Charlottesville Adult Learning Center's Health Curriculum 2011
by Leslie A. Furlong, Ph. D.
Web Resources - by Kelly Near, MSN, WHNP-BC, MLS
This eight-unit multi-level health curriculum is the result of a pilot project conducted by the Adult Learning Center of Charlottesville, Virginia, in the spring of 2010 with partial funding from an EL Civics Grant from the State of Virginia. It may be used freely for health education purposes. It is a curriculum intended for ESL students with a CASAS score of 190 and above and also for students seeking their GED. Each unit takes between two and four hours of class time to complete. It addresses CASAS competencies and incorporates the four basic skills of speaking, listening, reading, and writing within each unit. Each unit consists of lesson plans for four levels of students: ESL Beginning Level (students with CASAS score of 190 and above), ESL Low Intermediate Level (students with minimum CASAS scores of 201 and above), ESL High Intermediate Level (students with CASAS scores of 221 and above), and a Level for students seeking their GED.
Goals of the Curriculum:
A Civics Approach to Health
This curriculum is grounded in a civics approach to health. To be effective civics participants in any community requires:
We base this curriculum on a philosophy of active engagement with the issues of health care. We measure success by:
We encourage students to develop competency with regard to navigating the US health care system in the broadest sense possible. They look at holistic definitions of healthy living, good mental health, common ailments and symptoms, and treatments both from the perspective of living here in the US and from the perspective of experiences in one’s home country. They build life skills in accomplishing tasks such as making appointments, describing symptoms, filling out forms, locating information on reliable websites, and locating and understanding the different functions of health care facilities in the Charlottesville area.
Students also learn about their rights and responsibilities and how to become their own advocates in using health care facilities in the US. Internationals learn to think about their experiences of adjustment to life in a new culture in terms of stress, culture shock, and cultural awareness development. GED students think about the particular stresses and concerns that can arise when one doesn’t have a GED or is in the process of trying to get one.
One of the most important factors of the curriculum is that there are built-in opportunities for both health care providers and students to communicate with and learn from each other. Through fieldtrips and/or guest speakers there are structured opportunities for cross-cultural comparisons, question/answer periods, and written feedback in the form of letters to administrators and/or articles written and published in a student newsletter so that existing health care institutions can learn from and better accommodate all its residents.
The eight units of the health curriculum are organized in a logical and progressive order, with each unit building on the one before. Ideally, all eight units would be covered sequentially for each particular group of students either in one term or over the course of an academic year. Each unit, however, is able to stand on its own so that one or several units may be implemented depending on the needs and circumstances of the program. Units One and Two can easily be expanded to include more topics depending on the interests and concerns of the class. We also highly recommend includeingUnit Six so as to provide an opportunity for students and local health care providers to interact in a meaningful way.
Each unit incorporates:
The curriculum incorporates three types of reading material, all of which are necessary to meet the civic goals of the curriculum.
1. The first consists of a compilation of existing level-appropriate health education written material, including publications and public relations material from local health care facilities, all of which emphasize the information and skills health care providers say are important for the public to know so as to better navigate the US health care system. The curriculum also provides for opportunities to learn about existing health care facilities in the Charlottesville area through materials provided during fieldtrips and from guest speakers.
2. The second consists of reliable websites that relate to the topics of each unit. These websites provide students with opportunities to experience researching health care information using the internet.
3. The third kind of reading material consists of writings by students themselves around their experiences of healthy living and health care. We include this third kind of reading material because we believe that students must acknowledge and value their own experiences and voices in order to effectively develop leadership and advocacy skills and because these writings can be a valuable tool for health care providers as well. Student-written articles from the Multi-Cultural Brief (a student publication produced by the Adult Learning Center since 2000) and accompanying Study Guides are included as part of the Lesson Plans for most units, beginning at the Low Intermediate level, and are available online. These writings encourage students to learn about others’ experiences and to share their own. This, in turn, fosters a greater sense of involvement with the health topic, develops a sense of the importance of one’s own voice in the learning process, and brings forth the realization that one’s own experience can be of benefit to others. It also speaks to the issue that healthy living is as much a cultural experience as it is objectively scientific. There are many understandings of health both within this country and around the world; even those who follow the western allopathic model have distinct variations from culture to culture. Finally, these writings are made available to health care providers beyond the classroom, allowing greater opportunities for understanding and the mutual exchange of information to occur.
As part of an on-going process for keeping these experiences current, students are encouraged to keep a Health Journal throughout the curriculum which they will use to take notes in class as well as to write their own experience around issues addressed in each unit. Articles will be selected for future publication in the Multi-Cultural Brief and may be used by future classes using the curriculum.
