Cherry Hill High School East Lindenwold High School · PDF [email protected] 856-424-2222...

UPDATED as of 2/10/16

Medical Student Contact: Chien-Rong Chen

Phone: 626-487-1855 Email: [email protected]

Cherry Hill High School East

Dr. Kim Achilly Biology Department [email protected]

856-424-2222 ext. 2066

Lindenwold High School Laura Vaughn

School Counselor [email protected]

856-741-0320 ext. 1008

mailto:[email protected]




Rowan ShaD.O.w Program SOM

Contents: Letter to RowanSOM Administration

Proposal

Parent/Student Information Sheet

Student Application

High school student evaluation form

Educational Experience Agreement

Waiver

Release

Confidentiality Agreement

Consent to photograph

Cherry Hill East/Lindenwold HS: Parent/Guardian Permission/Notification of an Educational Field Trip form High school student feedback: Meghan Reilly

High school student feedback: Kaitlyn Towler

Requests/Questions for administration


604 Britton Place Voorhees, NJ 08043 February 21', 2006

RowanSOM Administration One Medical Center Drive Stratford, NJ 08084

Dear RowanSOM Administration:

Thank you for your consideration of this program.

This is of particular importance to me because I personally experienced a similar program when I was deciding whether to choose medicine as a career. Early exposure to the medical field and more specifically the medical school experience was instrumental in my decision to pursue medicine. As a high school student I had the opportunity to shadow a UPenn medical student for a day. While there, I experienced class time and anatomy lab, and interacted with many of the students. My personal experience was very moving in that when I attended the anatomy lab I was able, for the first time, to hold a human heart in my hand. This is an experience that has stayed with me and inspired me to excellence in medicine. In addition, after my experience I was much more comfortable with the thought of medical school, feeling that it is attended by regular people with similar abilities and aspirations as my own.

This type of experience can be duplicated in other students. I feel that it is important that other high school students have similar opportunities that may lead them to their future careers. Further, it is important for medical students to give back to the community that nurtured their growing abilities and interests. This program offers an ideal venue to accomplish both of these goals.

I appreciate your taking the time to consider my program proposal and would be grateful for any feedback.

Sincerely yours,

Lindsay Tjiattas OMS III



Medical Student Contact: Chien-Rong Chen Phone: 626-487-1855 Email: [email protected] Cherry Hill High School East Dr. Kim Achilly Biology Department [email protected] 856-424-2222 ext. 2066 Lindenwold High School Laura Vaughn School Counselor [email protected] 856-741-0320 ext. 1008

High school is a period during which students are finding themselves and exploring options for their future. Many have a general idea of their interests; however most do not have concrete career goals. The purpose of this program is to encourage local students with an interest in the medical profession toward more concrete goals. This will be accomplished by immersing these students in the graduate level academic environment, encouraging them to interact with students and faculty, and exposing them to the overall medical school experience for a day.

Goals for the program: -Give high school students with an interest in the medical profession the opportunity to experience a day with a medical student at RowanSOM. -Increase local high school students' awareness of osteopathic medicine. -Increase local high school students' awareness of RowanSOM.

Activities: Shadowing a medical student for 1 day will consist of the following:

-participants' arriving at the time of the medical student's first daily scheduled class -attending any lectures/labs with the medical student throughout the day -eating lunch with medical students, allowing time for social interaction





Only 1 high school student will be accommodated at a time, in the beginning. This will allow individual attention on the part of the medical students towards the participant, providing a full-immersion experience.

Anatomy Lab: For participants of the program during the second half of the academic year, the anatomy lab will be available to view, time permitting. Students demonstrating the maturity necessary to participate in the program will be given the option of observing the anatomy lab. The application will inform students of the opportunity either to participate or not, allowing them adequate time to consider the encounter and consult their parents/guardians.

As written on the application: "Would you be comfortable taking a tour of the anatomy lab, which would include viewing cadavers? Yes or No" and "The cadaver lab is an optional tour and your answer to this question will not exclude you from participating in the program."

Student Interest/Turn-out expectations: While the high school student interest is overwhelming, this program will host approximately 8-10 students monthly so as to minimize scheduling complications.

Student Selection/Application: -"A" and "Honors" track students currently enrolled in an anatomy or biology course at Cherry Hill High School East or Lindenwold HS interested in pursuing heath care as a future career -Interested students will be selected by CHE/Lindenwold HS Biology/Anatomy teachers and entered into a lottery to be chosen to attend -Students selected must be in good academic standing in science as certified by their nominating teacher (on application) -Students selected must demonstrate a level of maturity deemed appropriate by their science teachers to participate in this program -Students must complete a short application form (attached) and have it signed by a parent and nominating teacher before entering the program

Medical Student Involvement: Involvement of medical students as mentors will be on a purely volunteer basis. A list of volunteers will be kept by the coordinator, and a student volunteer will be contacted when a participant is selected.

