Category: Professional Studies

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A Mock Cultural interaction between a Hmong immigrant family and American Doctor

A Mock Cultural interaction between a Hmong immigrant family and American Doctor

Lisa Pope Fischer

Social Science

ANTH 2000: Medical Anthropology

Activity Description: Provide a brief description of the activity

This is a teaching exercise, or module, that will lead up to a mock interaction between a Hmong patient and American doctor. Essential to Anthropology is the ability to be sensitive to cultural differences. In terms of understandings of illness, one culture may have a different interpretation of, and different treatment for particular illnesses. I designed this exercise by drawing on issues and concerns presented in Ann Fadiman’s work with Hmong immigrants (1997, 2000). The objective of this module is to teach students skills of perception and interpretation. The module begins with reviewing some basic anthropological concepts and key terms. The duration of the exercise requires preliminary preparation such as assigning the readings to the students. The in class activity should allow time to discuss and review the material. This exercise would be suitable for smaller class sizes no larger than 40 but perhaps could be modified for a lecture demonstration or online learning if students handed in written descriptions.

Learning Goals: What do you aim to achieve with this activity?

The General Education Outcomes that the assignment aims to achieve are: Intercultural knowledge and Competence.
This lesson addresses: Cultural self-awareness, knowledge of cultural worldviews, empathy, shared forms of communication, curiosity, and openness .The objective of this module is to briefly outline the anthropological concepts of “cultural relativism,” “worldview” and “emic/etic” as tools for understanding that different cultures may interpret illness differently. This is important in terms of making diagnoses as well as treating patients in a culturally sensitive manner. Cultural relativism is an approach in anthropology that tries to maintain a neutral non-judgmental stance, showing both “empathy” for cultural differences, as well as “openness” to see cultures that are different from our own without bias. This exercise looks at beliefs regarding health and illness from Hmong culture teaching “openness” to other perceptions of health. A young girl is misdiagnosed due to cultural misinterpretation causing dire consequences, so the aim is that students can imagine their perspective, to learn “empathy.” “Worldview” is a concept central to anthropology, looking at how individuals perceive their world and their place in it, which can be different in different cultures. Emic and Etic are common concepts in anthropology that try to show differences in perception, “cultural self-awareness,” the emic being the perspective of the people we study, and etic being the outsider’s perspective, the perspective of the anthropologist who analyzes the culture. This assignment in particular looks at an example where communication between cultures lead to a horrible outcome for one little girl, and the aim is to try to understand and create “shared forms of communication” to avoid such a tragedy again. As a mock patient and doctor interaction, the students learn “curiosity” and “critical thinking” as, they articulate responses based on two different cultural worldviews related to health and healing showing ability to see things from multiple cultural perspectives. In terms of High Impact Educational Practices (HIEP), this exercise uses collaborative learning. Diversity and global learning, and community based learning. It will become part of my Open Lab site for ANTH 2000: Medical Anthropology, and Blackboard.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

The in class activity should allow time to present the concepts and themes, and have students perform the mock patient and healthcare practitioner scenario, followed by discussion of the issues raised in the reading and presentation. One standard hour –fifteen-minute class period would suffice but allowing a class period to view the film might expand the topic. This exercise would be suitable for smaller class sizes no larger than 40 but perhaps could be modified for a lecture demonstration if students handed in written responses to the discussion questions.

Film Suggestion:
“Split Horn: Journey of a Hmong Shaman” (2001, 56 minutes)

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

The module begins with reviewing some basic anthropological concepts and key terms. The Fadiman book The Spirit Catches You, wonderfully exemplifies issues of cultural difference and perceptions of illness, but she also has a short article that focuses on epilepsy that can also be used to illustrate cultural difference. A full-length film documents the story of a Hmong shaman, (Split Horn), but you can also use short video clips to illustrate the point of cultural difference. The duration of the exercise requires preliminary preparation such as assigning the readings to the students and handouts for the mock patient/healthcare practitioner interaction.

Fadiman, Ann. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Farrar, Straus, & Giroux, 1997.

Fadiman, Ann. "The Spirit Catches You and You Fall Down": Epilepsy and the Hmong. Epilepsy & Behavior: E&B [Epilepsy Behav] 2000 Feb; Vol. 1 (1), pp. S3-S8.

Activity: Cultural Perceptions
I.Review the Anthropological concepts either using PowerPoint or in handouts. This exercise gets students to think about how we might be quick to judge other cultures (ethnocentrism), yet also understand how others might perceive us.

KEY TERMS/ CONCEPTS:
Cultural Relativism: Anthropologists attempt to be neutral non-judgmental observers that take into account the culture’s practices relative to their own cultural understandings.

Ethnocentrism: People might judge a culture’s practices in a negative manner simply because they might be different from their own. Anthropologists try not to be “ethnocentric” or “Western centric” as it is important to understand why a culture might perceive or do something rather than judge it in a prejudice manner.

Emic/Etic: Anthropologists use the concept “emic” to explain the perspective of the people one studies. How do the people perceive their culture? How do they interpret the world in which they live? In contrast, the anthropologist must also retain the “etic” perspective, the view of the scientific observer. The etic perspective allows the anthropologist to step back and analyze the culture using the various theories in which to interpret a culture’s practices (i.e. Cultural Marxism/social conflict theory, Functionalism, Practice theory, Reflexive Anthropology/writing culture, etc.)

