Category Archives: Communities

Safety Culture

1) Watch the video: “Building a psychologically safe workplace” (TED talk by Amy Edmonson).

GOAL: Develop awareness of psychological safety and its importance in teamwork.

 

Optional After class:

IHI Online Open School Modules – http://app.ihi.org/lms/home.aspx

  • Supplementary activity to provide greater detail and context for the material covered in lecture.  Recommended for students pursing certificate in quality and safety.
  • GOAL: Improve understanding of culture of safety by providing additional examples.
    • PS 104 lessons 2-3
    • PS 202 Lesson 2

The Medical Safety Net

After Class:

GOAL for this reading: Provide additional data regarding community health centers, populations served, and funding received.

Instructions: Read the “Executive Summary” of “Community Health Centers: Recent Growth and the Role of the ACA” after class in preparation for community experience.

Optional video:

Optional additional references:

Community Violence: ACEs, Resilience, and Trauma Informed Care

Watch Nadine Burke Harris’s TED talk that introduces key concepts about Adverse Childhood Experiences and how they impact health.

Read about how one community is addressing violence (PDF) and adverse childhood experiences.

Optional: For students who want to see how the idea was started – Read the original ACE Study, Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults.

Relational Ethics

1) Review Ethics Key Terms

GOAL: Develop a preliminary grasp of using ethical frameworks that focus on social relations (see Ethics Worksheet Explained) and compare them to other ethical approaches covered thus far in the course.

Review these key ethics terms before turning to the video and reading:

  1. Care Ethics
  2. Communitarianism
  3. Interdependency

2) Watch video of Carol Gilligan on Moral Development and Care Ethics.

GOAL: Understand the basics of care ethics and how it might apply to the clinical setting.

Consider what is different about the approach that Gilligan is suggesting (i.e. a relational or Care Ethics based approach) from what you typically think of in terms of your ethical obligations as physicians.

3) Read Baby Aaron and the Elders by Ellen Wright Clayton and Eric Kodish

GOAL: Consider what you learned from Gilligan’s video and the above ethics key terms in this complex case of refusal of life sustaining treatment (LST).

Consider this is just one instance among a myriad of different clinical-community interactions. It will help us to begin to see the importance and sometimes the difficulty of respecting and valuing different community-based and relationship-based values and beliefs.

Have you ever found your own personal and community-based beliefs to be in tension with the norms of the institution of medicine?

 


For further research on The Amish and healthcare, see S. Talpos’ “The Amish understand a crucial thing about modern medicine that most Americans don’t“.

You can also find substantial research on many diverse communities of Americans here in a “Diversity Toolkit” created by Cleveland Clinic: https://my.clevelandclinic.org/-/scassets/files/org/about/diversity/2016-diversity-toolkit.ashx.

Social Ecological Model

Social Ecological Model

McLeroy, Bibeau, Steckler and Glanz are generally credited with creating the social ecological model of care.  A quick Google search for the social ecological model will reinforce how widely it has been adopted.  There are numerous community, state, national and international organizations that utilize this model in their programs.

Think back to your session in immersion on the social history.  How often do you think beyond the individual and interpersonal factors that influence you and your patients health?

Image result for social ecological model uw

 

From CDC Colorectal Cancer Control Program (CRCCP)