BY: TINA HOLLAND, PhD
Andrea Eberbach
The education and formation of professionals for service in Catholic health care will influence the future culture and mission identity of Catholic health care organizations. Therefore, mission and the way it shapes the students' experience is crucial to the overall preparation of future health care professionals.
The mission of Franciscan Missionaries of Our Lady University is to educate and form servant leaders of all faiths. We prepare highly skilled professionals, integrated thinkers and faith-filled citizens.
Formerly known as Our Lady of the Lake College, Franciscan is a small, Catholic university in Baton Rouge, Louisiana, founded and sponsored by the Franciscan Missionaries of Our Lady. The university is a subsidiary of Our Lady of the Lake Regional Medical Center and a member of the Franciscan Missionaries of Our Lady Health System.
Consisting of three schools — the School of Nursing, the School of Health Professions and the School of Arts and Sciences — the university has a strong Catholic and Franciscan identity. We have a particular responsibility to ensure that our graduates possess the abilities, behaviors and attitudes that reflect our mission and tradition. As the number of professed religious sisters diminishes, it is especially important that the university graduate Franciscan-formed professionals who will support the efforts of our health system's mission leaders and religious sponsors by enhancing the Catholic and Franciscan mission and identity across our health system's many entities.
The Franciscan Missionaries of Our Lady Health System's Franciscan identity is characterized by five core values:
Reverence and love for all life — acknowledging that all life is a gift from God
Service — the privilege of meeting the needs of others, especially those most in need
Humility — authenticity in serving as an instrument of God
Justice — fundamental fairness in relationships, with preferential treatment for those most in need
Joyfulness of spirit — an awareness of being blessed by God in all things
These values are woven into the university's mission, and they are inextricably linked to the Franciscan intellectual tradition, which is, itself, rooted in the Catholic intellectual tradition. Both adhere to a sacramental and incarnational view of the world.
The sacramental nature of Catholic higher education holds that all of creation, human and not, is a reflection of God's overflowing goodness. Therefore, at a Franciscan university, the pursuit of knowledge should lead to love of God and all creation. This is the ultimate learning outcome, and, to accomplish it, the university carefully crafts a holistic student experience.
Accordingly, a Franciscan higher education reveals the goodness of God, is achieved through relationships and has a moral purpose to serve the greater good. Furthermore, the curriculum and co-curriculum — the education and formation that happens outside of the traditional classroom setting — not only reflect the Franciscan intellectual tradition, but they also address our health system's Franciscan core values.
WHO ARE THE STUDENTS?
Admissions counselors recruit students not just by matching them with specific programs Franciscan offers — they also look for the right mission fit by evaluating candidates' openness to personal and spiritual formation.
A candidate's particular faith tradition is not a consideration for admission, and only about 30 percent of the Franciscan student population identify as Catholic. New students are introduced to the Franciscan mission during orientation events when faculty members, returning students and administrators welcome them to the university community. Orientation includes the typical lessons in rules and policies, safety and security, locations and hours, etc. But orientation also contains lessons in the Franciscan intellectual tradition, conversations with Franciscan Missionaries of Our Lady sisters, a paraliturgical convocation and a Mass of the Holy Spirit.
In our nontraditional university setting, most students have multiple "real life" obligations outside of campus life. There is no on-campus housing; most students have full- or part-time jobs, and many have families. Without close collaboration between academic and student affairs personnel, few students would be engaged in the co-curriculum. The expectation of student engagement, however, is firmly established even before actual enrollment, and it is reinforced both in and out of the classroom. Many informal social activities are scheduled throughout orientation, as well as during the academic year. These events — which typically involve good south Louisiana food — are opportunities for the entire university community to spend time together, establishing and nurturing relationships in a casual setting.
Among the other co-curricular, mission-centered events are weekly and special Masses and campus-wide celebrations of our Franciscan and Catholic heritage. In October, the university celebrates Franciscan week, a time to learn about and commemorate our Franciscan roots and our founders. Students, faculty and staff attend panel discussions, lectures and forums on subjects ranging from St. Francis' conversion, to the meaning of vocational discernment, to the theological foundations of the Ethical and Religious Directives for Catholic Health Care Services.
