COMMUNITY HEALTH AND SERVICE HANDBOOK

TABLE OF CONTENTS

PROFESSIONALISM IN MEDICINE

ASSESSMENT OF STUDENT PERFORMANCE
Site Orientation, Faculty Evaluation, "A Reflection on Professionalism in Community Health" Essay

EVALUATION CRITERIA (Report on Student Progress)

HELPING YOUR PATIENTS USING THE McGUIRE FUND

SUGGESTED READING

EVALUATION FORMS: Unit 1, Unit 2, Unit 3

DESCRIPTION OF THE COMMUNITY HEALTH ORGANIZATIONS

Area Health Education Centers	Hale Pulama Mau	Ke Ola Mamo at Papakolea	University Health Services
Clinical Trials Shadowing Project	Health Care for the Homeless	Native Hawaiian Center of Excellence	Waikiki Health Center
Diamond Head Mental Health Center	Healthy Keiki Can	Salvation Army Addiction Treatment Program	Waimanalo Health Center
Department of Health: TB Program	Hospice Hawaii	School Health Education Program	**WIC at Kalihi Palama Health Center
Emergency Medical Service	HUGS	St. Francis Hospice	Hawaii HOME Project
Geriatric Medicine Service	Ke Ola Mamo	Sunny Buddies	Youth Correctional Facilty

OBJECTIVES OF COMMUNITY HEALTH

By the end of MD 4 you should be able to:

1. appreciate the diversity of factors impacting health, including social factors,
2. recognize populations (communities) as valid targets of health care services,
3. understand community assessment as the basis for intervention design,
4. understand the importance of community input and collaboration in health related programs,
5. articulate the role of the participating health care organization in the community,
6. articulate the role(s) physicians and other health professionals play on a health care team,
7. view illness from the patient's and the patient's family's perspective,
8. develop effective communication skills with patients and/or their family and the health care organization's staff,
9. recognize community assets and detractors to health,
10. develop an awareness of the impact of cultural competency and the delivery of health care,
11. develop an appreciation for social responsibility and professionalism.

PROFESSIONALISM IN MEDICINE

Developing and maintaining professional behavior is an important part of being a health care provider as well as an important part of your assessment in Community Health. At your Community Health sites, you will be given the authority to intervene in the lives of patients and their families. This gift carries with it an obligation to act responsibly toward:

• Yourself: to recognize and acknowledge personal assets, emotional reactions and limitations in your own knowledge, skills, and attitudes. You should strive to build upon your assets and strengthen and overcome your limitations;
• Patients and their families: under appropriate supervision to take responsibility for the assessment and care of patients and their families;
• Colleagues and Faculty: to develop constructive communication and cooperation among your colleagues and other health professionals engaged in learning, research or health care;
• Community: to contribute to the maintenance and improvement of health of the general population.

Adapted from McMaster University. Overview of Learning Objectives. 2002.

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ASSESSMENT OF STUDENT PERFORMANCE

Site Orientation: Each site will arrange their own orientation session. Please check your email regularly for updates. Attending the orientation session is part of your overall assessment. If you can't attend the orientation session, you must inform the site faculty and OME as soon as possible.

Faculty Evaluation: Students are evaluated on attendance and accomplishments of the overall course and site-specific objectives. Unexcused absences will not be accepted. Scheduling conflicting courses (i.e., electives) or other activities are not acceptable. The only exceptions are tutorial and clinical skills sessions. For example, changes in clinical skills appointments take priority over community health commitments. Students should contact their community health site faculty and one of the Co-Directors of Community Health & Service when conflicts in scheduling arise.

The expectation is that students will participate at the Community Health site for a minimum of 4 hours per week spread out over the time frame of the MD Block. Exception to this time frame requires the prior approval of the Co-Directors of Community Health and the site faculty responsible for the student's activities at the site. In general, Community Health activities are not required during scheduled holidays and breaks, however check with your site coordinator before making alternate plans.

At the end of each MD Block, the site coordinator will submit a course evaluation form for each student to Office of Medical Education. The Co-Directors of Community Health will assign the final course evaluation (Satisfactory, Unsatisfactory or Incomplete). A sample evaluation form is available in OME.

Community Health Colloquia: Once each MD Block the Community Health and Service Program sponsors a colloquium on topics all students should be exposed to: public health, global health, cultural competency, and community research. You are excused from activities at your community health site, but attendance is required at the colloquium. Failure to attend the colloquium could result in a Unsatisfactory evaluation for the MD Block.

