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.

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