Learning to Care

At a Philadelphia hospital, inner-city students are taught hands-on health-care skills

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In a stately brick hospital building situated in the heart of West Philadelphia, a group of nine 8th graders from neighboring Turner Middle School don bright yellow lab coats and fan out into different wards like residents conducting their morning rounds. A little later, in the CAT-scan room at Misericordia Hospital, 13-yearold Monica Strickland sits in the technician's seat, plugging numbers into a computer that determines the angle of the scan. The patient, an elderly and somewhat agitated man, squirms on the table on the other side of the glass.

They are trying to rule out a blood clot in the brain, explains technician Amos Curtis. Seconds later, a silvery blue radiographic image representing a slice of the patient's brain pops up on the screen. “They develop that film so fast,” Monica marvels.

Monica and her classmates are not moonlighting as medical students but are part of an unusual public-private program that allows underprivileged students from an inner-city school to earn credit while learning hands-on health-care skills. Launched in September 1991, the Misericordia program--run jointly by Turner Middle School, the hospital, and the nonprofit West Philadelphia Improvement Corps, or WEPIC--is the only hospital-based health-care program for middle school students in the country, according to project directors.

The year-long program, which costs $32,000 annually, is designed to give young people firsthand exposure to the health-care professions in the hope of stirring their interest in the field. A majority of the students who participate in the program live at or below the poverty level, and hospitals and health-related industries, one of the largest employers in Philadelphia, can help pull them out of poverty.

“There are 130 different types of jobs in the hospital setting,” says JoAnn Mower, chief executive officer of Misericordia Hospital, which employs more than 1,300 people. “We are giving the students exposure to different jobs so that there is something else they can do instead of standing on the corner.”

During the 20-week course, the students meet not only doctors and nurses but also technicians, dietitians, food handlers, and a host of other hospital employees. For one two-hour session each week, students tour the hospital's respiratory-care unit, nursing station, radiology department, and emergency room. They are instructed on everything from patient relations to how to take blood pressure.

Demystifying hospital life is often the first task of the staff, says Sister Kathleen Kelly, director of patient relations at Misericordia, which was founded by Roman Catholic nuns in 1915. “They always ask to see the morgue,” she says. “But we haven't taken them down because I feel it is a sacred place.” Though certain hospital areas are off-limits, this select crew has unusual freedom to roam. They are given a tour of each wing except the critical-care ward and, by the end of their stay, can expertly navigate the corridors.

That doesn't mean the students' time is unstructured; in fact, they adhere to a strict routine. Every Wednesday, after a lunch provided by the hospital staff, the students get a taste of what a day in the life of a hospital worker is like. They rotate to a different department each month.

Last month, David Rice, a dimpled 13-year-old, went to the physical-therapy department and sat in on a class demonstration of cardiopulmonary resuscitation. “They were teaching the people in the class what to do if someone's heart stops beating,” David explains. “I'd like to learn CPR, so I'd be able to help.” For homework, the students are required to keep a journal about their experiences, identifying problems and jotting down observations and questions for their teachers. The hospital staff members are taught to check with students about the pacing of the instruction and to try to make the language as simple as possible.

Joseph Nyame, Misericordia's director of respiratory therapy and head of the program at the hospital, says journal-keeping often encourages students to reflect on their new knowledge and helps change unhealthful behaviors in their own lives. Hospital staff members advise the students to practice preventive medicine and give them the skills to do so. After a session on nutrition, for example, one student urged his parents to avoid fried foods and salt. And many, shocked and scared after a lecture on lung cancer, urged their parents to stop smoking.

The students are also called upon to teach what they learn to other students at school. In their language arts classes at Turner, several students from the program have created presentations about risk factors associated with certain behaviors and discussed hypertension and AIDS. “They are learning to become change agents,” says Cory Bowman, assistant director of the WEPIC program. Misericordia Hospital staff members, as well as graduate students from the University of Pennsylvania Medical Center, which developed the WEPIC program, are available for tutorials if the students want more instruction.

Students at Turner Middle School covet the hospital experience. Participants are chosen every year based on academic records and teachers' recommendations. In addition, students must demonstrate they have the ability to complete schoolwork taught in their absence. The adults involved with the project have found that the out-of-the-classroom apprenticeship enriches the learning process for the students. “The visual appears to imprint on their minds,” Nyame says. “Rather than giving them a passage to read on blood pressure, it's like a new toy to them when they actually take someone's blood pressure.”

But, in addition to its value as an academic tonic, the program provides the participating students with less tangible side effects that are at least as valuable. Every day in the community, Nyame says, “they are exposed to poverty, drugs, and violence.” The program, he notes, “may be able to increase their enthusiasm for positive alternatives.”

There are already indications that this is happening. Of the 40 Misericordia graduates thus far, 15 have expressed interest in pursuing careers in the health-care field. Thirteen-year-old Marika Fountain may soon have her name added to that list. “I want to be a nurse,” Marika says after listening to a nurse explain the procedure for a mammogram at a hospital-run community center, “because I like working with people and because of how much money they make.”

Since employment is a key goal of the program, the hospital is exploring ways to add a job training component to the curriculum, so older students could return to the hospital for individualized training before graduation. “The students have to know that there is an opportunity for them out there,” says Maria Bogle, activities director for WEPIC at Turner. “We have to let them know that anything is possible if you work for it.”

Vol. 04, Issue 06, Pages 18-19

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