Session Description

Learning by Experience:  Exploring Fadiman's The Spirit Catches You and You Fall Down

Jerelyn Resnick, PhD, RN - UW Bothell Nursing Program

In Social and Cultural Issues in Health Care, RN-to-BSN students encounter the concepts of ethnocentrism, explanatory models, culture, health beliefs, interpretation and communication.  Students read Fadiman’s The spirit catches you and you fall down, the tragic story of the collision of western medicine and a Hmong family.  Instead of requiring the standard cognitive paper, I wanted students to experience affective and cognitive learning, application and empathy.  Small groups are assigned to represent in a debate either the family or the doctors’ perspective by connecting “evidence” from the book to course concepts.  The next week, students submit individual papers, intended to expand and solidify their small group experience.  The papers explore the side they choose to support, how they would bridge the gap between the family and doctors if they were in such a situation, and address their affective responses to the story and to having to represent a side that might be at odds with their own health beliefs.

Formative evaluation of the small group preparation and debate revealed that students very quickly and sometimes rather loudly combined affective and cognitive learning as they explored this heartbreaking story.    During the debates, many students emotionally presented their evidence.  Some students slipped into character, heightening the affective component.

In their papers, beyond successfully connecting concepts to “evidence,” students demonstrated that they could very creatively place themselves in situations requiring a culturally competent broker.  Perhaps most meaningful for me as a teacher and nurse was how much emotion came through in their writing.  Students found empathy even for the side they disagreed with while sometimes remaining angry at that side.  Many said they would incorporate their new skills into their nursing practice to prevent the escalation of such unfortunate events in health care encounters.  The unexpected outcome?  Students wanted to learn more.