Logistics: Once participants have been selected to shadow a medical student, they will be contacted by their medical student mentor about their specific schedule and arrival times. It will be the responsibility of the mentor to coordinate the schedules of both the participant and the clinic.


Forms Required: RowanSOM: Consent to Photograph Emergency Contact Information Program Evaluation Form Parent Program Information Sheet Student Application Educational Experience Agreement Waiver Release Confidentiality Agreement

CHE/Lindenwold: Parent Permission Slip

Feedback: Upon completion of the program participants will be required to fill out a 1 page evaluation form of the program concerning their thoughts on the experience. The evaluation will be submitted to their nominating Biology/Anatomy teacher and then a copy sent to RowanSOM.

Program Future: The program with CHE/Lindenwold HS will be considered a pilot. With such a large population of students at RowanSOM that attended local high schools such as Cherry Hill East, West, Eastern and Lindenwold, eventually the program will expand to include these and other local schools.

To ensure the perpetuity of the program, the coordinating responsibilities will be passed down on a yearly basis to a RowanSOM student who is a graduate of one of the participating high schools.


Rowan ShaD.O.w Program SOMParent/Student Information Sheet

High school is a period during which students are finding themselves and exploring options for their futures. Many have a general idea of their interests, however most do not have concrete career goals. This program was established by a Cherry Hill East graduate and RowanSOM alumni who realized the impact of spending a day learning about the profession in which one is interested. The purpose of this program is to encourage local students with an interest in the medical profession toward more concrete goals. This will be accomplished by immersing these students in the graduate level academic environment, encouraging them to interact with students and faculty, and exposing them to the overall medical school experience for a day.

Goals for the program: -Give high school students with interest in medical professions the opportunity to experience a day with a medical student at RowanSOM. -Increase local high school students' awareness of osteopathic medicine. -Increase local high school students' awareness of RowanSOM.

Activities: Shadowing a medical student for 1 day will consist of the following:

-participants' arriving at the time of the medical student's first daily scheduled class -attending any lectures/labs with the medical student throughout the day -optional attendance in gross anatomy lab -eating lunch with medical students, allowing time for social interaction

Participants will be contacted by a medical student mentor about their specific schedule and arrival times.

Dress code: Business Casual. No tie, button-down shirt and slacks for men. and a skirt or slacks and blouse or shirt for women.

Required forms checklist: RowanSOM: Consent to Photograph Emergency Contact Information HIPAA Consent Program Evaluation Form Parent Program Information Sheet Student Application Waiver

CHE/Lindenwold Parent Permission Slip


Rowan ShaD.O.w Program SOMStudent Application:

Contact Information:

Student Name: Address: Phone #: Email:

Parents/Guardians names:

Permanent Address: Home phone or cell#: Work phone #:

Personal: Age: Grade:

Current Science Class (circle): Anatomy/ Biology I/ Biology II Level: A or H

Before hearing of this program, did you know of RowanSOM in Stratford? Yes or No

Do you know what osteopathic medicine is? Yes or No

If Yes, please briefly explain:

What are your current career interests?

What do you hope to see and learn from spending a day at medical school?


Would you be comfortable taking a tour of the anatomy lab, which would include viewing cadavers? Yes or No?

(The cadaver lab is an optional tour and your answer to this question will not exclude you from participating in the program)

The above student has been selected to attend the ShaD.O.w program and is currently in good academic standing in their above named science class.

Science Teachers Signature: ____________________________________ Date:

I have read and understood the requirements of this program and am willing to participate.

Parent/Guardian Signature: ________________________________________ Date: ____________

Student Signature: ___________________________________________ Date: _____________



Name: _____________________________________________

Date participated: _____________

1. What about your experience impacted you most?

2. What have you learned about osteopathic medicine?

3. What are your suggestions for making this experience more useful?

This form is to be completed and handed in to your science teacher.


EDUCATIONAL EXPERIENCE AGREEMENT WAIVER, RELEASE & CONFIDENTIALITY STATEMENT

Note: This form must be completed and forwarded to the RowanSOM Admissions Office one month prior to the start date of an educational activity. Further, no participant may engage in an educational activity until all Rowan University health requirements are satisfied for participation in that activity.

I understand that I have enrolled in an educational program at Rowan University ("Rowan") which will permit me to obtain direct experience in the health care related field. During this program, I may participate in educational experiences in laboratories, in classrooms, or other settings and I may receive instruction about all aspects of health care.