Worldview: Refers to how a person views their world and their place within it. Whereas some people may define themselves and behave according to a religious worldview, an atheist can also have a worldview. Different cultures may have different types of worldviews that affect perceptions of time and space, feelings about moral behavior, how they think about and how they seem themselves within their society.

Culture Bound illnesses: These are illness that might be found within particular societies.

Mind/Body dualism: Western medicine tends to separate understandings of how illness in the body might be separated from the mind whereas many cultures see the two as closely related.

II. Give illustrative examples to spur discussion about ethnocentrism and cultural relativism. Encourage students to look at cultures in a culturally relative way by reminding them that people outside our own culture may view American practices as unusual as well.

1. Female brutality or beauty? Female circumcision is a practice in which elders cut off a young woman’s clitoris to prepare her for womanhood. Some refer to this as Female Genital Mutilation (FGM). This practice evokes much debate about brutality and mutilation of women, yet studies indicate that women from these societies may perceive this practice as a means to obtain purity and femininity (Gruenbaum 2006). Ask students in what ways do American women brutalize their bodies in the pursuit of femininity or beauty? To shock them you might show an image of the Cat lady who has had too many plastic surgeries, or a hyper thin anorexic looking fashion model. (See suggested short video clips from youtube below – following the bibliography)

2.Food delicacy or garbage? Students often cringe when they hear that in some cultures grub worms or monkey brains might be considered a delicacy, however, there are foods that Americans eat that other cultures might find repulsive. How, for example are grub worms similar to shrimp? For people outside the United States, peanut butter might look like mud or feces. People might perceive fine cheese as smelly rotten dairy. In the south, or even at the Coney Island Nathans, one can buy fried frog legs. Americans often perceive French food as elite fine food, yet they make “escargot” from common snails, and they perceive horsemeat as a healthy specialty.

III. Discuss how the above examples illustrate an understanding of “ethnocentrism,” but also connect to the idea of “emic” and “etic” as a matter of different cultural perceptions. Expand their understanding of emic /etic by connecting to an example of interpretations of cultural illness.

In Freed’s (1999) work, “Taraka’s Ghost”, a young bride in a strange new village experiences spirit possession, but is this a form of anxiety attack or depression? Would anti-depressants work if she truly believed she needed a shaman to remove the spirit? Several anthropologists have looked at the culture bound illness “Susto” prevalent among Mexican and other Hispanic communities in which they believe a person who has a sudden fright or trauma may develop loss of energy, loss of appetite, sleeplessness, and depression. Whereas from a Western medical perspective “susto” might be explained as a psychosocial illness in which the person becomes antisocial and uses the excuse of illness to withdraw, “susto” also has underlying physical symptoms that may be covering up serious illnesses such as diabetes (Poss & Jezewszi 2002) or tuberculosis (Rubel and Moore 2001), or hypoglycemia (Bolton 1981).

IV. Instigate discussion of the suggested Fadimon reading with a mock patient and doctor interaction exercise. You can have student volunteers improvise a discussion between an ill person and a healthcare practitioner or have the students all do the exercise in pairs. The exercise creates a scenario between a Hmong immigrant family with a sick daughter and a Western medical practitioner. Discussion should follow the exercise.

HANDOUT FOR STUDENTS:
Each student will improvise or act out a “scene” that depicts a Hmong patient with a healthcare practitioner. We will discuss the reading in light of themes that result from this mock patient/doctor exercise.

PERSON ONE: You are a Hmong immigrant whose baby daughter is sick. Based on what you read in Fadiman’s article or book, how might a Hmong patient describe and present their illness.

Consider the following:
The immigrants understanding of the illness or self-diagnosis: The spirit catches you and you fall down. Her older sister slammed the door so loudly that her spirit was scared out of her and she fell down. Illness may have many causes but can be due to a loss of the soul to a malevolent spirit. It might be a sign that she will grow up to be a high status Shaman who can go into a trance and see the spirits and in this regard this illness (epilepsy) is highly distinguished and should not be cured as it may lead to prestige later in life.

Cultural perception of illness and health:
• Will not take pills if the colors are inauspicious.
• Will refuse surgery, anesthesia, autopsies, blood tests, and spinal taps.
•May wear a white “spirit string” on wrist that can’t be cut off while they are ill as their soul might endlessly wander.
• Hmong traditional medicine may include herbs, amulets, and animal sacrifices.

PERSON TWO: you are a health care professional and you are trying to understand or interpret what the person is saying to develop a diagnosis. Based on what you read in Fadiman’s article or book, how might a Western Doctor describe and interpret the illness.

Consider the following:
Western Medicines cultural understanding of illness:
• Customs and traditions – desensitized empathy.
• Cultural taboos- perception that only Western medicine can cure and to look at “alternative” practices would be inappropriate. There may be legal rules or “taboos” in treating patients, especially children.
• Hierarchies—tend to be “rational” and controlling.
•Have their own language that an ordinary patient might not understand.