In preparing students for their roles in the health care ministry, Franciscan focuses on educating hands (highly skilled professionals), heads (integrated thinkers) and hearts (faith-filled citizens). Students not only take a required core of academic courses, there are mission-centered learning outcomes embedded throughout the curricula of the different degree programs at both the undergraduate and graduate levels.
In clinical courses, for example, students are purposely confronted with the problem of health care disparities so that they may learn how to care for vulnerable populations with compassion and empathy. Students are exposed to challenging scenarios in the simulation lab as well. A student may have to address a serious health issue with a particularly difficult patient, or the student may be faced with an ethical dilemma. One scenario requires the student to inform the patient of a terminal illness.
To help them become integrated thinkers, students are exposed to a broad interdisciplinary curriculum that includes the liberal arts. The liberal arts core includes courses in philosophy and Catholic theology, introducing students to concepts of goodness, truth and beauty.
At the same time, program directors and their faculty have developed program-level learning outcomes that address the core competencies for hands, heads and hearts within students' respective program coursework. Graduate and undergraduate research projects assigned within the various programs are interdisciplinary in nature and require significant collaboration among and between students and faculty across all three schools. These projects exemplify a collaborative and highly integrated approach to student learning and also promote a sense of wonder and fruitful curiosity about all of creation.
As students experience interdisciplinary and collaborative learning, they are preparing themselves for service in future health care ministries. In the physician assistant program, for example, simulation exercises include participants from other clinical and nonclinical programs. The PA student might be expected to treat a patient who has a chronic respiratory problem, so the PA student may need to consult with a respiratory therapy student. The patient is 100 pounds overweight, so the respiratory therapy student may refer the patient for counseling by a nutritional sciences student.
This interdisciplinary approach to health care education aims to form professionals who value collaboration and who will embrace a team approach to health care delivery. They will be less likely to seek shelter in their own professional silos. They will be more likely to look beyond parochial interests and look for creative, collaborative and resourceful ways to improve health care outcomes, reduce costs and expand access. Furthermore, they will be more likely to serve in organizations where doctors, nurses, advance practice providers, certified nursing assistants, allied health professionals and even administrators see themselves as part of a complete and highly integrated team.
DISCERNMENT AND SERVICE
One of the university's most important co-curricular learning objectives is for students to understand the process of and to engage in vocational discernment. Although nearly all colleges and universities provide some sort of career counseling and job placement, at Franciscan, students are taught the theological foundations of vocational discernment, a necessary first step to planning one's future.
Students are introduced to the idea of a "divine calling" when they first arrive on campus, or sometimes as early as during the admissions process. Faculty members and academic advisers then help students to align their talents and aptitudes with their passions and the needs of the community.
The approach has been well received. In a set of focus group sessions and individual interviews, 100 percent of the students surveyed indicated that the university's emphasis on vocational discernment is either an important or very important aspect of their education. All attached a sense of moral purpose to their education.
Service learning is another flagship experience at Franciscan. All students must successfully complete the university's service learning requirement to qualify for graduation. Service learning is related to, and necessary for, vocational discernment, because through service and the reflective learning that must accompany a meaningful service experience, students learn about themselves, others and God. Also, students begin to understand that vocational discernment involves recognizing God's presence, especially among those most in need. Service, therefore, provides a natural opportunity for vocational discernment.
Service learning sites are chosen to expose students to at-risk patient populations, including but not limited to homeless, elderly and HIV-positive patients. Service learning that is embedded in coursework serves as a bridge between the curriculum and the co-curriculum, demonstrating for students the seamlessness of a truly holistic educational experience, one that flows freely between the didactic and the experiential.
Here is one nursing student's reflection:
"My service learning experience was among the homeless population in Baton Rouge. I clearly got to experience those who are most in need, part of our school's mission. We were able to be advocates, compassionate listeners and teachers to women and children who are dealing with so many challenging circumstances. Our role was bigger than just providing medical care. We are called to do more. We cannot forget everything going on in a person's life when considering their medical condition."
