Each year 12 high school students are chosen for the PATCH program. They go through extensive training and earn $10 an hour.
A few weeks ago a group of area high school students carpooled to Herzing University for a workshop with nursing students. Rosie Rodriguez, a junior at East High School, kicked off the session.
“I’m bisexual,” said Rodriguez by way of introduction. “I didn’t know anything about it or whether the way I was feeling about myself was a real thing or if it was all in my head. No one ever explained to my health care provider how to talk to me, what to say, how to say it, and how to communicate with me. So I had a lack of resources available to help myself stay healthy.”
Rodriguez is a teen educator with PATCH — Providers and Teens Communicating for Health. Founded in 2010 by the Wisconsin Alliance for Women’s Health, the program trains teens to teach health care providers how to most effectively communicate with their young patients on a variety of sensitive topics.
On this November morning, Rodriguez, Song Kim, a West High School senior, and Eliette Soler, a junior at East High School, lead the nursing students in 90 minutes of interactive activities, skits and question-and-answer sessions.
In one role-playing exercise, a trainer asks: “If an adolescent comes in with a parent or guardian, that adult can stay during the appointment. Myth or fact?” Many of the nursing students thought the adult could stay.
“Myth!” the trainer replies, following what is widely considered to be a best practice in the medical community; that is, ask a guardian or parent to leave the room so adolescents can discuss any concerns confidentially with their providers.
The trainer playing the role of the health care provider shows how to address the “adult”: “I appreciate it that you care enough to bring your teen in, but I really need to speak with her alone and have you wait outside.”
When the adult refuses to leave, the health care provider gives it another shot: “Your teen will soon be an adult and needs to learn to negotiate her health care on her own. Please allow us to have some time alone together.”
The “adult” leaves.
“See, it doesn’t have to be a confrontation. And you can do this!” a trainer assures the class.
The nursing students are a bit shy about participating at the beginning of the session, but by the end they are buzzing with questions about how to work with transgender teens and talk to teens who might not be forthcoming about their sexual history.
Teens are at great risk for all kinds of health-related problems, from experimenting with drugs and alcohol to pregnancy and sexually transmitted infections. Yet, they are also the age group least likely to seek health care services. And when they do, they frequently feel they are being talked down to, misunderstood and judged.
“Effective communication is critical,” explains Amy Olejniczak, director of PATCH, adding that if providers want kids to trust them, they have to trust the kids. “We teach our teen educators to teach doctors, nurses, physician assistants and other providers how to facilitate nonjudgmental, effective communications so they can provide better care.”
PATCH started with a $10,000 grant from the National Institute for Reproductive Health and is modeled on a similar program in New York City. Still under the auspices of the Wisconsin Alliance for Women’s Health, it has an annual budget of roughly $80,000 a year, garnered through a patchwork of small grants. The program has been able to hire a second staff member and is preparing to start a second program in Milwaukee.
Each year 12 high school students are chosen for the program. They go through extensive training and earn $10 an hour.
“It’s important that they get paid,” Olejniczak says. “It makes it a real job, and they take it very seriously.”
Olejniczak says the teams are as diverse as possible. “We have teen educators of all races, ages and sexual orientations.” This year’s team includes students from four Madison high schools as well as high schools in Verona, Sun Prairie and Oregon.
In addition to their outreach to health care providers, the teens present workshops for their peers on privacy rights, the importance of being honest when seeking care and how to access health care without insurance or if they don’t want their parents involved.
The teen educators say they learn a lot themselves from being in the program.
“I want to be a doctor one day,” Kim says. “So this is such a great experience. I get to be with medical students and doctors and see them in the position I want to be in the future.” She says she has also learned about grant writing by applying successfully for funding for PATCH.
Rodriguez says that being involved in PATCH has been great for her self-esteem.
“A few weeks ago we spent two days in Wausau where we led nine workshops in two days. It was exhausting,” she says with a laugh. “But after each one I had the feeling of ‘Wow! I just did something really good. I may have changed someone’s life.’”
