Dr. Heather Young Leslie
Medical Anthropology Program,
University of Hawaiʽi at Mānoa

Anth 667 Biomedicine & Culture

A COMBINED SEMINAR AND FIELD EXPERIENCE / PRACTICUM COURSE EXAMINING CRITICAL MEDICAL ANTHROPOLOGICAL, MEDICAL HUMANITIES AND SOCIAL MEDICINE PERSPECTIVES ON MODERN MEDICINE THROUGH INTENSIVE READING, GROUP DISCUSSION, PROBLEM-BASED LEARNING  AND PARTICIPANT OBSERVATION IN HEALTH SERVICE SETTINGS. THE COURSE IS OPEN TO GRADUATE AND UPPER LEVEL STUDENTS IN ANTHROPOLOGY AND RELATED DISCIPINES INCLUDING NURSING AND PRE-MED.  

Time:       (Tentative) Spring 2007, T/R                                              Place:      TBA /
Office:      Saunders Hall 306                                                          Phone:       956-7556 
Hours:       TBA                                                                                Email:       hyleslie at hawaii.edu
                                                                                                           Web:         www2.hawaii.edu/~hyleslie/

REQUIRED TEXTS:
Cassell, Joan
1997    The Woman in the Surgeon's Body. Cambridge, MA: Harvard University Press,.
Dreger, Alice
2004    One of Us; Conjoined Twins and the Future of Normal.  Cambridge: Harvard University Press.
Finkler, Kaya
2001    Physicians at Work, Patients in Pain; Biomedical Practice and Patient Response in Mexico.  2nd edition.  Carolina Academic Press
Lindenbaum, Shirley and  Margaret Lock
1993    Knowledge, Power, and Practice: The Anthropology of Medicine and Everyday Life. Berkeley, University of California Press

Selected readings will also be taken from the course bibliography

OBJECTIVES:

1.  Familiarize students with perspectives from critical medical anthropological, social medicine and medical humanities.

2.  Provide intellectual and experiential means for reflexive and informed discourse about biomedicine and the medical profession as a cultural system.

3.  Provide students with a venue for examining biomedicine as participant observers and as reviewers of medical ethnographies.

4.  Improve writing skills, especially as focused on the intersection of medical humanities, ethnography and biomedicine.

6.  Provide information and experiences indispensable for a career as a professional  in medical anthropologist (applied or academic), or for applying medical humanities perspertives in clinical settings.

GRADES:

10pts     Complete assigned (4) modules (analysis & presentation of readings &/or problems)
10pts     Weekly ethnographic notes from practicum
10pts    3/4-term test
20pts     Critical analytic paper applying medical anthropological theory to practicum insights.
50pts    Practicum (min. 150 mins/ wk) documented by practicum supervisor & annotated log.

THE PRACTICUM (50 pts):

One half of the class’s credit hours (equivalent to 3 credits) will be devoted to a ‘practicum’.  The practicum is a student-defined, designed and arranged experience in a health provision setting, which must reflect at least 150 minutes per week.  Each student is responsible for arranging their own practicum, although I will offer suggestions and assistance if necessary.  You must provide evidence of an arranged practicum before the term drop/add period in order to remain in the class. All students will file an annotated log documenting weekly practicum hours at the end of term.

Options for the practicum might be:
    ❧ ~ a volunteer position in an HIV clinic, on a needle exchange van, dental care program...
    ❧ ~ a paid position as a physician, nurse, an aide in a convalescent home, paramedic,  sex education counsellor...
    ❧ ~ an internship on a health research project, massage school ...

Suggestions: Volunteers are often needed at:
 
    •    Rehabilitation Hospital of the Pacific
    •    The Waikiki Community Center
    •    The Queen's Medical Center
    •    Kuakini Health System
    •    Waikiki Health Center
    •    St. Francis Medical Center
    •    Honolulu Shriners Hospital for Children 
    •    Hawaiʽi Foodbank
    •    Muscular Dystrophy Association
   
    For more suggestions, contact the Hawaiʽi Volunteer Match Organization.

The purpose of the Practicum will be for each student to be involved in a contemporary health services sector setting while reading anthropological literature about biomedicine.  Your real-life experience in the practicum will provide you and the rest of the class with:

     ❧ ~ ‘Problems’  an anthropological perspective can clarify
    ❧ ~  Experiences for comparison with course readings
    ❧ ~ Inspiration for a critical theoretical analysis paper

In some senses, this course design resembles other 6-unit classes such as field methods or labs.  However it is also influenced by the “McMaster Method” or problem-based learning (PBL) approach in medicine, in which academic learning is tightly integrated with hands-on, real-life experiences. This method was developed at my own alma mater (McMaster) and has been adopted by several schools of medicine, including JABSOM here at UH.  I have used it in the past, while teaching social and cultural dimensions of health to midwifery students. The approach has also been tried in other disciplines, including anthropology (see Robbins, “Cultural Anthropology, a Problem Based Approach”).  It is a particularly appropriate learning method for a graduate level class on the anthropology of biomedicine.  To understand more about PBL and how it will affect this class, please refer to the separate section.

MODULE PRESENTATIONS (10pts)

Each student will take responsibility to make 15-minute presentations through out the term.  The presentations will cohere with specific course modules and combine description of a problem or scenario based on the student’s practicum experience with a critical analysis of that scenario in relation to course literature.  The presentations will be scheduled evenly through out the term, with 2 before the mid-way mark, and 2 after.  Students will complete at least 4 presentations.

ETHNOGRAPHIC NOTES (10pts)

Your practicum experience must fill a minimum of 150 mins (2.5 hours) each week. More time is encouraged. You are there as both participant and observer, but not as a researcher. Nevertheless, each week you must make ethnographic style notes about what you observe and experience during the practicum, and log your practicum time. Keep your notes in a dedicated, hard-sided notebook, and bring this notebook to class each week. These will, on occasion, serve as a focus of discussion, problem solving or discursive analysis. I will collect and mark your notebooks at mid & end of term. Information recorded in the notebook is subject to confidentiality and privacy guidelines which we will review at the start of term. Please review the guidelines on human subjects research (the Institutional Review Board website), the AAA code of ethics.  We will cover important issues relating to ethics and confidentiality in the first module.  It is important for you to understand that unless you choose to complete an IRB review for a specific research project (which I do not require for the practicum), or you are hired as a research assistant, your practicum is not equivalent to conducting ‘research’.

3/4-TERM TEST (10pts)

A take-home essay-style exam based on the readings and seminar discussions, with a follow-up oral component will be given in week 11.  The Oral component will comprise 30% of the test mark.

Analysis Paper: (20pts)

Your paper should be 6500-7500 words in length.  It should include either an exhaustive precis of the literature on a well-defined subject, or an intensive review of a single theorist’s œvre, plus application of that literature to insights from your practicum experience. Bibliographies and paper subjects must be cleared with me by mid-term.  Follow standard guidelines for academic publishers’ and the Style Guide supplied to you at the start of term, when  submitting the paper.  The Paper is due by the last day of class (early papers are accepted, but not pre-marked).  Please provide a stamped, addressed envelop if you wish me to return the paper to you.