What type of questions does a typical healthcare practitioner ask?
• What is your name, your date of birth
• What brought you in today? What is your illness?
• What kind of symptoms are you experiencing?
• What is your medical history? Do you have prior ailments, surgeries, and/or allergies?
• What medications do you take?
• Is there a family history of illness? Does heart disease or diabetes run in your family?
• Can your occupation play a role in your illness?
•Review of systems: do you have headaches, vision troubles, trouble swallowing, nausea, etc.

How might a Western doctor interpret the Hmong explanation about a malevolent spirit causing the illness?
Symptoms /diagnosis from Doctor’s perspective: At first the doctors did not understand the parents and thought Lia had bronchitis or pneumonia and prescribed antibiotics. After the third time taking Lia to the hospital they saw she was suffering from a sudden attack of seizures or convulsions.

DISCUSSION QUESTIONS AFTER MOCK PATIENT/DOCTOR INTERACTION:

1. How might differences in language affect diagnosis and treatment? Why is it important to have access to skilled interpreters? What might be the challenges of having an interpreter?

2. How might cultural differences affect diagnosis and treatment? How might it be helpful to practice both allopathic and folk medicine? What are the challenges?

3. How did the patient interpret the doctor? What did they think about the doctor and his/her treatment of them?

4. How did the doctor interpret the patient? What did the doctor think about the patient? (I.e. “noncompliance” – patient’s refusal to disregard instructions)

5. What is the “culture of medicine”? How do Western doctors perceive health, illness, diagnosis and treatment?

6. How is Western medicine linked to legal practices (i.e. Child protective services/child endangerment, Brain dead = death) and how might this conflict with the patient’s perspective?

7. Why is the patient’s view of their illness important even if it is culturally different from the Western Medical perspective?

8. How might there be inequality between doctor and patient? How might a patient’s perception of doctor’s as authority figures impact their interaction with the doctor?

9. Why is it important, as Fadiman suggests, for health care practitioners to “develop certain habits of listening, empathy, and flexibility” (2000: 6).

10. Why does Fadiman suggest doctors to ask : What do you think caused this illness? What do you call this illness? What are you most afraid of?

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

Assessment for Intercultural Knowledge and Competence:
Student Learning Outcomes (SLO): Cultural Self Awareness, Cultural Worldview, Empathy, Verbal and Non-verbal communication, Curiosity/critical thinking, Openness.

(SLO) Knowledge: Cultural Self Awareness.
Intercultural Experience.
“The experience of an interaction with an individual or groups of people whose culture is different from your own. Intercultural/cultural differences: The differences in rules, behaviors, communication and biases, based on cultural values that are different from one's own culture(AAC&U).”

Assessment of Cultural Self Awareness:
Emic and Etic are common concepts in anthropology that try to show differences in perception, “cultural self-awareness,” the emic being the perspective of the people we study, and etic being the outsider’s perspective, the perspective of the anthropologist who analyzes the culture. The exercise tries to get students to understand Hmong cultural beliefs from their perspective (emic) but also be able to analyze and interpret them from an etic perspective (The anthropologist or doctor)

(SLO) Knowledge: Knowledge of cultural worldview frameworks.
“Worldview is the cognitive and affective lens through which people construe their experiences and make sense of the world around them(AAC&U).”

Assessment of cultural worldview frameworks.
“Worldview” is a concept central to anthropology, looking at how individuals perceive their world and their place in it, which can be different in different cultures. This exercise looks at the worldview from American culture in contrast to Hmong culture.

(SLO) Skills: Empathy.
"Empathy is the imaginary participation in another person’s experience, including emotional and intellectual dimensions, by imagining his or her perspective (not by assuming the person’s position). (Bennett 1998)"

Assessment of Empathy.
Cultural relativism is an approach in anthropology that tries to maintain a neutral non-judgmental stance, showing “empathy” for cultural differences. This exercises looks at beliefs regarding health and illness from Hmong culture. A young girl is misdiagnosed due to cultural misinterpretation causing dire consequences, so the aim is that students can imagine their perspective.

(SLO) Skills: Verbal and nonverbal communication.
Articulates cultural understanding of verbal & nonverbal forms of communication and show ability to create shared understandings.

Assessment of Verbal and nonverbal communication.
This assignment in particular looks at an example where communication between cultures lead to a horrible outcome for one little girl, and the aim is to try to understand and create “shared forms of communication” to avoid such a tragedy again.

(SLO) Attitudes: Curiosity/critical thinking.
Able to question and articulate responses showing ability to see things from multiple cultural perspectives.

Assessment of Curiosity/critical thinking
As a mock patient and doctor interaction, the students learn “curiosity” and “critical thinking” as, they articulate responses based on two different cultural worldviews related to health and healing showing ability to see things from multiple cultural perspectives.

(SLO) Attitudes: Openness.
Suspends Judgment in valuing their interaction with culturally different others.
“Postpones assessment or evaluation (positive or negative) of interactions with people culturally different from one self. Disconnecting from the process of automatic judgment and taking time to reflect on possibly multiple meanings” (AAC&U).”.

Assessment of Openness.
Cultural relativism is an approach in anthropology that tries to maintain a neutral non-judgmental stance, showing “openness” to see cultures that are different from our own without bias. This exercises looks at beliefs regarding health and illness from Hmong culture.

Association of American Colleges and Universities. "Intercultural Knowledge and Competence VALUE Rubric." 2009. https://www.aacu.org/value/rubrics/intercultural-knowledge.

