Community fieldwork collaboration between medical and social work students.

This article describes an educational demonstration in interdisciplinary community field experiences between social work and medical students at the University of Kentucky Medical school, the hospital social service department, the school of social work, and community social and health agencies. The pilot program in which students from different professions lived for 6 weeks in outling rural communities served by the medical center, provided an opportunity: (a) to study the feasibility of combining a borad community health study experimence with casework services in a hospital-based educational program and (b) to assess the benefits of early interdisciplinary community and clinical work between future doctors and social workers. Students saw the advantages of cooperative teamwork in studying community problems, and were able to apply classroom theory about community organization to real community situations. The organizational structure and staff resources required to carry out such a demonstration are described, and the implications of the training project are discussed.     

The AHEC contribution to social work education

The Area Health Education Center (AHEC) Program is a Federal initiative funded by the Public Health Service. The goal of the program is to improve the distribution and quality of training for health professionals. Funds are awarded to schools of medicine or osteopathy which in turn subcontract with at least two other health professional schools. Each project recipient must establish an AHEC center to plan and coordinate community-based educational experiences for health professions students in designated health shortage areas. The AHEC program fosters interdisciplinary training among health professionals. As part of the basic program thrust, some AHECs have included the social work profession in their program design. The Massachusetts AHEC, through Boston University's School of Social Work, established a health care concentration and interdisciplinary rotation that included students from social work, psychology, nursing, and medicine. Other examples of AHEC-sponsored training are presented from Baltimore, the eastern shore of Virginia, and several centers in Massachusetts. Through the AHEC training mechanism, social work students as well as practitioners in the field have the opportunity to encounter the most current and urgent issues in health care practice.     

Interdisciplinary Student Health Teams: Combining Medical Education and Service in a Rural Community-based Experience

Several initiatives have been introduced over the years to address the maldistribution of health care professionals and to improve access to care for underserved rural populations. One of these is the sponsorship of community-based, service-oriented teams comprised of students from various health disciplines. This study investigated extramural training as a complement to traditional hospital-based experiences. The specific objective of the study was to determine the extent to which the nation's medical schools combine training with a rural community-based experience in the form of an interdisciplinary student health team program. In the fall of 1994, a 32-item questionnaire was mailed to the chief academic or clinical affairs administrators of the nation's 126 allopathic medical schools. A total of 104 (82.5%) medical schools responded to the survey. Eighty-six of the respondents (82.7%) reported some type of rural training or public service activity; 22 (21.2%) acknowledged the sponsorship of an interdisciplinary student health team program. Small rural communities, those with populations of 5,000 or fewer, were the focus of 76 percent of the reporting programs. Nearly two-thirds of the reporting programs were located in the South, the region with the nation's lowest physician-to-population ratio. The nursing and medical professions were most frequently represented, although a wide range of disciplines were identified as participating on the student health teams. Activities of the teams included both ambulatory care and community outreach services. The majority of the programs used team-building exercises to enhance team effectiveness. Extramural training programs offer students a realistic examination of the social, cultural, economic, and political forces that influence both individual and community health. Rural community-based programs, such as interdisciplinary student health teams, should be valued because they can strengthen the link between the sponsoring institution's educational mission and its public service obligation.     

Developing service-based teaching in health education for medical students.

In the expanding concern about the social-behavioral aspects of health care in medical education, health education has opportunities for making itself an important part of basic medical training. The need is to actually define a physician's appropriate educational tasks and competencies as a basis for curriculum development in health education which would ideally be integrated into the whole educational program. This case study presents efforts to develop an educational service component at a rural health center which, connected to a major teaching hospital, serves as a learning base for medical students. Through trial and student feedback a program has been developed which includes patient counseling, evaluative home visits, group education sessions, exit interviews, medication counseling, community needs assessment and educational consultation with local school teachers. With this program as a foundation, the goal is to integrate health education learning throughout the rest of the medical curriculum.     

Public Health Social Work

Despite the disparate historical evolution, public image, and traditional approaches to problem solving characteristic of the social work profession and the field of public health, the potential for professional collaboration has never been greater. Indeed, the comprehensive management of social-health problems demands an interdisciplinary educational program designed to train upcoming professionals. The 4-year old, joint MSW-MPH program at the University of Minnesota provides a setting in which the public health social work student develops the philosophies, values, and skills of both social work and public health, and applies them to appropriate social-health settings. The purpose of this paper is to describe the Minnesota model and examine its implications for faculty and community professionals interested in developing similar training programs.     

