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What Does Culturally Sensitive Care Look Like? Ask a Teenager.

May 08, 2018 | Brooke Briggance, FACES for the Future Coalition | This post first appeared on the Global Health Fellows Program II website.

I am a parent of four boys—28, 22, 16 and 15—and I work with youth as Deputy Director for the FACES for the Future Coalition (“FACES”), a program of the Public Health Institute. That means I'm pretty much thinking about young people all day—what motivates them, what inspires them, how do you hold them accountable … it isn’t easy.

Like many of you, I’ve been watching the news and seeing how young people are front and center of nearly every social debate we are having in the U.S. I’ve been reminded about the power of the youth perspective and why it's urgently needed, particularly in the healthcare workforce. Underrepresentation in medicine has consequences for our workforce and for our communities.

Here at FACES, we’re working to address that challenge by exposing diverse high school students to healthcare role models who look like them. Our programming, with the support of the Global Health Fellows Program (GHFP) II, includes internship placement and career exploration in various healthcare settings, individualized tutoring, college preparation and psychosocial services.

Recently, our FACES high school students observed graduate level Physician Assistant (PA) students conducting simulations. These are practice sessions in which PA students prepare for actual patient care situations. Normally, faculty observe the PA students and deliver feedback laden with jargon and “medical speak.” But this time, they were hearing from high school students. The feedback was uncensored, raw, indelicately expressed … and it was spot-on.

FACES students shadow the pros at Samuel Merritt University in Oakland, Calif.
FACES students shadow the pros at Samuel Merritt University in Oakland, Calif.

One PA student was looking for a piece of equipment, but didn’t talk to his patient while he was trying to find it. The FACES student asked, “Why didn’t you even talk to your patient while you were looking for the gloves? That is really weird—just having to sit there in that little paper gown and have some stranger walking around you without even making pleasant conversation?”

Another PA student needed to examine an abdomen during a routine visit. “When you wanted to examine the patient’s abdomen, she unbuttoned the top button of her jeans and you just watched her. Dude, that was creepy! You should have looked at your papers or something. You have to make her feel comfortable—like you’re there but not really. I would totally have thought you were creepy if you did that to me. You have to make them feel comfortable. This isn’t about you.”

FACES students also took note of a PA student who got chatty and missed the opportunity to do any physical exam for a cough. “I guess it’s good that you’re a nice person, but that doesn’t do your patient much good. She’s still gonna have her cough if you’re too busy trying to be her friend and forget why you’re really there. You should learn to not talk so much,” they said.

As the PA students digested their feedback, I noticed a sea of nodding heads. Afterwards, I asked them what it felt like to be critiqued by teenagers.

One said, “Sometimes I would get my feelings hurt, but I want that because they are saying things I need to hear and that will help me get better.” Another said, “They picked up on things the faculty didn’t even see or tell me. But they were right. It doesn’t help us to sugar coat it. This is going to make me a lot stronger and I’ll do better next time.” Perhaps this sums it up best: “Man, they aren’t fooling around. That was my toughest exam yet!”

Having teenagers hold a mirror up to us isn’t easy. It can be pretty unflattering, actually. But their challenge to us is valid. They are, after all, inheriting the world we have created before them. They’ve been observing adult decisions and behaviors their whole lives and they have questions about the choices we’ve made.

These observations and sensitivities come from a diverse group of people. The challenge is getting them into the healthcare field, which is why we need to start as soon as possible and give students the microphone.

GHFP-II’s annual Global Health Youth Summit (GHYS), held in collaboration with FACES, is one of many forums in which young people have challenged us with their perspectives, voiced their frustrations, and most importantly, harnessed them into solutions that will change the conversation and the culture of care. We have taught them about global health, but they have taught us along the way. The GHYS is a GHFP-II activity in collaboration with FACES, a PHI program.

Yes, things are more complicated than they sometimes understand. And yes, sometimes their delivery needs a lot of work! But like the PA students, the adults in the room are better and stronger for listening to the voices of our youth. We are stronger, more accountable, and more driven to rethink possibilities.

Without youth being involved in our conversations about the world and the health challenges we face—we aren’t truly preparing for tomorrow. We just think we are.

Brooke Briggance is the Deputy Director at PHI's FACES for the Future Coalition.