Designing a Healthcare Driven English Language Arts Classroom

Healthcare-Driven Curriculum Materials

Introduction

The U.S. healthcare system is in a drastic need for diversity amongst physicians, caretakers, and supporting staff. The pandemic revealed the lack of quality healthcare provided to communities of color. More specifically, the youth experienced a negative impact from the pandemic. When there is a discussion about the youth in connection with the pandemic there is a heavy focus on their social emotional learning and loss of academics. However, we rarely discuss their experiences with the healthcare system, and the long- term effects it had on their families. Approximately 85% of my student population are black and brown students and 60% of my students have either been diagnosed with COVID or had a close family member who was impacted COVID. Even though healthcare is offered to these students and their families, a question is raised on the quality, equity, and intent of the healthcare provided.  

Historically, black and brown communities have had an estranged relationship with the practice of medicine in the United States. This strained relationship dates back as far as the mid-1800’s with James Marion Sims exploitation of slave women in his study of gynecology. This troubled relationship was also present in the 1940s when Henrietta Lacks’ cells were taken without permission by Dr. Gey at John Hopkins, and recently, the high black mortality which is displayed in the Hulu documentary, Aftershock. A recent Plain Dealer article, Not just Black and white; rethinking the use of race in medicine by Gretchen Kroen, addresses the new shift in the practice of medicine to exclude race as a factor in services, and decisions for patients. For example, physicians are shifting from using race in diagnostic tools and medical guidelines to inform medical plans and treatments. Just from these scenarios is proof that there is a lack of cultural knowledge, awareness, and representation in the medical field. There must be a way to change this narrative of quality, access, and most importantly representation. What if physicians mirrored the population that they served? What if more learning experiences were provided in the healthcare system? Or what if inner-city students were molded to become healthcare advocates and physicians? Learning experiences that are authentic and meaningful are one of the ways to address these questions. After listening to my students and reflecting on my own experiences as a teacher, I redesigned the senior English Language Arts (ELA) classroom at Lincoln West Science and Health. The new curriculum that is provided to students is driven by students’ personal healthcare experiences and was designed with the intent to promote student voice and advocacy. Using healthcare-driven concepts as the foundation of this senior course, students engage in field experiences and rich academic conversations around controversial topics.

Approach to Instruction

The first step to this healthcare drive instruction is the use of backwards design curriculum and planning (Wiggins, Grant, and McTighe, Jay. (1998). Backward Design. In Understanding by Design (pp. 13-34). ASCD). There is a tremendous amount of time devoted to building assessments and creating meaningful learning experiences. Using Ohio Learning Standards as a guide to drive instruction, the concepts, themes, and tasks are unique to each unit. Engage in a productive conversation with students to understand their backgrounds and experiences with healthcare. From my personal conversations with my students, I understood that they have endured some type of trauma, and or racial discrimination. Many of my students don’t have an understanding of their medical rights or deep-rooted historical health disparities in communities of color. Taking all of these factors in consideration leads me to create major concepts and themes from healthcare to discuss.

The second step is determining the concepts, essential questions, and enduring understanding you want your students to be able to know, answer, and understand. For example, when discussing healthy relationships with my students we focus on the core concepts of control and respect.

If we are discussing trauma and mental health our concepts are empathy and community. Lastly, when diving deep into the history of medical exploitation our major concepts are poverty, race, and access. Finding major concepts are key to designing essential questions and enduring understanding that will create a solid foundation for your unit plan. Essential questions are open-ended questions that do not have just one answer which should also be directly connected to your enduring understanding. An example of this would be concepts: poverty, race, and access.

Essential Question:

• How does having access to quality healthcare improve a person’s overall quality of life?

Enduring understandings:

• Analyze why black and brown people are fearful of the healthcare system.
• Understand the school-to-prison pipeline in communities of color.
• Detail common health issues found in black and brown communities.
• Explain the benefits of quality healthcare.
• Determine how the lack of access to quality healthy food options are creating disparities in black and brown neighborhoods

Aligning these major concepts, essential questions, and enduring understandings will (1) provide a guide for your curriculum map (2) ensure that the learning is engaging and rigorous, and (3) these help lay the foundation for the performance task students will conduct at the end of the unit.

The third step is finding books that align with your concepts, essential questions, and enduring understandings. Grade-level texts are included, but I also recommend texts outside typical grade-level texts, such as scholarly articles, medical books, and published medical case studies. Examples of novels that consist of healthcare topics are:

•  Bucking the Sarge by Christopher Paul Curtis
• All American Boys by Jason Reynolds and Brendan Kiely
• Their Eyes Were Watching God by Zora Neale Hurston
• The Immortal Life of Henrietta Lacks by Rebecca Skloot

The novels you select should not only be engaging but culturally relevant to the student experience.

