Educating the Next Generation of Health Professionals for Social Responsibility and Global Citizenship

TitleEducating the Next Generation of Health Professionals for Social Responsibility and Global Citizenship
Faculty/College/UnitUBC Health
Duration1 Year
Project Summary

By targeting "global citizenship" UBC's TREK 2010 vision boldly sets out the need to prepare students to be "responsible members of society, who will value diversity, work with and for their communities and be agents of positive change." To this effect, literature in the health sciences is replete with persistent requests for revising and reforming health professions education to address disparities and the needs of vulnerable populations. There is general agreement that improving how we teach and students learn about community needs, inequity and health disparities, and the social determinants of health is an important step toward addressing the problem. Our proposed project facilitates this step by examining how we are educating students in the health and human service professions to prepare them to respond. We realize that education within the confines of the four walls of the classroom is not having the desired impact on preparing students for social responsibility and global citizenship.

The Doctor, Patient, and Society (DPAS 410 and 420) course that I coordinate for Dentistry and also teach within, is a two-year longitudinal course in the integrated dental/medical curriculum that seeks to prepare future doctors to be socially responsive. Discussions with several dental students and tutors over the years reveal a collective sense that the course is not having the desired impact in preparing students to respond practically and actively to the problems related to health disparities and social determinants. Although our students appreciate the issues, they do not have a practical sense of what they should or can do as doctors. What does the knowledge in this area actually look like in their hands? For instance, they know how to fix teeth, but they do not know how to respond effectively to inequitable access to oral health care. We need to create learning opportunities that will build our students' capacity to address the needs of vulnerable populations, and to work with and for their communities. Although a number of optional innovative initiatives have been introduced into this course to respond to similar concerns in medicine generally (e.g., Dr. Gary Poole's self-directed initiative provides opportunities for students to opt out of the traditional DPAS format and to design and implement an independent community project), very few dental students elect to participate. Dental students resist such elective opportunities because they simply do not know what they would do that would be of relevance to dentistry, and they also believe that the workload would be too heavy. Consequently, I partnered with colleagues from the College of Health Disciplines (Lesley Bainbridge) and from the Learning Exchange (Margo Fryer) to explore how to enhance DPAS for dental students to better meet course goals and learning objectives. I have changed the reading package to reflect dental student learning needs, and we have developed and are piloting (January 2006-May 2006) an innovative interprofessional community-based education initiative in term 2 of year 2 of DPAS.

Our aim is to have a small group of dental students partner with students from different health and human service disciplines to work together in small groups within community settings. Not all of them were interested in an interprofessional experience. Understandably, some of them wanted to stay in their dental groups to develop a community-based project on their own, which is also a positive response. We believe that facilitating these types of transformative learning opportunities will have a better educational impact on students. Students want to ''make a difference" and they need to see that they can. Students require experiential and transformative learning activities through community engagement that will facilitate meaningful encounters. They also need opportunities for reflection. We will assess the impact of our initiatives by conducting focus group interviews with students, and assessing the quality of their assignments, reflective journals, and course projects in relation to more traditional assignments done in the past. If this initiative is successful we envision a gradual and sustainable change in students' level of awareness, values, knowledge, attitudes and skills relating to community engagement, social determinants and health disparities.

In our interactions with various faculty we realized that there is a general need for better understanding and knowledge translation of what educators in the other health and human service disciplines are doing to prepare their students in this area beyond the chalk-board.

As a result, we seek TLEF support to enable us to first lay the groundwork for eventually developing educational initiatives across the health and human service disciplines that address the social learning goals of TREK 2010 within the context of health disparities and promoting equity for vulnerable populations in BC. We seek to work with faculty and students across the health and human service disciplines, as well as with our community partners to examine how we can better meet the social learning objectives identified in our University's vision and related academic plan. However, first we need to understand what we are doing.

Through our project, educators and students from different professional disciplines will have an opportunity to work together and with UBC community partners to examine educational approaches to social responsibility and global citizenship from the perspectives of what and how students are taught and learn about things such as advocacy, health disparities, the promotion of equity for vulnerable populations, professionalism, global citizenship and cultural competence. We will examine the connections between curriculum and competency documents and accreditation requirements in relation to these issues. We know that health professions education does very well to prepare students to understand, diagnose and clinically treat illness. We are concerned, however, that the next generation of health professionals is not being adequately prepared to respond to the social determinants of health, related disparities and the needs of vulnerable populations within community-based settings. The knowledge we acquire will inform the development of innovative and creative educational initiatives for addressing these areas.