Each Study Guide has three sections: Before You Read; After You Read; and a Writing Prompt. Study Guides may be used as a whole-class activity or as an activity done in small groups led by an English-speaking volunteer. Before You Read consists of questions for students to discuss before they read the Multi-Cultural Brief article. The purpose is to help students become familiar with the topic before they read and help them to predict what the article may be about. It is important to emphasize that there are no right answers in this section. After You Read consists of a series of comprehension questions and some opinion questions about the reading. To help lower level readers build comprehension skills, the questions proceed in chronological order through the article. After each question there is space for students to write their answers. It is recommended that students not write during class time but instead use that time for in-class discussion. For higher level students, the instructor may choose to copy the questions onto cards, which students would then answer in random order. TheWriting Prompt consists of a writing assignment students should complete in their Health Journal notebook.
Special thanks to: Kelly Near, Outreach Librarian at the Claude Moore Health Sciences Library at the University of Virginia, for her collaborative support and assistance in clarifying in each unit issues that health care providers consider most important for the public to know, for providing reliable and appropriate internet resources for each unit, and for providing a template for a model field-trip experience to a local health care facility; Debbie Tuler, ESL Specialist at the Adult Learning Center, for facilitating the initial pilot of the curriculum in 2010 and for editing assistance; Sabra Timmins for all the work involved in placing the Health Curriculum on the adultslearn.org website; and Jim Gordon, Chip King, Cherry Stewart, and La Bonnie Allen for their participation and valuable feedback during the 2010 pilot. Above all, thanks go to Susan Erno for her believing in the importance of health in the context of empowering students in a civics context as a major educational concern impacting the quality of life and community on all levels and her advocacy for this project over many years and many metamorphoses.
Lesson Plan Ideas:
Part One: Healthy Living
1. All levels: Introduce the subject of health as a major theme of the term and emphasize that journal writing will be an important part of (a) keeping track of important information and vocabulary associated with health for all levels and (b) for ESL low intermediate, ESL high intermediate, and GED classes expressing their own opinions and experiences which could then be shared with others if students agreed to do so. Hand out notebook journals and explain that students will use these notebooks exclusively for the curriculum. They may use the journals to take notes in class, for homework, and for all writing assignments associated with the curriculum.
2. All levels: On Board: Mind map with “healthy living” in the central circle. Tell them that they are going to brainstorm what “healthy living” includes for them.
a. For ESL beginning level students, do this as a group activity. Have on hand many different pictures of activities in different categories, eg., body, hygiene, mental/emotional, spiritual, social, environmental, etc. Encourage them to find words to describe examples of each kind of activity. Make a poster using pictures and words of the mind map. Invites students to copy the mind map into their journals.
b. For ESL low intermediate level students, do this either as a large whole class group activity or as a small groups activity with the support of volunteers. Each group will have its own newsprint and create its own mind map. As ideas are presented, the volunteer may cluster them (without writing the category down) in groups around the central idea of “healthy living” (for instance, running, walking, swimming would all be under the category of “exercise”). After ideas have been collected, go over each cluster and decide as a group what the central idea of each cluster is.
c. For ESL high intermediate level and GED students, do this as a small groups activity. Each group will have its own newsprint and will create its own mind map. Students will cluster ideas in ways that make sense to them without the help of the teacher or volunteer.
3A. For all ESL classes, compare “healthy living” in Charlottesville with “healthy living” in students’ home countries. An excellent warm up for all levels is Kate Singleton's picture story "What Happened to My Body?" (copyright 2003) and "Snack Attack (copyright 2003)."
a. For ESL beginning level students, as a whole class activity use the healthy living mind map to ask simple questions that compare healthy living in students' home country with healthy living here in the US, asking, "Is it the same or different?"
1. Example one, if food is listed on the healthy living mind map, ask if healthy food is the same or different. Help students build a vocabulary of healthy foods. Invite students to bring to class examples of healthy food from their country. Ask if there is unhealthy food in the US and in their home country, and make a list of what that food might be.
2. Example two, if exercise is listed on the healthy living mind map, build vocabulary around different kinds of exercise and where people can go to get exercise here in the US. If possible, talk about how students got exercise in their home country.
3. Depending on the interests of the students, use one or more of the following sources: Picture Stories, "Unit 9: The Neighbor's Kitchen" or "Unit 13: Pickles", by Fred Ligon and Elizabeth Tannenboaum (copyright 1990); or More Picture Stories, "Unit 1: 12 Hours Old", by Fred Ligon, Elizabeth Tannenbaum, and Carol Richardson Rogers (copyright 1991); or Health Stories,Introductory, "Lesson 1: Too Much Sodium", "Lesson 2: Pollen Problems", "Lesson 3: Tired at Work", "Lesson 5: More Exercise", "Lesson 6: No More Candy", "Lesson 7: Wash Your Hands", "Lesson 11: Talk about Smoking", or "Lesson 12: Flu Season", by Ann Gianola (copyright 2007).
4. "Writing Assignment": In their Health Journals, have students create a picture story comparing healthy living in the US with healthy living in their home countries.
b. For ESL low and high intermediate level students, using questions 1-4 listed below, you could do this as a whole class activity, or small group discussion or pair work and then report to the whole class. If using the small groups format, have each group discuss the 4 questions in relation to their healthy living mind map and then report back to the whole class what they talked about with the 4 questions using the mind map for support. You can have one person report for the whole group, although it can be an excellent ice breaker for shyer students if each person in the group describes his/her own experience.
