Traditional Approach |
CHW Approach |
|
| Learning all aspects of the health system | Training for “lever-pullers" | Education for community health leadership: Learners get overview of health system and current debates. |
| Role of class members | Passive recipient of information from instructor | Class members’ experience valued and integrated (for example: experienced CHWs do presentations for class). |
| Relationship
between practice setting (employers/workers/ community) and college/university |
Minimal. Assumption that college/university “knows all" and practice setting/ employer is the learner. |
Dynamic
interchange. •Many classes taught by practitioners; •Internship integral to educational program; •Job task analysis defined by high-performing workers; •Performance standards set by employers and veteran workers; •Educational institution contributes to and disseminates "best practices" tested at the workplace. |
| Place of
interpersonal and process competencies (teamwork skills, conflict resolution skills, etc.) |
Marginal to curriculum and grading; program focuses on content and individual technical knowledge. | Integral to curriculum and evaluation/grading procedures, in accordance with SCANS* findings on what employers value. |
*SCANS: Secretary’s Commission on Achieving Necessary Skills
| Educational methods used for first-level health professionals | Rows and columns of students engaged in memorizing protocols and procedures via lecture/text/exam. | Use
same methods for teaching complex problem solving and critical thinking as used in top
universities: •Role plays with "standardized clients;" •Problem Based Learning; •Authentic Learning (Example: Learners develop and implement a health education display for a clinic waiting room, complete with a budget, project timeline, etc.); •Dialog with veteran practitioners and leaders in the field. |
| Classroom atmosphere | Formal and distant | Rigorous and also warm classroom atmosphere (for example, class members prepare potluck dinners, learning teams support students to overcome personal difficulties). |
| Relationships among segments of higher education system |
Separate. No educational ladders; courses taken at community college not transferable, so vocational training is dead end. |
Interwoven. •Courses articulation and enhanced counseling. •Cross-enrollment (example: CHW students studying at SFSU) •Planning and coordination across institutions and degree programs (AS/BS/MPH). |
| Attitude about socio-economic class | Assumption
made that all patients are middle class. (For the best nutrients: "Prepare a medley of fresh vegetables and stir-fry briefly.") |
Focus
on the special challenges of the urban and working poor. ("How to eat your best while cooking on a hot plate in your single room occupancy hotel room.") |
| Attitude about ethnicity | Assumption
that patients are white and English-speaking.
Assumption that cultural beliefs will be old-fashioned, exotic and deficient. |
Recognition
of new majority in California and urban areas: emphasis on cultural competency and ability
to work with linguistic diversity (For example, there are 120 languages in Los Angeles).
Strength-based approach. ("Cut back the junk food and cook like your grandmother did.") |
| Approach to gender | Gender a marginal concern. | Gender-appropriate services taught. (Example: Awareness that domestic violence is a major public health issue.) |
| Approach to sexuality | Assumption that all students, clients and providers are heterosexual. | Curriculum prepares learners to work respectfully with gay/lesbian/bisexual clients and co-workers; challenges homophobic myths. |
| Setting for field experience | Hospitals | Clinics and community based organizations |