Bridging Community and Medicine
Mohan Nadkarni, MD, Course Director
Darci Lieb, MEd, Director, Instructional & Clerkship Support
Dela Alexander, MSW, Course Administrator

Course Purpose

Social Issues in Medicine
Learning Objectives
~ To address how social and cultural issues, gender, economics and policy impact both the delivery of medical care and the health of populations.
~ To address how we understand humanism and professionalism in medicine.
~ To reflect on one’s practice and thereby increase the comfort level of future physicians in working with people different from themselves.
~ To develop partnerships between the University and community through which students may further their ethic of service .

• Content talks
• Curricular threads
• Pre-clinical patient experience
• Exposure to diverse populations
• Student-initiated proposals for placements
• Development of original health-related educational materials for particular populations
• Ethic of service
• Reflection and self-evaluation through written exercises, case reviews & discussions to achieve personal growth

a pedagogical model
• A structured, experiential learning activity that ties academic content to service in the community
• Utilizes self reflection and evaluative exercises to a) Link the service experience to the curriculum b) Promote personal growth
• Permits learner to make a contribution to the community AND develop new insights


In-class Content Talks by Community
Experts & Faculty e.g. Poverty & Homelessness; Health Care Policy;
Chronic Illness; Mental Health, LGBTQ Issues; Health
Disparities
 Community Service with a Partner Agency
30 hours in the field at a school, social service agency or health-related program
 Reflection Exercises & Small Group
Discussions in CPD (Clinical
Performance Development) Class

 Offering Concrete or Material Assistance
(e.g. research; administrative tasks; delivering material resources to clients)
 Advocacy
(helping clients access services; directing clients to other services in the community)
 Health Education
 Outreach
 Tutoring
 Listening, Offering Empathy/Support
 “Being” With Another; Affirming the Other’s
Humanity & Pain

Learning About…
 The conditions & challenges faced by the target population
 Agency services – How might they be helpful to future patients?
 The network of social services
 Helping strategies employed by agencies: i.e. counseling; material support; case management; financial assistance; etc.

Community Partner Visits
Talking with at-risk children about visiting a doctor.

Community Experiences
Talking about nutrition with a young patient at the children’s dental clinic.
Community Children’s Dental Center

Community Experiences
Meeting with parents of preschool children in a local pre-school to discuss nutrition and behavior management.

Community Experiences
Tutoring a child in an after-school program

Community Experiences
Chatting with a senior in the local adult care center

Community Experiences
Medical student assists therapist in Horses as Healers therapy program.

Community Experiences
Assisting a senior with therapeutic exercises

Community Experiences
Learning about homelessness in Charlottesville by talking with guests in a homeless shelter program.

Agencies & Schools & Community Partners
Schools
• Walker Upper Elementary School
• Charlottesville High School ESOL Program
• Charlottesville Adult Education Program -Adult Learning Center
• Virginia Institute of Autism
• Virginia School for the Deaf & Blind
At-risk Children
• Salvation Army Children’s Advocacy Program & Homeless Shelter
• Community Attention- Teens Give
• Big Brothers Big Sisters
• Boys & Girls Club of Charlo ttesville/Albemarle
• Blue Ridge Care Connection for Children
• YMCA After-School Program
• Hope Community Center After School Program

Agencies & Schools & Community Partners cont’d
Senior & Hospice Settings
• Jefferson Area Board for the Aging (JABA)
• Alzheimer’s Association
• Hospice of the Piedmont
• Legacy Hospice
• The Senior Center, Inc.
Social Services & Mental Health
• Legal Aid Justice Center
• Love INC
• Region Ten Community Services Board – Substance Use Disorders
• Region Ten – Intensive Services Team
• Region Ten – Blue Ridge House
• Creciendo Juntos Lay Health Promoters

Agencies & Schools & Community Partners cont’d
• Shelter for Help in Emergencies (SHE)
• PACEM Homeless Shelter
• On Our Own
• Piedmont House
Medically-related Settings
• UVA Children’s Fitness Clinic
• UVA Healthy Appalachia
• UVA Teen Health Center
• UVA Ryan White Clinic
• UVA Hospitality House
• Planned Parenthood of the Blue Ridge
• Blue Ridge Medical Center Rural Health Outreach Program
• Charlottesville Free Clinic
• CADA (Community Children’s Dental Center)

Agencies & Schools & Community Partners cont’d
• Horses As Healers
• Jefferson Area CHIP
• Women’s Health Virginia
• CARS Charlottesville/Albemarle Rescue Squad
• Midway Manor UVA University medical Associates Clinic
• Virginia Neurocare

SIM Statistics
2005-06 142 Students placed
 almost 5,000 hours of service
2006-07 140 Students placed

4200 hours of community service
2007-08 143 Students placed

4300 hours of community service
2008-09 145 Students placed

4350 hours of community service
2009-10 142 Students placed

4260 hours of community service
20010-11 155 Students placed

4650 hours of community service

Reflection Exercises and Discussions are
Opportunities for Raising Awareness of
and
For Deepening SelfAwareness of One’s
Role as a Professional & Humanistic
Physician

• Make connections between current
& past experiences
• Examine personal prejudices, preferences and misconceptions
• Explore the meaning of humanism
& professionalism in medicine
• Give evidence of the transfer of learning from classroom into the community and vice-versa

• D iscuss content talk issues
• I ntegrate SIM issues into cases
• M ake connections between talks and community experiences
• H ear what others are doing at other sites
• C hallenge misconceptions
• G rapple with pressing societal issues that impact the practice of medicine

• Open-ended, exploratory course that focuses on learning about the community
& oneself
• No memorization of data; No pat answers to questions; No easy solutions to problems
• Encourages the development of the practice of self-reflection and personal growth through better self-understanding