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About The daily Nebraskan. ([Lincoln, Neb.) 1901-current | View Entire Issue (April 15, 1992)
UNMC integrates AIDS facts into classes By Jeremy Fitzpatrick he medical, dental and nursing schools in the University of Ne braska have have to adjust their curriculum and clinical procedures to deal with the changing nature of health care because of AIDS, officials said. Gerald Moore, assistant dean of cur riculum for the college of medicine at the University of Nebraska Medical Center, said the college had been integrating the study of HTV and AIDS into regular course work since the virus was discovered. Moore said students were introduced to the virus in classes during their second year of medical training. In their third and fourth years, students work in clinics where they supplement their edu cation about AIDS by working with pa tients who have the disease. The most significant change in the college’s curriculum, he said, is AIDS day. All second-year medical students participate in the day devoted entirely to AIDS. James Booth, an assistant professor of pathology and microbiology at UNMC, is in charge of the yearly AIDS day. He said the idea came from a conference he at tended at the University of Pennsylva nia. Booth said the day was filled with lectures, speeches and. panels on AIDS. It begins with a survey administered to the students to gauge their knowledge, beliefs and opinions about AIDS. The students take the survey again before they graduate to test how their opinions have changed, he said. Students then listen to speakers and panels. This year, Booth said the keynote speaker would be John Kern, a lawyer for San Francisco General Hospital. Kern will speak on legal and ethical issues concerning AIDS. Students also will hear from a panel on people who live with the disease. Three or four people who have been infected with HIV will speak, and students will have more than an hour to question them on any topic. Booth said the panel had an impact on the students. “It is a very emotional time,” he said. “It has the attention of the students.... These are real patients." Todd Kendall, a third-year medical student who participated in AIDS day last year, said it was an eye-opening experience for him. Kendall said he had known about the “nuts and bolts” of AIDS before AIDS day. But he had never met someone with the disease. “I think it brought it down to a very personal level,” he said. Kendall said the panelists were very open with students and gave them the chance to ask a lot of questions. He said talking to the panelists helped him understand that AIDS was not lim ited to a particular group of people. “Unfortunately, because AIDS is asso ciated with one type of people, oftentimes society and physicians and physicians to-be forget tnere are a lot of people who can contract the disease. “It really opened my eyes that there are a lot of different people who can come to you with the disease,” he said. The Nursing College also has changed its curriculum to deal with AIDS. Roberta Kroeger, an assistant professor in the Nursing College, said a knowledge of AIDS and HIV was essen tial for anyone who graduated from the college. , “It’s a serious health problem, and our students — it’s important that they leave the curriculum with a very sound knowl edge of AIDS, and how to deal with it, and how to prevent it in their work situations and in their lives,” she said. Kroeger said the nursing college had integrated AIDS studies into all of its courses. While no new classes have been added to deal with AIDS, she said, the content of regular classes has been ex panded to cover the disease. "V “We have intensified our teaching quite a bit,” she said. Students learn about the disease itself in their first-year classes, she said, and then learn about teaching AIDS preven tion in their senior year. The college also makes sure that stu dents are aware of all new information on AIDS, Kroeger said. “We are always keeping extremely current on research and treatment, and integrate that information throughout all our courses,” she said. David Brown, associate dean for academic affairs in the College of Dentistry, said HIV had height ened the college’s awareness about protecting against the transmis sion of all infectious diseases. But the college’s curriculum has not significantly changed because of HIV, he said, because the college has been teach ing about infectious disease transmission for years. However, he said the college’s dental clinics had updated their procedures to protect against the transmission of infec tious diseases. “The HIV virus has made a difference in what we are doing, but it really stimu lated us to do what we should have been doing all along,” he said. Stephen Leeper, dean of the college, agreed that AIDS had pushed dentistry into using infectious disease protection measures it should have used before. He said that before HIV was documented, Hepatitis B had been the primary con cern of dentists. Leeper said the American Dental As sociation had tried to get dentists to take measures to protect against Hepatitis B since the 1960s. When AIDS — a disease for which there is no known cure — was documented, he said, dentists were forced to take those protective measures. “AIDS has frightened the dental pro fession into doing Swhat it should have been doing before,” he said. Michael Molvar, associate dean of clin ics for the dental college, said clinics followed guidelines set down by the Centers for Disease Control. The guidelines con tinually are updated. Molvar said the college followed uni versal precautions, which assume that all patients treated in its clinics could be infected with HIV. Gloves, masks, eye protection, disinfection or sterilization when possible and clinic gowns are used in the dentistry clinics, he said. The college adopted most of its proce dures before they were required by the CDC, Molvar said. “We consider ourselves to be a leader in infection control in dentistry and in modeling infection control for the state,” Molvar said. “We have taken that upon ourselves.” Last October, a Creighton University dental student who nad worked in Creighton’s dental clinics tested positive for the HIV virus. Jim Nolan, university spokesman for Creighton, said a panel of the student’s physician, an infectious disease special ist, the dean of the dental school, the school’s clinics director and the vice presi dent for health finances formed a com mittee to look for a way the student’s education could be completed. The student then withdrew voluntar ily between the fall and spring semester. Nolan said all of the 47 patients the student treated were offered free AIDS counseling and testing. None of them have tested positive for the disease, he said. Creighton already was following the same CDC universal precautions m its 1 — •• Unfortunately, because AIDS is associated with one type of people, oftentimes society and physicians and physicians-to-be forget there are a lot of people who can contract the disease. — Todd Kendall, third-year medical student at UNMC - - Robert Borzekofski/DN clinics that the UNMC used, Nolan said, so it did not revise its clinical procedures because of the student testing positive for HIV. He said some clinic patients were concerned about contracting the disease, and dental students contacted their pa tients to tell them thev weren’t the stu dent with the virus and explain that they were not in danger. “We tried to be as forthcoming as we could, so we could alleviate as much fear as possible,” he said. Molvar said that UNMC’s Dental Col lege was motivated by the incident to review its policies for students working in its clinics who tested positive for HI V. He said the Dental College decided to continue its practice of judging cases of students with HIV on a case-bv-case basis. “Cases are evaluated on tbeir merits, and decided in the best interests of the patient and anyone else that is involved,” he said. No student in the Dental College has tested positive for HIV, Molvar said. If one does contract the virus, he said the college would “try to make a rational decision based on the facts.” Molvar said students working in the clinics had been concerned about con tracting the disease during the outbreak of the virus. He said there still is concern, but it is now tempered by knowledge of the disease. “I think they have a healthv concern, which leads them to protect themselves and their patients,” he said. “I think we have done a good bit to discuss infection control, to discuss HIV and hepatitis. . . and when they understand the concern, I think there is healthy concern, but it’s not a phobia.” Despite the psychological ettects AIDS has on persons with the disease, John Berman, chairman of the psychology department at UNL, said the department had not changed its curriculum to deal with AIDS. Berman said the curriculum hadn’t changed because there weren’t enough cases of AIDS in the Midwest to necessi tate a change. “The curriculum around here is not changing — there is just not^^ enough numbers,” he said.