AAMC Reporter: May 2008

Kids in the Curriculum: Medical Schools and Youth Organizations Find Common Goals

Related Resources Eastern Virginia Medical School Marshall University Joan C. Edwards School of Medicine University of Texas M.D. Anderson Cancer Center University of Vermont College of Medicine Other Resources statehealthfacts.org Kaiser Family Foundation U.S. Obesity Trends 1985–2006 Centers for Disease Control and Prevention

Miriam Cantor-Stone hopes to be an educator some day. But until then, the bubbly teenager is practicing on her loved ones: She wants to make sure they learn all the facts about breast cancer.

"I am passing information about breast cancer along to my older relatives and friends," she said. "It's wonderful that I learned about it young, because it will always be with me. Even if I don't get breast cancer, someone else I know might, and it's good to know this information before anything happens."

Cantor-Stone can credit this newfound expertise to her involvement in Girl Scouts of America—and, more precisely, to a partnership between her local scout council and the University of Texas M.D. Anderson Cancer Center. The two groups joined forces in 1997 to help teenage girls learn more about breast cancer. It is one of many partnerships around the country between academic medicine and youth organizations, with the goal of educating younger generations and improving their lifestyles.

Throughout the Girls Scouts breast cancer program, interested scouts visit the Anderson center to meet oncologists and breast cancer survivors. They learn the difference between a malignant tumor and a benign one. They talk about what chemotherapy really means. They discuss what a mammogram entails, and why early screening and detection are important.

The San Jacinto Council even created a new breast cancer awareness patch for those who demonstrate their knowledge of the disease. The patch—and the program—is spreading to other scout troops nationwide.

"We had the audience, and M.D. Anderson had the medical expertise," said Carolyn Johnson, vice president of membership for the Girl Scouts' San Jacinto Council. "It has been the perfect partnership."

These kinds of collaborations serve many purposes. At Marshall University Joan C. Edwards School of Medicine, the Let's Get Moving! program targets childhood obesity.

Hovering at around 30 percent, the Mountain State's adult obesity rate is one of the nation's highest. Hoping to reverse that trend at the source, Marshall medical students started Let's Get Moving! in 2004 to promote better diets and exercise habits among children. The local YMCA teamed up with the organization this year.

Marshall University medical school student Chris Carey plays the popular Dance Dance Revolution video game with a new friend.

As part of the program, Let's Get Moving! features health fairs at local elementary schools. At the fairs, youngsters shoot hoops or tackle obstacle courses for prizes. Others show off their moves in Dance Dance Revolution, a popular video game where players score points by performing dance steps on a computerized mat. Nutrition sessions, blood pressure readings, and body mass index measurements complement the activity stations. Marshall's medical students are young enough to relate to the children, organizers said.

"Our children like listening to them, because these medical students are in their 20s and our kids think they're cool. They like how they dress. They're a little more hip than us teachers," said Kim Maynard, a physical education teacher at Southside Elementary School in Huntington, W.Va., which recently hosted a Let's Get Moving! fair.

The YMCA joined the program this academic year, when Let's Get Moving! expanded to include an obesity intervention program for 200 children. The YMCA offers free gym memberships to participating kids, and their families can join at a discount.

Program organizers are also bringing families together over the dinner table with healthy cooking classes. In classes at a nearby hospital, kids and parents prepare nutritious dinners under the watchful eye of local chefs, while dietitians use plastic food props to show proper portion sizes. Pasta dishes with olive oil—not butter or lard—are typical for the menu here.

To stock their pantries with healthy foods, families go on shopping excursions, where they learn to read nutritional labels and avoid the marketing ploys of junk-food companies.

"We have put every single component of obesity reduction into this one concerted effort," said Aaron M. McGuffin, M.D., senior associate dean for medical student education at Marshall and the Let's Get Moving! faculty sponsor. "We just want to inundate children and families to help stop a major problem in our state."

While students at Marshall work to lower obesity, their counterparts at the University of Vermont (UVM) College of Medicine are fighting the opposite problem—childhood hunger—in a special public health course that the school offers in partnership with the local United Way chapter.

The United Way works with other community agencies to identify pressing public health needs for children and adults, such as food insecurity. In Vermont, there are about 21,000 children who cannot get sufficient nutrition, which can lead to a host of problems including stunted growth, cognitive dysfunction, and increased aggression.

UVM students in the public health course look for ways to address the issue, taking any research or recommendations back to the relevant agencies. Students recently helped create a malnourishment assessment tool for local physicians, providing a consistent evaluation and referral mechanism. According to Jan K. Carney, M.D., M.P.H., the course director, some Vermont health professionals have already begun using this resource in their practice, and efforts are underway for statewide adoption of the resource.

A smoking cessation program for teenagers was another focus of the UVM-United Way partnership this academic year. This UVM team worked with residents at the Woodside Juvenile Rehabilitation Center in Colchester, Vt., which houses at-risk youth who have had trouble with the law and significant mental health and substance abuse problems. The cessation program incorporated both introspective activities—so that people could examine what drew them to smoking—and medical information about the consequences of nicotine.

Although participation was voluntary,many of the teenagers signed up.

"It is both concrete and supportive," said Judith A. Christensen, Ph.D., Woodside's clinical and education director. "It provides excellent information and gives positive strategies that teens find acceptable and are willing to try."

The Woodside staff is still implementing the program. This was the fourth such public health project on which UVM and Woodside teamed up, and Christensen plans to keep the collaboration going.

"Every project has had sustainability," Christensen said. "The Vermont students are leaving a legacy here." UVM students benefit from learning firsthand what goes into developing a public health initiative.

"The amount of effort and coordination required to improve health in our communities is immense: the implementation of an intervention, the follow-up required to evaluate for effectiveness, all the while staying up to date on the newest science," said Elizabeth Duncan, a third-year student who completed the course in January 2007. "I really gained an appreciation for the complexity of this process."

In the Tidewater region of southeastern Virginia, teenagers learned how a medical examiner sorts through autopsy results to solve crimes. Or how rescue squads fly in helicopters to save people from emergency situations. In a partnership with Eastern Virginia Medical School (EVMS) faculty and students, these teens can learn all sorts of ways that people apply those biology classes and chemistry labs to the real world.

A program set up by EVMS lets local teenagers come to the school's campus to learn about different medical professions. In monthly information sessions spread across the academic calendar, adolescents hear from and interact with a panel of experts on a specific health career. While the program is open to all local teens, the Tidewater Boy Scouts of America troop provides marketing and administrative support.

EVMS has hosted a health careers exploration program for about eight years now. Local teenagers have input on which professions are covered, and EVMS students shape the curriculum and line up speakers—sometimes performing the speaking duties themselves, as they did recently on anatomy night. For this session, the teenagers learned about the human body just as a medical student would—by viewing cadavers. EVMS students served as the lecturers, pointing out organs and tendons to a captive audience.

"The teenagers are fascinated to get so close to the cadavers. It's our most popular night by far," said Michael Solhaug, M.D., associate dean for academic affairs at EVMS. "The medical students prepare the scouts well so that they are not upset by the specimens."

Solhaug said he is amazed by how many teens show up at EVMS eager to learn.

"Two years ago, on our first session of the year, it was like a movie premiere—all you needed were the bright lights and red carpet," he said. "We had no idea that our program was so well received. To see that kind of interest in health careers was great."

—By Elissa Fuchs

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