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UF Community Health Scholars program lets students spend the summer helping communities

When University of Florida first-year medical student Nadege Touzin arrived last summer in the tiny Panhandle town of Graceville to work as a diabetes educator, she didn’t expect to become a local celebrity.

But that’s exactly what happened. Touzin, a Boynton Beach resident, had volunteered to spend her summer with Community Health Scholars, a UF service learning program that enables health-care students to explore community-oriented care issues in medically underserved areas.

To Graceville’s 2,500 residents, Touzin quickly became known as “the diabetes girl,” thanks to educational events she organized. The town is part of an area that suffers most of the state’s deaths from type 2 diabetes, she said.

“(Residents) would come up and say ‘are you the girl from UF, are you a med student?’” laughs Touzin, who is considering a career in rural medicine, practicing obstetrics and gynecology. “It was a really close-knit environment, so it was easy to get my work done there.”

For eight weeks, Touzin became a one-woman public health campaign. She developed a 30-minute presentation, solicited educational materials from pharmaceuticals companies and the American Diabetes Association, recruited local health-care professionals to appear at events, booked venues, advertised and acted as presenter.

“Even though I gave the same presentation every time, some people kept coming again and again,” she said. “They said they enjoyed it and wanted to see if they missed anything.”

Motivating citizens and students to work together is what Community Health Scholars is all about, said Richard Davidson, M.D., M.P.H., who has directed the program since 1995 and is a UF alumni distinguished teaching professor in the College of Medicine’s department of medicine.

“Part of the goal of Community Health Scholars is to expose the students to community issues, to population issues instead of individual patient issues,” Davidson said. “We’d also like to interest students in a primary-care career, but that’s not the sole goal — many of the students who participate are not going to do that, and will still have a wonderful experience.”

Davidson, who is chairman of the UF College of Medicine curriculum committee, said that Community Health Scholars has special appeal to medical students who want to explore public health issues beyond what’s offered in the standard curriculum. He also directs Interdisciplinary Family Health, a sister program that uses teams of first-year UF health-care students from four colleges to address the needs of specific families.

Both programs are affiliated with the UF Health Science Center’s Program for Interdisciplinary Education, which promotes service learning, a growing trend in health-care education that gives students practical experience by letting them put their skills to use solving real problems for individuals, families or communities. A description of the Community Health Scholars program, written by Davidson, was referenced in a 2003 report issued by the federal Institute of Medicine, “Health Professions Education: A Bridge to Quality,” as an example of a successful community-based service learning project.

Each summer, Community Health Scholars conducts about 10 projects in medically underserved North Florida communities, involving about a dozen student volunteers who may come from UF’s Colleges of Health and Human Performance, Medicine, Nursing, Pharmacy and Public Health and Health Professions, Davidson said. Because the projects are scattered over a wide geographic range, students from Florida State University, the University of North Florida, Florida A&M University and other institutions occasionally participate.

Depending on the project, the students may try to help groups of individuals make changes in their lives, as Touzin did, or they may conduct research to help local agencies improve services or infrastructure, Davidson said. Project sites are located throughout North Florida, in both urban and rural areas.

“Some sites lean more toward research questions and some are more experiential,” he said.

Case in point: Last summer, UF first-year medical student Tony Rodriguez and second-year master of public health student Brian Wells created a computer database that collected information on Alachua County motor vehicle accidents occurring in May 2003, to help identify specific places, days and times associated with greater or lesser numbers of accidents. The project was intended to evaluate whether the concept was viable, rather than establish a permanent database, Rodriguez said.

Working with project director Thomas Benton, M.D., a Gainesville physician and UF adjunct assistant professor of pediatrics, and biostatistics expert Gary Stevens, Ph.D., a UF research associate professor of statistics, the students made arrangements to obtain reports from law enforcement agencies, emergency medical services and hospitals, then entered information — by hand — into a database program.

“Motor vehicle crashes are the leading cause of death in individuals age 1 to 34 years old in this country,” Benton said. “So there’s obviously a need for some work to be done to (reduce the number of deaths).”

The project was the first effort in Alachua County to gather all relevant motor vehicle accident data in one place, Benton said. He hopes to continue the project with grant funding and help from local agencies.

Wells, a Palatka native who plans to attend medical school and conduct policy research, said he found the fieldwork a valuable addition to his studies.

“CHS teaches you some of the teamwork aspects of academic research that you may not get from the MPH curriculum,” he said.

Most Community Health Scholars students conduct their projects during the summer after their first year of health-care studies, so the fieldwork lasts an average of eight weeks, Davidson said. All students receive a stipend and assistance with basic living needs, but only the master of public health students earn academic credit for participating, because the program is considered part of their internship.

Community Health Scholars was launched in 1993 by the University of Florida North Florida Area Health Education Centers Program and its four regional centers, as their first collaborative service learning initiative for interdisciplinary teams of students, said Barbara Richardson, Ph.D., R.N., executive director of the UF AHEC program. Overall, UF AHEC serves 37 counties and provides health education services to medically underserved communities throughout the northern half of the state.

“It is through the centers’ ongoing relationships with community partners that the projects become a reality,” Richardson said.

Each fall, staff members at the four UF AHEC regional offices, located in Jacksonville, Alachua, Tallahassee and Crestview, solicit proposals from community organizations including county health departments, schools, physicians, hospitals and community organizations, Davidson said. He then selects the most viable possibilities and works with center personnel to develop projects and assist the preceptors who will supervise the students.

“I get the projects around the first of the year, recruit students in mid-February, we have an orientation in April or May, and students start their projects in June or July,” Davidson said.

The UF AHEC centers’ staff recruit students from other disciplines to work with medical students, convene regional workshops for students and preceptors, arrange housing and travel for the students and provide stipends for students.

Davidson visits all project sites at least once during the summer, he said. After completing their fieldwork, students write reports summarizing their results. Some students are encouraged to submit articles to professional journals or present results at scientific meetings.

The crowning achievement for a Community Health Scholars student is to have a project carried on by the community after the summer ends, Davidson said. The best-known example is a screening program to identify rural children with attention deficit hyperactivity disorder, developed several years ago in Taylor County by UF medical student Sean McMillan and Jerry Boland, M.D., who was then director of the Taylor County Health Department.

During the third year of the project, Community Health Scholars student Karen Tapp, a UF medical student, summarized the entire effort and submitted it to the National Rural Health Association, which selected the paper for a national award for medical student efforts in rural health care. Boland was later elected head of the Florida Academy of Family Physicians and succeeded in having the program implemented on a statewide basis.

But regardless of the notoriety that may follow, all students gain valuable hands-on experience from participating, Rodriguez said. “I’d never really had an interest in public health at all until this project,” he said. “I definitely think it’s (the program is) a good mix of a lot of different opportunities — clinical, research and community-based opportunities. It’s a nice way to get your feet wet if you’re not sure you’d be interested in public health or not, because by the end of the summer, you’ll be pretty sure if you’d be interested or not.”

For more information, see the Community Health Scholars Web page at www.flahec.org/nfahec/chs/.

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