UBC Reports | Vol. 47 | No. 01 | Jan. 11, 2001

Health science students care for inner city residents

Student initiative focuses on service-based learning

For more than 200 UBC health sciences undergraduates learning has moved off-campus and into Vancouver's inner city.

They are volunteers in a student-run project called Community Health Initiative by University Students (CHIUS).

With backgrounds in disciplines such as medicine, pharmacy, nursing, dentistry and social work, the students form an interdisciplinary team that is bringing health-care services to residents in Vancouver's Downtown Eastside.

They provide health-care services under the supervision of a physician and nurse while gaining skills in health-care delivery, administration and education. It is an educational model called service learning -- a model that organizers believe to be unique in Canada.

"We wanted to increase the scope and relevance of what we were learning in the classroom," says Steve Mathias, a fourth-year medical student who created the project with Katharine Smart, also a fourth-year medical student.

"When we see inner city patients in the emergency room, it skews our perception of their needs. The clinic helps us develop a better understanding of the health-care problems in this area."

"A big part of the learning has come from the opportunity to work with students from other disciplines," says Smart. "This is how health-care practice is developing."

The pool of student volunteers has been working since April at the Downtown Community Health Clinic on Cordova Street. In addition to the volunteers, a Social Work student is completing a practicum at the clinic.

The students' service has allowed the clinic to extend its hours of operation to include two weeknights and two weekend days. On Saturday afternoons students helped to create a women's only clinic.

"I am inordinately proud of these students," says Dr. Peter Granger, clinical assistant professor of Family Practice and mentor with CHIUS. " They're providing a real service in the area and learning what primary care is all about."

CHIUS aims to integrate curricular issues into practical experience, such as immunization, addiction medicine and determinants of health. Patients seek attention for a wide range of health issues ranging from foot disease to suspected pneumonia as well as psychiatric and social work problems.

"The atmosphere at CHIUS is different than at most clinics," says Mathias. "We serve coffee and food in the waiting area and require that one to two students simply be there to talk to people."

Each patient session takes 30-40 minutes and about 25 patients are seen during each shift.

Third- and fourth-year students provide primary care under the supervision of a physician. First-and second-year medical students offer health education and referral to community services. Nursing students also provide health education and nursing care under the supervision of a registered nurse.

A daily debriefing is part of the learning for clinic workers. It is a chance for students to talk about which patients need follow up and also to discuss what has personally affected them.

Interested volunteers are given a weekend training session that includes an orientation session, a confrontation management seminar and a walking tour where students meet residents of the Downtown Eastside.

CHIUS is entirely student-run and many of the project organizers will graduate in May. Second-and third-year students will be brought into the project as student supervisors to overcome this challenge, says Mathias.

Support for CHIUS comes from the Vancouver/Richmond Health Board which has provided staff, space and supplies. UBC gave an $80,000 grant from the Teaching and Learning Enhancement Fund.

More information about CHIUS can be found at the Web site www.interchange.ubc.ca/chius.