In consideration for participating in this educational experience at Rowan, I agree that I will release/hold harmless/ indemnify Rowan, to include the Rowan University School of Osteopathic Medicine its directors, officers, subsidiaries, representatives, agents and employees from all liability for any physical or emotional injuries which may occur during my educational activities. I further agree that I will not bring nor cause to be brought on my behalf any legal action against Rowan with respect to my activities.

I understand and agree that I am not an employee of Rowan under the terms of this Agreement and further understand that I am not entitled to workers' compensation benefits, and that I am responsible for the cost of any medical care or other services that may be required as a result of any or injury or illness incurred while participating in my educational activities.

I recognize that during my educational experience, I may have or be provided with access to confidential information, including Protected Health Information ("PHI"). As an educational experience participant, I shall accept a patient's right to refuse permission for my observation of the delivery of medical care or services to that patient. I acknowledge that I am permitted access to confidential information only to the extent required for my educational experience. I further acknowledge my obligation to maintain all confidential information which I may possess as a result of the educational experience STRICTLY CONFIDENTIAL. I understand and acknowledge that disclosing such confidential information is a violation of Federal and New Jersey state laws.

I agree to dress and conduct myself at all times in an appropriate and professional manner during my educational activities. I understand that the inappropriate use of any digital imaging devices, cameras or cell phones is prohibited in patient areas and/or any other areas where privacy is expected or where confidential information is shared.


I understand that if my educational activities take place in a Rowan laboratory, I am prohibited from the use of or any contact with hazardous materials of any kind and am responsible to comply with laboratory safety guidelines as outlined by my Instructor or the responsible Rowan representative.

I understand that I am forbidden to touch or interact with patients in any way. I am not authorized to have any direct patient contact nor will I be permitted to assist with any medical procedures or services. I further understand that the unauthorized performance of patient care shall result in automatic removal from the premises.

Participant Name (Printed) Date

Participant Signature Phone & Email

If the Participant is under the age of 18, a parent or guardian must sign the following:

I acknowledge that I have read and understand all of the above information and agree that during my child's educational experience at Rowan, we will comply with the above requirements.

Parent/Guardian Signature Date



Emergency Contact Information IN CASE OF EMERGENCY, I AUTHORIZE ROWAN UNIVERSITY- SCHOOL OF OSTEOPATHIC MEDICINE TO CONTACT:

NAME:

ADDRESS:

WORK PHONE:

CELL PHONE:


Rowan ShaD.O.w Program SOM CONSENT TO PHOTOGRAPH;

The undersigned hereby authorizes Rowan University-School of Osteopathic Medicine to permit other persons to photograph________________(student name) while under instruction at the above institution, and agree that they may use or permit other persons to use the negatives or prints therefore for purposes and in such manner as may be deemed appropriate.

Student Signature/Date:

Parent/Guardian Signature/Date:


PARENT/GUARDIAN PERMISSION/NOTIFICATION OF AN EDUCATIONAL FIELD TRIP

I give my permission for my son/daughter/ward ____________________________ (name and grade) to participate in the activity described below. I accept full responsibility for his/her actions during this activity

Parent/Guardian________________________________________________________

Field Trip Information

Name of Class/Group/Club______________________________________________________

Supervisor____________________________________________________________

Phone#_______________________________________________________________

Destination__________________________Date:______________________________

Departing Time and Meeting Location ___________________________________________

Returning Time and Site _________________________________ Cost ___________________

Additional Trip Instructions ____________________________________________________

My student has the following medical condition: ____________________________

Treatment could be required YES / NO Explain ___________________________________

My Student usually takes daily, in school medication YES / NO

If yes: (1) Can the timing of this medication be adjusted to before and/or after trip hours? YES / NO

(2) Can the medication be skipped during this activity? YES / NO (Parent Initials ___________

(3) Additional health information or instructions_______________________________________


Rowan ShaD.O.w Program: Feedback SOMFeedback 1: Written by a high school student who shadowed RowanSOM students and a osteopathic physician at the University Family Medicine office.

At some point in high school, the seemingly vague concept of what path you hope to direct the rest your life down becomes a very real question. While applying to college is an exciting process, on the same hand the thought of choosing the best school based on what you think will suit your future is also quite terrifying. For me, planning, from the next five minutes of my day, to the next 5 decades of my life, has always been a major issue. Therefore, as a student who has always been disposed in English related topics, however deeply always interested in medicine, I hoped to pick a school that was best in the field I wanted to pursue, but was unsure of exactly what I wanted, making the whole college process very overwhelming. Luckily, one summer, while working as a lifeguard at my local swim club, my manager Lindsay Tjiattas, presented me with the opportunity to further explore my interests in medicine when she brought me with her to RowanSOM for a day. The experience, which I have found myself continually referring back to as both an inspiration and a reference guide, offered me a very real insight into both medical school and practicing in the medical field.