"A Reflection on Professionalism in Community Health" Essay. At the end of each MD Block, students are required to complete an essay reflecting on how their experiences at the site illustrated an aspect of professionalism. Students should select a different aspect of professionalism to write about each MD Block. The tone of the essay should be positive and reflect at least one aspect of professionalism. The essay should be a minimum of one page and maximum of two pages (single spaced, 12 point).

Aspects of Professionalism:
1. Integrity
2. Trustworthiness
3. Accountability
4. Excellence
5. Attitude
6. Effective and constructive communication
7. Self assessment, self regulation, self reflection
8. Other aspects of professionalism should be accompanied by a reference

The essay will be graded using the following criteria: 1) was the essay turned in on time, 2) was the essay the required length and font size, 3) did the essay address the theme of professionalism in relationship to your Community Health experience for the MD Block, 4) did the essay contain specific examples of professionalism, 5) was the tone of the essay positive, and 6) was the essay mechanically correct (grammar, punctuation, and spelling). Each criteria is worth 10 points. You need 70% to pass (42 points). An acceptable essay is needed to satisfactorily complete the Community Health requirement for the MD Block.

The essay should be turned into OME by 4:30 pm of the due date. Please check the Community Health Calandar for due dates.

Your essay will be shared with the site faculty. Portions of your essay may be used in the site's newsletter.

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DESCRIPTION OF THE COMMUNITY HEALTH ORGANIZATIONS

Area Health Education Centers. For a description of the AHEC Program and faculty contact information, please visit their website at www.ahec.hawaii.edu/

Clinical Trials Shadowing Project
This program is currently not part of the Community Health Rotation.
Websites: Cancer Research Center: http://www.crch.org Triper Army Hospital: http://www.tamc.amedd.army.mil/
Faculty Coordinators: Tripler - Chrstine Hoover 433-40898. Cancer Research Center of Hawaii - James Tom 586-2979.
Objectives: 1) Students will learn about clinical trials at either Tripler Army Hospital or the Cancer Research Center of Hawaii. Students will be assigned a preceptor to coordinate his/her experiences, 2) Students will assist and attend monthly Clinical Trials Update meetings. Activities at Tripler include: participation in work-up with new clinical trials patients in Oncology or Hematology, perform or assist with data regulatory procedures and assist with the development or review of Patient Consent Forms. Activities at the Cancer Research Center will include: participation in work-up with new clinical trials patients for SELECT, for other cancer control or treatment studies, and the Four Cancer Support studies, perform or assist with data regulatory procedures, and assist with the development or review of Patient Consent Forms.

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Diamond Head Community Mental Health Center
This program is currently not part of the Community Health Rotation.
3627 Kilauea Av., #408, Honolulu, HI 96816. Phone: 733-9330.
Faculty Coordinator: Jeffrey Akaka, MD
The Center provides a comprehensive system of care through which adults in the Diamond Head service area (Nuuanu to Makapuu Point), with serious mental illness or in acute emotional crisis, are assisted to function better and live as independently as possible. Students are considered clinic volunteers and members of the larger clinic team. Orientation involves filling out forms and touring the clinic. Students will meet clinic staff as you pass them in the halls, during joint patient interviews or during interdisciplinary treatment planning meetings. Students will interview patients until they have made a differential diagnosis and treatment plan or until they get stuck. Students will present their findings, reasoning, and will receive feedback and pointers. Students will be expected to attend an evening family support group meeting. A written statement or critique is expected at the end of the Unit.

The objectives of the Diamond Head Community Mental Health Center experience include:
a. to become comfortable around people suffering from serious mental illness and/or in emotional crisis,
b. to develop an appreciation of being a member of a mental health care team,
c. to develop an appreciation of the doctor-patient relationship,
d. to learn how non-medical forces impact medical decisions and outcomes,
e. to develop an appreciation for psychiatric issues/problems as they relate to primary care,
f. how to avoid malpractice lawsuits.

