|
Research Agenda for Psychosocial and Behavioral Factors in Womens Health: Education and Training Agenda
|
|
Guiding Principles
Education and Training Priorities
Major changes are needed
in approaches to education and training in the health professions if we are
to produce health scientists and professionals with the knowledge, skills, and
sensitivity required to generate and apply new knowledge concerning the health
needs of women from all ethnic groups over the life cycle and in diverse social
and cultural contexts. In particular, a comprehensive approach is required that
both critiques traditional approaches and provides innovative and exciting alternatives,
and that is responsive to women's diverse sociocultural contexts and identities.
Guiding Principles
Guiding principles for
the development of curricula for the training of health professionals include
the following:
Training health professionals
to recognize and value diversity is of paramount importance to ensure the quality
of health care.
Institutions that offer
health education should actively enhance the diversity of their curriculum,
student bodies, faculty, administration, and governing bodies.
Health professionals should
be taught to value equalitarianism and collaboration with their clients, patients,
and research participants.
The goal is to enable patients
to become active collaborators in the health-promoting process and to make the
most informed judgments about participating in the health enterprise.
A model of human behavior
that assumes individuals are active and adaptive (rather than passive victims)
leads to more effective health interventions.
Blaming or pathologizing
women and other subordinate groups for the manner in which they cope with the
challenge of surviving in a sexist, racist, classist, homophobic, "ablist",
and violent environment is a poor intervention strategy. Health professionals
need to be taught to recognize the dynamics and sequelae of the many coping
strategies developed by relatively powerless individuals, their cultural components
and validity.
Lectures, textbooks, and
other pedagogical materials should challenge negative stereotyped thinking and
assumptions regarding individual, cultural, and other differences in the framing
of research and other questions, interpretations of research findings, characterizations
of peoples and illnesses, and therapeutic possibilities.
Educators of health professionals
need to create or adapt mechanisms that encourage students/trainees to collaborate,
to respect and value themselves and their fellow students/trainees, to be intolerant
of sexual, racial, or any other harassment, and to interrupt such behavior should
it occur.
Health professionals should
be encouraged to see themselves as part of a larger social system which creates,
exacerbates, or ignores health problems as well as diminishes or eliminates
them.
Training in awareness,
analysis, and amelioration of these problems should be intrinsic to the education
of all health professionals.
There should be continuous
evaluation of and reflection on values, ethics, and practices.
In particular, health professionals
need to examine accepted practices that benefit or accommodate themselves more
than those they serve (e.g., self-referrals, unnecessary surgeries, skimming
the cream of a pool of research participants to maximize favorable outcomes
for therapeutic evaluations). Supercilious attitudes toward nontraditional and
indigenous therapies need reexamination.
Health is a complex function
of the interaction of economic, political, cultural, biological, psychological,
physiological, spiritual, and familial factors.
Health prevention and intervention
efforts that do not take into account this complexity will be less effective
than they could be.
Back to Top
Education
and Training Priorities
Include health professionals
from all health-related fields and subfields in transformation efforts.
Design programs targeted
to multiple educational levels from undergraduate to postdoctoral, and to diverse
training settings, encompassing universities, hospitals, community health centers,
clinics, medical schools, other professional schools, vocational schools, and
continuing education venues.
Make the conceptual model
for a women's health curriculum a biopsychosocial one that is interdisciplinary
in nature, crossing departmental boundaries.
In addition, medical schools
should provide an integrated clinical experience in women's health across the
four years of their programs.
View curriculum development
as a dynamic process; design it to be responsive to new psychosocial and behavioral
research theories, methods, and findings.
Transform all aspects
of the education and training experience, including content, process, and climate.
Content. Educators
need to develop appropriate lectures, textbooks, and other materials, including
videos, films, computer-assisted instruction, electronic classroom bulletin
boards, and instrumentation for use in the classroom and the laboratory; establish
on-line resources, including syllabi banks and other resource materials (WMST-L
and the Women's Studies on-line resources at the University of Maryland at Baltimore
provide a model for these actions); and make women better consumers of health
care and more self-care and self-help oriented.
Process. In addition
to training educators in traditional pedagogical techniques, new skills are
needed that will equip them to (a) intervene in social dynamics of the laboratory
and classroom that undermine the performance of women and ethnic minorities
and (b) break through the resistance of colleagues and students who find their
values and beliefs challenged by this new knowledge.