Integration of health into the school curriculum in Botucatu, São Paulo

This study focuses on the drafting and development of a public health program aimed at strategies to integrate health activities and the school curriculum. The program is based on three main lines of activity: full health care for schoolchildren, with special emphasis on the public school system; training of personnel in the fields of health and education by means of internships allowing participants to experience, work, and reflect critically on the activities with an interdisciplinary team; and work with teachers from the public elementary school system to implement and develop innovative measures in the fields of health and education to respond to the demand by schools and the community.     

An Interdisciplinary Health Team Training Program for School Staff in Minnesota

ABSTRACT: This paper describes an interdisciplinary health team training program for school-based clinic staff in Minnesota. The project sought to improve team functioning, level of practice, and health care services at the school sites. Participants were interdisciplinary staff members from clinics in senior high, middle, and elementary schools. The program consisted of further development in team training knowledge and skills and educational sessions on issues identified by participants. Evaluations indicated participants reported greater knowledge and improved team functioning experiences from the team training. Gains also were shown in knowledge and skills in specific school topic areas such as violence, resiliency, working with resistant families, and self-care. The program could serve as a model for other interdisciplinary school health team training.     

A rural community-based interdisciplinary curriculum: a social work perspective

Although social workers are frequently part of interdisciplinary teams in health care and community settings, interdisciplinary training is often lacking in social work education (Berg-Weger & Schneider, 1998). This article describes a study of the effects of an interdisciplinary community-based experiential course preparing new health care professionals for work as part of interdisciplinary teams. The interdisciplinary curriculum was established for a summer course taught in 2006 by faculty from five disciplines: social work, nutrition, medicine, nursing, and public health. The course, Quality Improvement in Rural Healthcare, which focused on health literacy in people with a diagnosis of diabetes that live in northeast Tennessee, provided a model environment for learning interdisciplinary teamwork. Evaluation of this course found that social work students displayed a statistically significant increase in positive attitude toward interdisciplinary teamwork. Course strengths, weaknesses, obstacles, and opportunities for curriculum improvement are elaborated.     

NEW APPROACHES TO EDUCATING SOCIAL WORK PROFESSIONALS FOR ADMINISTRATIVE ROLES IN A NATIONAL HEALTH SYSTEM

As national health insurance becomes a reality we can anticipate a shift in emphasis from delivery of acute in-hospital care to community-based care. Professional social work functions in the future will likely be increasingly directed toward the administration and management of supportive health care services. This paper describes an interdisciplinary graduate educational program in administration and management of social health care services, developed by the School of Social Work jointly with the Maxwell School of Citizenship and Public Affairs at Syracuse University and the Upstate Medical Center in Syracuse. The curriculum is designed to train future social work professionals in planning, evaluation, and managerial skills necessary to perform middle-management and decision-making functions. The curriculum is provided by an interdisciplinary faculty team, and implemented with a task-oriented problem-solving approach. The program is in its 3rd year and hsa graduated 20 students.     

Interprofessional Leadership Training in MCH Social Work

The need to train health social workers to practice interprofessionally is an essential goal of social work education. Although most health social workers have exposure to multidisciplinary practice within their field work, few social work education programs incorporate interprofessional learning as an integrated component of both course work and field experiences (McPherson, Headrick, & Moss, 2001; Reeves, Lewin, Espin, & Zwaranstein, 2010; Weinstein, Whittington, & Leiba, 2003). In addition, little is written about the kinds of curricula that would effectively promote interdisciplinary training for social work students. These findings are particularly puzzling since there is increasing and compelling evidence that interdisciplinary training improves health outcomes (IOM, 2001). This article describes a social work education program that incorporates an Interprofessional education and leadership curriculum for Maternal and Child Health Social Work (MCHSW) at the University of Maryland's School of Social Work. The University of Maryland's Interprofesisonal Training Model is described along with the components needed to formulate an interdisciplinary learning experience. Various outcomes and lessons learned are discussed.     

