Aisha Queen-Johnson, MSW of UCSF School of Medicine PRIME-US @UCSF_CCE highlights the power of community engagement (CE) in health professions education to allow for bidirectional opportunities to understand the lived experience of individuals and communities to reduce health inequities. We cover how to partner with community groups, best practices for choosing projects where learners can engage with the community, and key features of the CE curriculum. Listen to hear key tips on how to bring this amazing opportunity to advance understanding and innovations in health by learning from the incredible people that make up the community in which we live and work.
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Community engagement (CE) is an important element in clinical training that addresses health inequities by providing the opportunity to understand the lived experience of individuals and their communities and better understand how they live, work, and their support structures. CE helps the learner understand the social factors that contribute to the well-being of individuals and communities. Community engagement is a bridge between the expertise and knowledge of institutions and communities, which can become an effective partnership for building and promoting healthy community living long-term. Community engagement curricula are focused on competencies around assessment of a community, relationship-building, and defining social determinants of health (Khazanchi 2021).
The terms community engagement and service learning could be interchangeable but Ms. Queen-Johnson sees community engagement as a bidirectional, broad continuum of community experiences ranging from one touchpoint of outreach to long term engagement of creating and implementing policy changes or program innovations. Alternatively, service learning can be a one-direction entity. Community engagement identifies learning objectives around a topic or population with whom the learners are working. Community engagement also includes the key component of critical reflection, wherein the learner identifies new content that resonates with them after they have completed their engagement. It challenges learners to think about how they have changed or may act in the future. Service-learning takes community service one step further (Tiako 2021).
Time is a major constraint that can affect consistent participation in community engagement, particularly because there is much to do in medical education. Ms. Queen-Johnson suggests being clear about availability to help identify a project in which one can participate.
Communication is another roadblock that could affect community engagement projects, particularly with expectation and scope of work. She recommends establishing a clear communication strategy with your team and community partners wherein you have outcomes and benchmarks of success to revisit throughout the project.
To acquire the institution’s buy-in and support the development of curriculum that addresses social determinants of health, Ms. Queen-Johnson suggests creating opportunities for learners to hear from community experts about successful innovations in the community (Khazanchi 2021). Ms Queen-Johnson recommends using examples of community engagement successes to advocate for more community engagement opportunities. She emphasizes the importance of the student-voice for pushing institutions to include CE to improve understanding the lived experience of individuals affected disproportionately by poor health outcomes. Highlight the resiliency of community improvement efforts that have made addressing health more successful.
Ms. Queen-Johnson notes communities have experienced how the institutions “take away” from the partnership so it is important to invest people, time and resources in community partnerships in order to establish policies and procedures about how to work together, promote well-being of the community in which we work and live, and communicate openly about goals and outcomes. We need to identify leaders in the institution that will help community engagement partners navigate opportunities for service.
It is important to have faculty or staff that can maintain the relationships with a given project when trainees or learners cycle in and out. This enables the faculty to sustain community relationships and sets up the learners for success by setting expectations early as to the best practices of community engagement. The learners support the work that is already identified as important; learners at all levels (students, trainees, early faculty) with different skill sets and schedules can then be matched to support the projects, efforts and policies of the community.
Cultural humility is a valuable framework to teach learners before they participate in a community engagement project. Melina Tervalon and Jann Murray-Garcia developed a cultural humility framework focused on a lifelong commitment to self reflection and learning (1998). Ms. Queen-Johnson relates that one can never be fully culturally competent but suggests remaining curious and aware of the power dynamics that occur in the individual encounter or with a community partner. Encourage learners to find respectful ways to partner and be accountable for the relationship outcomes agreed upon.
Community Campus Partnerships in Health is an organization that has identified best practices where they detail steps to take before partnering with community members. In an ideal world, learners in all health professions would learn these skills.
Ms. Queen-Johnson underscores the benefits of critical reflection, either as individuals or group-setting, as well as the importance of dialogue with the community members with whom the project was completed. Reflection is a key way of assessing the depth of the relationship built from the shared experiences. It serves as an opportunity to find the “Aha” moment for the students (Van de Heuvel, 2014). She also suggests implementing an opportunity for the community to reflect on what they learned about the learners and the institution.
Ms. Queen-Johnson encourages students in their want of opportunities for experiential learning while also asking institutions to promote these learning experiences. She recommends partnering with organizations or initiatives that are already in place and finding faculty mentors that will support the work the learners are doing. At the beginning of the project, Ms. Queen-Johnson advises to be familiar with the limitations and the resources needed. Also, spend time with community partners to gain resources, increase project members/participation, and set small benchmarks of success to measure along the way of the project (Chandratre, 2021).
According to our expert, an ideal curriculum would include longitudinal, interprofessional experiences with organizations where there is a focus on advocacy and uplifting the voices of marginalized communities while also highlighting the expertise of the community. She envisions an experience where not only do students learn ways to address the health inequalities but also explore ways to reform health systems and institutions and clinical encounters to make them more inviting and equitable. She adds that community leaders and the community voice should co-lead the curriculum.
Community engagement highlights the voices and experiences of those affected by health disparities by keeping them in the center of the dialogue which is essential in developing solutions to problems in healthcare.
Deconstruct knowledge hierarchy and power imbalances to address racist systems that have been proven to be very detrimental in their impact on health outcomes.
Improving health is best done in partnership, not in silos or alone.
Approach community partners with cultural humility, respectful communication, and agreed upon goals.
Community Campus Partnerships in Health
AAMC Center for Health Justice
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Listeners will understand the key aspects of community engagement curricula or service based learning in health professions education.
After listening to this episode listeners will…
Aisha Queen-Johnson, MSW reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
Queen-Johnson A, Heublein M, Kryzhanovskaya E, Valdez I “#16 Community Engagement: How the Community Teaches Tomorrow’s Health Professionals . The Curbsiders Teach Podcast. http://thecurbsiders.com/teach August 30, 2022.
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