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Obstacles and Solutions
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A Medical Student's Guide to Improving Reproductive Health Curricula

IV. Identify Potential Obstacles and Solutions

Goal: Identify potential obstacles and develop strategies for overcoming them.

Action: Consider the following scenarios and problem-solving techniques.

Student Issues

  • Student Issue 1: Students think they receive sufficient information on reproductive health.
    • If you have not conducted an evaluation, do so now. (See I . Conduct Your Own Research: Determine Needs and/or Appendices 6, 7 and 8.)
    • If you have conducted an evaluation and the results indicate that students are satisfied with what is being taught, make sure that you have surveyed a truly representative group of students, particularly third- and fourth-year students. Make sure that the questions give students the opportunity to express opinions about perceived gaps in their education. Make sure you are asking the right questions.

Ask the Right Questions

Asking the right questions can help students see that they are lacking information in certain areas. For example, asking if students are satisfied with the curriculum may not elicit the most accurate response. However, if you provide a list of specific reproductive health topics and ask students if they think they should be covered, you will get a better sense of what students think the curriculum is missing. For more information on formulating survey questions, see Appendix 6.

    • Provide students with clinical cases that require a breadth of knowledge that is absent from their current training.
    • Give students information about topics taught at other schools that are not included in your school’s curriculum.
  • Student Issue 2: You cannot find students who seem interested in working to improve your school’s reproductive health curriculum.
    • Do more research to find students who are interested in improving the curriculum. When you locate these students, consider working with just them rather than using a survey to establish need on a larger level. Even if there is only one student per year interested in receiving more training in reproductive health, it is worth the effort to make sure that student receives the education she or he deems critical.
    • Educate students about the impact of inadequate reproductive health medical education. The statistics listed in the introduction to this Guide can help you do this.
  • Student Issue 3: You know that there are more people interested in improving the curriculum, but they have not attended organizational meetings or volunteered their time.
    • Set up a short meeting or talk informally with them about curriculum improvement.
    • Present the facts (e.g., reasons for implementation, statistics, etc.). Ask for their opinion and whether they will support your efforts.
    • Solicit their support with a petition. Petitions do not require a lot of time, and they demonstrate student interest to the administration.
  • Student Issue 4: Communication is lacking between pre-clinical and clinical students.
    • Talk informally with students about your work on curriculum improvements and ask for their opinion on the suggested improvements.
    • Hold an organizational meeting at a time convenient for all classes, to get students together to talk about improvements. Make sure you spread the word about the meeting (see Appendices 4 and 5).
  • Student Issue 5: Some students are opposed to the school teaching certain reproductive health topics, such as abortion.
    • Be diplomatic; do not get angry, but be firm and stand your ground.
    • Emphasize that the goal of your efforts is to improve medical education and that it is important for future physicians to be knowledgeable about and prepared to provide comprehensive reproductive health care.
    • Concentrate on working with students who are supportive of improvements.
    • Always document the date and time of all negative experiences, especially any threatening encounters, and inform faculty members.
    • Talk to MSFC about potential opposition and ways to respond.
  • Student Issue 6: Students have conducted the assessment and devised a plan and goals, but the year has ended and some of the leaders are moving on to clinical rotations.
    • Identify committed first- and second-year students early in the year and ensure that they are involved in the development of the plan and goals.
    • Develop a list of allies on the faculty and in the community to support the ongoing efforts during the transition of student leadership
    • Schedule a meeting every few months with third-year medical students who worked on the project so that the new leaders can gain from their knowledge and support.
    • Ask the third-year medical students who worked on the project the previous year to be available for questions and to provide mentoring to the first- and second-year medical students who assume leadership of the project.

