Overall Course Objectives
After completing the AHEC Curriculum and Experience, participants will be able to:

1. Define the concept of service learning and describe how it was applied to your work in the community.
2. Provide a working definition of community-oriented primary care, including the essential elements.
3. Compare and contrast traditional health care models with community-based models.
4. Identify unique skills and knowledge needed by health care providers working in a community-based setting and with culturally-diverse populations.
5. Develop strategies for creating successful partnerships between health care providers and specific communities.
6. Explain the special health care needs of the least served populations in the District of Columbia and identify community strengths which could form solutions for those health care needs.

This course is divided into two essential parts, curriculum sessions and service learning, to provide AHEC participants with the skills and knowledge needed to create successful community partnerships:

1. Curriculum Sessions
2. Service-Learning Experience

The AHEC Curriculum Sessions serve as the academic component of the program. They are designed as a set of web- based, self-directed learning modules with assigned readings and activities. They provide a framework to support and assess the clinical experiences. Each Session has its own specific objectives, content and evaluation. All sessions can be found under OUTLINE in the menu to the left. Each health professional program will determine which additional Sessions will be required or suggested to enhance and complete the learning experience. There may be additional assigned readings or specific faculty directed activities.

All students are required to complete Session 1, INTRODUCTION TO THE AHEC AND THE COMMUNITY, before beginning the clinical component of the curriculum. See the following annotated list for information about current or planned Sessions.

INTRODUCTION TO AHEC AND DC (available and required, session 1)

The Introduction module will help you begin to define the DC community, its strengths and challenges. You will begin to identify the rich community-based networks of organizations in DC and their efforts to affect change. It also will give you an introduction to the concept of "service learning".

CULTURAL COMPETENCY (available, session 2)

Cultural competence is a set a behaviors, attitudes and policies that enable systems, agencies and professionals to work effectively in cross-cultural situations. The changing demographics of our nation demand that health care providers become aware of and acknowledge various cultural beliefs and practices--their own as well as their patients'. When these beliefs and practices differ, respect and understanding can enhance the service delivery experience.

INTERDISCIPLINARY TEAMS (available, session 3)

"The interdisciplinary team …defined as a functioning unit, composed of individuals with varied and specialized training, who coordinate their activities to provide services to a client or a group of clients" (Ducanis & Golin, 1979, p.3).

Characteristics of the team includes consideration of the composition, function(s), and task(s).For example, there is an identifiable leader but leadership may shift depending on the task, teams function both within and between organizational settings, and a team is client-centered and/or task oriented

COMMUNITY ORIENTED PRIMARY CARE (COPC) (available, sessions 4 & 5)

"The process of critically examining the characteristics, resources, assets, and needs of a community in collaboration with that community, in order to develop strategies to improve the health and quality of life of the community" (Hawtin, Hughes, & Percy-Smith, 1994 (Hitchcock, Schubert & Thomas, 2000, p.252).

CORE CONCEPTS

Need to define community:

• as populations & geographic areas (Rissel, 1996)
• as a social system bound together by either shared values or shared interests (Hawe, 1994)
• as an interacting group of people with shared needs and interests (Wadsworth, 1988)

Need to complete a community assessment

• Discuss the sources of data about communities
• Explain the various tools (quantitative & qualitative) used in community assessments

ADVOCACY (planned)

Community advocacy: "An advocacy model of community health returns power to communities through partnerships of professionals and representatives of all members of a community. Through partnership, professionals and communities develop a health initiative that expresses the diverse values of the community regarding health" (Schroeder& Gadow, 2000, p.90).

Patient advocacy refers to supporting the needs of patients beyond the doctor-patient relationship. In the case of patient advocacy, communicating the needs of a patient helps ensure that s/he will receive the care that s/he needs. The advocate could be a health care provider, a legal professional, a community activist, a family member, etc.

EPIDEMIOLOGY (planned)

One definition of epidemiology is the study of the distribution (where? how much? among whom?) and determinants (identifying factors important in the etiology of disease in terms of statistical associations) of disease and health in human populations. Epidemiology is the science which directly addresses the question of disease risk in humans. The methods of epidemiology by and large are observational. Results of epidemiologic investigations may not (probably will not) lead to unequivocal conclusions.

HEALTH EDUCATION (planned)

Health Education - is any combination of planned learning experiences designed to facilitate voluntary actions conducive to health. Health education is aimed primarily at the voluntary actions people can take on their own, individually or collectively, as citizens looking after their own health or as decision-makers looking after the health of others and the common good of the community. (Green and Kreuter, 1999:27).

Organized health education activity intervenes in the process of development and change so as to maintain, enhance, or interrupt a behavior pattern or condition of living that is linked to improved health or to increased risks for illness, injury, disability, or death.

HEALTH PROMOTION (planned)

Health Promotion is the combination of educational and environmental supports for actions and conditions of living, conducive to health. It is aimed at the complementary social and political actions that will facilitate the necessary individual actions needed for health enhancements and quality of life gains (Green and Kreuter, 1999:27)..2)

The service-learning experience takes place in a participating community clinic in the District of Columbia, under the supervision of an assigned preceptor from the clinic and in cooperation with a faculty member from your health professions school. Contact your school's AHEC liaison, listed below, with any questions about your program's requirements.

Each student will be assigned to a community clinic for a rotation half a day a week. This may range from one month to one year. Your program also may assign you to other rotations at the same or different clinics for the remainder of your rotation time.

Information on all DC AHEC clinical sites is available at the web links below in RESOURCES. Students are encouraged to become familiar with the community clinical site before beginning the rotation. A planned orientation will introduce the student to important points about the community. Case presentations and/or community projects will be an integral part of the service learning experience.

1. Completed SESSION 1, INTRODUCTION TO THE AHEC AND THE COMMUNITY
2. Visited the web site of the assigned clinic to become familiar with the clinic location and the services provided
3. Attended an orientation to both the assigned clinic and the community
4. Reviewed program expectations with both community and academic preceptors to determine specific activities to be completed, establish timelines, and establish evaluation methods.

After the completion of the service-learning experience, each student participant will have:

1. Completed assigned Sessions.
2. Participated in an ongoing project as assigned by his/her community preceptor
3. Completed the evaluation of AHEC experience.

Evaluation of AHEC experience