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Department of Health: Tuberculosis Program
This program is currently not part of the Community Health Rotation.
The TB Program is part of the Department of Health. Its goal is to reduce and control the incidence of TB in the State of Hawaii by the identification and treatment of active TB cases in order to prevent the transmission of the disease to the general population. The prevention plan of the program involves identification of individuals with active contagious TB and the administration of appropriate therapy. In addition, the health center performs TB screening by administration of tuberculin skin tests and follow-up x-rays on skin test positive individuals. The program is responsible for treating active TB cases and performing contact investigations in order to assess transmission. The Program maintains an active registry for all TB cases in the State including cases identified by private physicians and the military.

Students will rotate through various departments in the clinic such as registry, laboratory, chest-clinic, and nursing facility. Students will accompany the consulting physician on several morning sessions, reviewing chest X-rays, seeing patients in the clinic and learning appropriate treatment modalities and drug regimens. Students will spend one morning with the outreach team, making home visits and observing daily directly observed therapy (DOT).

The specific objective of the TB Program are:
a. to understand the general concepts of tuberculosis (transmission, pathogenesis, epidemiology, treatment and prevention),
b. to understand the principles of TB skin testing and learn to administer the Mantoux test,
c. to understand the pharmacology of TB drugs (mode of action, dosage and side effects),
d. to understand the basic principles for the laboratory diagnosis of TB including non-tuberculosis mycobacteria,
e. to understand the problems of TB control (multi-drug resistance, patient compliance).

The TB program is relocating from Leahi Hospital to the Lanakila Health Center. Students will resume activities at the TB branch in August 2004.

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Emergency Medical Services
This program is currently not part of the Community Health Rotation.
Program: CHS1
C&C of Honolulu, 3375 Koapaka St, #H450, Honolulu, HI 96819. Phone: 831-4356.
Faculty Coordinator:
Students will accompany an EMS team for one shift every other week. Students will be observers only and can not assist the EMS team. The objectives of this program are to: 1) observe the operations of an EMS team in a busy metropolitan city and 2) to document the non-emergency use of the ambulance service. To qualify for this program, the student must be willing to work around his/her academic schedule in order to fit in one 8-hour shift every other week. Students are pre-selected from qualified students who identify themselves at the Recruitment Fair in July.

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Geriatrics Medicine Service (GMS)
This program is currently not part of the Community Health Rotation. Fellowships in Geriartics are sometimes available between June and August of each year. The program will contact the class when applications are being accepted.
347 North Kuakini St, HPM-9, Honolulu, HI 96817. Phone: 523-8461.
Faculty Coordinator:
Program Administrator:
The GMS is a teaching clinical service of the JABSOM Geriatric Medicine Program. Several outpatient geriatric experiences are available at different sites, including Queen’s Medical Center, Kuakini Medical Center, Leahi Geriatrics Clinic, VA Geriatric Evaluation and Management (GEM) clinic, and Kaiser Permanente. Students will be assigned to a specific site, and experiences are variable according to site. At some sites, students gain experience in primary care geriatrics, including principles of preventive medicine. At others, students gain experience in outpatient consultations for geriatric patients referred by their primary care physicians. These consultations are often performed with the help of an interdisciplinary team, which includes a Geriatrician, Geriatric Medicine Fellow, Medical Social Worker, and occasionally Geriatric Psychiatrist and other disciplines. Family members are encouraged to attend the appointments. Patients seen in for geriatric consultations often present a combination of complex medical and psychosocial problems. The comprehensive geriatric assessment may include a home visit or home safety evaluation. This rotation will include instruction on community resources for this population as the need is identified.

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Hale Pulama Mau at Kuakini Hospital
This program is currently not part of the Community Health Rotation.
Program: CHS1
Kuakini Hospital, 347 No. Kuakini St, Honolulu, HI 96817 Phone: 956-5505.
Faculty Coordinator:
Managing Director, Kuakini Geriatric Care.
The goal of this program is to introduce first year medical students to the physicians' role in caring for the elderly in the community. Meaningful, sustained contact (12 weeks) with the client and his/her family and caregivers is stressed. All information and material related to the client will be held in strict confidence. Client assignment will have the approval of the client, his/her family, physician, nurse and social worker responsible while the client is a resident of Hale Pulama Mau. Activities: 1. Comprehend the epidemiology of the elderly in the U.S. and Hawaii. Learn about Medicare, Medicaid, Long-term insurance and financing of long term care. Learn the services for the elderly in the community-Office of Elderly Affairs, and the City and County Office of Aging, 2. Become knowledgeable about all of the programs at Hale Pulama Mau-Skilled Care, Intermediate Care, Care Home, Day Care and Day Health. Meet with physicians serving Hale Pulama Mau to learn their role(s), 3. Three-four clients (one from each of the various service (SNF, ICF, Care Home and Day Care) will be assigned for the 12-week period. The student will serve as a client advocate and will become thoroughly familiar with each client's educational, medical, social and economical background, and 4. A weekly journal will be kept on each of the clients assigned. This journal will be submitted every three weeks. During the final week, an oral presentation will be made to the interdisciplinary team on the subject of, "Thoughts on Long Term Care for Me--When the Time Comes."

