University of Vermont

Fair Offers Medical Students Cultural Observation Opportunity

Medical Students at the Champlain Valley Exposition
A few of the 79 medical students who participated in the Champlain Valley Exposition this September.

A new educational activity provided University of Vermont medical students with a unique opportunity to actively observe a diverse range of populations and subcultures at the Champlain Valley Fair in Essex Junction, Vt., between August 25 and September 3, 2012.

Called “COM Goes to the Fair,” the activity served as Part One of the Vermont Culture Series at the UVM College of Medicine, and was supported by the Department of Family Medicine, College of Medicine Office of Diversity, and the TOPMEd (Team-Oriented, Patient-Centered Medical Education) U.S. Health Resources and Services Administration Predoctoral Education Grant, in collaboration with Paula Tracy, Ph.D., director of the Vermont Integrated Curriculum’s Foundations level and professor of biochemistry. A total of 69 first-year medical students and 10 upperclassmen from the College of Medicine participated in the exercise.

Described by Tracy as a “crash course in Vermont culture and diversity,” the activity required that students observe subcultures, relationships, communication differences, challenges, lifestyle choices and health consequences while at the Fair. Students were asked to be astute observers and were provided a guide for details to observe.

At a debrief session held in the Sullivan Classroom in the College’s Medical Education Center on September 7, students shared their observations with the larger group and discussed experiences in smaller groups. Martha Seagrave, PA-C, R.N., assistant professor of family medicine and director of medical student education in family medicine, led the discussion, with assistance from Candace Fraser, M.D., associate professor of family medicine and director of the Family Medicine Third Year Clerkship; Lee Rosen, Ph.D., Professionalism, Communication and Reflection course director and assistant professor of psychology and lecturer in psychiatry; and Mark Kelly, research associate in family medicine.

Among the questions raised by facilitators at the debrief session were: What populations/cultures did you see? What population health issues/challenges did you see? What health behaviors and attitudes did you observe in fairgoers? What types of relationships/interactions did you observe?

General observations from students ranged from typical fair attractions – pig races, Jacuzzis, pumpkins, cows, fried dough, and maple cremees – to more social perspectives. In small group discussions, students reported noticing “teenagers roaming in groups;” “people of lower socioeconomic status;” “people with disabilities;” “older, retired people;” pregnant teens; smokers; and obese people. Seagrave challenged students to identify which characteristics they associated with lower socioeconomic status, which yielded such comments as “interest in NASCAR,” “language use,” and “hygiene.” They then considered stereotyping and the validity of these associations, and discussed observed behaviors linked to health.

Students described witnessing smoking, alcohol consumption (in the beer tent), fried food consumption, availability and use of hand sanitizer on the fairgrounds, and under-age sales at a tobacco pipe booth. In terms of relationships, students observed human-to-animal interactions in the petting zoo; multigenerational teaching in family groups; fights in the high school groups; parent-child interactions, both positive and negative; and communication between fairgoers and fair employees.

“Students were charged to be astute observers, increase their awareness of the different populations they will be working with, note the challenges patients face as a result of positive and negative behaviors, and think about how this will inform their future practice,” says Seagrave.

The second half of the Cultural Series will take place in February 2013 and will include a conference on wealth and poverty in Vermont and how it impacts health.