Current Projects

I. The Dermatology Clinic for Homeless Men and Women at the Downtown Emergency Service Center (DESC)
Through participation in the dermatology clinic, medical and physician assistant students learn and practice a set of clinical and interviewing skills, as well as becoming familiar with the special health challenges of homelessness, including limited access to health care, mental health services, and basic amenities such as water and toilet facilities. Student coordinators and student care providers attend quarterly seminars taught by Frederica Overstreet, MD, MPH and and other physicians on topics relating directly to special problems of Seattle's homeless population. All student leaders also attend an orientation at the Downtown Emergency Service Center, led by DESC staff, and a training on clinic administration. Since 1994, the Dermatology Clinic has provided dermatology care for more than 2,400 persons on two Wednesday evenings each month at the Downtown Emergency Service Center (DESC), a shelter for more than 200 adult men and women. Dermatological problems are common in the homeless community, but often go untreated in the presence of more serious medical and social concerns. Approximately six student coordinators share leadership responsibility, scheduling students and attending physicians, ensuring that supplies are stocked and supervising each clinic session. Care is delivered by two medical student teams, each consisting of a pre-clinical medical student (first or second year) and a clinical (third or fourth year) medical. The teams are precepted by a volunteer attending physician. This program helps students appreciate and learn the complex, tacit skills and knowledge essential in family medicine and many other specialties. Effective diagnosis and treatment requires sophisticated cognitive skills, particularly in the care of underserved and vulnerable patients with multiple comorbidities in communities of special need. ARTE helps future health care providers master skills essential for meeting the challenges of building patient investment, setting priorities, engaging patients in behavior change. Expert practitioners like our preceptors use tacit knowledge and skills that are not often apparent to learners.
II. Pilot Project: Tiered-Youth Mentoring in the Seattle School District
In the past, CHAP students worked with The Seattle World School, which served recently arrived high school-aged immigrant and refugee youth who are very new to the Seattle area. Students offered health mentoring on a variety of relevant health topics. Immigrant youth have been shown to be at a higher risk of unhealthy behaviors for a variety of reasons, even more so than youth of this age in the general population. From April 1997 to May 2010, CHAP students worked with Hamilton International Middle School in Seattle to offer this program to sixth – eighth graders. Our partnership with the SWS rose out of a decreasing need for this project at Hamilton, and a very high need at the SWS. Our new pilot project aims to expand the previous work and provide youth with the tools and support to make positive decisions towards becoming a leader. CHAP students and staff will work closely with the Seattle Public Schools to develop and present a variety of topics within the mental, physical, and emotional health realm, in a classroom setting of supportive small group mentoring. This project welcomes health sciences students in medicine, nursing, pharmacy, public health, social work, and physician assistant training. Mentors and students would remain in the same groups throughout the year and are able to build meaningful relationships with the kids.
III. Foot Care Clinics
Medical and Nursing students who participate in CHAP Foot Care Clinic develop a toolkit of clinical and health promotion skills for working with the homeless community, for whom quality foot care can be a potential life-saver. Prior to each clinic, students attend a two-hour seminar by Frederica Overstreet, MD, MPH, and Josephine Ensign, DrPH, which teaches students principles of diabetic pathophysiology and foot care management, in addition to health education techniques and strategies for encouraging positive health behaviors by diabetic and non-diabetic patients.
During clinics for individuals affected by homelessness, students work one-on-one with clients to provide foot examinations and foot care while gaining skills in relevant health education and promotion. Current sites for this project include Mary's Place Drop-in Center for Homeless Women, Downtown Emergency Service Center in collaboration with CHAP Dermatology Clinic, ROOTS (Rising out of the Shadows), a shelter for young adults in the University District, and Hammond House, a shelter for women in Downtown, Seattle.



Teeth & Toes Clinic
Students who participate in CHAP Teeth & Toes Clinics develop a toolkit of both clinical and health promotion skills for working with the homeless community, as well as an opportunity for interprofessional education. Teeth & Toes is a partnership with the School of Dentistry and School of Nursing to provide patients with both a foot and oral exam. Clinics are usually held on holidays (Mondays) when students are out of class and can provide services during the day. Community partners currently include Mary's Place and ROOTS, both shelters downtown serving local women, children, and adolescents.