Abstract
There are over 100,000 people in the United States in need of an organ for transplant. Last year approximately 13,000 people donated their organs. As a result of the vast difference in these numbers, thousands of Americans died while waiting for a transplant. Two classes in the Health and Community Services Department at California State University, Chico viewed the lack of potential organ donors as a public health problem. The classes planned and implemented an Organ Donor Drive which focused on increasing awareness of organ donation and removing misconceptions with being an potential organ donor. This event helped students apply concepts taught in class to a real life situation, brought awareness to the cause, and provided invaluable lessons outside the classroom.
Introduction
There are over 100,000 people in the United States in need of an organ for transplant (Organ Procurement and Transplant Network [OPTN], 2009). Last year approximately 13,000 people donated their organs resulting in over 25,000 transplants (OPTN). It is estimated that approximately 50% of potential donors actually donate (Raclin, 2008). As a result of the vast difference in these numbers, thousands of Americans do not get the organs they need and die as a result.
People over the age of 18 can sign up to be organ donors through the state in which they reside. For many states this involves registering to be an organ donor at the time a person receives a driver’s license. In many states when a person registers to become an organ donor, they receive a special sticker on their driver’s license. While this sticker signifies the person’s interest in donating their organs, it does not guarantee they will donate. Actual organ donation is not determined until the registered donor is declared brain dead by their physician (Department of Health & Human Services [DHHS], n.d.). Brain death is declared when the person’s brain permanently stops functioning. At the time of imminent brain death, a specially trained person from an organ donor network is brought in to seek permission from the descendant’s family for organ donation. This process demonstrates that being a registered organ donor is not enough. It is vital that someone who wants to donate their organs discuss this desire with their family. This way the family is aware of the person’s desire to donate their organs and can consent on their behalf.
Service Learning
The concept of service learning is by no means a twenty-first century innovation. In theirAnnotated History of Service Learning (2004), Titlebaum, Williamson, Daprano, Baer and Brahler cite President Abraham Lincoln’s donation of public land to several states in 1862 “to promote the liberal and practical education” as a first step toward service learning (p.1). Also chronicled in their time line are President Franklin D. Roosevelt’s innovative Civilian Conservation Corps (CCC); the creation of the GI Bill; President J. F. Kennedy’s Peace Corps; and President Lyndon B. Johnson’s VISTA program. These landmark efforts were followed by college work-study programs and one of the first environmental programs for youth: the Youth Conservation Corps, established in 1970. More than two decades later, in 1993, President Clinton signed legislation creating AmeriCorps and the Corporation for National Service. The importance of service learning and commitment to the community was recognized during George W. Bush’s presidency in the form of the President’s Volunteer Service Award program (Titlebaum, et al. 2004). This impressive history assists in creating modern day educational goals and projects.
Today, service learning is a type of experimental education in which “students engage in activities that address human and community needs together with structured opportunities intentionally designed to promote student learning and development” (Jacoby, 1996, p5). The Higher Education Research Institute found service learning to positively affect many student outcomes (Astin, Vogelgesang, Ikeda, & Yee, 2000). These outcomes include improved academic performance, increased self-efficacy, and plans to participate in service after college. Similarly, Astin & Sax found students who participated in service had improved academic development, civic responsibility and life skills (1998).
California State University, Chico (CSUC) identifies service as a fundamental part of its strategic plan. CSUC defines community service as “all work or services performed by . . . students that contribute to the quality of life in the community … ” (CSU, Chico, 2006). The importance of service to the community has become part of the culture within the Department of Health and Community Services. As a result, many different classes in the department perform service learning projects each semester. The classes which participate in these projects vary from freshman level, general education classes, to senior level classes required for a bachelor’s degree in health education or gerontology.
The authors of this article are instructors for the Department of Health and Community Services at CSUC. Holly Nevarez teaches a junior level Community Health class and Linda Bilsborough teaches the freshman level Personal Health class. Both instructors were looking for a community service project to implement in their classes. After a series of conversations about a personal acquaintance in dire need of an organ transplant, the two instructors decided to integrate an organ donor drive as a service learning project in their classes.
Before the semester started a vision for the project was created. The decision was made to pick two days for students to host a booth on campus. April is National Donate Life month, which seemed like the opportune time for the project. The plan was to have various education materials and activities available at the booth including laptops where people could register to be organ donors. CSU, Chico is a wireless campus, so the booths were able to register people through the donate life website (http://www.donatelifecalifornia.org).
