Syllabus

The Evergreen State College
U.S. Health Care Foundations: Values and Formative Culture
Fall Quarter 2002

Joan Bantz, MPA, RHU L3213, (360) 867-5095 e-mail: bantzj@evergreen.edu

Room: Lab I, Room 1040 An Intensive Saturday and WebX Class 4 Credit Hours

Class Sessions: Saturdays, Oct 5, Oct 26, Nov 16, and Dec 7, 2002

You MUST be present Oct 5 to be considered registered. All class sessions are from 9:00 AM to 5:00 PM.
Computer access for WebX participation is required.

I. Program Description

"Exploring health care from the early roots of medicine and health to the present."

Although it often seems that the current problems we face in health care emerged overnight, they are a direct result of the accumulated cultural constructions, values, beliefs, politics, policy decisions and market choices, etc., made over the last century.

Students will explore how we got to where we are today. We will examine the underpinnings of U.S. health care by looking at historical development and underlying values; viewing through the lenses of functionalism, political economy and social constructionist; and mind/body/spirit and pathways of delivery through alternative and traditional medicine. We will pay special attention to how special interest groups have captured and framed health care policy, reform and other rhetoric.

This foundation course will prepare students for further study in health care policy and promulgation, as well as seeking to, or working in, health care fields.

II. Learning Objectives:

The Objectives of the program are:
¨      Develop an awareness of the social, cultural, political and policy areas that influence health care.
¨      Understand how personal and cultural values and beliefs affect our expectations of health care.
¨       Comprehend health care's historical underpinnings and its impact on reform strategies.
¨      Develop proficiency with web-based communication tools.

III. Program Methods:

Class attendance and participation
Teamwork
Assigned Text
WebX postings – critique required readings and peers’ responses.
Seminars
Assignments:

Assigned Readings and Postings:

Each student will write a critique to the readings and post your writing on WebX. You will also respond to the posting of at least one other student peer.

Personal Cultural Assessment (Due October 27, 2002):

Each student will complete a personal cultural health assessment. This exercise will prepare you to develop awareness of your own cultural and its impact on your view of health.

Team Project

Each team will select a specific health policy topic to focus on for the quarter. The following two assignments will address your selected health policy area:

¨ (Individual) Health Policy Cultural Paper (Due, November 16, 2002):Each team member will identify separate relevant formative US cultural underpinning and other issues that affect the selected topic and develop a two page paper outlining these impacts. ¨ Group Project (Due December 7, 2002): Each team will present a final overview of their selected health policy topic addressing the central questions for the quarter. "Why have we not enjoyed a equitable or universal health care system in the United States and how do begin to address issues of cost, quality, access and coverage given US culture and historical underpinnings?"

Cumulative Self-Reflection (Due, December 7, 2002): A two-page reflection paper on your individual perspective about health and health care from looking through the lens of the US culture.

Collaborative learning will be emphasized through work groups, seminar, and group and individual exercises. Students are expected to participate fully in all aspects of the class, to thoroughly prepare for each class session and to complete all assignments on time. Attendance at all program sessions is essential.

IV. Required Reading:

Goldstein, Michael S. Alternative Health Care: Medicine, Miracle or Mirage?
Dougherty, Charles, Back to Reform: Values, Markets and the Health Care System
Lupton, D., Medicine as Culture: Illness, Disease and the Body in Western Societies
Starr, Paul, The Transformation of American Medicine

V. EVALUATIONS, CREDIT

A. Credit
Students will receive graduate or undergraduate credit based upon satisfactory and on-time completion of all course requirements and assignments. Decisions to deny credit will be make by faculty. Plagiarism, failing to complete one or more assignments, completing one or more assignments late (without having made special arrangements in advance of the due date), or more than two program absences may constitute automatic denial of credit. (NOTE: More than two (2) program absences requires that you arrange the completion of make up work with faculty).

B. Evaluations
All students will receive a written evaluation of their academic performance by faculty. Faculty will evaluate students based on their seminar contributions, written assignments, team projects and class participation. Faculty will consider the learning goals/objectives in the "Program Description" in preparing evaluations. Each student is expected to participate in an evaluation conference mid quarter and at the end of the quarter. For the end of quarter conference, each student is expected to complete and bring to the conference a written self-evaluation - a written and signed evaluation of the faculty member must be turned into the program secretary at the same time. These two evaluations are part of the requirements of the course and must be completed to obtain full credit. A Self and Faculty evaluation must be completed prior to the final evaluation appointment.

VI. Covenant within a Learning Community
The class is designed to be an active/experiential learning community. We employ a variety of formats – lectures, seminars, interactive workshops, and other techniques to ensure that the learning environment is one in which all participants play a role in its success. In particular, the content of the program -- exploring health reform options-- especially lends itself to active in class participation.

A successful learning community requires that students attend class, arrive prepared to be engaged in the activities for the evening, and submit assignments when they are due. Students will receive graduate or undergraduate credit based on satisfactory and timely completion of all course requirements and assignments. Credit denial decisions will be made by the faculty. Plagiarism (i.e., using other peoples’ work as your own), failing to complete one or more assignments, completing one or more assignments late (without having made special arrangements before the due date), or multiple absences may constitute denial of total credit. Arriving late or leaving early may be considered as absences.

In turn, students can expect the faculty members to be prepared for classes and seminars, to be available for office hours as posted, to respond to telephone or email messages in a timely manner, and to provide timely feedback on assignments.

In furtherance of our learning community, we expect students and faculty to:

Act in accordance with the Evergreen Contract and Student Conduct code.
Promote a cooperative, supportive atmosphere within the community; give everyone opportunity for self-reflection and expression.
Use high standards in reading the text and preparing our papers, lectures, and comments in seminar.