Faculty and Administrator Issues

  • Faculty and Administrator Issue 1: You are having trouble finding a faculty member who will work toward improving the curriculum.
    • Ask people who may have insight into faculty members’ reproductive health politics.
    • Talk to advisors, professors, and clinical preceptors to solicit their help and ask them to suggest others who might be interested.
    • Identify community clinicians or members from local reproductive health organizations who are willing to help with your efforts.
  • Faculty and Administrator Issue 2: Faculty members are unresponsive to your requests or too busy to work with you.
    • Speak with faculty members about what you can do to make it easier for them to be involved in improving the curriculum (e.g., identify potential guest lecturers, clinical placement sites, qualified adjunct faculty members; offer to collect information or make calls for speakers). Determine why they are unenthusiastic; hesitancy in becoming involved may have to do with lack of time, money, or resources. Show them relevant parts of the Reproductive Health Model Curriculum (see Appendix 1).
    • Suggest that the workload be shared by multiple faculty members.
    • Prioritize changes and make many small changes over a longer period of time.
  • Faculty and Administrator Issue 3: Key administrators or faculty members are not supportive of reproductive health curriculum improvements.
    • Seek the support and help of people who have a good relationship with them. If possible, have your supporters present your case.
    • Present your case in a non-confrontational manner.
    • Solicit administrators’ and faculty members’ opinions after presenting your case. Write down their responses and prepare replies that address their concerns.
  • Faculty and Administrator Issue 4: The curriculum committee is not responsive to the concerns of students.
    • Make sure you are presenting committee members with sufficient information and reasons why curriculum changes are needed, including survey and evaluation results, petitions, other signs of student support, and statistics that demonstrate need.
    • Highlight prominent medical schools that are covering reproductive health topics.
    • Use your school’s list of competencies and APGO’s Women’s Health Care Competencies for Medical Students (see Appendix 20) as a means of influence.
    • Document all interaction with the committee.
    • If the committee remains unresponsive, appeal to the dean of students or to someone in a position of authority and seek advice.

Operational Issues

  • Operational Issue 1: Your school is ideologically opposed to the teaching of certain reproductive health topics, such as abortion.
    • Emphasize that curricular improvements will better prepare students for residency or specialty training.
    • Use resolutions and policies from major medical organizations to indicate the wide base of support for this education (see Appendices 17, 18, and 19).
    • Use your school’s list of competencies and APGO’s Women’s Health Care Competencies for Medical Students (see Appendix 20) as a means of influence.
    • Unless you are aiming to integrate reproductive health topics into your school’s core curriculum, emphasize that the new educational offerings would be voluntary.
    • Consider a letter-writing campaign. Work with your student government and school newspaper to publicize your efforts and/or circulate a petition to show student support for curriculum reform.
  • Operational Issue 2: You cannot find a time when all interested students are available to attend a lecture or course.
    • Consider offering it twice.
    • Offer seminars or invite guest lecturers to speak during common “breaks” such as lunchtime or in the evenings.
  • Operational Issue 3 (For those who are working to create an elective): There are not enough clinical sites to hold the clinical component of the elective.
    • Suggest that the school use alternative forms of education such as anatomical models and videos to demonstrate and practice procedures.
    • Use case studies and problem-based education to teach certain aspects of the course.
    • Bring in speakers to give informative talks on clinical issues.
    • Use a CD-ROM or Web-based virtual patient program to teach clinical skills.
  • Operational Issue 4 (For those who are working to create an elective): An elective is offered, but registration numbers are low.
    • Make sure the course is being offered when students are available.
    • Talk with students who were initially interested to find out why they did not register.
    • Advertise the elective opportunity both within the school and to students at other schools via student groups (e.g., MSFC, AMSA, etc.).
    • Confirm that the course was listed in the course catalog.
    • Make sure advisors know the curriculum content and are educated on its importance.
    • Hold another informational meeting to generate interest in the course. Talk about the need for increased reproductive health training and the topics in the elective.

Can’t Get an Elective or Course at Your School?

  • Advertise electives held at other medical schools and encourage students to attend. Visit www.arhp.org/electives/ for a list of electives and clerkships that use the ARHP Reproductive Health Model Curriculum.
  • Advertise the abortion training externship opportunities available through MSFC and encourage students to participate in them. Visit www.ms4c.org for information on the program, which funds medical students training in a private physician’s office, hospital, or clinic setting to learn about reproductive health services.