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Health Care for the Homeless Project
This program is currently not part of the Community Health Rotation.
350 Sumner Street, #101, Honolulu, HI 96817. Phone: 791-6334.
Faculty Coordinator:
The Health Care for the Homeless Project at the Kalihi-Palama Health Center provides for over 2,000 individuals who are homeless. The project staff provides medical, psychiatric, outreach, hospital in-reach, substance abuse, and case management services through several different programs within the Project. Students will complete an orientation session which consists of an introduction to the Project, including it's site, staff and programs, and a walking tour of the downtown area where clients/patients frequent. Students will rotate among the various programs. The staff involved in the rotation includes nurses, clinical nurse specialists, nurse practitioners, outreach workers, case managers and social workers. Students will have the opportunity to interact with the clients/patients on different levels and will accompany HCHP staff members on outreach to the streets, shelters and downtown; and in-reach to homeless patients at Queen's Medical Center. Students may have the opportunity to learn and practice some basic clinical skills.

The general objectives of the Homeless Project are:
a) to become familiar with individual(s) who are homeless and gain knowledge about their medical, psychiatric and social needs, b) to gain an understanding of the effects homelessness has on an individual from various perspectives, c) to learn outreach, engagement and case management strategies, d) to observe an Interdisciplinary Care Plan Team meeting(s) at Safe Haven, a residential program for individuals who are homeless and have mental illness, e) to gain an understanding how traditional medical interventions are modified to meet the needs of a person who is homeless, and f) to be able to articulate ways that the Project staff are advocates for individuals who are homeless.

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Healthy Keiki Can
Program: CHSP
Phone: 779-6394 (c)
Faculty Coordinator: Winnie Mesiona Lee, MD
The Hawaii Youth Mentoring Program provides medical students the opportunity to participate in one-on-one mentoring of 3rd graders at Pohakea Elementary School. As a mentor, medical students will be part of a team consisting of pediatric residents, community pediatricians, schoolteachers and administration, and community service groups such as Big Brothers/Big Sisters.

The goals of Healthy Keiki Can (HKC) are:
a. to learn about child development, health issues in pediatrics and medical homes
b. to become an effective mentor to elementary school aged children
c. to develop effective learning modules for 3rd graders

Student will be recruited for HKC during the Recruitment Fair and will commit to participating in Healthy Keiki Can for 3 Units. However, all students interested in mentoring children are welcome to join the program.

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Hospice Hawaii
This program is currently not part of the Community Health Rotation.
860 Iwilei Rd, Honolulu, HI 96817. Phone: 924-9255. Website: www.hospicehawaii.org
Faculty Coordinator: Clarence Liu
Hospice Hawaii is dedicated to promoting hope, healing and comfort for patients and their family members facing a terminal illness within the familiarity of their own community. Hospice care is provided in the patient's home, in the Hospice Hawaii's Kailua Home or in a hospital in-patient unit according to the patient's wishes and needs.

The specific objectives for the Hospice Hawaii experience include:
a. to gain insight into the philosophy, mission and goals of Hospice Hawaii in its care for the terminally ill, their families and the community,
b. to gain an understanding of the concepts related to the physical, spiritual, emotional and psychosocial needs of the terminally ill and their caregivers,
c. to recognize and cope with personal reactions to terminal illness and death,
d. to learn about grief and loss issues that patient's face and about Hospice Hawaii's support for families who deal with these issues before their loved one has died and up to a year after the death,
e. to become familiar with the coordination of support systems through involvement with the Interdisciplinary Team which implements the plan of care in such a manner that the patient and family are the primary unit of care,
f. to develop or enhance active listening and communication skills with health care peers and the community.

