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Impacting Community Wellness in a Developing Country (Panama)

This seven day program in Panama for nurses in training engages in a sequence of clinical and community nursing experiences that deliver health services to resource-limited communities in rural settings in Panama. Students  will

  • design health education and disease prevention materials that will be presented to Community Health Entrepreneurs/Community Healthcare Workers for use in their communities,
  • engage with Panamanian physicians, pharmacists, and patients,
  • explore details of region-specific diseases and health issues impacting individual and community health,
  • understand pharmacological practices and the application of traditional medicines,
  • learn how to conduct monitoring and evaluations in the context of a community clinic,
  • develop and deliver educational services to patients, and
  • work to develop intercultural competencies throughout the program.

Nursing Program Learning Objectives

Students that successfully complete the Nursing Program will be able to:

  • Explain how the social determinants of health impact the lives of people in rural communities in a developing country.
  • Understand the assessment, diagnosis, and treatment of common diseases identified in community clinics.
  • Explain to patients the proper use of medications, adverse drug reactions, and drug interactions of medications prescribed.
  • Educate patients and families on the prevention of infectious and chronic diseases.
  • Analyze data to monitor health trends and identify health risk factors unique to a single rural community in a developing country.
  • Discuss the role and practice of the Community Health Entrepreneurs(CHEs)/ Community Healthcare Workers (CHWs).
  • Develop a Training of Trainers for Community Health Entrepreneurs(CHEs)/ Community Healthcare Workers (CHWs).


This program includes Asynchronous and In-Person Sessions.  Modules 1-8 are Asynchronous and are to be completed before the trip to Panama. Module 9 is a live  Zoom session (scheduling to be coordinated with the faculty member and students),  and is also to be completed before the trip to Panama. Modules 10-24 are In-Person in Panama.

MODULES 1-8 – ASYNCHRONOUS SESSIONS (to be completed before the trip to Panama)

Module 1 – Self-paced Activities: Reflection and Action Activities; Global Brigades Overview 

  • Watch the Reflection and Action videos that reviews how to bring about change, intercultural competencies, relational and community meetings, and the Public Narrative.
  • Students complete the Public Narrative assignments as outlined in the video.
  • Watch the Global Brigades Foundations video that reviews ​​the Holistic Model and the community development approach and activities of the NGO.
  • Students take a Quiz on the Global Brigades Foundations video.
  • Note any questions that arise in anticipation of the in-person discussion in Panama.

Module 2 – Self-paced Activities: Introduction to Panama; Medical and Healthcare Systems in Panama

  • Watch the introductory video on Panama.
  • Watch the Global Brigades Medical Program in Panama video.
  • Students write responses to the following questions:
    • What is the difference between the training of medical doctors in Panama and doctors in your country?
    •  What are the strengths and weaknesses of the Panamanian healthcare system? Compare and contrast with the healthcare system of your own country.
  • Students draft at least 2 questions for use in a discussion with a medical doctor during the in-person session in Panama.
  • Students begin to review the Spanish Medical Vocabulary and Phrasebook in preparation for the in-person Clinic Days.

Module 3 – Self-paced Activities: Social Determinants of Health; Community Selection Process 

  • Watch the Social Determinants of Health video.
  • Students write responses to the questions at the end of the Social Determinants of Health video.
  • Watch the Community Selection Process video to become familiarized with the process our teams use to identify new partner communities and how the Rapid Needs Assessment (RNA) data is collected.
  • Students take a Quiz on the Community Selection Process video.
  • Students analyze Rapid Needs Assessment data from three different communities in Panama and complete the assignment.

Module 4 – Self-paced Activities: Community Health Entrepreneurs (CHEs) /Community Healthcare Workers (CHWs)

  • Watch the  Community Health Entrepreneurs (CHEs)/Community Healthcare Workers (CHWs) video.
  • Prepare questions for the CHEs/CHWs to be used during the meeting with them in the In-Person program.
  • Students continue to review the Spanish Medical Vocabulary and Phrasebook in preparation for the In-Person Clinic Days.

Module 5 – Self-paced Activities: Infectious Diseases and Chronic Diseases

  • Watch the Infectious Disease video.
  • Students identify one infectious disease from the video with which they are not familiar and complete the brief research assignment.
  • Watch the Chronic Diseases video.
  • Students identify one chronic disease from the video with which they are not familiar and complete the brief research assignment.
  • Students continue to review the Spanish Medical Vocabulary and Phrasebook in preparation for the in-person Clinic Days.

Module 6 – Self-paced Activities: Pharmacology and Traditional Medicine

  • Watch the Commonly Prescribed Medications video.
  • Students identify one commonly prescribed medication from the video with which they are not familiar and complete the brief research assignment.
  • Watch the Traditional Medicine video.
  • Students identify one traditional medicine from the video with which they are not familiar and complete the brief research assignment.

Module 7 – Self-paced Activities: Monitoring and Evaluation 

  • Watch the two Monitoring and Evaluation videos to learn how to monitor health trends and identify health risk factors unique to the assigned rural Panamanian community in preparation for Day 1 activities in-country.

