|
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 |