The PA (Shafik Dharamsi) has assembled a team of educators and students (listed as partners in this proposal) to work collaboratively in developing an initiative that will bring together educators, students and community partners to learn how we can improve teaching and learning relevant to social responsibility and global citizenship across the health and human service disciplines. We are working on the following premise: TREK 2010 articulates a fundamental commitment to provide "students with outstanding and distinctive education" within the context o "social responsibility and global citizenship." Yet, many educators and students in the health disciplines do not really know what this should look like in practice. How are concepts of social responsibility, civil and sustainable society, and global citizenship taught and learned? How are related educational outcomes developed and assessed? How are they articulated in curricular and competency documents and how do they relate to accreditation requirements? What ''best practices" exist? What education related evaluation processes are in place to help ascertain if we are meeting the social vision and mission of our university? These are only few among a range of questions that emerge upon reflection.

Objectives and Methods

We seek TLEF support to assist us in laying the groundwork for ultimately developing powerful educational initiatives across the health and human service disciplines that address the social learning goals of TREK 2010. We need first to begin a critical and constructive examination of the current educational goals and practices across the health and human service disciplines at UBC for meeting the social vision and mission of the university as articulated in TREK 2010. We want to take a systematic approach, ·grounded in educational literature and current practices, and relate our findings to the development of sustainable educational initiatives. We will work closely with the College of Health Disciplines and its interprofessional faculty representatives to achieve our objectives.

Our project will evolve in overlapping stages drawing on heuristic and iterative approaches. From January 2006 to June 2006 we will implement and evaluate the interprofessional community-based pilot for which we have received some funding from the Dentistry S. Wah Leung Endowment Fund. At this time we will also develop our team, convene meetings, and hire and train student research assistants. On March 30, 2006 the PA is convening a panel of educators, students and community partners for dialogue on the topic of educating for social responsibility and global citizenship at the Living the Global City program of the World Urban Forum. From April 2006-March 2007 we will be ready to conduct a comprehensive environmental scan and needs assessment to identify, analyze, and document how educators in the different health and human service disciplines at UBC are attending to the social education goals of TREK 2010. We seek to develop a participatory approach by engaging key stakeholders at the university, comprising students, educators and community partners to achieve the following:

  1. Using existing funds from S. Wah Leung, assess the impact of the interprofessional community-based education pilot initiative in DPAS 420 on student learning about social determinants and health disparities: conduct focus group interviews with students and community partners; assess the quality of course assignments for achieving course objectives; and examine links to competency documents (further study would be required to assess the longitudinal impact of community-based education on practice);
  2. Using TLEF funds develop participatory and rigorous approaches to identify, document, and examine curricular development, teaching practices, competency documents, accreditation requirements and related projects that impact on learning across the health and human service disciplines in relation to the social goals and strategies articulated in TREK 2010. Through review of relevant educational documents and focus group interviews with faculty and students we want to learn:
    • How the university's social mission and vision is embedded in curricula, competencies and accreditation requirements across the health and human service disciplines?
    • How is it articulated in competency documents?
    • How is it reflected in teaching and learning?
    • How are related educational outcomes assessed?
    • How does it reflect accreditation requirements?
    • How do graduates apply related competencies?
    • What barriers and enablers exist?
    • What "best practices" exist and/or are aspired to?
    • What evidence do we have to support these matters?
  3. Using focus groups and individual interviews, explore what TREK 2010 goals and strategies, particularly in the category of social learning, mean to our educators, students, administrators and community partners;
  4. Engage curriculum committees from the different disciplines on on-going developments of this initiative;
  5. Conduct a comprehensive literature review of education in the health professions for addressing social responsibility, global citizenship, community-based education, service-learning, etc.;
  6. Explore the feasibility of a curriculum database that is linked across the health and human service discipline websites that can be searched using social learning related keywords such as: community, global citizenship, social responsibility, health disparities, service-learning, etc. Such a database could connect students and faculty and provide information on courses and teaching and learning objectives and related activities that address the social learning goals of TREK 2010;
  7. Consult with community partners (such as the Dr. Peter Centre, BC Homelessness and Health Network) to seek community involvement and collaboration in informing curricular evolution as it relates to social accountability and global citizenship;
  8. Develop a plan to write and disseminate findings to stakeholders (e.g., presentations at CIHR/CIH forums, CHD forums, TAG seminars, UBC reports, community forums, etc);
  9. Establish next steps toward developing powerful educational initiatives that can have a demonstrable impact on the next generation of health and human service professionals to address health disparities and to promote equity for vulnerable populations.
Funding Details
Year 1: Project YearYear 1
Year 1: Funding Year2006/2007
Year 1: Project TypeSmall TLEF
Year 1: Principal InvestigatorShafik Dharamsi
Year 1: Funded Amount50,000
Year 1: Team Members

Shafik Dharamsi, College of Health Disciplines

Faculty Partners:

Lesley Bainbridge
Jim Frankish
Peter Granger
Jerry Spiegel
Joanne Walton

Student Partners:

Kieth Ahmad
Victor Law
Sean Nixon
Bhuvinder Vaid