Get me a student, STAT!
By Jayne M. Iafrate
IT'S ANOTHER THURSDAY NIGHT, and Jenna Stiegler '08 is starting to see some of the drama that makes NBC's "ER" such a popular television show. A steady stream of sick patients file into the emergency room - each with a unique complaint - and nurses and doctors begin the difficult task of diagnosis and treatment. There is blood. There is screaming. And pre-med student Stiegler, in her white lab coat, is there to see it all. In person. Welcome to BIO 244, nicknamed "Physiology in 'ER.'"
What began in Biology Professor Ed Tong's classroom as an opportunity to introduce students to the realities of careers in the health sciences has become one of the college's most successful and enduring service-learning projects. Today, scores of students in several disciplines are working alongside the professional staff at Attleboro's Sturdy Memorial Hospital. It's a win-win situation, according to Anne L. Messier, CAVS, director of Volunteer & Student Services at Sturdy.
"Students are able to help our patients and staff in many departments and, in turn, they are given opportunities to observe procedures and learn from the healthcare professionals," Messier said. "Having students in a healthcare environment is a rewarding experience for the practitioners to share their knowledge and passion for what they do and for the students to see the complexities and compassion of healthcare firsthand."
Approximately 30 students engage in experiential learning projects at Sturdy each fall. Tong's physiology students shadow staff members in the laboratory, imaging, physical therapy, wound care center and cardiac rehab, and shadow a doctor in the emergency room. In some areas, Messier said, they have an opportunity to interact with patients by providing social support. Students in Psychology Professor Grace Baron's "Human Services Practicum" spent six hours each week volunteering in the emergency room as volunteer patient care liaisons, in the Patient Transport Department, in the Case Management Department or in the Dietary Department. These students perform specific duties that help both the staff and patients.
During the fall 2006 semester, Stiegler - a psychobiology major - and her physiology classmates completed shifts in three Sturdy departments; in her case, those were the lab, imaging and the emergency room. Stiegler's father, Paul, is an emergency room doctor in her hometown of Madison, Wis., so she knows her way around a hospital. Still, she found a great deal of value in her service-learning experiences at Sturdy.
"I was able to observe the doctor's interaction with his patients and, after examining them, he would tell me what he thought the diagnosis was and why he thought it was so," Stiegler said. "What was like the show 'ER' was that Sturdy happened to be very busy on the night I was there, and there were a couple of unhappy patients yelling and screaming at the nurses and doctors because they weren't getting what they wanted. The staff had to deal with those issues along with helping patients get better."
Capitalizing on the chaotic nature of the emergency room and creating a learning experience from it was exactly what Tong had in mind when he first developed the course.
The course begins as most in the sciences do, with classroom discussions and labs, where students explore various physiological systems - respiratory, nervous, cardiovascular, etc. - and collect data for analysis. However, early in the semester something different happens; Tong turns on the TV.
"I remember first watching 'ER' with students; we were amazed at the medical jargon they used and we wanted to know whether it was accurate," Tong said.
Because emergency medicine involves a great deal of knowledge in anatomy and physiology, he explained, "ER" must include highly detailed biomedical information. By studying selected patient cases from "ER," students become motivated to learn more anatomy and physiology, better understand certain physiological concepts, and recognize the important clinical applications of information they acquire in the classroom.
"We started just by analyzing the episodes, and the following year developed the service-learning component with Sturdy. Officials there said 'yes' immediately." He added that conditions at both Wheaton and Sturdy - both smaller institutions with strong reputations - make this program work: "This wouldn't be possible at a larger hospital."
Students are required to present case studies of patients they watch on "ER" (see page 21), as well as keep logs that detail their observations at Sturdy. Tong believes this twofold approach not only helps students grasp complex concepts and issues in physiology, but also helps them better understand themselves and their potential within the health professions.
"This course does two things," Tong explained. "It awakens or confirms a student's interest in a career in healthcare, or it helps them decide that such a career is not for them. One year I had three pre-med students choose careers in biomedical research instead."
For the students who are inspired to health sciences as a career, the experience can be life-changing. Students in Baron's "Human Services Practicum" spend 72 hours at Sturdy over the course of a semester working alongside professional patient care liaisons, providing "tangible services (warm blankets, water, delivery of messages, play with children, response to urgent needs of staff) and social support (waiting with patients, talking with families, etc.) to ER patients and visitors," Baron said.
"My students have been doing this for three years and their weekly logs show me their learning in knowledge, skills in helping and medicine, and sensitivities to the patients and staff of hospitals," she said.
Tong agrees: "Everything students learn in a book is two-dimensional; in an actual healthcare setting, the experience is multidimensional. Even if students are just keeping patients company, they are providing a valuable service. This experience completes the link between the textbook and the person."
According to Sturdy's Messier, many of Baron's and Tong's students return to volunteer at the hospital, and other students hear about the opportunities at the hospital and volunteer on their own time.
To better understand the long-term consequences of this sort of experiential learning on Wheaton students, Tong is set to embark on a survey of former students. He wants to know how many chose careers in health and how the course might have affected that choice. He is also seeking grants to expand the collaboration between Wheaton and Sturdy.
One thing Tong knows for certain today about his BIO 244 students is that they always rise to the challenge of their work at Sturdy. When he developed the program, he wondered whether undergraduates were up to the task of observing the potential chaos of the hospital without getting in the way or becoming queasy about medicine.
"Fainting?" Tong responded to a question about his students' stomach for medicine. "Fainting is no problem; it happens in wound care all the time."