3B. For GED classes, using the healthy living mind map, have students compare the ideal of healthy living with their own experiences. Use the Multi-Cultural Brief article, "Would You Like to Be Healthy?" (November 2008) to help generate discussion. Some questions to consider are the following:
1. What for you is the most important factor in healthy living?
2. How successful do you think you are at living a healthy lifestyle? What are some good habits that you have? What are some challenges?
3. Do you think people who have a GED or higher education have healthier lives than people who do not? Explain.
4. Do you think people in some parts of the country have healthier lives than people who live in other parts of the country? Explain.
5. Homework: In their Health Journal, have students write a short essay about the above four questions. They may choose to answer just one or all four, but they must write their answers in standard paragraph format. Emphasize to students that their voices and their experiences are an important part of the health curriculum and that their writings can help other GED students in the future.
Part Two: Prevention, Risk Factors, and Screenings
1. All levels: Introduce the idea of “prevention”. Use the example of “hygiene” and the importance of washing hands to illustrate “prevention”. Then, use the mind maps to illustrate (or, if possible, brainstorm) other examples of different kinds of prevention, like the importance of eating healthy food to prevent disease.
2. For ESL low intermediate and ESL high intermediate levels and GED classes, introduce the idea of “risk factors”. Use the mind maps to talk about what could happen if healthy living doesn’t happen and also what can happen even if healthy living does happen. Talk about what particular risk factors internationals or people who do not yet have their GED may face.
3. All levels: Introduce internet use, for example healthyroadsmedia.org. Point out the different health topics to look at, “short” version and “full” version, multiple languages. Remind students of “risk factors” and prevention (salt, fatty food).
a. For ESL beginning and low intermediate levels, show video of “Cut Down on Salt and Sodium” (from healthyroadsmedia.org, go to Diet/Nutrition and then “Cut Down on Salt and Sodium”). (For reinforcement, you could also have students read Health Stories, Introductory, "Lesson 1: Too Much Sodium", by Ann Gianola (copyright 2007).) Brainstorm with students how students can use this website to learn about health issues, including prevention, and also as a tool to practice English: listening, reading, using the pause feature, vocabulary, etc.
b. For ESL high intermediate and GED classes, show “Immunizations for Tetanus and Diphtheria” (from healthyroadsmedia.org, go to Diet/Nutrition and then “Immunizations for Tetanus and Diphtheria”) and then read and discuss the Multi-Cultural Brief article, “A Terrible Tetanus Shot” (April-May 2004)and accompanying Study Guide (to be created) to encourage conversation. Brainstorm with students how students can use this website to learn about health issues, including prevention, and also as a tool to practice English: listening, reading, using the pause feature, vocabulary, etc.
4. For ESL high intermediate level, introduce the importance of screenings particularly for people who may be at higher risk for certain kinds of illnesses. Use Step Forward 4, Unit 9, to discuss the importance of health screenings as part of healthy living leading to long life.
Diet and Nutrition
1. Hand washing: Do’s and don’ts handout. Mayo Clinic
1. Build vocabulary related to emotional and mental health. Be able to identify emotions and how one is feeling inside.
2. Be able to recognize some of the risk factors for stress, particularly for ESL and GED populations in Charlottesville. Be able to discuss the issues of stress as they relate to GED and ESL populations in Charlottesville.
3. Know some of the consequences of stress if not addressed. Identify how stress affects the body, mental well-being, family, work, etc.
4. Identify activities that can help to reduce stress.
5. Identify and locate resources in the Charlottesville area that can help to reduce stress.
6. For ESL classes, be able to understand and talk about issues of cultural adjustment. For GED classes, be able to discuss the stresses of not having a GED and the stresses of trying to get the GED.
7. Create a plan for reducing stress in one’s life.
Lesson Plan Ideas:
1. Explain to the class that we are now going to talk about good mental health. Students are usually nervous and/or embarrassed about the subject of mental health (often expressed by laughter and jokes about "crazy people"). To help reduce the sense of stigma, it can be helpful to acknowledge the stereotype and at the same time let students know that good mental health is important for everyone. To help normalize the topic, begin with the subject of stress.
2. Define stress. There is positive stress and too much stress. An example of too much stress is when one has too much to do and not enough time or resources to do it. Brainstorm other examples of stress. An excellent warm up resource are Kate Singleton picture stories, good for all levels: Stressed Out!!! (copyright 2001); Depressed (copyright 2003); and What Should She Do? (about domestic violence) (copyright 2001).
3. Using mind maps from Unit One, brainstorm how stress can occur in each category of a holistic model of healthy living. For example, part of healthy living may include having a happy family, but stress can occur when one is separated from one's family or when there are problems within the family. Another example may be if good transportation is part of healthy living, but stress can occur when a person does not have a driver's license or enough money to buy a car. A third example may be if having a good job is part of healthy living, but stress can occur when a person does not have a job or does not have a job that he/she likes.
