University of Utah
Dr. Claire Clark
Medicine 710, 711
The Patient in the Community: Longitudinal Experience, School of Medicine
Quarters: Winter and Spring, 1998


Overview of the Course: This is a multi disciplinary course taught by University faculty, community physicians, and a host of other medical and non-medical disciplines. The student will do much applied teaming in the real life laboratories of the community (doctor's clinics and service agencies) interspersed with regular classroom sessions to continually link the experiential with the theoretical: the hands-on teaming with the academic goals and objectives. Service Learning is an especially unique goal of this course in which students will learn by providing a needed service to the community. Autumn Quarter (Block 1) of the three-quarter course will be spent in medical clinics with two classroom sessions. Students will focus on understanding how primary care clinics are run, how interdisciplinary teams function, how to talk to patients, take their vitals and present them in the classroom. Student and longitudinal patient will be introduced by the clinic physician to establish their year-long match. Block H and Block R (winter and spring quarters) will be spent in the community agencies. Students will spend four hours every other week in their agency placement site for a total of approximately 24 service hours. In addition, they will meet three times in the classroom, as well as continuing to stay in touch with their longitudinal patient; for example, meeting the patient at their doctor's visits, for any community agency interactions, and for a home visit. Students will work in a variety of agencies with whom they will form partnerships in meeting the needs of their clients and in meeting the course goals. Community agency and school of medicine partnerships to date cover a population range from infancy through geriatrics. Examples include: BabyWatch, Children with Special Needs, Child Protection Team, Teen Mom, Community Nursing Services, Salt Lake County Aging Services, Valley Mental Health, Homeless Clinic, Services for People with Disabilities, etc. As in Block I, students will write of significant experiences in their journals to take to the classroom reflection sessions where their teaming will be processed. In addition, students will report on their agencies both orally and written so that: 1) each student can learn about agencies other than their own, and 2) as a class of 100 they can create a resource guide and manual to be put on the Internet as well as distributed in hard copy to their physicians' clinics and to each other for future reference.

Service Learning Criteria

  1. Students in the class provide a needed service to individuals, organizations, schools or other entities in the community. The course master and course coordinator met with each community partner during the spring and summer of 1997 to introduce the course, describe the course goals, and discuss how the agency's needed service could fit with those goals. Each agency will be revisited again during this autumn quarter for the purpose of identifying the contact person with whom the medical students will meet and with whom they will negotiate the specifics of their service for the next two quarters.
  2. The service experience relates to the subject matter of the course. The service experience will relate to the following course objectives that are stated in the syllabus: a. Develop a working knowledge of the physician's role in longitudinal patient management
  3. Understand and explain the concept of the interdisciplinary team in the delivery of health care c. Learn in-depth about the services and programs offered to clients from a variety of community service agencies d. Communicate their thoughts and feelings regarding self and patient experiences with peers and small group leaders in the reflection sessions e. Keep a journal in which to record cognitive, affective, and behavioral impressions during the agency experience, using journal entries to add detail and richness to the reflection discussion
  4. Activities in the class provide a method or methods for students to think about what they learned through the service experience and how these learnings relate to the subject of the class. Students will be required to complete 6 written assignments and make 2 oral presentations. These assignments are designed to assist the students to integrate large and small group presentations, small group discussions, readings, and service experiences into their developing identities as citizens of their communities and in the future, as practicing physicians in their communities, who are aware of local agencies and the services they offer.
  5. This course offers a method to assess the learning derived from the service. Credit is given for the learning and its relation to the course, not for the service alone. Students will be required to keep an ongoing journal of their experiences in the community agencies. Journal entries will then be used for reference by the students in the Reflection Sessions and turned into the small group leaders as an assignment. All small group leaders (of which there are 20) attended an orientation session and were instructed by Drs. Nickman and Frances on how to facilitate a reflection session. This was done to insure that students would link their community experiences to course goals and to optimize a consistent learning experience across all 10 small groups.
  6. Service interactions in the community recognize the needs of service recipients, and offer an opportunity for recipients to be involved in the evaluation of service. All medical students will evaluate their experience, both for themselves personally and as a future placement site for future medical students. They will be asked to make comments regarding both strengths and areas for improvement. This will allow the course master to continually improve the service learning component of the course. Community partners will be invited to attend and participate in the reflection sessions. Their assessment of the value of students working and serving in their organizations will also be obtained. In their syllabi and in the course orientation, students and community partners were given the names and telephone numbers of a variety of resource people to contact in the event of a problem in the community placement site, so that formative as well as summative evaluations can be made.
  7. The service opportunities are aimed at the development of the civic education of students even though they may focus on career preparation. One of the stated course objectives is that students will demonstrate "positive attitudes of social responsibility to act in behalf of or in partnership with their patients". Small group leaders, who in many cases will act as student role models will encourage students to participate in their communities, not just as physicians but as citizens who have something of value to contribute (in part because of the experiences and commitment to service learned through this service learning course). (Interestingly, many of the faculty who volunteered to participate in this course as small group leaders, were themselves involved in similar courses during their training. They were excited to promote this type of learning back to the students who follow them.)
  8. Knowledge from the discipline informs the service experiences with which the students are involved. Medicine has a long tradition of examining the connection between service and doctoring. A more modem examination includes that of serving the underserved, working as an equal part of the larger interdisciplinary team, developing greater cultural and social sensitivity in a more diverse world, and more humanistically caring for the whole patient-as-a-person rather than patient-as-a-diseased or broken part. Several other courses address many of the above issues in their readings and weekly discussion sessions. This course is often seen as the real-life laboratory of hands-on experience where the students can apply the more academic and classroom learning.
  9. The class offers a way to learn from other class members as well as from the instructor. Students will be placed in a wide variety of settings. During their classroom presentations and reflection sessions, they will learn of the experiences of their classmates. As a class of I 00, they will compile a resource manual of all community experiences in which they will describe the agency, the population served, how it is accessed, cost, location, etc. This manual will be provided to all students, their physician clinics, their Web page, etc., to remind them as future physicians to participate in and utilize their communities in the treatment of their patients.
  10. Course options ensure that no student is required to participate in a service placement that creates a religious, political and/or moral conflict for the student. All students will be required to participate in the service component of this course; however, the variety of service options is such that no service placement need create a religious, political or moral conflict for any student. Students have been informed that if they experience such a conflict, that they are to contact the course master or their small group leader for a more acceptable alternative placement site.
                                        Date: Fri, 24 Oct 1997 09:42:16 MST
                                        From: Renee Buchanan []