Next, contact was made with the local transplant network, the California Transplant Network (CTN) to collaborate on the event. CTN was eager to support the event. Representatives from the organization met with the instructors to provide information about organ donation and to help prepare for the event. CTN also donated giveaways such as stickers, pens, bracelets, and water bottles. It was decided that these items would be given away to those who registered to become potential organ donors during the drive. CTN provided several brief videos about organ donation. Some films provided information about the process, while others told stories of those who had received transplants or died waiting for a transplant. From CTN, it was learned that other California colleges have held similar events with mixed results. Based on CTN’s input about these events, a two-day drive appeared to be a good approach. A goal of registering 100 new organ donors was set as a difficult yet attainable goal. Community Health students, by virtue of their chosen major/minor and better understanding of the community, took a leading role in strategic planning for the organ donor campaign. Personal Health students had specified responsibilities in advance of the drive and provided staffing support during the drive. With the support of CTN and a broad plan in mind, the authors went to their prospective classes to further develop the program plan. The remainder of this article discusses how two very different classes worked together to achieve a common goal.
Personal Health
Personal Health is an entry-level general education course primarily composed of freshmen and sophomores who are not necessarily health majors or minors. A service learning project aimed at increasing organ donor awareness and registration is ideally suited to this course. The course’s focus on the dimensions of health and their connections to the multitude of health issues facing today’s college student included space for a discussion of organ donation. The physical need for organ donation was certainly obvious to all as the project unfolded. Additionally, students quickly recognized the importance of such a selfless gesture from a mental, emotional, social, and intellectual perspective as they brainstormed, researched, and listened to compelling first-hand accounts of the dire need for organs. In Personal Health the specifics of the required service learning project were introduced during the first day. To build support and empathy for the project, two videos were shown during the first week of class. Both “Ray of Hope” (an award-winning ESPN film about a college mascot who tragically died in an accident and allowed others to live through his decision to be an organ donor) and “Saving Bambi” (the story of a young mother whose death left her children alone) served as powerful tools, affirming the project’s importance.
Four distinct goals were established for the project in the Personal Health class: (1) conduct website research and analysis; (2) develop a professional quality advertising poster; (3) work for two hours on either a media team or laptop team during the drive; and (4) complete a reflective essay analysis of the project.
During the third week of the semester, a required review and written analysis of two websites (www.donatelifecalifornia.org and www.organdonor.gov) was conducted. The research was an essential starting point to better understand not only organ donation, but also the myths, misconceptions, registration protocol, and frequently asked questions about the process.
Week number six concluded with a poster contest. Students, working individually or in pairs, developed a mock advertising poster for the event. Each poster was numbered and hung in the classroom for a vote. The top two posters were used to advertise the event in poster and handbill form. The class favorite was a poster featuring the Tin Man. Second place was awarded to the poster with the figure from the game, Operation. Because the Tin Man was so recognizable, “he” became the project mascot and a costume was rented for the event.
The two-day Organ Donor Registration drive occurred during week number eleven. Students signed up in two hour blocks to be part of either the media or laptop team. Media members were assigned specific locations to hang posters, write white board classroom announcements, or pass out handbills. Booth teams assumed one of three responsibilities: caller, educator, or laptop supervisor. Additionally, several students satisfied their two hour obligation by wearing the Tin Man costume and distributing handbill announcements.
Finally, a reflective essay analyzing the entire organ donation service learning project was due the twelfth week of the semester. Students carefully assessed the goals of the project and made suggestions to enhance not only their learning experience, but strategies to maximize the benefits to the community served by the project.
Community Health
The Community Health class is a junior-level course required for students who are pursuing a major or minor in Health Science with options in either health education or gerontology. This class is ideally taken as the first class in the major or minor and is viewed by the instructor as an introductory survey class.
During the first day of class the instructor introduced the project and the required class participation. Each of the students would be required to work on this project for at least two hours and have the opportunity to earn extra credit by volunteering additional time. The students could self-select jobs based on their interests and availability.
During the second week of class the students were assigned to learn about organ donation. They were referred to a website that is run by the Department of Human Services called decision donation (http://www.organdonor.gov/student/). This website provides a large amount of information on organ donation. In class there was a discussion about organ donation and what the students had learned. The students made lists on the board of ‘what we know’ and ‘what we want to know’ The major points that were discussed included the (1) numbers of people waiting versus the number of organs donated (2) the sticker on a person’s driver’s license not being an adequate consent for organ donation (3) and misconceptions that students had about being an organ donor. An example of a misconception is the belief that emergency personnel will not try to save you if you are in a car accident and have an organ donor sticker on your driver’s license. At the end of this session the class split up the ‘what we want to know’ list and assigned students to find the answers and report back to the rest of the class.
