care and are willing to act on that caring, 2) especially
in the field of health there is just too much information for a 
teacher to be expert in all of it.  Actually I think teachers would welcome
experts from other areas if their school system will allow it.

> --
>      John Angelo Gnassi			Lab of Computer Science
>    jgnassi@hstbme.mit.edu		Massachusetts General Hospital
>      "Eternal Student"			Boston, Massachusetts, USA
> 		"24 years of school down, 2 to go!"

Joyce Morris                          MORRIS@ZODIAC.RUTGERS.EDU
Urban Studies and Community Health