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HUGS (Help, Understanding & Group Support)
This program is currently not part of the Community Health Rotation.
3636 Kilauea Av, Honolulu, HI 96816. Phone: 732-4846.
Faculty Coordinator: Ms. Leilani Fernandez
HUGS is a private, non-profit agency which provides a full range of support services for families whose child is diagnosed with a life-threatening illness or is considered medically fragile. Upon completing the initial orientation session at the HUGS Center in Kaimuki, students will be assigned to work with HUGS children and families. In addition, individual hospitals may have required orientation sessions before volunteers can see their patients. HUGS activities include the respite program at the HUGS Center and the Laughter Wagon program at various hospital sites. Students will function as volunteer members of the HUGS Team and communicate regularly with the Volunteer Coordinator and other HUGS staff to work through issues that may arise. Students must submit "Volunteer Notes" to HUGS every month. These notes document the scope and nature of their volunteer activities.
The specific objectives for the HUGS experience included:
a. to learn about and respond to the needs of seriously-ill children and their families,
b. to understand the unique physical, psycho-social, and spiritual aspects of life-threatening illnesses in children, and how it affects the family,
c. to identify issues related to one's limitations, mortality, and personal belief system,
d. to become familiar with a volunteer-based team of agency support,
e. to demonstrate/acquire active listening and communication skills.

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Ke Ola Mamo
This program is currently not part of the Community Health Rotation.
Program: CHS1
1505 Dillingham Blvd, Honolulu, HI 96817. Phone: 848-8000.

From birth to age 64, Native Hawaiians have the highest mortality rate of any ethnic group in Hawaii. Our mission is to lower these mortality rates by providing Native Hawaiians on Oahu with access to primary health care, health promotion and disease prevention services. Our culturally sensitive services include: 1) educating Native Hawaiian on the State's health care system and how to access its services, 2) developing partnerships with existing health care services to improve access of Native Hawaiians to the health care system and 3) working with Native Hawaiian communities to identify their health care needs. Medical students may be involved in our Ho'oikaika Program, which encourages healthy eating and regular exercise, our Malama Program, which supports young mothers with their pre-natal and early childhood needs and our Ho'akahele Program, which uses traditional Hawaiian values in teaching safe-sex education. Although Tuesdays are set aside for JABSOM's community health activities, these Ke Ola Mamo Programs are busier on other days of the week. Students are expected to adjust their schedule whenever possible to fit Ke Ola Mamo's schedule of activities.

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Ke Ola Mamo at Papakolea
This program is currently not part of the Community Health Rotation.
Program: CHS1
1329 Lusitana Street, Suite 704, Honolulu, HI. Phone: 524-2100
Faculty Coordinator:
The Papakolea Community Health Program is committed to the development of cultural competence and the mitigation of barriers facing native Hawaiian patients' acquisition to needed medical services. Students will learn cultural values and the physician responsibility to community health by fulfilling the following objectives: 1) by increasing the student's knowledge of the Hawaiian culture, 2) by becoming oriented to the predominant host Hawaiian culture of Papakolea, 3) by becoming familiar with community resources available to patients of the Papakolea Wellness Program, 4) by becoming familiar with the role of a physician in a semi-rural community, 5) by increase the student's awareness of prevalent diseases in the Papakolea population, 6) by learning to conduct a windshield assessment of Papakolea, and 7) by beginning to develop a meaningful relationship with the community of Papakolea. The student's responsibility will vary from participating in outreach home visits to developing service plans and referral sources to shadowing Dr. Jurek in her clinic.

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Native Hawaiian Center of Excellence (NHCOE)
Program: CHSP
1960 East West Rd, Biomed B204, Honolulu, HI 96822. Phone: 956-9904.
Webpage: http://www.hawaii.edu/nhcoe/welcome.html
Faculty Coordinator:
The NHCOE is committed to improving the health status of native Hawaiians by developing educational and research opportunities for interested medical students. Research into Native Hawaiian health issues are just beginning to determine the multitude of factors affecting the health of Native Hawaiians, therefore students will be encouraged to become involved in on-going local research efforts. Weekly guest speakers will provide a foundation on health issues affecting Native Hawaiians and numerous research topics, such as conducting a literature review, designing a study, conducting a research project, data analysis and how to write a scientific paper. By the end of Unit 3, students will either have a research proposal completed or will be ready to conduct their own research project or will be ready to become part of an on-going research project. The goal of this program is promote research in areas of interest to Native Hawaiians, while providing medical students the opportunity to complete a research project during the academic year. Students are selected for this rotation during the Recruitment Fair in July and will commit to three Units of Community Health at the NHCOE.