4. Begin to build vocabulary to describe other kinds of emotions. Try to think of examples of when one might feel a particular emotion. For ESL beginning level, choose only a few of the emotions to talk about.
5. Brainstorm ways stress can affect the body, thoughts and feelings, and the way people act. See Mayo Clinic: Stress Symptoms. Some symptoms include headache, chest pain, stomach upset, anger, restlessness, eating too much, worrying, butterflies in stomach, tingling fingertips, inability to concentrate, mood swings, irritability, forgetfulness.
6. Use Healthy Roads Media and Scavenger Hunt (see File Cabinet) to learn about different issues of mental health.
7. Identify resources and activities in the Charlottesville area that can help to reduce stress: for example, participate in exercise (gyms, hiking trails, bicycling, swimming), relaxation classes (yoga, tai chi, art classes, meditation classes), talking (Dialogue Café, meeting with friends, meeting with volunteers); join parenting groups; join a spiritual community; seek a mental health professional; create a regular schedule of activities to do during the day, especially coming to school every day. Use a phone book or Community Resource cards to begin the process of problem-solving.
For ESL beginning level:
1. Use Health Stories: Low Beginning, "Lesson 3: Under Stress", by Ann Gianola , and/or More Picture Stories, "Unit 10: Ok, No Job" (copyright 1992).
2. "Writing Assignment": In their Health Journals, have students create picture stories about stresses they experience living in the US.
For ESL low intermediate level:
1. Divide the class into small groups and use the Multi-Cultural Brief article, "Culture Shock" (October 2000) and accompanying Study Guide to read and discuss a writer's experience of culture shock.
2. For homework: In their Health Journals, have students use the writing prompt at the end of the Study Guide to write their own experiences with culture shock.
For ESL high intermediate level:
1. Read stories relating to stress and adjustment to life in a new culture. Divide the class into small groups for reading and discussion. You may choose one, two, or all three of the following stories from the Multi-Cultural Brief and their accompanying Study Guides: “You Are Not Alone”(November 2009), “Culture Shock” (October 2000), “Who Am I?”(April-May 2005). If all the students read only one story, it should be "Culture Shock" (October 2000). If students in different groups read different stories, have them report out to the rest of the class a summary of what their article was about and make those stories available for all students to read for homework.
2. For homework: In their Health Journals, have students use the writing prompt at the end of the Study Guide for the particular story they read and discussed in class to write their own experience.
For ESL low and high intermediate levels (GED students may be interested in this, too):
1. Explain that we will now begin to look at a model that has been developed to help describe levels of intercultural competence development regarding the issue of culture shock and adjustment to a new culture. Introduce "A Developmental Model of Intercultural Sensitivity" by Milton J. Bennett, M.D. (in R. Michael Paige, ed., Education for the Intercultural Experience. Yarmouth, ME: Intercultural Press, 1993) or use adapted handouts (See file cabinet at ALC). (Alternatively, you may use the four stages of culture shock or a variation thereof.)
2. If using the Bennett model, after presenting the different stages, divide the class into small groups, and have each group read and discuss a particular scenario from the "Cultural Awareness Stages" handout (See file cabinet at ALC) and try to decide which level of adjustment that particular scenario best describes.
For GED classes:
1. Read "Stella's Story (in HEAL: Breast and Cervical Cancer Core Curriculum, by Lee Hewitt, Developed by World Education in cooperation with the Centers for Disease Control and Prevention, September 2000).
3. Use local newspapers and local internet news sources to identify stresses that can occur in the Charlottesville area. For example, students may look at the Disparity Statistics noting the high incidence of infant mortality in the Charlottesville area and to what extent stress may play a role in this high infant mortality rate. Another example is to read and discuss "Concepts That Living Poverty Teaches" by Donna Beegle, Ed.D. (published by Communication Across Borders, Portland, Oregon 2000) and "Educating Students from Generational Poverty: Building Blocks from A to Z," also by Donna Beegle, Ed.D. (published by Communication Across Borders, Portland, Oregon 2001; second edition 2004) 2. For homework, use your Health Journal notebook to write your own experiences of stress, particularly as a GED student (what stresses occur because you do not have a GED, and how can stress occur while trying to get your GED), and how you deal with this stress. You may also write about other stresses that you see around you at home, at work, and in your community.
1. Pulling it all together: Divide the class into small groups and give each group a picture of a person from a magazine or newspaper. The group’s task is to give the person a name, where that person is from, how long that person has lived in Charlottesville, what stresses that person is experiencing, what emotions that person has right now and why, what resources that person can use in the Charlottesville area to reduce stress, and finally what Action Plan that person is going to use to reduce stress.
2. Homework: Using your Health Journal notebook, write your own Action Plan for how you are going to reduce stress in your life.
