Clinical and Health Affairs
Service Learning in Rural Communities
Medical Students Teach Children about the Brain
By Janet L. Fitzakerley, Ph.D., and Ruth Westra, D.O., M.P.H.
Abstract
Incorporating service learning into a medical school curriculum can have significant benefits for both the students and the communities they serve. The University of Minnesota Medical School-Duluth Campus has integrated an established neuro-science literacy program into a community service requirement for second-year medical students. Since 2005, medical students taking part in the program have made presentations about the brain and how it works to more than 10,000 elementary school students throughout Minnesota and northwestern Wisconsin. This article describes this initiative and the potential benefits to both the medical and elementary school students.
Service learning can expose medical students to the communities they will serve as physicians.1 Spending time in a small, rural community is particularly critical for students who wish to practice in such areas, as it shows them the excellent care delivered outside major metropolitan areas and makes them aware of the skills needed to practice in smaller towns. In addition, medical students who are involved in community service activities perform better academically than those who do not take part in such projects.2 This suggests that there are significant benefits to including a service learning component in a medical school curriculum. The University of Minnesota Medical School-Duluth Campus incorporates service learning into its second-year curriculum. This requirement has benefited a number of communities as well as the students who participate.
The Community Service Requirement
The University of Minnesota Medical School-Duluth Campus prepares students to practice family medicine in rural Minnesota and in American Indian communities. As part of the curriculum, Duluth medical students spend 12 days with a family physician preceptor in a rural setting. The preceptors serve as role models, helping students develop their clinical skills and providing them with experiences that will help them decide on the type of setting in which they want to practice.3
A community service requirement was added to the second-year rural preceptorship curriculum in 2004. The idea behind this additional requirement is that medical students would learn how health care issues affect rural communities and to be a resource for the people who live there.4 In simple terms, the expectation is that the students will “pay back” the community for supporting them during their training. The service requirement is flexible, and students have selected to do such activities as participate in health expos, do blood pressure checks at local pharmacies and nursing homes, and deliver Meals On Wheels. The option of making a presentation to grade school children about the brain was added in 2005; that year, 59% (30/51) of the class selected that as their project. In 2008, 96% (54/56) of second-year students elected to participate in what is now known as the Brain Awareness program.
The University of Minnesota Brain Awareness Program
Brain Awareness Week is a national event that was launched in 1996 by the Dana Alliance for Brain Initiatives and the Society for Neuroscience as a way to educate the public about progress in and the benefits of neuroscience research. University of Minnesota faculty members and students from the Graduate Program in Neuroscience on the Twin Cities campus and the medical school on the Duluth campus have been involved in Brain Awareness Week since its inception. Outreach activities have focused on teaching fourth- through sixth-graders in Duluth and the Twin Cities about the brain. In total, students and faculty from both campuses have made presentations to more than 85,000 elementary school students, making the Minnesota program one of the largest in the United States. Since the Brain Awareness option was added to the medical school’s preceptorship program, students from the Duluth campus have made presentations to more than 10,000 students in greater Minnesota and western Wisconsin (Figure 1).
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Figure 2
Brain Awareness Activities
Medical students do a variety of activities with schoolchildren depending on the children’s ages and the interest of the medical students. In addition to allowing the children the opportunity to look at and touch a real brain, they might do exercises such as the following that teach about brain function.
Storyboards
Medical students can use 12 different storyboards to help them illustrate that different regions of the brain perform different functions. This one tells a story about a girl named Susie who goes for a walk in the woods. The storyboard can be used to talk about the cold water, the sound of the waterfall, and having a drink of water. The medical student can follow up by showing students the anatomical regions of the brain that are matched to temperature detection, hearing, and performing motor tasks such as swallowing.
Stroop Test
Name the colors of the words as fast as you can (do not read the words, say the color out loud). For example, for the first word, you should say “blue.”
Pink
Black
Blue
Yellow
Green
Grey
Brown
Red
White
It usually takes longer to say the colors than to read the words. The processing delay arises because different cortical areas process words (generally, the left side of the cortex) and colors (the right side of the cortex). The conflicting commands from the two areas (“say pink” versus “say blue”) result in a delay in the speech-generation process. More information about the Stroop effect can be found at: http://faculty.washington.edu/chudler/
words.html.