The REACH Project: An Innovative Health Delivery Model for Medically Dependent Children

Rural Efforts to Assist Children at Home (REACH) is a service/demonstration and training project designed to provide specialized health care and case management services to medically dependent children in a 16-county area in central Florida REACH nurses, acting as Health Care Coordinators, provide instruction, consultation, coordination, and supervision of health care services in collaboration with tertiary care physicians and services at the University of Florida Health Center Patients include infants, children, and adolescents with a wide variety of chronic illnesses including leukemia, muscular dystrophy, pulmonary disorders, failure to thrive, and seizure disorders In addition to extensive work with families in the home, the REACH program incorporates a feedback system for its nurses, a progress-oriented record system, carefully designed agreements between tertiary care centers and community agencies, and an innovative training program for its nurses REACH intends to serve about 1000 children during its 3-year demonstration phase Success will be based on careful monitoring of costs, family functioning, and school attendance lf successful, the project will provide a model for the structured utilization of health and social services for families with medically dependent children.     

The REACH Project: An Innovative Health Delivery Model for Medically Dependent Children

Rural Efforts to Assist Children at Home (REACH) is a service/demonstration and training project designed to provide specialized health care and case management services to medically dependent children in a 16-county area in central Florida REACH nurses, acting as Health Care Coordinators, provide instruction, consultation, coordination, and supervision of health care services in collaboration with tertiary care physicians and services at the University of Florida Health Center Patients include infants, children, and adolescents with a wide variety of chronic illnesses including leukemia, muscular dystrophy, pulmonary disorders, failure to thrive, and seizure disorders In addition to extensive work with families in the home, the REACH program incorporates a feedback system for its nurses, a progress-oriented record system, carefully designed agreements between tertiary care centers and community agencies, and an innovative training program for its nurses REACH intends to serve about 1000 children during its 3-year demonstration phase Success will be based on careful monitoring of costs, family functioning, and school attendance lf successful, the project will provide a model for the structured utilization of health and social services for families with medically dependent children.     

Factors Affecting Students’ Evaluation in a Community Service-Learning Program

A community service-learning curriculum was established to give students opportunities to understand the interrelationship between family and community health, the differences between community and hospital medicine, and to be able to identify and solve community health problems. Students were divided into small groups to participate in community health works such as home visits etc. under supervision. This study was designed to evaluate the community service-learning program and to understand how students’ attitude and learning activities affected students’ satisfaction. The results revealed that most medical students had a positive attitude towards social service and citizenship but were conservative towards taking the role to serve people in the community. Students had achieved what they were required to learn especially the training in communication skills and ability to identify social issues. Students’ attitude towards social service did not affect their opinions on the quality of the program and subjective rating on their achievement. The quality of the program was related to the quality of learning rated by the students.     

Meeting the needs of rural populations through interdisciplinary partnerships

This article describes the organization and outcomes of a Rural Health Outreach Initiative (RHOI) designed to increase collaboration between the medical education and health care delivery sectors to improve the quality of health care delivery and health outcomes in rural communities. Two inter-related partnership strategies were utilized in rural communities to address the health and social service needs of rural populations. The partnerships were created through the efforts of a rural health professions education program located in a community-based medical school. The two partnership models were implemented at the same time and target the same rural populations. Both strategies relied upon interdisciplinary collaborations to achieve their goals and outcomes. One strategy involved the creation of partnerships among rural medical students and the projects they initiate, using the model of community oriented primary care (COPC). The second strategy involved the establishment of partnerships by a variety of rural, community-based entities that resulted from a three-year Health Resources and Services Administration Rural Health Outreach grant that supported a "mini-grant" program. This article summarizes the process and results of these innovative collaborations that occurred at two levels: (1) between health and service institutions representing multiple disciplines and (2) between academic institutions and local communities. Specific attention is given to projects that resulted from the work of the partnerships that address the needs of older adults residing in the rural communities. The two strategies are compared and implications for the success of similar efforts are discussed.     

Rural Alabama Health Professional Training Consortium: six-year evaluation results

The Rural Alabama Health Professional Training Consortium is a rural community health center-based program that began in 1990 to provide interdisciplinary training for medical, nursing, pharmacy, dentistry, and nutrition students. After 6 years, 166 students had participated. This article discusses an evaluation of the impact of this program on these students by means of comparing pre-tests and posttests. Dentists demonstrated attitudes less favorable to locating in rural practices compared to other students. There was a significant increase in clinical competencies relevant to rural practice. Professional perceptions about working in an interdisciplinary environment were significantly lower for medical students compared to pharmacists, but their attitudes improved over time. The team concept was highly rated. Over 90% of the students thought that the program met or exceeded their expectations and would recommend it to other students, except for nurses. Over 80% of the students will consider working in a rural area on graduation, except for dentists.     