Module 8  – Self-paced follow-up activities: Getting to Know Your Community in Panama

  • Students review the Community Profile.
  • Review information from Module 6, as needed.
  • Students will need to understand the living conditions in the community to help them better prepare responses and materials to the community’s healthcare challenges. Students prepare a list of questions for community members on Day 1, based upon the assignment.

MODULE 9 – LIVE ZOOM SESSION (to be completed at least 1 week before the trip to Panama)

Module 9 – Live Zoom Session (scheduling to be coordinated with the faculty member and students)

  • Meet the In-Person Program coordinator.
  • Review the In-Person Itinerary, goals and objectives for the program, and Safety and Security Regulations.
  • Students will receive and begin researching the assigned topic for the Training of trainers Session with the Community Health Entrepreneurs (CHEs)/ Community Healthcare Workers (CHWs).
  • The topic that students will develop as an educational activity for children and  adults who are in the clinic waiting room will also be introduced.

 

MODULES 10-22 – IN-PERSON PROGRAM IN PANAMA

DAY 1: ARRIVAL IN COUNTRY AND SETTLING IN

Module 10 – Introduction to the In-Person Program (2 HOURS )

Staff and students introduce themselves to one another. Review of the program’s itinerary and ground rules.

DAY 2: 

Module 11  – Visiting the Community (9:00 AM- Noon)

Students visit the community and meet its leaders, identify the social determinants of health in the community (to be discussed in more detail in Module 12). . If there is a healthcare center in the community, students tour the facility and learn about the work of the center.

Module 12 – Review of the Community Selection Process; Social Determinants of Health (2:00 – 3:00 PM)

Review of how communities are selected. Work in small groups and discuss the social determinants of health observed in the community visit, and learn how Global Brigades addresses some of the social determinants of health in the community.

Module 13  –  Medical and Healthcare System group in Panama (3:00 4:30 PM)

Discussion with a Panamanian physician on the healthcare system in Panama and compare/contrast medical training, healthcare systems between Panama and the students’ home country.

Module 14 – Clinic Preparation 1:  Infectious Diseases (4:30 – 5:30 PM)

A local physician will  discuss the most common infectious diseases that students will encounter in their clinic visits.

Module 15 – Training of Trainers Preparation 1 (7:00 – 9:00 PM)

Students begin to develop materials for the Training of Trainers session (TOT) for CHWs/CHEs (Agentes comunitarios). They will draft questions for CHWs/CHEs to determine their level of training to date on the topic of the TOT.  Students will write a brief introduction about themselves in Spanish.

Day 3: 

MODULE 16 – Meeting Community Health Entrepreneurs (CHEs)/Community Healthcare Workers (CHWs)  (9:00 AM – Noon).

Students will meet with CHWs/CHEs to discuss their role in supporting continuity of care within the community, the details of the CHWs/CHEs’ training program, and the specific diseases and patients encountered in their community. Students will  determine the level of CHW/CHE training to date on the topic of the TOT.

Module 17 – Clinic Preparation 2:  Clinic Simulation (2:00 – 4:30 PM).

Students and a local physician will role-play a clinic session to practice interview questions in Spanish and will also engage in local symptom-disease exercises. Students continue to develop their educational activity for their presentation to children and  adults who are in the clinic waiting room.

Module 18 – Clinic Preparation 3: Chronic Diseases; Assisting with Packing Supplies for the Community Clinic (4:30-6:30 PM)

A local physician will  discuss the most common chronic diseases that students will encounter in their clinic visits. Students will assist with the packing of supplies for the Community Clinic.

Module 19 – TOT PREPARATION 2 (7:30 – 8:30 PM)

Students continue to work on their CHWs/CHEs TOT session.

Day 4 

Module 20 – Community Clinic Day 1 (9:00 AM – Noon and 1:00 – 4:00 PM)

Students will rotate between various Clinic stations: intake, triage,  medical consultation, educational activity area (presentations to children and adults in the waiting room), pharmacy, and (optionally) dental.

*Dental station upon request and needs of community members

Reflections and Observations from Community Clinic Day 1 (7:00 – 8:00 PM)

Self paced activities: CHWs/CHEs TOT session and Spanish practice (8:00 – 9:00 PM) 

Day 5

Module 21 – Community Clinic Day 2 (9:00 AM – Noon and 1:00 – 4:00 PM)

Students will rotate between various Clinic stations: intake, triage,  medical consultation, educational activity area  (presentations to children and adults in the waiting room), pharmacy, and (optionally) dental.

*Dental station upon request and needs of community members

Reflections and Observations from Community Clinic Day 2 (7:00 – 8:00 PM)

Self paced activities: CHWs/CHEs TOT session and Spanish practice (8:00 – 9:00 PM) 

Day 6

Module 22 – CHWs/CHEs Training (TOT) Presentation (9:00 AM -Noon) 

Students will  present their health educational activity and disease prevention materials to the CHEs/CHWs for use in their communities.

Module 23 – Celebration with the Community (2:00 – 4:00 PM)

Module 24  – Final Reflection on the Program Experiences (7:00 – 8:00 PM)

DAY 7 Depart for Airport

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