Clearly, relationships between and among students, faculty and the communities we serve result in valuable life lessons. Students learn course content and skills while they also learn about themselves, others and God.
Physical therapy students work with elderly members of the community to introduce healthy physical activity into what can be very sedentary lifestyles. One physical therapy student clearly learned more than the technical skills necessary to care for this vulnerable segment of the population. He wrote, "I didn't know if any of my actions had an impact on the [elders] there, but they definitely had an impact on me, because they made it clear that I was doing something good … something real. I think my company really meant something to them… I will certainly remember them."
MISSION-CENTERED LEARNING
Although interdisciplinary collaboration is highly valued at Franciscan, the university mission is the real linchpin that keeps the various programs and schools connected.
All programs have learning outcomes that are mission-centered. In the physician assistant program, one learning outcome is "to provide patient care that is compassionate, appropriate and effective for the treatment of medical problems and the promotion of health." Another learning outcome is "to demonstrate servant leadership by emulating Franciscan values in clinical practice while serving individuals and communities."
In the medical lab science program, students are expected "to demonstrate the Franciscan core values in both clinical and classroom settings." The doctoral program in physical therapy requires students "to administer effective physical therapy services through written and oral communication, interdisciplinary collaboration, [and] servant leadership…as reflective practitioners." The master of science in nutritional science has, among its learning outcomes, "to demonstrate leadership and service," and "to exhibit professional responsibilities to provide safe, ethical and effective counseling."
Students are required to reflect on and respond to critical questions about their experiences. For example, they may be asked to discuss "the barriers to therapy compliance in relation to diabetes management such as socioeconomic barriers, limitations caused by a lack of knowledge of the disease, or barriers related to the patient's level of formal education." Students' responses contain much more than the textbook answers found in community health literature. Rather, their responses place the demographic realities into a context of humane understanding, opening the door to humane solutions to be included among the many medical, economic and political suggestions that are so often emphasized.
Throughout their coursework, students grapple with a variety of topics in health humanities, including the social determinants of health, all of which have a profound impact on the practice of medicine and patient outcomes. When assessing the achievement of learning outcomes, we have found that students come to understand and appreciate the human, social and spiritual dimensions of providing health care to diverse populations with complex needs.
Examples of evaluative comments from clinical preceptors include: "demonstrates sensitivity and awareness of patients' preferences and unique needs" and "demonstrates humility, compassion, integrity and respect for others." Furthermore, evaluations of student reflections indicate that students are developing "tools to help them become reflective, self-aware and compassionate medical practitioners."
Each of the various programs at Franciscan has its unique content requirements and skills criteria, but all contain holistic learning outcomes, varied learning activities, effective pedagogies and useful assessment methods. All curricula and co-curricula are designed to prepare highly skilled professionals, integrated thinkers and faith-filled citizens.
Such a rich combination of experiential and didactic methods maximizes the opportunity for an authentic Franciscan education because: 1)learning that happens through service to those most in need reveals the goodness of God; 2) student engagement results in relationship-based learning and a deep appreciation for collaboration; 3) when students have clinical assignments among the marginalized members of the community, the students see clearly the moral purpose behind their education to serve the greater good.
When health care professionals acknowledge and embrace their moral purpose, they value life and possess a genuine sense of joy. When they see the goodness of God in those whom they serve, we can expect their care to be compassionate, timely and provided with a genuine sense of hope. When health care professionals understand that God represents all that is true, beautiful and good, they know that life is good and worth preserving, and there is sense of urgency to their work.
Franciscan Missionaries of Our Lady University is dedicated to graduating highly skilled and faith-filled servant leaders who embrace that sense of urgency and who know that what they do matters greatly. The abilities, behaviors and attitudes of health care professionals are a direct reflection of their higher education experience. Therefore, it is paramount that we educate and form our future health care professionals with a focus on mission and with a genuine sense of joy in knowing God is present in all things.
TINA HOLLAND is president of Franciscan Missionaries of Our Lady University in Baton Rouge, Louisiana.