Bennett, J. 1998. Transition shock: Putting culture shock in perspective. In Basic concepts of intercultural communication, ed. M. Bennett, 215-224. Yarmouth, ME: Intercultural Press.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

I have not been able to run the ANTH 2000 “Medical Anthropology” class yet for lack of enrollment, but I hope to try to offer it in the Spring 2021. I am not sure how I could adapt this lesson for online learning if that should continue, but perhaps have students write response papers.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Materials needed
1) Anthropology key terms
2) Readings:
Book: Fadiman, Ann. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Farrar, Straus, & Giroux, 1997.
OR
Article: Fadiman, Ann. "The Spirit Catches You and You Fall Down": Epilepsy and the Hmong. Epilepsy & Behavior: E&B [Epilepsy Behav] 2000 Feb; Vol. 1 (1), pp. S3-S8.
(Available thru City Tech library article database EBSCO)
3) Xerox of mock patient/healthcare practitioner scenario (https://openlab.citytech.cuny.edu/popefischeranth2000medicalanthro/files/2020/06/Intercultural-Knowledge-and-Competence-for-ANTH-2000-Medical-Anthro-.pdf)
4) Optional: Video “Split Horn: Journey of a Hmong Shaman”. Or you might show a short video clip from youtube that shows a Hmong Shaman doing a ritual cure (See suggestions below after bibliography of references and suggested reading).

Other Resources
Possible links:
•Pdf course notes
•Powerpoint slides
•List of online resources
• Google images are a good way to find pictures AND Youtube.com has a number of short video clips.

REFERENCES AND SUGGESTED READING:
Arntfield, Shannon L., Kristen Slesar, Jennifer Dickson, Rita Charon “Narrative medicine as a means of training medical students toward residency competencies” Patient Education and Counseling. Volume 91, Issue 3, June 2013, Pages 280–286

Bolton, Ralph (1981) “Susto, Hostility, and Hypoglycemia” Ethnology , Vol. 20, No. 4 (Oct., 1981), pp. 261-276.

Fadiman, Ann. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Farrar, Straus, & Giroux, 1997.

Fadiman, Ann. "The Spirit Catches You and You Fall Down": Epilepsy and the Hmong. Epilepsy & Behavior: E&B [Epilepsy Behav] 2000 Feb; Vol. 1 (1), pp. S3-S8.

Freed, Stanley A. and Ruth Freed (1999) “Taraka’s Ghost,” Natural History, October 1999, pp. 84-91.

Gruenbaum, Ellen. “Sexuality Issues In the Movement to Abolish Female Genital Cutting in Sudan.” Medical Anthropology Quarterly, Vol. 20, Number 1, (2006) pp. 121-138

Hahn, Robert A. and Marcia Inhorn (eds.) (2010) Anthropology and Public Health, Second Edition: Bridging Differences in Culture and Society.Oxford University Press.

Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med 1978;88:251–8

Oubre, Alondra. Shamanic trance and the placebo effect: The case for a study in psychobiological anthropology. PSI Research, Vol 5(1-2), Mar-Jun, 1986. pp. 116-144.

Poss, Jane and Mary Ann Jezewski (2002) “The Role and Meaning of Susto in Mexican Americans' Explanatory Model of Type 2 Diabetes” Medical Anthropology Quarterly , New Series, Vol. 16, No. 3 (Sep., 2002), pp. 360-377

Rubel, Arthur J. and Carmella C. Moore (2001)”The Contribution of Medical Anthropology to a Comparative Study of Culture: Susto and Tuberculosis” Medical Anthropology Quarterly, New Series, Vol. 15, No. 4, Special Issue: The Contributions of Medical Anthropology to Anthropology and Beyond (Dec., 2001), pp. 440-454

Thompson, Jennifer Jo Ritenbaugh, Cheryl Nichter, Mark. Reconsidering the placebo response from a broad anthropological perspective. Culture, Medicine and Psychiatry, Vol 33(1), Mar, 2009. pp. 112-152.

Suggested photograph images or videolinks:
Film Suggestion:
Split Horn: Journey of a Hmong Shaman

The spiritual healing of Hmong Shamanism (7:28)
https://www.youtube.com/watch?v=ymJnUHxqRpE

ASA Documentary: Second Generation Hmong Shaman (33:39)
https://www.youtube.com/watch?v=OrSZBsGn-4M

Anorexic Models: The curse of fashion modeling (2:47)
https://www.youtube.com/watch?v=ZK-Lhy-HqCs

Extreme Plastic Surgery (8:42)
https://www.youtube.com/watch?v=9R149OXxsGg

The link on Open lab includes the handout I would give students:

Click to access Intercultural-Knowledge-and-Competence-for-ANTH-2000-Medical-Anthro-.pdf

Please share a helpful link to a pages or post on the OpenLab

Click to access Intercultural-Knowledge-and-Competence-for-ANTH-2000-Medical-Anthro-.pdf

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Impact of Culture, Geographic Location, and Oral Health Literacy on Dental Hygiene Practices

Impact of Culture, Geographic Location, and Oral Health Literacy on Dental Hygiene Practices

Isis Marsh

Dental Hygiene

Dental Hygiene Seminar III or IV

Activity Description: Provide a brief description of the activity

Dental hygiene students have applied previous learning from DH seminar and clinical instruction to integrate Medical/Dental histories and clinical findings to assess and determine the appropriate course of patient management and communication. This activity will require students to advance their patient management and communication skills by having them consider the impact of their patient’s culture, geography, and oral health literacy into their total assessments. As dental professionals, students must be prepared to communicate effectively in real-world scenarios and care for patients with differing levels of health knowledge and diverse backgrounds. Students will participate in a combined independent/collaborative project by gathering and researching patient information, and then working with peers to evaluate and discuss case reports.

