complete her brief presentation, the director pronounced the program a waste of time and suggested that she volunteer to file articles, reports, and journals in the agency office. It was a revealing response, clearly stating that the director felt there was no reason even to find out anything about the student, a recent honors graduate of the University of Alabama on her way to Vanderbilt’s school of medicine with considerable scholarship support. Her well thought-out career aspirations were service-based and in line with the agency’s mandates, but the director was unwilling to engage her or to listen to her presentation of a program to which she was obviously committed. Unfortunately this was not the only occasion on which I saw young persons and their aspirations dismissed without a hearing.
In forming the SCCH and preparing for its first health fair project, students faced a variety of crises mainly centered on the establishment of partnerships with communities, agencies, professionals, and funders. The project had no track record, and it was being promoted by college students who were asking a lot. Inevitably there were ups and downs that required students to be persistent and smart. The most critical of the problems was a last-minute change in requirements by the Robert Wood Johnson Foundation (RWJ), the major initial source of financial support. The foundation determined that funds would have to be routed through the University of Alabama and not the Wesley Foundation as originally specified. The change placed students in a difficult situation. The Wesley Foundation Board of Directors had assured students that, within normal organizational rules, they would be the decision-makers regarding the expenditure of grant funds. The turn of events left them without that assurance. After hours of difficult deliberation in a meeting to decide their course of action, SCCH student members decided overwhelmingly to reject the grant and cancel their plans. In order to insure the integrity of their organization, they were willing to turn down indispensable financial resources, face up to their failure with community members and other supporters, and lose summer jobs in which they had invested a great deal—including a substantial amount of hope. They understood that their decision put the SCCH in serious jeopardy; but they had taken responsibility for the project, and it would succeed or fail under their leadership. Whether the decision was right or wrong, it demonstrated character and a willingness to sacrifice for principle.
The decision and the process whereby it was made shaped the organization. Students had tested their commitment and had demonstrated their belief in their own competence. Ultimately, through the intervention of David Mathews, president of the University of Alabama, and Neal Berte, dean of its New College, arrangements were made that allowed students to take the responsibilities they sought, accept the RWJ funding, and proceed with their work. Both Mathews and Berte were committed to having students take initiative and assume civic responsibility. The university provided administrative support requisite for SCCH success, facilitated student decision making, and matched the existing commitments of the Wesley Foundation. The efforts of the SCCH made a significant difference to students and to many people and communities in the state, thereby furthering the goals of the supporting institutions that maintained their own organizational integrity while fostering the creation of new contexts where young people could grow in character, prepare for their futures, and understand more clearly the relevance of their education.
With funding from the Robert Wood Johnson Foundation and the United Methodist Church and with support from the University of Alabama and the Wesley Foundation, SCCH students set about implementing their first health fairs in three rural Alabama communities. Living with community members who provided room and board, students offered free comprehensive health assessments; they were assisted by physicians, nurses and nurse practitioners, hospitals and health agencies, medical, nursing, and optometry schools, local health departments, and several university departments. Screening clinics were usually set up in schools and were operated at times that were accessible even to persons working night shifts. The hours were long and the work difficult, but growing awareness of the seriousness of local health problems confirmed they were doing the right thing.
Students also valued the health fairs for the personal development opportunities they offered, and this reinforced their commitment to the SCCH. The preparation done by its founding students was insightful and thorough and laid the groundwork for future accomplishments. Over time SCCH effectiveness correlated with student leadership, funding levels, community response, and the support of agencies and individuals. In the judgment of external evaluators, community members and the students themselves, the SCCH was highly successful and provided a history that warrants reflection.
There are two questions about the SCCH that are especially relevant for understanding Consequential Learning: What happened as a result of students’ efforts? What values and interests did these efforts reveal? The first question focuses on the organization and its activities as a context for student learning, personal development, and effective civic action. The second examines motivations and aspirations.
What did the health fairs and the SCCH achieve? In the first place, students learned a lot. They developed and applied a variety of skills, many of which related to their college majors and their potential careers. Medical students learned how to take patient histories, give screening exams, and begin to trust their own judgment; social work students gained knowledge about the functioning of communities and the operation of government agencies; and history students occasionally chronicled local life. Participants also developed civic capacities: SCCH student coordinators became skilled at organizing; public speaking and interpretation built the confidence of most members; collaborative decision making, problem solving, and action were routine; and students learned how to take stock of their efforts in demanding and complex circumstances.
Students sought and gained considerable first-hand perspective on health systems and on individual health. They became conversant with the sources of many of the state’s health problems. Some learned why they were interested in being medical professionals and others that they wanted no part of medicine. SCCH work gave participants a chance to study their state and to appreciate the value of the knowledge of place. They made friends, often across racial and cultural lines, and they had fun doing so. Their self-esteem was bolstered by the gratitude and affirmation they received from community members. Students were pleased that they had tested their values and resolve and had proved their capacity to make a difference.
Many members considered their SCCH experience to be the most important in their education and in their personal growth. I regard that assessment as particularly significant, since students in the formative years of the SCCH were not afraid to pass negative judgments on their own efforts or those of their peers. Consequential Learning’s emphasis on young peoples’ attention to self-evaluation is grounded in its benefits for SCCH students who made the case that they were entitled to judge their lives for themselves. Students—who are citizens—are not often encouraged to carry out their responsibility to assess the contexts and content of their education. As a result, it often seems that they are conditioned to focus primarily on what they must do to obtain the grades they want.
The health fairs also produced benefits for community members—many of which they would not otherwise have enjoyed. Thousands of people were screened and tested, and previously undiscovered pathologies were revealed. A number of them were life-threatening and were treated by physicians and hospitals that had agreed to receive health-fair referrals. Communities remembered the life-altering and life-saving cases. They influenced peoples’ attitudes toward their own health care and engendered an appreciation for the SCCH; and they were the foundation for partnerships later created between the University of Alabama and rural communities in the state.
I was routinely told by community participants in the health fairs that their physical exams were the best they had ever had. Although supervising physicians frequently questioned such valuations, it was agreed that people were responding positively to the thoroughness with which medical and nursing students explained the examination process. They also provided useful information on healthy living and on how to make connections with local or regional health agencies. Through the administration of medical histories and SCCH-designed community health surveys, and through physical examinations, water testing, and demographic studies, SCCH members collected significant local information as well and used the results to foster local improvement.
With energy and insight, SCCH members gathered, analyzed, interpreted, and acted on information. As a result of that practice,