First and foremost, attending medical school with a student allowed me a hands-on experience in which I was able to foresee what medical school could be like for me. Starting my day off by, sitting in on a lecture class with Lindsay, I was able to get a feel for the classroom; the plethora of information that students are expected to know, the types of classes; even the teaching methods professors at higher levels used. I can still remember that we learned about all of about the different parts of the eye and how fascinating I found all of the information. Because I was there with a student, I got the entire student experience; we went to the library to study in between classes and we ate lunch with other students, who told me about their own medical school experiences, before returning to my favorite part, the cadaver lab! Enrolled in a vertebrate anatomy course at my high school at the time, I had been looking forward to this. Honestly, being able to have hands on experience, to see the wealth of information medical students knew about the human body and realize that I too could learn that, has been the biggest inspiration I gained from the entire experience. As a freshman in college now currently enrolled in biology, when I find myself dreading the thought of studying science, I remind myself of that experience, of how badly I hope to be there one day, and find it as a very good source of inspiration.

While the experience of medical school was very inspiring, Lindsay had also set up an informative information session with the admissions director for a high school pre-medical program, as well as an opportunity to shadow a physician. Meeting with the director was a very informative experience of what I needed to do, even starting in my high school years, in order to best enhance my chances of getting into medical school. While the program, which I would have loved to do, but unfortunately was unable to due to other commitments, seemed like a very good prelude to preparing oneself for medical school, the information that the director offered me the importance about volunteering, becoming informed on current medical issues, as well as shadowing a doctor to find where my own specific interests lie have


all helped me in my own college experience now. As a freshman in college, the Health Professions Office immediately throws you into the preparation process for medical school. Obtaining recommendation letters, starting to volunteer, becoming involved in the surrounding medical community of our school is all expected of freshman. As freshman students who are just transitioning to a new lifestyle as a whole, loading on all of these extra-circular responsibilities can be very daunting. In my own case, however, I found that because I had already had an idea of what would be expected of me, I was more prepared to immediately get myself involved in every possible way.

Conclusively, spending a day at medical school as a high school student was both a generally informative and self-reflexive experience. Being able to gain hands on experience offers young students the opportunity to explore where their interests really lie. Because medical school is a so much of someone's life, I feel it is extremely important that students have a very real idea of what path they are choosing to pursue and what that path requires. For me, spending the day with the students was the most interesting; however spending the day shadowing the doctor, as well as meeting with the director, became the most informative. Personally, I would recommend anyone who had the opportunity to be exposed to an experience similar to mine to take it and use it to its fullest advantage.

Meghan Reilly, Freshman at Rutgers University Cherry Hill East Class of 2005

Feedback 2: Written by a high school student who recently shadowed RowanSOM students both in a classroom setting and on location at the office of Sicklerville Family Medicine.

I chose to spend a day at Medical School simply for the experience, and to know what to expect when I attend Medical School myself. Since I can remember I have wanted to become a pediatrician, therefore I must attend Medical School after college. I really enjoyed the occasion and I am glad that the opportunity was presented to me. I attended Microbiology, and although I found it somewhat boring, I found it exciting when I recognized material from my tenth grade Biology class. I believe that if in the future you wish to attend Medical School this would be an awesome experience for you, too. Although the one class I attended was not the most exciting, it did not change my mind on becoming a doctor, there is nothing I want to do more. At RowanSOM I also learned about Osteopathic Medicine. This is a technique where you diagnose and treat with your hands. Not all medical schools offer this. During my tour I got to go into the anatomy lab. Although I was nervous at first, it was not bad at all. I always thought that working on the cadavers would be the hardest part of Med. School, but it was not at all what I expected. The bodies did not even look real, and this relieved my fear of the cadavers. I am very glad that I got to have this experience, and if in your future you wish to become some type of doctor this would be a great experience for you too!

Kaitlyn Towler Sophomore


Clearance/Rules/Regulations:

Public Safety: Once the students have been scheduled Chien-Rong Chen will notify Lieutenant Phillip Michael Powers letting him know when the program begins and the number/frequency of outside students that will be on campus.

Funding: RowanSOM will give the visiting students RowanSOM folders with admissions information. Visiting students will be able to partake in a cafeteria lunch provided by RowanSOM’s admissions department funds permitting.

Clinic Experience: ShaD.O.w participants will “shadow” medical students working in the Anatomy Lab and have the opportunity to touch the cadaver and hold the organs of the cadavers. As part of this the student will be exposed to organ anatomy and function. ShaD.O.w students will not be allowed to perform any dissections or otherwise use surgical tools. ShaD.O.w students may opt out of this part of the program if they wish to.

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