It was my pleasure to co-author this post with Claire Norman, public communications coordinator in the Department of Family Medicine at the Keck School of Medicine of USC
“Meeting people has really helped us understand the community as a whole more than statistics that we may read on paper.” – Tracy Nguyen, PA-S (Class of 2018)
Imagine a street in your neighborhood. Now close your eyes and hear the sound of passing cars, music from the local stores, laughter from a group walking down the street together. Maybe you pick up the delicious scent of a favorite local dish. What can you learn about this neighborhood just from paying attention to all the messages your senses are receiving? Could you be better prepared to work with patients by knowing what’s available in their neighborhood? And how can we use these insights to teach the lesson of empathy?
These questions are the driving force behind the USC Keck School of Medicine’s vision of how to integrate technology into the Primary Care Physician Assistant Program. One of the greatest advantages of mobile devices is that they allow for discovery beyond the typical confines of the classroom and a greater appreciation for the patients in our communities.
“In preparing medical providers to care for people — for individuals — it’s not enough for them to know only diseases, treatments, and counseling theory,” said Professor Christopher P. Forest. “If they want to help people in underserved communities, they need to listen, taste, and feel what individuals in that community experience.”
There is a gap that exists between gathering information and first-hand experiential learning. When I worked with Forest, who has taught the Behavioral Health Science (BHS) class to first-year PA students at the Keck School of Medicine, I found that by changing an assignment from a 40-page paper to a five-minute documentary, he has been able to bridge that very gap.
Lights, Camera, Action!
Armed with just a smartphone or tablet, students are given an assignment to create a short video documentary that highlights important health topics including transportation, nutrition, housing, emergency services, recreation, and religious institutions.
Video is a powerful way to communicate ideas, share stories, and build relationships. By creating video documentaries, students get to empathize directly with a community more than they could through secondary sources that they may find on the Internet or in a book. Experiencing a community first-hand provides them with a personal account of what these communities look like and helps them discover the problems that patients may face in maintaining their health and wellness.
By visiting these neighborhoods, talking to the people, eating the local food, and embracing the customs of the area, they become better able to understand patients from that neighborhood and, as a result, help provide the best health care.
When the students from the class of 2018 went out to their neighborhoods this year, they experienced the difference between what insights you can find online versus what you will find by visiting an area in person. Instead of hearing about fear of high crime rates, students heard about the pride locals had for their neighborhoods. The students came to better understand not only the cultural barriers that play into an individual’s health but also how they could be more effective PAs when they start seeing patients.
“In Boyle Heights there is a lot of crime in the news, and it is always about people getting shot,” said PA student Alexa Schwarzmann. “But when you are actually talking to the people who live there, they talk about how safe they feel walking around at night and how it is such a tight community… everyone helps each other out when they need it.”
One group tasked with visiting Echo Park noticed that while there were several clinics that serve the area, they are all closed on Sunday — forcing locals who don’t have cars or insurance to ride the bus to Los Angeles County Hospital. To better understand this barrier to care, they took the bus on a Sunday so they could see first-hand how challenging it could be for a patient who had serious health concerns. Their journey showed them how a patient could easily be delayed, sidetracked, or lost while trying to get to the emergency room — where they would still have to wait to see a clinician. In understanding this, the students developed greater empathy for the patient population in Echo Park, allowing them to identify gaps that exist and placing them in a position to work toward developing solutions.
Immersion > Google
Once the projects were completed, all the students were able to view and share them via YouTube with authentic audiences beyond the four walls of the classroom. (You can watch all of the videos here.) This project had a much greater impact on students than a typical lengthy research paper and allowed them to use their 21st century skills of critical thinking, communication, collaboration, and creativity in the service of community.
It is clear that an unprecedented era is emerging where we can talk with others — instead of about others — to bring us closer to the stories of our patients and understanding how we can best improve their care.
Video produced by Claire Norman, public communications coordinator, Department of Family Medicine, Keck School of Medicine of USC.