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Unit Three: Body Parts and Ailments, Tracking a Problem Chronologically, Being Able to Describe Level of Intensity
Vocabulary and Grammar:
ESL Beginning Level:
Low Intermediate Level:
ESL High Intermediate Level:
Lesson Plan Ideas:
Part One: Body Parts and Ailments
For GED Classes: In addition to the above:
1. Explore vocabulary of internal organs, where they are located, and some of the functions they serve. Use Healthy Roads Media, My Body from the Nemours Foundation, MedlinePlus "Anatomy," and MedlinePlus Medical Encyclopedia.
2. Discuss the significance of the difference between commercial websites (those ending in .com) and more disinterested information websites (those ending in .org) especially when conducting research on issues related to health.
Part Two: Being Able to Explain the Experience of Ailments Chronologically
For ESL Beginning Level Students: Whole Class Activity:
For ESL Low Intermediate Level and ESL High Intermediate Levels:
Whole Class Activity:
For GED classes:
1. Explore vocabulary of internal organs, where they are located, and some of the functions they serve. Use Healthy Roads Media, My Body from the Nemours Foundation, MedlinePlus "Anatomy," and MedlinePlus Medical Encyclopedia. Go over the symptoms of some major illnesses like heart attack, stroke, or Type 2 Diabetes. Note that symptoms may differ between women and men and that some illnesses may show no obvious symptoms for a long time.
2. Using the following websites to explore vocabulary of internal organs, where they are located, and some of the functions they serve. Use Healthy Roads Media, My Body from the Nemours Foundation, MedlinePlus "Anatomy," and MedlinePlus Medical Encyclopedia to choose a particular illness to write about in your Health Journal notebook. Include all important organs, risk factors, and all important symptoms as well as any information about the progression of that particular illness.
Symptoms and Accidents
Vocabulary and Grammar:
Lesson Plan Ideas:
ESL Beginning Level:
1. Step Forward #2, Unit 8 addresses these topics.
1. Use a First Aid Kit to build vocabulary and discuss different saftey measures to take in the home.
2. Use Picture Stories, by Fred Ligon and Elizabeth Tannenbaum (copyright 1990) (or Kate Singleton's Picture Stories) that recommend fire extinguishers, poison control, measuring the correct dosage.
3. Discuss where to go in Charlottesville for Over-the-Counter (OTC) medicine. This may include CVS, grocery stores, convenience stores, health food stores (Integral Yoga, Rebecca's, Whole Foods). A further option, is to take a fieldtrip to a place that sells OTC medicine.
4. Use handouts and/or actual OTC medicine containers to practice reading medicine labels. Look for key words that tell what name of the medicine is and what it is used for.
5. "Writing Assignment": In their Health Journals, have students create a picture story about home remedies and/or going to a place that sells OTC medicine.
ESL Low Intermediate, ESL High Intermediate Levels and GED classes:
1. Mystery Word game (like "hangman", but instead of drawing a picture, as each student calls out a letter, that student must then connect the letter to a word: "a" as in "apple"; the teacher writes the word the student calls out on the board and, if there is a match for the mystery word, fills in the appropriate blank) for the word "dosage". After the word has been discovered and a definition is clear, discuss with students the importance of understanding that on medicine labels in the US, "adult dosage" is for a person who weighs 120 pounds or more.
2. Write a particular ailment on the board and brainstorm ways students recommend treating that ailment. Note and discuss differences between home/natural remedies, culturally specific remedies, and OTC medicine.
3. In small groups, read the Multi-Cultural Brief article, “We Have Different Stomachs” (December 2005) with the accompanying Study Guide.
4. Homework: For ESL classes: In their Health Journals, have students use the writing prompt from the Study Guide of "We Have Different Stomachs" to write about their own experiences, both in their home countries and encountering cross-cultural differences. For GED students: In their Health Journals, have students write about (1) any experiences they have had using natural or home remedies or (2) their opinion or experiences they have had that are similar to those described in the article "We Have Different Stomachs".
1. Use a First Aid Kit to build vocabulary and discuss different safety measures to take in the home. Beginning Level students can use Picture Stories that recommend fire extinguishers, poison control, etc.
2. Discuss where to go in Charlottesville for OTC medicine. This may include CVS, grocery stores, fast food stores, Health Food Stores (Integral Yoga, Rebecca’s, Whole Foods).
3. Using Chapter Two, "What Do You Recommend?", of Choices: In Good Health, by Elizabeth Claire (copyright 1991), practice role plays where students describe to the pharmacist or homeopathic specialist what the symptom is, how long the person has had the symptom, the intensity of the symptom, etc. (from Unit 2).
4. Use Chapter Two, "What Do You Recommend?", of Choices: In Good Health, or other handouts and/or actual OTC medicine containers to practice reading medicine labels, including directions, dosage, warnings, ingredients, what symptoms the medicine is for.