During the fourth week of class the students broke down into small groups and brainstormed for ideas of how to run the organ donor drive. The initial ideas from the authors were explained. The students were also told about the giveaways provided by CTN. Beyond that, the students were free to form the project into whatever they saw as appropriate. From this brainstorming session a list of possible components to the service project was created. Some items were eliminated from the list due to time or budget constraints (there were no extra funds available for this project). With the remaining items, students signed up for what they wanted to do as their job for the organ donor drive. The jobs included:
- hanging posters on campus to advertise the events (posters were created in the personal health class),
- asking businesses to donate goods and/or services for us to give away as prizes for registering to be a donor. The event ended up with so many prizes that each person who registered to be a donor received a small prize (free cookie or free fries from local vendors) in addition to the CTN giveaways. Larger prizes were raffled off to those who signed up to be donors.
- getting news and media coverage to advertise the event,
- creating displays to have at the booth,
- creating a flyer for those who sign up as potential donors titled “now what.” This flier would discuss the importance of talking to friends and families about the decision to donate.
- providing classroom presentations to advertise the event. Some instructors gave the students up to 10 minutes to talk about the event. In these instances, the students showed Saving Bambi. This video was about 5 minutes long and had a great impact on those who watched it.
- working at the booth.
Once the students had signed up for their jobs, they were put into groups by job. This allowed the students to brainstorm with each other on achieving the individual jobs. For example, those who were asking businesses to donate goods or services made sure they were not duplicating what businesses they would solicit. The poster hanging group divided up the campus to ensure that each section of the campus was going to have posters to advertise the event. For each job, timelines were created so that the groups knew when their job needed to be done. Two weeks before the event two representatives from CTN came to the class to speak. They provided students with more detailed information about the process of organ donation. This was very important for the class. The instructor saw this as training the trainers. The class would become educators on the importance of organ donation and would have to help break down misconceptions while they were promoting the event and working at the booth. It was important that they had answers to the questions.
Both Classes
In the weeks leading up to the event, all students were asked to make brief announcements in their classes and to write the event information on classroom whiteboards. The booth was available on the two busiest days on campus (Wednesday & Thursday) during peak hours (10am – 2pm). There were three to six laptops at all times for people to register to become organ donors. The booth was staffed with at least six students from both Community Health and Personal Health during its operation. Students self-selected their roles at the booths. There were a total of four roles available at the booth:
- The Tin Man. Since the posters advertising the event featured the tin man, a tin man costume was rented for the drive. During booth hours a student walked around campus passing out fliers advertising the event. This drew a lot of attention to the booth and the event.
- Callers. Some students walked around other areas of campus as well as some who were stationed in close proximity of the booth. The purpose of this job was to spread-the-word about the event both verbally and by handing out handbills. These students often answered questions and corrected myths about organ donation registration to those passing by. A student wrote of her approach in her reflective essay. “I talked to people by asking if they would be interested in saving a life. By asking them this, I would usually catch their attention.”
- Educators. The students who acted as educators explained the process of registering to be an organ donor to those who approached the tables. They also addressed myths about organ donation. As one student wrote,” Misconceptions such as a lack of medical care given to organ donors, or whether the patient would be fully deceased at the time of collection, were surprisingly common.” Once someone was ready to register, the educator introduced that person to a laptop supervisor.
- Laptop supervisors. These students made sure the laptops were functioning properly. They also handed out the appropriate materials/prizes to those who completed the registration process. People who registered to be donors received a flier titled “Now what” which discussed the importance of talking to their family and friends about their decision to be an organ donor. They also could choose items from a give-away basket which included the items donated by CTN (stickers, pens, bracelets, and water bottles). In addition, they received a coupon for a free cookie or free fries and their names were entered in a raffle. The final step was to write their name on a strip of construction paper. This paper was looped and added to those of other donors, creating the ‘chain of life’.
Outcome
There were several immediate outcomes that resulted from this service learning project. For students, the event provided a hands-on learning experience. As a result of their research, students became the experts on organ donation. They used their expertise to educate their peers, classmates, and their own families and friends. Through the education provided by this project we were able to change stereotypes, decrease myths about organ donation, and increase awareness of the issues among our students, the students at Chico State and their friends and families. As one student, Melissa, wrote in her reflection essay, “The organ donor drive was one of the best volunteer experiences that I have ever found myself to be a part of.”
The Community Health students learned the essentials of program planning, goal setting, collaboration, public health education, and marketing. One student commented that “I learned that within the health field, education is one of the most important steps when getting people to look at something in a different way.” This project demonstrated to all the students that a little bit of work can have a large impact. The lives of many people were impacted even though they only dedicated two hours to this program. Katie, a community health student wrote that “I should become more involved in the community because one person can make a difference and it really doesn’t always take that much extra time to help out in a project.”
