Hi, all.
I'm happy to have below a Jpeg of the latest picture story by Adult ESL Practitioner/Health Care Specialist Kate Singleton.
In 6 small panels she provides content to use with adult learners at any level, but especially at the beginning level. This is an addition to her earlier picture stories, which you can find at http://www.cal.org/caela/esl_resources/Health/healthindex.html
Certainly timely! I'd love to hear how you use these materials and questions you have about Health Literacy.
Miriam
Comments
Instructions & background for "New Insurance, New Doctor"
Hi everyone,
Below please find instructions and background information to go with the new ESOL picture story "New Insurance, New Doctor" posted here earlier this week. I am working on finding a web home for the picture story and instructions, but for now this is probably the best way to make it available. Please share it with colleagues! Unfortunately I can't add an attachment on this list, so I am pasting the instructions from a Word document --- hopefully the format won't get too crazy in the conversion.
Kate Singleton
ksingletonlcsw@gmail.com
Picture Story: “New Insurance, New Doctor” --- Instructions and Background
This health literacy picture story was created in 2/2014 to help English for Speakers of Other Languages (ESOL) teachers explain basic information to adult English language learners about:
The story may also be helpful in other educational and healthcare settings to raise awareness of patients and providers alike to issues of communication, information, culture, and overall mutual understanding that are likely to intensify with current healthcare system changes.
The Basic Story:
Frame 1: Ana applies for new insurance on www.healthcare.gov. It’s her first time getting insurance.
Frame 2: Ana receives her new insurance card about a month later. She is ready to make an appointment for a check-up.
Frame 3: Ana goes to her appointment and presents her new insurance card at the front desk (reception). She has many questions about how to use the card and what she needs to do now that she is at the doctor’s office.
Frame 4: The receptionist says a lot of things that Ana doesn’t understand. Ana feels more confused.
Frame 5: The receptionist gives Ana many forms to fill out. Ana feels even more confused.
Frame 6: Ana is now very confused. She says, “I’m so confused! Please explain!”
Introducing the story:
Tell learners they will be working on a story called “New Insurance, New Doctor.” Say that many things are changing about going to the doctor and paying for health care in the US, and the story will help them talk about this. Ask them what they have done in the past in their native country or in the US to get health care or to pay for health care. Where did they go? What did they have to do to get to see a doctor or other healthcare provider? How did they pay for it? Ask them if they have had experience with medical forms, insurance, and making medical appointments in the past. Let them share experiences if they’d like to and their English is up to it.
Vocab to Preteach:
Possible Question Prompts and Issues to Discuss for Each Frame:
NOTE --- Because of the complexity of US health care today, discussion of any one of these frames can get complicated quickly! Please look through the suggested question prompts and issues below and gauge how much info and detail your learners can realistically handle in one class. For many classes it is advisable to stick to only the most basic questions and issues.
Frame 1: Ana applies for new insurance on www.healthcare.gov. It’s her first time getting insurance.
Question Prompts to Elicit Story from Learners:
Issues to discuss (choose depth of questioning according to learner level and ability):
Frame 2: Ana receives her new insurance card about a month later. She is ready to make an appointment for a check-up.
Question Prompts:
Issues:
Frame 3: Ana goes to her appointment and presents her new insurance card at the front desk (reception). She has many questions about how to use the card and what she needs to do now that she is at the doctor’s office.
Question Prompts:
Issues:
Frame 4: The receptionist says a lot of things that Ana doesn’t understand. Ana feels more confused.
Question Prompts:
Frame 5: The receptionist gives Ana many forms to fill out. Ana feels even more confused.
Question prompts:
Issues:
Frame 6: Ana is now very confused. She says, “I’m so confused! Please explain!”
Question Prompts:
Examples:
No unique issues are listed for this frame as it can be used to summarize discussion of previous frames.
Thank you so much, Kate, for posting your detailed lesson plan to the community. I have a question for you. Have you, or anyone you know tried out the lesson plan? I would really like to hear how it went, and so on.
Also, do you think it is a good idea to fill out generic forms in the classrrom as a practice? Has anyone tried that?
Thanks again, Kate.
Everyone: I'm sure we would all benefit from feedback on using this picture story and the lesson plan - so what do you think?
Miriam
Hi Miriam,
Great question. The story and lesson are hot off the presses, created in the past week in response to comments from local ESOL teachers and public health folks who are quite concerned about what many people with LEP who are new to health insurance and US healthcare are experiencing or soon to experience as they begin to use their new coverage (if they qualify for it). I will be teaching with the story for the first time in about 2 weeks and will post about how it goes. I'd love to hear from others who use it how their experience goes. I would ask that people share their comments here rather than contacting me directly because I think there is so much value in an open discussion to flesh out how to address these complex health care topics for the ESOL field. We are all in this together! I think key considerations with this story will be knowing in advance what community resources are available to help learners with the marketplace, having that contact info available for the class, and deciding in advance of the class how much or how little detail your class can handle, then sticking to your plan and not getting sidetracked or in too deep.
