4.1 Demonstrate leadership and collaborate effectively with other healthcare team members and professional associates.
4.2 Understand how human diversity may influence or interfere with exchange of information.
4.5 Use information technology appropriately to manage medical information and patient care decisions, promote education, and communicate in the interests of patients.
4.6. Effectively prepare and deliver educational materials to individuals and groups.
Working with immigrant and refugee students is a long-held passion of mine. As an undergraduate in Arizona, I volunteered tutoring K-12 students from refugee families. When I learned about the Somali Health Initiative for Nutrition Education (SHINE) in medical school, I was excited to volunteer.
Through SHINE, we provided 11 weekly health education lessons at Focus Learning Academy of Northern Columbus. About 96% of their students are of Somali background. I volunteered to teach and help organize a field trip and fell in love with the project. When I applied for leadership for the following year, I was asked to fill in as Treasurer.
I was excited to make an impact for refugee students locally, although I had never served as treasurer of an organization before. Our leadership team was eager to expand the project and host two field trips. As I reviewed our budget though, I worried how we would find sustainable funding. We worked together to search for local funding sources, knowing how important these learning experiences could be for the students. Throughout the semester, I wrote grant applications, ordered supplies, purchased healthy snacks to provide at lessons, and covered our transportation costs. When I had spare time on Fridays, I volunteered at the school and helped design a lesson on mental health.
Applying for funding meant advocating for the program, both on paper and in person. I was nervous to present to groups outside of the College of Medicine, but I needed to persuade others of the importance of our project. I submitted a referendum to the interprofessional student council and gave a powerpoint presentation at their senate meeting. Two of my team members helped me present, and our funding request was approved. After the meeting, the dental school representative asked us if dentistry could get involved in the project. We collaborated to make the program more interprofessional. The dental students taught a lesson at the school, volunteered for our panel discussion, and hosted a tour of the department during our spring field trip.
In October, we were informed that the Columbus Dispatch was looking to write a feature about the community health education program at Ohio State, and our program had drawn their attention. A reporter came to interview and observe us teaching. We were featured on November 5th, 2018.
Although I normally shy away from public speaking, I was passionate about providing health education and mentorship for local refugee students, and that passion came through in my presentations. I accepted another invitation to present at the annual Medical Alumni Society meeting. We received several questions on our approach to impacting mental health. This inspired me to question how we can better address mental health as educators and providers in refugee communities.
In the clinical setting, language and cultural barriers create unexpected challenges for refugee patients. Finding a translator can take up time and is not always available in under resourced areas. Differing cultural norms—such as a physician taking time to explain care plans to all members of a patient’s family—can frustrate patient and provider. In some instances, patients fear blame, punishment, or stigmatization and delay seeking care until necessary. Open-mindedness and an ongoing desire to learn and connect are necessary to improve cultural competency in healthcare.
Teaching is often a two-way street, and I learned the most about Somali culture by spending time directly with students at SHINE. I wondered if these interactions could help my classmates and I to become more well-rounded physicians. I discovered that Columbus Refugee and Immigration Services (CRIS) offered training for students and community members interested in working with local refugees. Out of curiosity, I attended a session and learned more about the resettlement process and local needs of refugees. When I asked classmates if this would be an interesting workshop topic, they helped me to network and arrange an event.
In February, I coordinated a Refugee Health and Wellness Workshop with a CRIS partner who is passionate about educational outreach for health providers. I collaborated with Leading in Global Health Together (LIGHT), our global health interest group. At this session, we discussed how to provide culturally competent care in diverse communities in Columbus. Hopefully this effort promotes awareness of health barriers and mindfulness in how we might improve care for refugee communities as future physicians.
- Show my effort to engage with patients’ language and culture. For example:
- Asking patients what language and dialect they understand best
- Greeting a patient in their native language
- Asking patients to teach me a word in their language
- Asking patients to tell me more about food, sports, music, or hobbies they enjoy
- Use a translator rather than a family member if possible
- Ask refugee patients if they have access to transportation for health appointments and picking up prescriptions
- Always use the teach-back method to ensure the patient understands their treatment and why they are being treated
- Print discharge instructions in the patient’s native language
- Allot extra time for outpatient visits with non-English speaking patients when possible
- Find out where refugees can find mental health resources in my city
- Find out where refugees can find help with job applications in my city
- Help my patients navigate the health system by connecting them with social work and case management as needed
- Advocate for health needs specific to refugee patients when opportunities arise