Learning Goals: What do you aim to achieve with this activity?

This activity aims to encourage critical thinking that produces effective written and verbal communication with patients of various cultural/demographic backgrounds that have different levels of dental knowledge. The learning goals of each student is to correlate global and multicultural impacts into patient assessment, care, and communication, and to work collaboratively with others from diverse backgrounds. This project will progress students’ conceptual knowledge, reasoning and problem solving, cultural self-awareness, understanding of cultural worldview, and how to relate such experience into clinical application.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This student activity lesson is best suited for senior dental hygiene students. Thirty minutes of classroom time will be devoted to oral health literacy tools and interpreting findings. Students will then use thirty minutes of clinic time to conduct an interview. Two to four hours of out-of-class time is expected for this project; 1-2 hours of research/writing and 1-2 hours of collaboration with the group.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

Students will read an assigned article and view a video on oral health literacy and cultural sensitivity for supplemental learning before a 30-minute in-class lecture. Students will also be provided with an interview questionnaire and assignment instructions to follow accordingly. The activity will be a low-stakes assignment. To begin, students will work independently by interviewing one patient (with consent) on cultural background, demographic location, and oral health literacy. Individually students will explore patients’ cultures (beliefs, attitudes, customs, and diet), demographic location (access to transportation, care, and fluoridated drinking water), and oral health literacy findings (better or poorer than expected). Students will then write a research/case report (2 pages) with a reflection portion discussing if any of the information they acquired changed their perspective of the patient, and how communication and patient management may have been modified due to the additional information. The collaborative portion of the assignment will require students to present their case report on Open Lab and collaborate with peers (groups of four) to discuss and answer questions on similarities and differences between their patients and themselves.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

This activity was developed using the AAC&U Intercultural Knowledge and Competence VALUE Rubric as a guide. Students will be evaluated using a rubric to assess writing quality, analysis & application, problem-solving & decision making, connection to course material, contribution to learning, and timeliness.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

The activity has not yet been implemented.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

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Restorative Dentistry Students Externship Program Summer 2020Place-Based-Learning Methodology

Restorative Dentistry Students Externship Program Summer 2020Place-Based-Learning Methodology

Laura Andreescu

Restorative Dentistry Department

RESD 1215 Introduction to Restorative Ceramics

Activity Description: Provide a brief description of the activity

For more than 14 years, the Restorative Dentistry Department established and conducted a Summer Externship Program for 2nd semester students, where students were assigned to an external facility for 24 hours as a place-based learning pedagogy.
Due to COVID 19 pandemic, the Externship Program – Spring/Summer 2020 semester needed to be modified in accordance with the distance learning methodologies, and follow the recommendations given by the Commission of Dental Accreditation. Therefore, the students are grouped in teams and assigned to an Externship Site, such as: dental office, dental laboratory, dental manufacturer, etc.; students must conduct online interviews and write individual reports answering the question: How was the Externship site affected by COVID-19 crisis?
The Externship Program, by engaging the Open Digital Pedagogy strategies, will give students the opportunity to have an experience outside of the classroom, even tough is virtual. Also, the students will learn about the hardship that many dental practices are facing in these times and how they are planning to return to providing dental services for their patients and retaining their employees. The scope of the program is to have the students be accustomed with dental practices and their role as future dental technicians in the dental filed. Also, it is important that students develop important abilities, such as empathy and verbal and non-verbal skills, which are vital in any medical/dental practice.

Learning Goals: What do you aim to achieve with this activity?

Student Learning Outcomes as stated in the syllabus:
Skill: (Laboratory) develop tools needed for communication, inquiry, analysis, and productive work.
Inquiry/Analysis: derive the meaning from experience, as well as gather information from observation; describe and solve problems.
To develop/improve their verbal and non-verbal skills, the students must be concise in their questioning, being aware that the participants are more preoccupied with the daily operation process, thankful and polite that the Externship Sites participated in this program and dressed properly for the virtual interview, showing respect.
Similarly, to develop/improve their empathy skills, the students might ask:
How the patients’ will be treated in compliance with the social distance protocols?
What are the new regulations about the personal protective equipment, which will protect the patients and employees?
What measures can be developed for employees’ retention?
How many dental technicians lost their jobs?
What are the plans for the immediate future?
The Program will implement High-Impact Educational Practices by having students working in teams to prepare and conduct virtual interviews. Students will learn more about each other and hopefully they will develop strong relationships that can beneficial for many years to come, in their careers.
For this project, the intercultural awareness can be evaluated in two ways:
(1) how the students interact with each other to complete the Externship
By collaborating in their teams, the students will better their communication and organizational skills, because they will have to listen and respect their teammates opinions and express their ideas in polite manner.
and
(2) how students interact during the interviews, with the Externship Sites participants
The students must show compassion and understanding for the hardship that many dental practices experience in this time, prepare clear questions for the participants, and show interest in what the other person is conversing.