When I pilot this story later in the month I will be co-teaching what we are calling an ESOL health literacy mini-course in my county's adult ESOL program (in Fairfax Co., VA). It will be a 3 session course (2 hrs. per class) focusing on accessing care, affordable care resources in the community, using health insurance, and communicating with healthcare providers. The course will use the picture stories "Emergency;" "New Insurance, New Doctor;" and "A Doctor's Appointment" to introduce language and information for the topics brought up in these stories. We are very excited to see how it goes. We are offering the class as a free elective to lower level students who are already enrolled in ESOL classes on other nights of the week. I've just learned that at the first site where we are offering it there are already 47 students signed up for it! That is a huge level of interest considering these students are already coming to school the other nights. One other thing we are excited about --- on the night we are presenting "New Insurance, New Doctor," the local organization funded to provide application assistance to the public for the insurance marketplace has agreed to send certified application counselors to speak with learners in the class. The folks at this organization have been wonderful to work with so far, providing us with terrific information and resources that have helped us in planning the class, and they are very interested in making sure what they present to the learners is clear and useful without being overwhelming. Sorry for digressing from your question about using the plan, but as you can tell I am pretty excited about this class model and wanted to share!
Kate
This looks fascinating. I saw a link to other picture stories to health care topics too! I think this will be a great help to one of my ESL students in particular. She is a personal care attendent, but her long time patient recently died. She is now trying to get her CNA license, but does not have the proper vocabulary. Her former patients wife is trying to help her - and I think this is a great way to provide vocabulary for what she wants to do! Thanks for sharing!
Hi Miriam and others,
As promised I’m reporting back on using the new ACA-related picture story “New Insurance, New Doctor” with an ESOL health literacy class in the last week. The class I used the story with was multilevel but very much in the intermediate range. They related well to the story and were engaged in discussion about it the whole time we were using it. I’ll describe what we did in the lesson and then tell you our big takeaway at the end.
Our basic plan for the 2 hour class (which had quite a full agenda) was as follows:
http://www.valrc.org/toolkit/docs/6-4MedicalHistory.pdf
http://www.valrc.org/toolkit/docs/6-5MedicationList.pdf
We also used an online form from a local chain of primary care practices, for a real-life complex example. We talked about how when forms are online, it’s possible to practice the forms at home before your appt. Here’s the form: http://www.inova.org/upload/docs/Inova%20Medical%20Group/Forms/IMG-adult-packet.pdf
6. Guest speaker. We had a guest speaker from a local org which provides ACA application assistance.
Our biggest takeaway from the lesson: The most surprising aspect of the class for me and my co-teacher was that we noticed learners came into the class thinking that once one has obtained insurance, getting and paying for healthcare is smooth sailing; and they left with a much more realistic and sober view of the complexity of using health insurance. Starting with the discussion of the picture story, but really noticeable in the discussion of insurance terms that followed, light bulbs were going off all over the room about how complex and not user-friendly health insurance is. Learners gained awareness of:
We were glad we had the picture story to ease learners into the discussion, and to start the class off with some levity before the mood got serious! We are next using the story with a mixed beginner-low intermediate group so I’m in the process of simplifying the support materials for that lesson. I'll let you know if there's more to report from that group.
Kate
Thank you, Kate, for sharing the detailed information on your lesson plan and how the class went. I found the comnments about the aha moments with your students particularly interesting.
I have a question about the second form from VALRC, where the students record in detail what medicines they take and what the medicines look like. This seems a great way to practice English colors and shapes and so on, as well as being a good way to keep records. I wonder, howver, about the value of describing the pills and medicines they take for certain generic medicines: I find that the generic prescription medicines I take may change shape, color, and size depending on the month!.same is true as to whether you are taking advil or Safeway's or CVS's generic ibuproferin.
Even that isn't foolproof, though. I'm thinking about the recent news story about the Kennedy who took Ambien instead of her allergy pill and crashed her car. She said aftewards that the pills are very similar. I guess the point is not to be casual about taking medicines and to read and doublecheck before taking. Very good vehicle for teaching English. Thanks again, Kate.
What activities do some of the rest of you use when teaching health?
Miriam
SME, adult ELL CoP
Hi Miriam,
Sorry it's taken me a few days to get back to you. I see your point about the lack of visible differences between generic drugs. We included the column about color and shape on that form in the Health Lit Toolkit since those are features experts in medication safety tend to emphasize to help patients keep their meds straight. However, I think you are right that these days generics don't always resemble the brand name drugs they represent and do tend to look a lot more like other generics than they used to. One nice feature of the Toolkit is that it includes Word versions of handouts in addition to PDFs so teachers can edit out a column that they don't want to cover or feel would be too complicated for learners.
Kate
Thanks, Kate. That is an excellent solution to have the forms in word as well as PDF. Would love to hear from others that have tried this.
Miriam