Compassion is derived from understanding and love. This concept is what drives Associate Professor Sandra Earle, Pharm.D., in her mission to prepare University of Findlay pharmacy students to improve patient lives throughout their careers. Earle’s “Diversity through Service” course offers experiences in the classroom and the field where students strive to achieve greater cultural competency, and therefore acquire a more comprehensive understanding of the human condition. The course addresses topics regarding classist struggle, race and power, and cultural barriers not only in the service of pharmacy, but in life.
Learning through immersion is Earle’s preferred method of teaching for this class. Students have the opportunity to travel in a mobile medical lab to offer free check-ups to underserved populations. During the class’s first offering in 2016, students made weekly trips to inner-city Toledo, Ohio. In 2017, students worked with migrant workers on various Northwest Ohio farms.
“I wanted our students to be exposed to all forms of diversity, but especially economic diversity. These are people that we really need to jump in and make sure we’re taking care of as a society and as pharmacists,” said Earle, who also mentioned the importance of social interaction nuances related to circumstance and emotion. “Sometimes it is hard to be pleasant when you haven’t eaten in a while or haven’t been able to take a bath. I want to make sure our students are exposed to that early so that they can be caring and maybe treat those folks with more understanding than they might otherwise,” she said.
Field Experience, Literally
In the spring and summer, migrant workers across the country travel to Ohio for work. With its many acres of farmland and seasonal crops, there is no shortage of jobs available in the agriculture industry. As the workers who fill many of these positions travel extensively every year, they often miss out on check-ups and general care, luxuries that are often taken for granted by those with regular access to doctors.
Under the supervision of Earle and various pharmacists, students visited a local farm outside of Tiffin, Ohio to perform blood pressure and glucose tests, and administer tetanus and flu shots.
Migrant workers in the area are typically young men from Central and South America who travel seasonally making money to send back to their families. Due to the language barrier and a disinclination to take time off as to not lose wages, these workers often go without preventive medical care. “There are too many barriers inhibiting the farmers from getting to medical clinics, so we went to them,” explained Earle.
Students and faculty supervisors transported chairs, tables and medical kits from campus to set up a functioning clinic in a barn. “We brought flu and tetanus immunizations because the types of activities the workers do put them at greatest risk for those two diseases,” explained Earle. “One of the biggest challenges was that many of them didn’t speak any English. Luckily, we had one student who is Mexican-American, who was able to translate and another student who was very fluent in Spanish. Initially, they didn’t think they’d be able to help but they quickly realized they were very useful in that setting.”
Earle plans to return with her students in spring 2019, when the workers return for planting season.
The Mobile Med Lab
While rural areas and inner-city life are often on different ends of the spectrum, they often share similar health care challenges. In Toledo, the lab was driven right into neighborhoods and parked in church parking lots or simply on corners. One of the most successful stops was across the street from a soup kitchen. As people would stop by for meals, they saw the mobile medical lab as they walked out and stopped in for their tests. The pharmacy students’ weekly presence built relationships and trust, said Earle, the kind of trust that can make a difference in more than one life.
One Findlay student worked with two patients, a husband and wife who worked at the soup kitchen. They were in their seventies and were very kind people who would look after others in the neighborhood but rarely thought of themselves, said Earl. The student testing revealed that both of them had blood pressure and glucose levels that were far too high. Earle and the student arranged for them to attend a free clinic, and both of them were hospitalized for more than a week. Upon their release, they were given the appropriate medicine and lifestyle advice to make a lasting positive impact on their health. The couple credits Earle and the student with saving their lives, and passed along their praise to other community members who then sought help with their medical problems.
In the same neighborhood was another gentleman in his seventies with lung issues who required an inhaler. Earle and the students helped him obtain a new prescription for his inhaler and he began to stop by regularly to visit with the group. Suddenly, he stopped showing up and was not seen for weeks. Earle discovered that the man had previously struggled with alcohol addiction, and there was a good chance he was back in that situation. After a long talk with him during a personal visit to his home, she arranged for him to join a group to help him maintain his sobriety, and he ended up going to rehabilitation. Earle saw him again towards the end of the year and said he looked like a new person.
“Through this class, we opened a door to a whole new way of serving,” said Earle. “Jesus said to love and serve the needy and that is what we are trying to do here. Our students are learning how to use their skills, talents and education to make a difference in the real world not just for themselves and their career, but for others. We cannot be successful pharmacists and improve patients’ lives unless we are open-minded and loving of all,” she pointed out.
Earle’s favorite part of the course is seeing the students interact with the patients. “It’s an extremely wonderful moment. I get out there at first and try to break the barrier a little bit, but then I fall back so they can take over. It’s awesome to see them take over in such a compassionate and competent way and really help people, and then to see their excitement afterward,” she said.
While the field experiences give students the exposure to diverse groups, the work completed in the classroom creates a paradigm shift in their beliefs about diversity. Earle begins the course with an exercise in which the students are separated into two groups, each with their own fictional culture. Each group elects one person to act as an ambassador to send to the opposite group to learn about them and bring information back. “Right away, students begin to identify with their own group and it became an us-versus-them situation,” Earl said. “We talked about how it’s human nature to want to belong to a group,” she explained. “As humans we are looking to belong, and that inherently means that others don’t. That want sets us up for wonderfulness and difficulty.”
The course also focuses on guided discussion with topics arranged by Earle and her fellow professor Akesha Edwards, Pharm.D., Ph.D. Throughout the semester, pairs of students are given an underserved population to research and make recommendations on how to better serve them. Lesbian Gay Bisexual Transgender and Queer (LGBTQ) individuals, Native Americans, the obese, veterans, the impoverished and elderly populations have been addressed.
Findlay’s Director of Intercultural Student Services Robert E. Braylock, who graduated from the University’s College of Pharmacy in 2016, lead a discussion on race and power. Braylock presented on American history that exposed not only the racism that occurred, but the housing policies that led to many of the issues we have today. “Many students say the course was very challenging of their viewpoints of things that they didn’t really consider before,” said Earle. “I think everyone left that discussion very sobered and with the idea that while we can’t change what happened, we have to recognize the inequality and make sure it’s as even as possible moving forward. It was enlightening and disturbing and important.”
The idea for a course in diversity came about in 2015. Findlay’s College of Pharmacy was interviewing for a new dean, and students were invited to participate in the selection process by asking candidates questions. As Earle sat in the back and listened to the students questions, she noted that many of the questions were about diversity and how the new dean would foster diversity in the college. “It made me worry,” said Earle. “I believed we had a fairly diverse student body, but I was totally naïve as to if there was a problem. After investigating the cause behind the questions, it came to light that many students did feel there was a need for a diversity class. They [the students] said that there was nothing mean or overt, it was simply ignorance about how other people lived,” explained Earle.
Although Earle has no prior experience in teaching a diversity course, she has a heart for it. The course forces students to grow in ways they wouldn’t be able to through other experiences. While people can never achieve full cultural enlightenment, she strives to increase students’ cultural awareness by encouraging them to maintain an open mind and not immediately leap to conclusions.
“The goal of this course and a major part of our discussions is how this information will help us improve and then how we can use our knowledge to help other people’s lives improve,” said Earle. “The more our students see and understand the world outside their own experience, the more they will grow in their compassion and be able to care for patients when they see them in their practice.”