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Salvation Army Addiction Treatment Program
This program is currently not part of the Community Health Rotation.
3624 Waokanaka St, Honolulu, HI 96817. Phone: 595-6371. Webpage: http://www.salvationarmyhawaii.org/page13.html
Faculty Coordinator: Ms. Susie Quick
Description of this program was not received in time for printing.

School Health Education Program: "Improving Health Through Knowledge"
Program: CHSP
Office of Medical Education, Biomed B102. Phone: 692-0935.
Faculty Coordinator: Gwen Naguwa, MD
The School Health Education Program (SHEP) is a collaborative, service-learning model designed to encourage healthy life style choices among high school students in grade 10. JABSOM students and faculty along with high school health education teachers will develop learning modules for presentation at public high schools. Medical students, under the guidance of JABSOM faculty, will develop innovative ways to teach health-related topics, such as substance abuse, STDs, nutrition and violence prevention. In addition, survey tools will be developed to determine how effective the presentations were in improving the knowledge of the high school students.

The objectives of SHEP are:
a. to learn about health care issues important to young people,
b. to develop creative ways of teaching this information to high school students,
c. to gain an appreciation of social responsibility, altruism, and the role a physician plays in the health of their community,
d. to learn to relate to 10th grade students in a positive way while encouraging the students to consider a career in the health care field.

Students are recruited into the SHEP program during the Community Health Recruitment Fair in July.

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St. Francis Hospice
This program is currently not part of the Community Health Rotation.
24 Puiwa Rd, Honolulu, HI 96817. Phone: 595-7566.
Faculty Coordinator: Ms. Sallyanne Pekelo
St. Francis Hospice provides services for terminally ill patients and their families both in the home setting and in the inpatient unit (The Sister Maureen Keleher Center) where respite and inpatient services, related to symptom management and pain control are provided. Students will start their experience at St. Francis Hospice with a mandatory orientation session. This orientation will include two 4-hour didactic sessions or one 8-hour didactic session and one 4-hour hands-on experience in the Sister Maureen Keleher Center Inpatient Unit. Failure to complete any part of the orientation sessions will result in dismissal from the program and the student will be disqualified from further participation in the program. Upon satisfactory completion of the orientation, students will be assigned to visit patients in the facility and at the home. A typical experience includes facility visits and home visits. The total hours for facility and home visits will be approximately 28 hours. Total time with our organization is approximately 40 hours. On going communications and documentation, related to the student patient/family interaction, will be expected. A written evaluation or exit interview is required.

The specific objectives for St. Francis Hospice includes:
a. to gain an increased knowledge of St. Francis Hospice, its criteria, philosophy, and goals in the provision of care for terminally ill patients,
b. to learn to deal with personal issues related to death and dying,
c. to learn to identify the patient and family as the single unit of care,
d. to participate as a member of the Interdisciplinary Team process,
e. to understand the importance of both symptom control and pain management and identifying the physical, psychosocial, and spiritual needs of the terminally-ill patient,
f. to become familiar in dealing with grief and the bereavement process.

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Sunny Buddies
Program: CHSP
651 Ialo Street, Honolulu, HI 96813
Faculty Coordinator: Ryan Sato, MS2 and Darren Teshima, MS2
Sunny Buddies is an agency, founded by JABSOM medical students, which strives to foster meaningful friendships between individuals with mental retardation and screened volunteers. By helping people with mental retardation build relationships within the community, our program aims to nurture leadership/social skills, self-confidence and the autonomy necessary to function in a diverse community. At the same time, Sunny Buddies challenges society's perceptions of individuals with mental retardation. Our program aspires to increase public awareness by showing mainstream society that peoplewith mental retardation are functional and capable members of our community. Medical student volunteers are required to 1) fill out a volunteer registration form, 2) pass a screening process (CPS check and criminal history check), 3) complete a pre-orientation interview and 4) attend a 3 hour orientation.

Duties and Responsibilities of a Sunny Buddy Volunteer:
1) be a friend to your buddy by providing companionship & support (regular bi-monthly visits)
2) encourage social interaction & accompany your buddy in recreational activities
3) be on-time and dependable
4) be a good role model by using positive words and actions
5) attend and contribute to the regularly scheduled progress meetings
6) report all problems to the director

Objectives of Sunny Buddies:
a. to become comfortable interacting with people with mental retardation.
b. to understand the psychosocial and health care issues related to mental retardation.
c. to appreciate the therapeutic role of non-medical intervention in patients with mental disabilities.
d. to acquire communication skills to effectively interact with individuals with mental retardation.