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A typical presentation consists of an introduction about the presenter and the university, interactive demonstrations of brain functions, and the presentation of a real brain (Figure 2). Each presentation lasts 45 minutes to 1 hour (typically 1 class period). The medical students choose the grade level, school, and number of presentations they wish to make and are responsible for coordinating their activities with the teacher. Although speaking to a single class sufficiently fulfills the service requirement, in 2008, the average medical student presented to 3 classes (approximately 105 elementary school students).
Everyone Benefits
A number of benefits have been associated with the Brain Awareness/community service partnership. First, the partnership gives medical students the opportunity to serve as ambassadors for the university and to share their enthusiasm for medicine in schools that may not have robust science programs. This has obvious implications for inspiring the best and brightest young students to pursue careers in health care and science. To quote a medical student from rural Minnesota who has participated in the Brain Awareness program, “Even if only one child’s imagination was sparked, the presentations were well worth the effort.”
Second, the partnership serves as a resource for elementary school teachers. Science is just one of many topics that they must teach, and they frequently lack formal science training.5 Yet children need to become “neuroscience literate” as they eventually will encounter people who are affected directly or indirectly by a neurological disorder and they need to understand how lifestyle choices such as drug abuse can affect brain function.6 In this context, medical students can assist teachers by serving as reliable sources of scientific information.
Finally, participating in the community service program benefits the medical students themselves. In their comments about the experience, students have described how making presentations to elementary school students helped them understand the importance of being able to explain basic disease concepts and body processes to patients at an appropriate level. They have also commented that they felt they were contributing to the community as a whole—an important component of small-town practice.
Conclusion
Community service is an increasingly valued component of medical education. The University of Minnesota’s Brain Awareness program offers medical students a particularly rewarding opportunity to give back to the communities in which they do their preceptorships. Given that almost 70% of U.S. medical schools are affiliated with a university that is listed as a Brain Awareness Week partner,7 this type of collaboration could be replicated in many institutions. If a formal preceptorship program does not exist, medical student interest groups, the American Medical Student Association, or a Physicians for Social Responsibility chapter could sponsor the activity.
Participation in Brain Awareness activities has benefited medical students by enabling them to become health educators in rural communities. It also benefits the children they interact with—children who may be the next generation of scientists and physicians. MM
Janet Fitzakerley is an associate professor in the department of physiology and pharmacology and Ruth Westra is chair of the department of family medicine and community health at the University of Minnesota Medical School-Duluth Campus.
The community service component of the preceptorship was supported by a Title VII HRSA grant awarded to the Department of Family Medicine and Community Health Duluth. The Medical School-Duluth Campus Rural Preceptorship Program is organized by Jim Boulger, Ph.D. The University of Minnesota Brain Awareness program is supported by the University of Minnesota’s Graduate Program in Neuroscience, the Medical School and Academic Health Center, the Minnesota Medical Foundation, as well as the Keith Kajander scholarship fund of the School of Dentistry.
References
1. Ferrari ND 3rd, Cather GA. Community service, learning and the medical student. Educ Health. 2002;15(2):222-7. 2. Blue AV, Geesey ME, Sheridan ME, Basco WT Jr. Performance outcomes associated with medical school community service. Acad Med. 2006;81(10 Suppl):S79-82.
3. Boulger JG. Family medicine education and rural health: a response to present and future needs. J Rural Health. 1991;7(2):105-15.
4. Oandasan I, Byrne N, Davis D, Shafir M, Malik R, Waters I, Stubbs B. Developing competency-assessment tools to measure the family physician’s ability to respond to the needs of the community. Acad Med. 2001,76(10 Suppl.):S80-3.
5. Weiss IR, Banilower ER, McMahon KC, Smith PS. Report of the 2000 national survey of science and mathematics education. Horizon Research Inc., Chapel Hill, North Carolina, 2001.
6. Cameron W, Chudler W. A role for neuroscientists in engaging young minds. Nat Rev Neurosci. 2003;4(9):1-6.
7. Dana Alliance for Brain Initiatives. Brain Awareness Week Partner Listing. Available at: http://brainweek.dana.org/partlisting.cfm. Accessed November, 10, 2008.