The students’ reports should reflect their empathy and verbal and non-verbal skills

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

The Externship Program Spring/Summer 2020 is in progress and as mentioned before in online only activity.
The estimated completion is before the beginning of the Fall 2020 semester, based on the availability of the Externship Sites participants and of the students.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

Please see the above Program description.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

RD Externship Program and Intercultural Knowledge And CompetenceValue Rubric
(1) EMPATHY:
– EXCELLENT (10 to 8 points) (1) Student interprets intercultural experience from the perspectives of own and more than one worldview and demonstrates ability to act in a supportive manner that recognizes the feelings of another cultural group
– GOOD (7 to 5 points) (1) Student recognizes intellectual and emotional dimensions of more than one worldview and sometimes uses more than one worldview in interactions
– SATISFACTORY (5 to 3 points) (1) Student identifies components of other cultural perspectives but responds in all situations with own worldview
– UNSATISFACTORY (3 to 1 points) (1) Student views the experience of others but does so through own cultural worldview

(2) VERBAL AND NONVERBAL COMMUNICATION
– EXCELLENT (10 to 8 points)(2) Student articulates a complex understanding of cultural differences in verbal and nonverbal communication
– GOOD (7 to 5 points)(2) Student recognizes and participates in cultural differences in verbal and nonverbal communication and begins to negotiate a shared understanding based on those differences
– SATISFACTORY (5 to 3 points)(2) Student identifies some cultural differences in verbal and nonverbal communication and is aware that misunderstandings can occur based on those differences but is still unable to negotiate a shared understanding
– UNSATISFACTORY (3 to 1 points)(2) Student has a minimal level of understanding of cultural differences in verbal and nonverbal communication; is unable to negotiate a shared understanding

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

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Image Critique

Image Critique

Zoya Vinokur

Radiologic Technology and Medical Imaging

RAD 1225 Radiologic Procedures

Activity Description: Provide a brief description of the activity

This is an in-class activity which involves student interaction and critical skills. Students will look and analyze two films a week every other week. Then they will discuss their finding and share with class. Radiologic Technologists take and review a lot of films daily as part of our routine job performance. Acquiring an acceptable radiograph or digital image requires knowledge of the anatomy, positioning criteria, radiographic exposure, and other skills. In addition, the radiographer must know and meet specific diagnostic imaging criteria to provide the radiologists images suitable for interpretation. A knowledgeable RT assesses acquired images as a point of quality control to make sure it meets the diagnostic criteria. Students need to make critical thinking decisions and be able to evaluate images. Combining imaging skills with patient skills is truly an artful use of scientific principles and people skills. Occasionally we must be creative to present anatomy in a way that meets the diagnostic criteria. After each activity students will discuss findings and give feedback. In addition, they will be required to write reflection on their findings and post on Open Lab.

Learning Goals: What do you aim to achieve with this activity?

• Students will learn effective methods of analyzing images and communicate with other students.
• Students will be able to identify qualities of image as radiologic technologist and be able to critique it
• Students will be able to interact with patients of diverse cultural backgrounds, disabilities, sexual orientations, age groups or illness with the utmost respect and care and provide best possible images.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

The in-class portion of this activity will be in done during semester lectures every other week, where is the place-based learning must be done. Homework will be given and reflected on Open Lab.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

This activity is low stakes .

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

This activity includes General Education Learning Goals:
1. Skills:
• Communication- communicate in diverse settings and groups, using written (both reading and writing), oral (both speaking and written)
• Inquiry/Analysis – Derive meaning from experience, as well as gather information from observation. Use creativity to solve problems.
2. Integration:
• Integrate Learning – Resolve difficult issues creatively by employing multiple systems and tools.
3. Values, Ethics, And Relationships:
• Global/Multicultural Orientation – Discern multiple perspectives. Use awareness of cultural differences to bridge cultural and linguistic barriers. Demonstrate proficiency and capacities in dealing with a diverse society.
This activity also includes High-Impact Educational Practices:
1. Collaborative Assignments and Projects.
2. Diversity/Global Learning
3. Service Learning/Community–Based Learning

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

This activity was successful in the Lectures. It will be implemented in my different courses with the addition of place-based learning. As we view images contained in this activity we will also address two important issues: what anatomy should be presented in a specific view, and how should that anatomy be presented. For example, a radiograph that is positioned correctly and demonstrates the proper anatomy must also have optimal exposure technique to yield maximum diagnostic value. My students enjoyed this activity since it is reflecting in their daily activity in Hospitals, but in more formal way.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

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Setting the Table Across Cultures: A Scaffold Approach to Intercultural Knowledge & Competence

Setting the Table Across Cultures: A Scaffold Approach to Intercultural Knowledge & Competence

Dolores C. Urena

Hospitality Management / School of Professional Studies

HMGT 2305 / Dining Room Operations (Lab)