Students are selected into the Sunny Buddies Program during the Recruitment Fair in July and commit to 3 Units with the program. However, Sunny Buddies welcomes anyone interested in working with patients with mental disabilities.

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University Health Services Manoa
This program is currently not part of the Community Health Rotation.
University of Hawaii at Manoa, 1710 East West Rd, Honolulu, HI 96822. Phone: 956-4493.
Director: Dr. Lily Ning
Faculty Coordinator: Dr. Nancy Stockert Phone: 956-4493
University Health Services Manoa (UHSM) provides clinical services and health education/promotion for the U.H.-Manoa community. The majority of visits are U.H – Manoa students seeking primary care on a walk-in basis; however, women’s health and other specialty services are provided. Preventive services include immunizations and TB screening; health education is offered both in-house and through peer education presentations to classes and dormitories on campus. The general objectives for medical students at this site are to:

1. become familiar with the range of objectives (clinical, public health, educational) of a health service in a campus community
2. gain a basic understanding of finance and management of a community health center
3. learn about current models of health promotion and assist in health education activities
4. gain familiarity with and participate in clinical care in a college health setting

Activities will depend upon the student’s interest and prior experience, as well as patient load and events that may be scheduled during the rotation. Activities may include: sitting in on advisory committee or business meetings; attending staff development and CME activities; interviewing staff in different areas (psychiatry, alcohol and drug education, etc.); assisting with data gathering and/or analysis for purposes of needs assessment, evaluation, or other research; accompanying peer educators doing class presentations or health fairs; developing and dispersing educational materials; assisting in clinical functions such as intake or referrals; shadowing physicians or nurse practitioner; and working on other projects consistent with the above objectives.

The clinic is currently undergoing rennovations. Students will rejoin the clinic during Units 2 and 3.

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Waikiki Health Center
Program: AHEC
277 Ohua Avenue, Honolulu, HI 96815. Phone: 922-4787. Webpage: http://www.waikikihealthcenter.org
Faculty Coordinator: Elliot Kalauawa, MD
The Waikiki Health Center serves a diverse population of patients throughout the Island of Oahu. The Primary Care Medical Clinic is at the heart of the Waikiki Health Center's programs and services. Care is provided by a team of physicians, nurses, health educators and volunteers. Available services include physical examinations, general medical care, long term treatment for chronic problems, health education, immunizations, TB testing, services for the elderly, family planning, screening and treatment of HIV infections and other STDs. Students will be exposed to the main clinic as well as our Friendly Neighbors Program for the Elderly, our Youth Outreach Project, the Care-A-Van and satellite clinics on the North Shore.

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Waimanalo Health Center
Program: AHEC
41-1347 Kalanianaole Hwy, Waimanalo, HI 96795. Phone: 259-7948. Webpage: http://www.waimanalohc.org/
Faculty Coordinator: Kelley Withy, MD
The Waimanalo Health Center (WHC) is a community health center that provides primary care to Waimanalo families. Sixty-five percent of WHC's clients are Native Hawaiian. Services include pediatrics, women's health, teen clinic, adult medicine, WIC, cultural healing services and family counseling services (FCS). FCS provides behavioral health services and substance abuse treatment to children, families and adults from a primary care and culturally-appropriate perspective. The student will be considered a WHC volunteer and be oriented to WHC.
The specific goals of this rotation include:
a. To become comfortable in working with children, families and adults with behavioral health and substance abuse issues.
b. to understand the pros & cons of a multidisciplinary team.
c. identify the similarities and differences in working with different ethnic populations.
d. begin to appreciate the overlap between primary care and primary psychiatric care.
e. to learn basic case management and clinical skills to engage clients in treatment.
f. increase awareness & interest in a physician's role in advocating for patients.
g. begin to appreciate the importance of health in education.

WIC Program at the Kalihi Palama Health Center
This program is currently not part of the Community Health Rotation.
952 No King Street, Honolulu, HI 96817. Phone: 841-0011.
Faculty Coordinator:
The WIC (Women, Infant & Children) Program provides nutrition education, supplemental nutritious foods and health care referrals for low-income women, infants and children. WIC helps to assure normal healthy pregnancies and birth, promotes and supports breast-feeding practices, and nurtures the healthy development of young children. Students will participate in the various sections of the WIC Program at the Kalihi Palama Health Center. Discuss the specific goals with the WIC Program site faculty.