Climate. Educators
need to develop positive learning environments for women and minorities (including
designing environments that emphasize cooperation and collaboration rather than
competition); address issues of sexual harassment and discrimination, preventing
their occurrence, ameliorating their effects, and empowering women who have
such experiences; provide positive role models and supportive mentoring relationships;
and promote women's full participation in policymaking roles in education and
training settings, including academic institutions, and accreditation, licensing,
and regulatory bodies.
Reconceptualize professional
roles and career development in the health professions to support integration
rather than fragmentation of research, teaching, and practice functions.
Design research training
experiences in both quantitative and qualitative methods for application to
women's health issues including new and innovative research models and methods,
collaborative and community-based research approaches, econometric models, and
evaluation techniques.
Train health professionals
for the traditional roles of researcher, practitioner, consultant, teacher,
and administrator, as well as for the responsibility of communicating their
knowledge to the public and to the media.
Communicating effectively
with the media is particularly important, given the important role that women's
magazines play in educating women about health issues.
Train learners in all
content areas to (a) consider the relationship of women's multiple identities
and circumstances to their health care and (b) appreciate the profound implications
for women's health of biological and social factors differentially associated
with gender, ethnicity, age, and disability.
Communicate knowledge
of and sensitivity to the way differences in gender role norms, expectations,
and power may affect health promotion and disease prevention in diverse ethnic
groups.
For example, women may
do most of the meal planning and preparation or be the one to make sure dependents
visit health care providers. When ill, these women may have difficulty getting
sufficient rest because of having to care for dependents' needs.
Incorporate new knowledge
about women's health into curriculum offerings dealing with diseases/disorders
that are common in, unique to, or more prevalent in women.
Information on risk factors,
etiology, outcomes, and interventions of diseases/disorders all need to be included.
Here priority areas include osteoporosis, HIV infection, eating disorders, depression,
anxiety disorders, substance abuse, systemic lupus erythematosus, cancer, reproductive-related
conditions, and heart disease.
Educate health care providers
that women may respond differently to drug therapy on the basis of gender-related
differences in pharmacokinetics and pharmacodynamics.
Drug doses may need adjustment
for women of different ages, in different menstrual phases, or of different
ethnic group membership. All of these issues require further evaluation in multi-ethnic
studies.
Design reproductive health
curricula to equip health professionals with knowledge and skills that will
enable them to help women (a) understand and enjoy their own sexuality; (b)
regulate pregnancy and childbearing effectively and safely; (c) remain free
of disease, disability, and death associated with sexuality and reproduction;
and (d) bear and rear healthy children.
Examination of links between
inequalities in women's power and status and their sexuality and reproductive
health would be included (e.g., violence and unwanted pregnancy; poverty and
low birth weight; SES, substance abuse, and AIDS/HIV infection; ethnicity and
sexuality).
Develop institutional
structures to promote interdisciplinary research collaboration and build new
biopsychosocial models of women's health over the life cycle and in differing
cultural contexts.
The establishment of offices
that focus on women's issues in various agencies, such as the National Institutes
of Health, Centers for Disease Control and Prevention, Substance Abuse and Mental
Health Services Administration, Food and Drug Administration, and the Veterans
Administration, is an important step. To be effective, however, they must be
adequately staffed and funded, with the clout needed to have an impact on the
funding of other offices as well. Although the concerns of such institutional
structures would encompass more than training, they do need to exercise leadership
in the training area through the funding of research training workshops, and
pre- and postdoctoral fellowships specifically targeted for women's health.
Develop training programs
specifically focused on women's health and mainstream knowledge into other types
of training programs.
Develop policy that mandates
addressing issues of diversity in programs receiving training grants, including
both trainee selection and program content, just as there is policy mandating
inclusion of women in study populations.
Create new training opportunities,
including multidisciplinary training centers, specialized training institutes,
and faculty/staff development offerings modeled after the National Institute
of Mental Health staff college courses on women's mental health of the early
1980s.
Expand sources of funding
for curriculum development and integration projects, both in the public and
private sector.
Back to
Top
BACK
NEXT
Table of Contents
|