Another outcome was the number of registered organ donors. The program goal was to recruit 100 new donors, yet 222 signed up as new potential organ donors; more than double the goal. This was a huge success for the Community Health and Personal Health students and the campus community. “Although it was a class assignment, I ultimately think everybody learned something from this experience that they could take with them for the rest of their lives” wrote one student in a reflective essay. Cathy Olmo, the Community Affair Spokesperson for CTN wrote that “We recognize that the way to impact our donor designation rates depends on the efforts of many people within our communities. Efforts like California State University Chico exemplify our belief that outreach efforts driven by peers works well in both business settings as well as educational settings. Since 2006, more than 15,000 lives have been saved or healed through organ and tissue donation as a direct result of our California State Donor Registry. Each registration on the Donate Life California website gives hope to those who wait for transplants. With this in mind, we applaud the efforts of the students and staff at CSU, Chico and thank them for the push to save more lives” (Olmo email). The classes were awarded with a Service Excellence Award from CTN.
Conclusion
This project was challenging, but extremely rewarding. The authors feel that the short-term outcomes and lessons learned from this service learning project were hugely beneficial. Students could not have learned this depth of program planning through traditional lectures and in-class assignments. By taking students out of the classroom, students were provided real-life situations that lead to invaluable lessons.
Considering how successful the program was, there are few recommendations for change. Once such change involves reducing the number of prizes solicited for this event. The giveaways from CTN were great, but the raffle proved to be a lot of work. Contacting those who won prizes and scheduling prize pick-up was time intensive. The belief is that those who registered to be donors would have done so without the incentive of prizes. At times during the drive registrants were lined up, waiting for laptops. Providing more laptops would have reduced the wait during these times. A final recommendation for change would be to incorporate an evaluation component. The event took place on campus, but does not account for those people who were spoken with and registered at another location (ex: at home). A possible solution would be to add a question to the registration process asking if they are registering in response to an event. This could include a drop-down menu with the organizers name. This addition would give the organizers a more accurate count of those they educated.
One of the great things about this project is the ability to apply the principles of health education planning to two very different classes: Personal Health and Community Health. There is potential to apply this project to other classes as well, and thus to extend service learning’s reach in the curriculum.
References
Astin, A.W., Vogelgesang, L.J., Ikeda, E.K., and Yee, J.A. How Service Learning Affects Students. Los Angeles,CA: Higher Education Research Institute, UCLA, 2000.
CSU, Chico (2006). Community service and service learning. Retrieved from http://www.csuchico.edu/catalog/cat03/community/service-education.html on February 25, 2009.
Department of Health & Human Services [DHHS] (n.d.) Decision Donation: A school program that gives the gift of life.
Jacoby, B.L. (1996). Service-learning higher education: Concepts and Practices. San Francisco: Jossey-Bass.
Olmo, Cathy (2008). From an email sent to Holly Nevarez regarding outcome of organ donor drive.
Organ Donor and Procurement Network [OPTN] (2009). Retrieved on February 19, 2009 from http://optn.org.
Raclin, William (2008). Donation Services Liaison, California Transplant Donor Network. Personal interview conducted by Holly Nevarez.
Titlebaum, P., Williamson, G., Daprano, C., Baer J., & Brahler, J. (n.d.). The annotated history of service-Learning: 1862-2002. Learn and Service America’s National Service-Learning Clearinghouse. Available:
http://www.servicelearning.org/what_is_service-learning/history/index.php
About the Authors:
Holly Nevarez, Ph.D., is an Assistant Professor in the Department of Health and Community Services at California State University, Chico. Holly received her Bachelor’s of Science degree in Health and Community Services from Chico State. She earned her MPH from Benedictine University and eventually she returned to the West Coast to earn her doctorate in Public Health from Oregon State University. Dr. Nevarez strives to bring real life examples into her teaching by working within the Chico community. Before she became an instructor, Holly worked in both hospital and clinical settings for 12 years. Phone: 530-898-5013; Email:[email protected]
Linda McAfee Bilsborough , MHS currently teaches Personal Health, Human Sexuality and Health Education for Elementary Teachers in the Department of Health and Community Services at California State University, Chico. Her undergraduate degree is from CSU, Chico in Health Education and Health Care Management. Her Masters degree is in Health Systems Leadership from the University of San Francisco and teaching credential in the area of Health and related subjects is from the University of California, Berkeley. Service learning is a component in all of the courses taught with projects ranging from the Organ Donor drive described in this article to sexuality fairs, health academies at local elementary schools and health fairs at the local homeless shelter.