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Hawaii HOME Project
Program: CHSP
Department of Family Practice and Community Health
Department Webpage: http://www.uhfpres.org/
Faculty Coordinator: Jill Omori, MD
2005 was the first year of this program. It will focus on health care issues of the homeless in urban Honolulu.
Students are recruited into the program during the Community Health Recruitment Fair in July.

Hawaii Youth Correctional Facility
Department of Pediatrics: Division of Adolescent Medicine
This program is currently not part of the Community Health Rotation.
Program: CHS1
Faculty Coordinator:
2005 will be the first year of this program. It will focus on helping the students who have obtained their high school degree to find a career path. This will assist them in their transition from being at the detention center to being part of the community. The medical students will be involved with counseling the students and helping them design specific career goals. The objectives of the program are:
1. to become comfortable working with adolescents who have criminal backgrounds.
2. to empower each ward with the opportunity to design a positive path for the future.
3. to identify and appreciate the ethnic and socioeconomic discrepancies between incarcerated individuals and the general population.
4. to increase awareness of the physician's role in advocating for patients.
5. to become familiar with community assets for this population that will help them develop into productive members of society.

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HELPING YOUR PATIENTS USING THE McGUIRE FUND

The Howard and Dorothy McGuire Fund was established in 1988 by Mrs. Dorothy McGuire after the death of her husband, who was a patient of Dr. Christian L. Gulbrandsen, former JABSOM Dean. Mrs. McGuire endowed the fund after noticing that other patients, who were not as fortunate as she and her husband, were unable to afford some basic necessities related to their health care. Students may request up to $300 per patient per year to help with expenses not covered by other agencies or sources.

For more information about the McGuire Fund and how to apply for funding, please visit the McGuire Fund website.

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SUGGESTED READING

Building Communities from the Inside Out: A Path Toward Finding and Mobilizing Community Assets, Kretzmann, J., McKnight, J. 1997. ACTA Publications (Chicago, IL).

Cross-Cultural Caring: A Handbook for Health Care Professionals in Hawaii. Palafox, N., Warren, A (editors). 1980. Transcultural Health Care Forum (Honolulu, HI).

Dying: A Guide for Helping and Coping. Shepard, M. 2000. The Permanent Press (Sag Harbor, NY).

The Careless Society: Community and Its Counterfeits. McKnight, J. 1996. Basic Books (New York, NY; ISBN: 0465091261).

The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. 1997. Anne Fadiman. Farrar Straus & Giroux (New York, NY; ISBN: 0374267812)

The Unfinished Health Agenda: Lessons From Hawaii. Grossman, B., Shon, J. (editors).1994. University of Hawaii Press (Honolulu, HI).

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Report on Student Progress
The following criteria will be used by the site faculty to evaluate student performance as Satisfactory or Not Satisfactory:
1. Attendance: Satisfactory means the student was punctual and has fulfilled the attendance requirement of the organization, including orientation sessions and Community Health Colloquia.
2. Appearance: Satisfactory means the student was neat, had a well groomed appearance and was dressed appropriately.
3. Learning Skills: Satisfactory means the student was able to learn from the patient or situation, acquired and put into practice concepts and information learned at the organization, actively sought to understand the role of the organization in the community. The student showed initiative when activities were light.
4. Personal Qualities: Satisfactory means the student was well-mannered, creative, compassionate, open to constructive criticism, a good communicator and completed assigned tasks on time. The student demonstrated a professional approach to patient care.
5. Teamwork: Satisfactory means the student demonstrated a positive, constructive working relationship with the staff and patients.
6. Goals and Objectives: Satisfactory means the student meant the goals and objectives of your program.
Further comments:

The following criteria are used by the Community Health Faculty to evaluate student performance as Satisfactory or Not Satisfactory:
1. Essay: Satisfactory means the end of the unit essay was turned in on time, was well-written and met the goals of the essay as outline above (Essay Criteria)
2. Performance: Satisfactory means the student received a Satisfactory evaluation from the site faculty and the evaluation form was turned in on-time. (It is the student's responsibility to have the evaluation form turned into OME by the deadline).

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