The fourth step is creating a collection of learning activities that include field experiences and align with the healthcare performance tasks. The learning activities should be interactive and collaborative. Examples would be gallery walks, socratic seminars, workshops, and research scavenger hunts. Field experience examples would be visiting a local ACLU event, working alongside a local lead coalition, and or engaging with a trauma unit at your community hospital. Field experiences should be hands-on and should be applicable to the performance task. Each learning activity and field experience is a unique opportunity to teach the Ohio learning standards which is demonstrated through the performance task.

Performance Tasks

Performance tasks are a unique way for students to demonstrate their learning in science and health topics. The task is where the student will apply what they have learned from the field experiences and daily learning activities. Performance tasks should contain elements of research, critical thinking, problem-solving, and presentation. Most importantly the performance task is where the student chooses the healthcare topic they want to explore and demonstrate mastery of as their culminating step in the unit. This task allows them to step into the role of a healthcare advocate and practitioner. Topics for the performance task vary based on the major concepts, essential questions, and enduring understandings of the unit.

There are two strong performance tasks that demonstrate mastery of learning and contain healthcare topics. The two tasks are Workshops and Academic Talks. Workshops allow students to (1) select a topic from healthcare that they feel a strong interest and connection with (2) be able to educate and promote change in the selected topic. For example, when focusing on health relationships students will conduct learning workshops to lower classmen. Students will take the role of a family specialist focusing on promoting healthy relationships and community. Students will choose from one of the major concepts and enduring understandings from the unit. An example of a major concept would be control and respect paired with the enduring understanding Explain the impact of abuse and violence on individuals and society. By focusing on these concepts and enduring understandings there are deep-rooted conversations regarding community, impact of mental health, and possible strategies to overcome these issues. Students create and facilitate these learning workshops and are mini healthcare advocates in their school community.

The second task, academic talks, invite students to address the professional community. Again, the concepts and enduring understandings are the anchors for this task. Students will engage in a planning document to organize their thoughts, research, and solutions. The goal of this task is for students to become pioneers of change in the healthcare system. They are presented with a problem and after thorough research, they find realistic solutions to change the current situation. One of the topics of an academic talk would be Why marginalized communities are fearful of the healthcare system. Using classroom materials, and research students craft a problem statement, solution statement, claims, evidence, reasons, and a call to action from their community.

Tasks such as these allow for students to engage in the healthcare community. They are able to sharpen professional skills, depth of knowledge, and advocacy. To ensure fidelity of these learning experiences, it is essential to design rubrics that are in alignment with Ohio Learning Standards and the essential skills that are being assessed. Curriculum rubrics should be created for each skill being assessed for example professional skills should have its own rubric similar to depth of knowledge, and advocacy. Rubrics are scaffolded to students prior to assigning the tasks. The goal is for students to have ownership of their learning and strengthen their voice. Students are able to truly see advocacy and be molded into future healthcare professionals and physicians. While also maintaining academic standards, students are exposed to rigor and high expectations.

Their Eyes Were Watching God Student Workshop Examples (Student Work Samples)

Workshop Example A

Workshop Example B

Academic Talks: Future Leaders Creating an Equitable Healthcare System (Student Work Samples)

Gallery Walk Videos

End Result and Purpose

The goal for the learning is for students to become community and health advocates. Opportunities must be provided to students to be successful in these arenas. Exposure and authentic learning experiences are key to promoting the change we want to see in healthcare. Thoughtful and meaningful planning is needed for students of color. Their physical, mental and emotional health are basic human rights which is also vital for student academic success. When we think of culturally responsive teaching and learning we often exclude the physical health and experience of our students. Educators and physicians must engage in that difficult discussion and provide opportunities for real change to take place.

In order to truly create future healthcare pioneers, it is essential that students are exposed to complex tasks and high standards. Regardless of a student’s academic background, educators have a responsibility to provide the experience for the student. Any tasks can be modified based on student skill level but why not let them try first?  Engagement and relevance of the topic will always trump academic ability.

The following instruction, activities, experiences, and tasks are high-level, thoroughly researched and promote a rich and diverse learning environment. After preparing our children to go into the healthcare field they will be academically prepared, have empathy, and understand the community they serve. Most importantly they will feel confident that they have the tools to support and advise their own families. Students need to find their voice in order to step into their purpose. They must be armed and ready to engage in crucial conversations with knowledge and solutions. Lastly, we know the children are the future so prepare the next generation to pioneer the journey of healthcare change