Self-Medication: Food and Rest
Complementary Medicine in Charlottesville
Lesson Plan Ideas:
ESL Beginning Level:
1. Introduce the topic that we are now going to learn about some of the different kinds of health care facilities in the Charlottesville area and the kinds of services they provide. Brainstorm why it might be important to know what to dobefore a person needs a health care facility in a new country.
2. Ask if anyone has had an experience using a health care facility in Charlottesville and if that experience was the same as or different from experiences they have had in their home country.
3. Introduce the fact that there are two major hospitals in the Charlottesville area, UVA Medical Center (a public teaching hospital) and Martha Jefferson Hospital (a private hospital). On a map, find where each hospital is located.
4. Discuss what to do if a person has a medical emergency. This could include calling 9-1-1 and a trip to the emergency room at one of the hospitals. Emphasize that 9-1-1 and the emergency room should only be used in case of a real emergency. Use Picture Stories, "9-1-1", by Fred Ligon and Elizabeth Tannenbaum; Health Stories, Introductory, "Lesson 9: Calling 9-1-1", by Ann Gianola (copyright 2007); and/or Kate Singleton's Picture Story "Emergency."
5. Introduce some of the different clinics that are located in Charlottesville like the International Family Medicine Clinic, the Charlottesville/Albemarle Health Department, the Free Clinic, and Prompt Care. Hand out copies of the brochures for each clinic and find basic information for each clinic: where it is located, hours it is open, and phone number.
6. "Writing Assignment:" In their Health Journals, have students write down the information they learned from the clinic brochures. Have students write down a plan for what they will do if they need a health care provider: include the name of the hospital or clinic, where it is located, the hours it is open, and the phone number.
ESL Low Intermediate and ESL High Intermediate Levels:
1. Introduce the topic that we are now going to learn about some of the different kinds of health care facilities in the Charlottesville area and the kinds of services they provide. In small groups, discuss the following questions: (a) Do you know where to go if you need a medical professional in the Charlottesville area? (b) Do you think it is important to know what to do and where to go before you get sick? Why or why not? (c) Have you had experience using a health care facility in the Charlottesville area? Was it a positive or a problematic experience? Explain.
2. On board brainstorm hospitals (UVA Medical Center [public teaching hospital] and Martha Jefferson Hospital [private]) and clinics (appointment needed/no appointment needed) in the Charlottesville area.
3. Hand out brochures for clinics in the Charlottesville area (UVA Medical Center International Family Medicine Clinic, Martha Jefferson Hospital [if available], the Charlottesville/Albemarle Health Department, the Free Clinic, Prompt Care). Divide the class into small groups and have each group use accompanying questions (see attachment) to locate information on the brochure. Then have each group present their findings to the whole class. Using a map of Charlottesville, help students to locate each facility. Another way to approach area health care facilities is to have students choose from a list of facilities and research the facility using the internet. This can be done as a homework assignment or in class using their Health Journals. After research the students can present their findings to the class.
4. Discuss the importance of finding a personal physician before you or a family member needs one. Include here a discussion of when and when not to use 9-1-1 and the emergency room. Brainstorm ways people can go about finding a personal physician: recommendations from people they know, or using internet resources (listed below).
General Referral Resources
Finding a Physician in Charlottesville
Local wellness centers
Mental Health Care:
Resources for students:
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Develop a collaborative relationship with health care providers and/or administrators at a local health care facility. Introduce them to the student population at your school. Invite them to share information about the services their health care facility offers, including specializations and financial aid. Invite them also to share concerns they may have about the degree to which their facility is accessible to the student population. Together work out a fieldtrip agenda that (1) suits the strengths and needs of that particular health care facility and (2) provides an opportunity for students to share their experiences and feedback with the health care providers/administrators.
Follow Up after the Fieldtrip:
After the fieldtrip, meet again with health care providers and/or administrators to discuss findings regarding what went well in terms of logistics and meeting objectives, and what could be improved for next time. Discuss feedback students provided regarding the fieldtrip and how this information could be helpful in providing easier access for students who may use the facility in the future. Discuss any other ways communication between students and those working at the health care facility may improve quality of service and care in the future. Determine how best to maintain this collaborative relationship in the future.
1. Visit a local health care facility.
2. Learn the steps it takes to get to the facility.
3. Build skills in navigating the facility such as asking for help, reading signs, following directions.
4. Learn about specific services the facility offers, including but not limited to specializations, financial aid, language assistance services.
5. Be introduced to the facility’s recommendations for making future visits to a health care provider at the facility most successful.
6. Share with health care providers and administrators at the facility student issues and concerns as well as feedback about the fieldtrip experience.
Lesson Plan Idea:
Take a field trip to the University of Virginia Medical Center
1. Students should be organized in groups of two or three prior to their trip.
2. On the day of the fieldtrip, students will travel to the medical center by car or public transportation and in the process find out about parking rules, how to obtain a parking ticket and a parking pass, or how to reach the hospital via public transportation.
