CVAHEC Student Project Reports

Leslie Bradford
Freeman Scholar Program

In January of 2003, Abigail Donaldson, Ian Zenlea, and I inherited a lunchtime education program from two second-year students. The program lacked any sort of organization and infrastructure, and so, this summer we set out to develop a resource guide that could be used by the staff and clients at Spectrum as well as by medical students teaching each topic.

The end result has been three comprehensive health and well-being resource guides. The first two are geared toward the medical students and staff at Spectrum and include lesson plans, fact sheets, and interesting journal articles on current research. The third guide is a condensed version that will be kept at the Spectrum Drop-In Center and can serve as a resource guide for teens who may have additional questions or those who were unable to attend one of the lunches.

Much of what has been included in each binder was based on our experiences at Spectrum this past spring. The lunch sessions continued throughout the summer and provided us with an opportunity to test many of our teaching strategies and to flesh out many of the lessons.

For example, one of the first topics we tackled this summer was the topic of addiction and dependence, using nicotine and tobacco products as an example. At the end of the lesson, we found ourselves writing down an extensive list of questions (i.e. are organic cigarettes better than regular cigarettes? What is the difference between a regular and a light cigarette? How can teens get involved in a Burlington-area anti-tobacco campaign, etc.) which helped us to get a better idea of the changing concerns of the group.

Interestingly, when we had taught the same lesson in the spring, the teens were much more interested in the effects of nicotine on the brain rather than types of cigarettes. With revisions, our lesson plan and information packets are now much more complete. Researching the answers to these questions not only helped us to make our information packets more thorough, but allowed us to predict which questions are most likely to be asked so that the next group of students to take over teaching the lunchtime sessions will be much better prepared.

For me, the process of making the binder became a very effective of teaching myself about many of the issues facing this “at risk” group of teens, a way to better prepare myself for work in a clinical setting, and an opportunity to learn about community resources.

As with any project, however, there were some pitfalls. Ina Zenlea and I had hoped to take advantage of the summer increase in number of clients at Spectrum in order to extend our health education lunchtime session to other lunchtime activities. We began to work with the AmeriCorps volunteers at Spectrum to plan a movie/discussion group in which teens could sign up to watch a movie that addressed many charged topics and then to hold a discussion group following the showing. We also discussed revitalizing the walking group as a way to promote physical activity. Unfortunately, due to summer vacations and scheduling, both projects are still in the “planning stage”.

As a continuation of the lunchtime sessions, however, I volunteered in the Adolescent Health Clinic (a division of the Community Health Center that operates out of Spectrum One Stop). The experience has been incredible and I can’t even begin to describe how much I have learned! The clinic provided me with an incredible opportunity to apply my basic science knowledge and to improve my clinical skills.

I have been working with Lee Orsky, PA, who is an amazingly patient and meticulous teacher and mentor. Over the course of the summer I progressed from observing patient visits to taking histories performing physical exams. Although no formal data was collected, Lee Orsky, the social workers and counselors, and medical assistants were constantly commenting on the effect that our lunchtime sessions had on their clinic experiences.

For instance, during the week in which we discussed STDs, inevitably a slew of teens would show up that same afternoon to be tested. In this way we did achieve our proposed goal of serving as liaisons between the clients at Spectrum and the medical community.

To be able to take part in both the educational and clinical aspect of all of this was and experience I will never forget. I went from being inundated with lists of “bugs and drugs” from microbiology, to finding my way around the exam room at the clinic, to being shocked by each pregnant teenager, to finally being able to smoothly and confidently administer a pregnancy test, perform a pelvic exam, screen for STDs, discuss options, set up a plan, assign a case worker, etc…. and only then gape at the fact that another sixteen-year-old was pregnant and still using narcotics once I was out of the exam room!

The clientele at the clinic has had such a profound impact in shaping my clinical education. I saw patients present with complaints that resembled those I saw from my Doctoring in Vermont experience, such as asthma complications, chest pain, sore throats, etc.

However, there was always another, darker and more complicated angle to the problem. For instance, a patient being treated for Hepatitis C not only faced an arduous six months of interferon with the side effect of depression, but was also battling the urge to return to using heroin in order to beat the depression.

While both have been positive, my experience at Spectrum stands in such stark contrast to my Doctoring in Vermont experience, which now seems so tame. In my previous clinical experiences, I witnessed physicians and nurses skirting around “touchy” subjects. What made working in the clinic so incredible was that no topic was taboo; no one shied away from inquiring about sexual practices or drug use patterns and I was always impressed with the high level of professionalism exhibited (and expected of staff) when shocking answers were given.

Overall, I learned not only about the healthcare aspect of treating “at risk” teens in the Burlington area, but I also learned a great deal about other community services (i.e. Act One, The Howard Center) as well as the social and legal aspects of homelessness and foster care.

By the end of the summer, I came away with a much broader base of clinical knowledge (and confidence!) as well as a mental picture and better understanding of a complicated web of community organizations.

I am eagerly looking forward to this fall when I will be able to continue to work in the clinic as well as teach during the lunchtime sessions. The experience has been remarkable and I am thankful and grateful for the opportunity to work with the clients and incredible staff at Spectrum.