In addition, faculty agrees to:

Handle all disputes in a spirit of goodwill.
Make time available for individual conferences.

Both students and faculty agree to discuss any problems involving others in the learning community directly with the individuals involved, with the right to support from other program members during those discussions, if that seems helpful. For example, students must first discuss any problems involving a faculty member directly with the faculty.

^{The overall goal
of this class is individual participant fulfillment and learning community
success. Let us strive together for such a}balance.

Schedule and Assignments:

!st Class Session – Saturday October 5, 2002

Class Overview - Syllabus Review

WebX Orientation/Training andClass photos

Cultural Workshop and Assessment Assignment

Selecting of Health Policy Areas and Group Assignments

October 6 to October 13, 2002

Read - The Transformation of American Medicine - (Due October 13).

October 14 to October 20, 2002

Post critiques - The Transformation of American Medicine - (Due October 16).

October 21 to October 25, 2002

Post Response to Fellow Student's Critique of The Transformation of American Medicine - (Due October 20).

October 26, 2002 (bring to class)

* Personal Health Cultural Assessment Paper 2nd Class Session - October 26, 2002

Saturday October 26, 2002

Health Care Administration Mandates and Culture

Seminar: The Transformation of American Medicine

Guest Lecturer: Larry Mosqueda, Member of TESC Faculty, Political Economy

Group Projects

* First Paper Due (personal health cultural assessment)

October 28 to November 3, 2002

Read - Medicine as Culture: Illness, Disease and the Body in Western Societies - (Due November 3).

November 4 to November 10, 2002

Post Critique Medicine as Culture: Illness, Disease and the Body in Western Societies - (Due November 6).

Post Response to Fellow Student's Critique of Medicine as Culture: Illness, Disease and the Body in Western Societies - (Due November 8).

Read - Back to Reform: Values, Markets and the Health Care System - (Due November 10).

November 11 to November 15, 2002

Post Critique of Back to Reform: Values, Markets and the Health Care System - (Due
November 13).

Post Response to Fellow - Back to Reform: Values, Markets and the Health Care System - (Due November 15).

November 16, 2002 - (bring to class)

* – Health Policy Cultural Paper 3rd Class Session - November 16, 2002

Saturday November 16, 2002

Guest Lecturers: Jehrin Alexandria, Dance and Alternative Movement Therapy
Kate Fehsenfeld, Acupuncturist, Acutonics Sound Therapy

Seminar: AM -Medicine as Culture: Illness, Disease and the Body in Western Societies

PM - Back to Reform: Values, Markets and the Health Care System

Group Project Preparation Time

Evaluation Conferences sign-up sheets

* second paper Due Health Policy Cultural Paper

November 18 to November 24, 2002

Read - Alternative Health Care: Medicine, Miracle or Mirage? - (Due November 24)

November 25 to December 1, 2002

Post critique of - Alternative Health Care: Medicine, Miracle or Mirage? - (Due November 25)

Post Response to Fellow Student’s Critique of - Alternative Health Care: Medicine, Miracle or Mirage? - (Due November 29)

December 7, 2002 (bring to class)
*Group project biblio
* Reflection Paper

Final Class Session - December 7, 2002

Saturday – December 7, 2002

Seminar On: Alternative Health Care: Medicine, Miracle or Mirage?

Speaker: Sharon Parker, Cross-Cultural Workshop

Group Projects Presentations

    * Reflection paper due
    * Group project outline due
    * Self and Faculty Evaluations due

The Evaluation Conferences sign-up sheets will be circulated on, Saturday November 16, 2002.

Assignments:

Assigned Reading and Postings - (Due Weekly)

Each week students will write a 1-2 page critique to the readings and post your writing to WebX. You will also respond to the posting of at least one other member of your small group. Students are expected to critique (analyze, interpret and evaluate) the assigned readings. Your critique should be a synthesis of the reading and should include your own reactions. In your postings on fellow student’s work, you should speak to their explanations of the text. Your 1-2 page critique and 1-2 page response to a fellow member should be posted by date assigned in calendar by the end of day.

Personal Cultural Assessment: (Due October 26, 2002):

Each student will complete a personal cultural assessment. This exercise will prepare you to develop awareness of
your own culture and its impact on your view of health.

Health Policy Cultural Paper: (Due November 16, 2002): This assignment is provided to allow an opportunity to become familiar with health policy challenges and cultural underpinnings. Each team member will write about a different formative cultural area and apply it to the selected health care policy area. This exercise will help clarify/refine the final group project. This paper should be 3-4 pages in length.

Team Project: (Due December 7, 2002)

           Each team will select a specific health policy area to focus cultural understandings for the quarter. The following
           two assignments will central questions for the quarter: "Why have we not enjoyed an equitable or universal health
           care system in the United States and how do begin to address the issues of cost, quality, access and coverage
           given US cultural and historical underpinnings?"

            Each team will explore how US cultural rules and norms have created our current health care system. The presentation
            should include the different lens we view organizational, structural, and political drivers, the delivery systems and
            healthcare beliefs. Each team will present to the class an hour in-depth analysis of their selected policy areas addressing
            the central question for the quarter. Creativity is encouraged and seminaring or workshops versus lecturing is appreciated.

Visual aids for the class are encouraged, handout are mandatory. The group will prepare an executive summary, detailed
outline and biblio. of 4-6 pages in length given to faculty prior to presentation.

Cumulative Reflection Paper: "U.S. Health Care Foundations: Values and Formative Culture" (Due December 7, 2002) Each Student will be given the opportunity to review what they have learned in the class regarding culture and US health care values. This 3-5 page reflection paper will include how or if you may view your world or "constructs" differently. This reflective process can also be a means of creating your cumulative student self-evaluation.