3. After they arrive, each group will be met by a facilitator who is a hospital volunteer who will accompany the group as they find their way through the medical center.
4. Each group will be given a list of two to three places to locate in the medical center. They will then be expected to find their way without asking questions of their group facilitator. If unable to find their designated destination, the facilitator will then recommend strategies for the students to consider (finding an information desk, a map, etc.).
5. After this exercise, the students will gather together with their facilitators to discuss their experiences. Problems and possible solutions will be discussed.
6. Facilitators will then introduce students to services the medical center provides, including specializations, financial aid, language translation services, etc.
7. Facilitators will introduce students to some best practices recommended by health care providers, such as Ask Me 3, so as to make a future visit to the medical center most successful.
8. Students will provide verbal and written feedback to the facilitators about the fieldtrip experience as well as other issues and concerns they may have.
9. Information about the exercise will be shared with hospital administrators by facilitators.
1. Gain practice at preparing for and making an appointment with a health care provider over the telephone.
3. Be able to describe symptoms, degree of severity, when they began, and place what happened in an understandable sequence (review of unit 3).
4. Be able to fill out medical history forms including a brief family history.
5. Become familiar with some of the different kinds of health professional staff a patient will meet and what they will do on a routine visit (take temperature, blood pressure; find weight and height; ask for a urine sample; ask for a description of symptoms before the doctor arrives, etc.)
6. Be able to compare this routine with what usually happens in one’s home country. Be able to give feedback about what would be helpful for health care providers in the U.S. to know about GED populations and ESL populations who need to use the U.S. health care system.
Lesson Plan Ideas:
ESL Beginning Level:
1. Review some of the places that need/don’t need an appointment in Charlottesville from Unit Five.
2. Brainstorm the different information you will need when you call to make an appointment. (a) What kinds of questions will the receptionist ask? (b) What answers can we give to each question?
3. Use Picture Stories, "Dr. Lee", by Fred Ligon and Elizabeth Tannenbaum (copyright 1990) and/or Health Stories, Introductory, "Lesson 13: Making an Appointment", by Ann Gianola (copyright 2007).
4. "Writing Assignment": In their Health Journals, have students create a picture story about the steps they need to take when making an appointment with a health care provider.
ESL Low Intermediate and High Intermediate and GED Levels:
Part One: Making the Appointment
1. Review some of the places that need/don’t need an appointment in Charlottesville from Unit Five.
3. Brainstorm the different information you will need when you call to make an appointment. (a) What kinds of questions will the receptionist ask? (b) What answers can we give to each question? [For example, “What is the problem? What are the symptoms?”, “Is it urgent? Do you need to see someone right away?”, “How long have you had these symptoms? When did the problem start?”, “Have you been here before?”, Do you have insurance?”, “What is your name? Could you spell it, please?”, “When can you come in? What time is good for you?”, etc.] Let students know that they may ask for a translator/interpreter at the time they make the appointment. At a public health care facility this service should be free. Also, if the receptionist gives a date and time, how to agree to it or say that you can't come then (e.g. because of class time) and ask for a different time or day.
4. Pair work: Role play a dialogue making an appointment (see attachment). Divide the class into two groups with one group being "receptionists" and the other group being "patients". If possible, have every student have a cell phone and place the "receptionists" in a different location from the "patients". Give each "patient" the telephone number of a "receptionist", a scenario for why they want to make an appointment (see attachment) and a model dialogue of what to say to the receptionist as well as a schedule of when the patient is available (see attachment). Give each "receptionist" a model dialogue of what to say to the patient and a schedule of possible appointment times (see attachment). This could also be done as a homework assignment. If cell phones are not available, have students sit back-to-back so they can not read each others' scripts.
Part Two: After You Arrive at Your Appointment:
1. Brainstorm the information you will need to give the receptionist (name, time of appointment, the name of the health care provider if you know who it is, insurance information, a picture ID, how you plan to pay, etc.).
2. Use the picture in Choices: In Good Health, "Chapter 3: Have You Been to Our Office?", page 13, by Elizabeth Claire (copyright 1991), to identify different parts of the waiting room. Ask students to volunteer to act out what to do, or have volunteer assistants act it out and have students ask follow-up questions. Discuss how long you should wait before asking the receptionist how soon you will be able to see the health care provider.
3. Learn about the different health care staff and what they do. In particular, learn what the admitting nurse does and how that is different from a doctor. Have volunteers act out the process of taking the patient from the waiting room, taking temperature, blood pressure, weighing and determining height, possibly asking for a urine sample, finding out what medications the patient is on, possibly asking the patient to describe symptoms. This last may be done by a different nurse after the patient has been shown to an admitting room. When the nurse asks about medications the patient is on, they should also mention home remedies/alternative remedies. Hand out to each student a copy of the wallet-sized "Personal Medicine List" developed by Martha Jefferson Hospital, UVA-HealthSouth Rehab Hospital, and UVA Health System.