Activity Description: Provide a brief description of the activity

In this three-part assignment, students identify, explain, and demonstrate the differences and similarities involved in the provision of dining experiences across different cultures in comparison to the specification of fine dining service as practiced in the dining room laboratory at City Tech.
Part I: OpenLab (Week 3 of the semester)
• Students individually post a picture of a tabletop setting different than the one learned in class.
• Students are required to post with the picture a short description of why the setting (silverware, china, glassware, table, etc) is different or similar to the one practice in dining room laboratory.
• Each student is required to comment on two other posts-more are welcome.
Part II: Collaborative Research Paper/ Self Reflection (After an in-class discussion on OpenLab postings, the instructor assigns groups on Week 4 of the semester)
• Students will be placed into groups of three to conduct research on the significance of the tabletop setting, and dining and service etiquette they have selected.
• Individually students are required to write a personal reflection paper.
• The instructor will provide prompt questions and instructions to assist students with the research and reflection papers.
Part III: Final Group Project / Presentation (Week 14 of the semester)
• Each group will submit a two-page research paper.
• Each group will explain and illustrate in class the tabletop setting they have selected.
• Individually students will submit a one-page personal reflection paper.

Learning Goals: What do you aim to achieve with this activity?

The purpose of this assignment is for students to interact and build a consensus that supports knowledge of an expanded cultural worldview. The assignment scaffold approach will help students assimilate the awareness, sensitivity, and proficiencies needed to succeed in the multicultural industry of hospitality. To do well in their chosen field, they will need the ability to interact, adapt and build relationships effectively across cultures.
Learning Goals associated with:
• Global / Multicultural Orientation
• Lifelong Learning
• Communication
• Information Literacies
• Professional / Personal Development

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

The instructor distributes the three-part assignment on the first day of class.
Part I – Week 3 of the semester:
• Out of class time is expected to obtain, and post picture/comments on OpenLab.
Part II – Week 7 of the semester:
• An in-class two-hour workshop at City Tech Library.
• Additional out-of-class time is expected to conduct research before and after the workshop.
Part III – Week 14 of the semester:
• An in-class five to ten minutes presentation.
• Additional out-of-class time is expected to write assignments.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

Part I – Knowledge of OpenLab:
• The instructor will instruct students on how to use OpenLab.
Part II – Visit to City Tech Library
• The instructor will give instructions to the students on how and what to research and reflective questions to contemplate will be provided.
Part III – Review Expectations:
• Preparation for final group presentation will be discussed in class.
• The instructor will provide students with the appropriate guidelines and rubrics to complete assignments.
The semester-length three-part assignment is medium-to-high stakes-15% of the final grade.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

The assignment will be assessed using the Intercultural Knowledge and Competence Value Rubric, as well as an additional rubric evaluating the quality of the presentation and teamwork.
Written assignments will be graded using an appropriate writing intensive course rubric.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

This information is not available yet. The activity has not been implemented.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

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Radiology Assignment

Radiology Assignment

Audra Haynes

Dental Hygiene

Dental Radiology/ DEN 1218

Activity Description: Provide a brief description of the activity

This semester you have learned about the production, use and safety of x-radiation. As dental professionals, you will encounter people with diverse backgrounds and ideologies. Exposing x-rays is part of overall patient assessment, yet that can be a challenge for some. Your assignment will be to explain to clinical patients what x-radiation is and why we use it. You must be able to explain the benefits versus the risks. You will have to demonstrate and articulate the understanding of x-radiation in patient care and assessment. You will do this using different case scenarios that a dental hygienist may encounter in the dental setting.

Learning Goals: What do you aim to achieve with this activity?

The learning goals that each student will aim to achieve are learning to communicate to diverse groups with both written and oral skills.
Students will apply global and multicultural orientation, by understanding the role cultural barriers play in patient care and assessment.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

Students will work on the assignment at the mid-semester period. The assignment will be worked on outside of class time, based on course material.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

This activity will involve working in groups of 2. Each group will be given a case scenario involving a situation that will require the group to develop patient education, which will address the case scenario. The patient education must involve a description of x-ray production, x-ray safety, and why x-rays are used in dental patient assessment. The group must account for cultural challenges and incorporate that into their patient education. While you will be working as a group on the assignment, each member of the group will submit their own written paper. The paper should be a 2 page, doubled spaced paper that will be submitted to the instructor. You are free to use additional resources not covered in class. All resources used must be cited.
Each group will create 2 role play videos of the case scenario. Each member of the group will have the opportunity to be both the clinician and the patient. The videos will 5-7 minutes at length and will be uploaded to OpenLab for peer review. The video must include all aspects of the case scenario as well as the written patient education developed by the group. Feel free to have fun with the video and make it as entertaining as you want but stay to the 5-7 minutes and keep to the case scenario and patient education developed. This low-stakes assignment is designed to help you incorporate what you have learned in the classroom into clinical practice.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

This activity will be assessed using a 2 rubrics. One rubric will assess the written portion of the assignment, evaluating the completeness, the understanding, and the writing mechanics of the assignment. The second rubric will evaluate the role play, which will address the communication style, interactive dialogue and non-verbal communication. The role play rubric will also have a peer rubric where the students will evaluate each other.
The AAC&U Intercultural Knowledge and Competence VALUE Rubric will be used to as a guide in creating the assignment.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

This information is not available yet. The activity has not been implemented yet.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

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Dental Hygiene Community Education

Dental Hygiene Community Education

Maria Dimino

Dental Hygiene

Living Lab

Activity Description: Provide a brief description of the activity

Students will be divided in groups of four (three groups total). The assignment will be done on open lab as an E-Portfolio. This assignment is Place Based Learning. Each group will have an underserved population. The first group will have Head Start 0-5 years of age. The second group will have the YMCA ages 6-19 and the last group will have a group home ages 20-60. They will discuss and educate daily oral hygiene. They will assess their level of knowledge and perception.

