Ryan was the class clown. My fellow Duke University students and I could tell as soon as we walked into his ninth-grade health class. We were there to teach the students about a variety of sensitive, yet important health topics, such as tobacco use, unhealthy dietary choices, alcohol and drug use, risky sexual behaviors, and inadequate physical activity. We knew that the decisions they make and the behaviors they adopt as teens will affect their health for the rest of their lives. Establishing healthy and safe behaviors during adolescence, then, would ideally lead to similar healthy choices in adulthood. Unfortunately, Ryan didn't share our motivations. He only cared about the fact that his regular teacher was no longer in the room and the rumor that we were there to talk about sex, sex, and more sex.
Our program, Health, Education & Youth in Durham (HEY-Durham), is a 12-week, interactive health education program run by volunteers from the Duke University School of Medicine to teach ninth graders in a Durham public school near campus. Medical students lead 50-minute classes each week on a variety of topics, including contraception, drugs, smoking, alcohol abuse, gang/domestic violence, STDs, self-confidence issues, and even peer pressure. The course is taught in an open forum environment, which enables the teachers to cater to the students and their interests or concerns on specific topic areas. We try to promote interactivity through provocative discussions, games, and role-playing. The overriding theme of the curriculum is the idea that the ninth graders have the power to make healthy choices, but they need the knowledge and the skills to put these healthy choices into action. Because of the sensitivity of the topics, we anticipate that many students will be reluctant to ask questions during class. To address questions, then, every class period ends with the students dropping index cards into the “question box.” All questions are anonymous. Some are silly, but many are sincere. These questions are then addressed during the next class.
Our first impression of Ryan was pretty much on-target. He tried to establish his dominance in the classroom and offered a nonstop barrage of smart comments on that first day. During our second session, though, an interesting thing began to happen. Because Ryan was so outspoken, we asked him to join in the role-playing, a chance to show off for the class that he relished. Over the next few sessions, he continued to challenge us with his questions, which became more relevant to the curricular content, enhancing our class discussions instead of distracting the other students. By the end of the program, Ryan was our star student. We had been able to use his outspokenness to the advantage of the whole class.
While we like to think that we left our students better off than when we first met them, in the end, we, the teachers, were more knowledgeable for the experience too. Following the class, the medical students and high school students alike were more comfortable discussing difficult topics, such as sexuality, violence, race, gender, and many others. We hope that the high school students learned something about their health and how to apply it to their daily lives. We also hope that they realize how they contributed to our education. We are confident that Ryan is happily bragging to everyone he knows about how he schooled those medical students.
Ankur M. Manvar
Terrill Bravender, MD, MPH
Mr. Manvar is a third-year student, Medical College of Georgia, Augusta, Georgia. At the time this essay was written, he was a student, Duke University, Durham, North Carolina.
Dr. Bravender is chief, Section of Adolescent Medicine, Nationwide Children's Hospital and associate professor, The Ohio State University College of Medicine, Columbus, Ohio. At the time this essay was written, he was director, Department of Adolescent Medicine, Duke University, Durham, North Carolina.