4. Fill out a medical history form. Use the Health Heritage website or use the UVA Medical History Form as a model and the accompanying "patient scenario" (See file cabinet at ALC). Go over any terms students may not understand, like "advance directives".
5. Use the Health Journal (See Multi-Cultural Brief) article, "The Health Care System in China" and accompanying Study Guide to compare this routine with what usually happens in one’s home country. Be able to give feedback about what would be helpful for health care providers in the U.S. to know about ESL populations who need to use the U.S. health care system.
6. Homework: In their Health Journals, have students use the writing prompt in the Study Guide for "The Health Care System in China" to write their own experience.
Finding a doctor:
Making an appointment
Filling out forms: medical history forms
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1. Understand why it is important to be your own advocate or have an advocate when you go to a health care provider.
2. Learn how to be your own advocate or prepare someone else to be your advocate when you go to a health care provider.
2. Have clear strategies for a successful interview with the health care provider, like “Ask Me 3” and “Teach Back”.
3. Be introduced to online resources like Medline to begin to learn vocabulary and what to look for, and/or ask about regarding different diseases or ailments.
4. Be introduced to online resources (Medline) that may help in learning about different diseases and ailments.
5. Know what rights the Civil Rights Act of 1964 provides for all residents and how it applies to GED and ESL students. Know the rights and responsibilities of anyone who uses a publicly funded health care facility in the U.S.
6. Understand the differences between a translator, an interpreter, and an advocate.
Lesson Plan Ideas:
ESL Beginning Level:
1. Define "advocate" as someone who wants to help and support you, not just the health care provider. Explain that it is important to be able to understand the health care provider and for the health care provider to be able to understand you. Brainstorm how to solve these two problems.
2. Describe the translator phones available at UVA Medical Center and Martha Jefferson Hospital. If possible, show one and how it works.
3. Have students practice writing the date and time symptoms began and/or ended. Tell them they can bring this to their appointment so as to help the health care provider understand.
4. Hand out "Pocket Medications" form and show students how to use it. Tell them to take it with them when they go to a health care provider.
5. Introduce and go over "Ask Me 3". There are 3 parts of a consultation to be ready for: (a) what to ask the health care provider; (b) what to tell the health care provider; and (c) what you need to remember from the visit.
6. "Writing Assignment": In their Health Journals, have students create an example of using "Ask Me 3" during a visit with a health care provider.
ESL Low Intermediate and High Intermediate and GED Levels:
1. Define “advocate”. Brainstorm why it is important to be your own advocate when you go to a health care provider. Talk about how people feel when they go to a health care provider. They may feel relief that someone will help to solve their problem, but they may also have more challenging feelings (nervous, worried, sick, find it hard to listen and understand, etc.) Talk about why it might be helpful to have someone else be your advocate and who that person might be. Talk about the difference between a translator/interpreter and an advocate. (You may also talk about Patient Representatives: 434.924.8315. Patient representatives at UVA Medical Center handle complaints, problems and suggestions. They can also help with questions about hospital services, policies and procedures. Even though they are “Patient Representatives”, however, they ultimately work for the hospital so if there is a conflict, students need to be able to understand this.)
2. Learn about “Ask Me 3”. Show one of thevideos, Questions are the Answer; show the website for "Ask Me 3". There are 3 parts of a consultation to be ready for: (a) what to ask the health care provider, (b) what to tell the health care provider, and (c) what you need to remember from the visit. Have students role play the three parts. Brainstorm any other tools that may help the process.
3. Learn to use a modified version of the “Teach Back” process that physicians are often trained to use (for background information on the "Teach Back" method see website: (http://www.nchealthliteracy.org/toolkit/tool5.pdf). While this method is a tool health care providers use, it can also be used by patients to make sure they are communicating effectively with the health care provider. Explain to students: After listening to the health care provider, it is important to make sure you understand what the health care provider has said. Role play where one person is the health care provider and the other is the patient. The health care provider gives instructions to the patient. Then the patient asks the health care provider, “May I tell you what I understand? You want me to …” Then the health care provider either agrees or corrects what the patient has said. Have students role play.
4. Talk about the Civil Rights Act of 1964 and how it is important for all people who use a publicly funded hospital in the U.S., including GED and ESL populations (that health care providers must be able to explain what is happening in language patients can understand, that all health care facilities must be accessible to all patients, discrimination, etc.).
5. Using “Patient Rights” as posted at UVA Medical Center (see attachment), go over some of the basic rights all patients have, including right to a free translator, right to a second opinion, right to informed consent, etc.
6. Using “Patient Responsibilities” as posted at UVA Medical Center (see attachment), go over some of the basic responsibilities of patients.
7. In small groups, use the Multi-Cultural Brief article, "Ok! Ok!" (June 2010) and accompanying Study Guide to read about and discuss how difficult it can be to be your own advocate.
8. Homework: In their Health Journals, have students using the writing prompt in the Study Guide for "Ok! Ok!" to write their own experience with trying to be their own advocate.
Obtaining Insurance and Other Assistance
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