The postgraduate education of physicians in preventive medicine

The Graduate Medical Education National Advisory Committee report projected a serious shortage of preventive medicine specialists in 1990, and the recommendations of a recent report from the Association of American Medical Colleges called for increased training of medical students in health promotion and disease prevention and in adapting to changes in health and health care. To help meet the need for physician manpower in preventive medicine a new residency was established at the State University of New York at Stony Brook in July 1983. The program features a structured approach to the practicum year, incorporating an organized core curriculum and opportunities for a varied field experience. In addition to the School of Medicine and University Hospital, major training sites include two large county health departments on Long Island, three community hospital departments of community medicine, a health maintenance organization as well as several neighborhood health centers, and community-based programs operated by these hospitals and health departments. The curriculum includes both longitudinal experiences at the medical school involving teaching, research, and didactic conferences, and block field rotations within the above affiliated agencies, providing practice experience in preventive medicine and public health. The diversity in the organization and type of preventive medicine institutions used for training enriches the residency experience and is complemented by core educational activities.     

Communal health promotion in child and adolescent health services -- report on the experience with a organisational model for setting up an interdisciplinary network in a socially important area

This report focusses on health promotion for children adolescents und families and on the aspects of organisation and resources. In 1991 the Public Youth Health Care (KJGD), a community health service for children und adolescents, set up a multi-professional "district committee" of distributors in leading positions in a socially important area (social workers, school teachers, kindergarten teachers, councillors, medical personnel, architects and town planners etc.). Medical examinations of all school beginners and children with special educational needs formed the basis of the social paediatric observations and data. Until 2003 the author was responsible for the management and coordination of this local interdisciplinary district committee of leading representatives from local social and educational organisations as well as town councillors who created a local multi-professional network. The district health reports of the discussions in the district committee including the different professional aspects of health promotion were passed on to the local politician actively involved in the discussions with specialists and invested in social and health promotion projects. Social paediatric issues and preventative strategies became part of the work in social and educational organisations in the area und the city. A healthy environment for children und families was promoted. For the KJGD the conceptual work with distributors in leading positions led to initiatives for communal health promotion making time-saving use of existing resources.     

Balancing service and education: ethical management of student-run clinics

At medical schools across the United States, students operate free clinics that have the potential to provide health benefits to patients while furnishing unique educational opportunities for students. While they provide the energy necessary to make these clinics successful, students must, due to their inexperience, collaborate with faculty, clinic preceptors, community members and medical school administrators to ensure that their clinics attain high standards in health care and education. Medical school faculty and clinic preceptors must make certain that appropriate health care is provided and that desirable educational messages regarding physician professionalism and altruism are conveyed effectively. As faculty availability in such clinics is limited, it is important that the pursuit of educational goals not compromise clinics' patient care. By valuing faculty time dedicated to this work and actively supporting clinic organizers' applications for external funding, medical school administrators can facilitate high quality care and education at student-run clinics.     

福建省定向农村社区全科医学生教育现状调查

目的：了解福建省定向农村社区全科医学生的教育情况。方法：对福建医科大学271名定向农村社区的全科医学生和251名普通临床医学生进行问卷调查。结果：定向生入学的主要原因是可降分录取和就业保障；成绩较普通医学生差；心理呈现出自卑倾向并感觉被歧视；对学校的教学情况满意度较低；毕业后更倾向于留在大中城市和选择继续深造；长期从事基层卫生工作的观念淡薄，超过了80％的定向生有想过违反协议。结论：当前定向生培养工作存在一定问题。建议从保证生源质量、激发学习主动性、营造良好氛围、建立有效利益驱使机制等方面完善相关制度。     

Using a community networking approach in a bereavement program

This paper reviews the history of St. Anthony's Hospice and Life Enrichment Program. St. Anthony's provides bereavement counseling and death education to the community using a networking approach involving the educational, religious, social, and mental health organizations in the area. At present, this model features a church satellite program, grief recovery and anticipatory grief seminars, on-going bereavement support and social support groups, volunteer speakers' bureau, a volunteer staffed bereavement team, and training of psychology, nursing, and medical students.