Learning Goals: What do you aim to achieve with this activity?

The main goal is to get them out of their comfort zone of the clinic they are in daily. Also, they will be exposed to a diverse population in need of oral hygiene education. They will create a daily home care plan for each patient. In addition, they will interview staff and see if oral hygiene is a part of their daily regimen. They will create the E-portfolio discussing the interview process with staff and the patient's perception of of daily oral hygiene practice. They also have to comment on two other student's E-portfolio.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

I plan on implementing this toward the end of the semester when the students are more comfortable with their own knowledge on oral hygiene. I plan on devoting one class per month on their assignment. The out of classroom time is around three-four hours.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

This is a low stakes assignment. I want the students to focus more on the communication process rather than the assignment being a big percentage of their grade. The students were instructed to interview the management staff and the patients. Then they are to create an E-portfolio with all the data collected from their assessments.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I plan on using a Value rubric and they will be mainly graded on communication (verbal and non verbal), writing skills and cultural self awareness. I developed the rubric based on the goals of the assignment and wanted to keep it focused on those three areas to grade.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

I have not implemented this assignment as of yet, but I plan on in the near future. I truly hope the students will enjoy this opportunity to help others that do not have access to care. I definitely plan on doing this every semester and will probably make changes as I go along. I am looking forward to this Placed Based Learning activity.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

In the future if the assignment goes well I will look into getting a grant. The funds would go towards toothbrushes, toothpaste and floss.

Please share a helpful link to a pages or post on the OpenLab

http://www.jdentaled.org

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Perception of homecare

Perception of homecare

Catherine Monchik

New York City College Of Technology

Principles of Dental Hygiene Care II

Activity Description: Provide a brief description of the activity

All students are required to take a “Prevention Exam” in Den 1200 lab. This exam consists of two components which consist of having the student teach home care to patients during two visits. The patient needs to have a 30% plaque score, with a minimum of 20 teeth present and 7-10 days between the two visits. The first visit will include assessing initial skills and homecare regimen, disclosing patient with solution so you can visualize where improvement is needed,  and choose an appropriate aid (flossing, brushing, interdental aid etc). On the second visit and second part of the exam, we check the patients compliance and technique. The student can reinforce what was originally taught if patient needs more assistance. Then we disclose again, to choose another aid, if the patient seems comfortable with the original method taught. The second aid will access another area of the teeth that the patient is finding difficult to reach and keep clean. The student will be required to write a reflection of both visits on the perception of value, of homecare taught due to their cultural background. They will need to analyze the patients level of ability to learn new skills. The assignment will be posted on openlab using only the patients initials with at least one paragraph.

Learning Goals: What do you aim to achieve with this activity?

There will be different goals from this assignment for the students to learn. The student will decide, based on the need of their patient, which aid is appropriate. By seeing the visible plaque with disclosing solution, the student should be able to choose the right aid. At the follow up appointment, check if the patient is compliant and has the ability to use the aid correctly. At this time we need to reinforce aid or introduce a new aid for another area that needs help. The student will see what worked or did not work, and why. The reflection will teach the student that along with dexterity, and ability to perform the aid, that compliance is essential. There are other barriers, such as cultural beliefs and background that have a big impact on accepting prevention measures. Professional development along with diversity learning will help the student grow as a better clinician.
*The student will gain knowledge from cultural self-awareness and knowledge of cultural worldview frameworks.
*Demonstration of skills of verbal and nonverbal communication and attitudes of openness will also be assessed.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This assignment will be discussed in the beginning of the semester. The student will post it on open lab one week after the completion of their prevention competency. It can be submitted at any time before the end of the semester. There will be no classroom time devoted to this. The out-of class time will require one to two hours.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

The preparation of this assignment is minimal. The prevention competency is found in the back of the students clinic binder for them to review. After completing the competency, the student will have one week to write the reflection and post it on open lab. The student will analyze the the perception of value for homecare based on the patients cultural background. It will be a short paragraph reflecting the background of their patient. It will need to be submitted on time, with correct spelling, grammatical format and quality content. This reflection is a low stakes assignment, having a small percentage of their overall Den 1200 lab grade. Failure to complete the assignment will have a deduction of ten points to their final Den 1200 lab/lecture grade.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

This assignment is geared towards second semester dental hygiene students, and not a college wide assessment tool. The grade will be determined on the completion of the assignment and the use of the Intercultural Knowledge and Competence VALUE Rubric.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

As of right now, we do not have this implemented in our Den 1200 lab. If we did, I believe our students can learn a lot about their patients. Cultural backgrounds have a big impact on how patients perceive value in homecare and prevention measures in their dental health. Compliance is not only the reason, it is an understanding of what we believe in.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

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