June 16, 2022

Public Education is Vital

Over the past two weeks several intelligent, progressive and well- educated individuals who are non-scientists asked me to explain the science behind sex differentiation, reproduction and the health disparities surrounding pregnancy and birth. Their interest in these facts came about by recent news reports; in particular the public discussions of girls in sports regarding sex and gender identity as well as news regarding high black maternal mortality. Despite my past experience in teaching detailed anatomy and physiology in childbirth classes at Maternity Center Association in New York to similar persons in 1964 to 1967 and teaching courses for the general public on reproduction as faculty of the State University of New York at Buffalo’s Mini Medical School in the late 1990s, I found the task of explaining reproductive science to my recent questioners a challenge. Not because I did not know the science nor concern about my teaching ability but because these very smart persons simply did not have any background in science. When I teach adults, I always make a point to discover what facts they already know. My inquirers simply had so little knowledge of science that I needed to start with very basic facts. I began by pointing out that science is a process of discovery and that it is ongoing and new things are always being uncovered. What a person learned a few years ago is now supplanted by newer experimentation and analysis. And a few years from now this new analysis will be further expanded. I also told them that reproductive processes are complex with many genes and chemical pathways involved. I found myself taking a few hours to discuss the facts of sex differentiation as we understand it struggling to find the exact level of detail needed for each individual. I learned that I had to be patient and non- judgmental. I have some indication that I was at least somewhat successful from the feedback I received and I continue to dialog with them.

Those experiences caused me to reflect on what was different now compared to my memory of teaching about reproduction decades ago. Why is it so challenging to explain science to non-scientist now?  First, the way knowledge is acquired currently by the general public is through on-line forums, TV news, social media and other forms of very short sound bites. The persons I taught during my early career in the mid -1960s up through the 1990s had exposure to media that allowed for much more detailed in-depth reporting through newspaper articles, magazines and in-depth TV reports. There was a time when women’s magazines printed series of articles on reproductive health written by health professionals that wrote comprehensive articles. Many men’s magazines had health articles from time to time.  Now so many cities and towns do not have printed newspapers. Many magazines, while they might discuss new scientific and medical discoveries, tend to do so in very short articles often only a few paragraphs in length.  Sometimes the information is presented as bullet points. In other words, print media mimics the on- line approach to knowledge. This represents the first challenge. The second challenge is in some ways even more difficult.  It is now possible to graduate from many colleges without having taken any course in science or math at all!  In many public intermediate and high schools, health education of any sort is not taught. Science might be a requirement for graduation but the courses are not always taught by persons with the most expertise. There may be exceptions but that is not terribly common. In the US reproduction and reproductive health have become a very polarizing topics fraught with high emotion. We seem to have a philosophy that anything about reproductive health should be taught at home by parents. But if the parents themselves do not have scientific facts, then how can they teach their children?  Finally, science is not always respected and is often not trusted. It is hard to trust something that one does not fully appreciate and understand. Science is a foreign language to many people.

Reproduction and reproductive health are exceedingly important for humans and our survival on earth depends on healthy reproduction.  Individuals deserve to be taught the facts. Thus, I think that it is necessary for every scientist and medical professional now working in the field of reproductive science and health to spend energy getting scientific facts out to our non-scientist friends and neighbors.  If physicians, advance practice nurses, nurse-midwives, physician assistants make a deliberate effort to really educate their patients progress could be made toward scientific literacy. It is not enough to hand out pamphlets or ask an assistant to talk to the patient, each provider needs to make sure that they use clear, concise language to convey diagnoses, treatment plans, medications, physical findings to all patients that they see along with the scientific rationale behind them.  It is helpful to ask the patient to then tell you in their own words what they heard and to clarify if necessary. Providers need to find the right words and sometimes metaphors to get these facts across to their intended audience. I do realize that time constraints and the electronic medical record demands are difficult. All providers, including nurses and medical assistants could begin by allowing the monitor screen to be truly visualized by the patient and when entering anything into the electronic chart, telling the patient out loud what is being entered. That would be a start. Providers can and should learn to write short op-eds and to be willing to be interviewed on pod casts or on local TV. We need to make this a very critical part of our profession practice. Basic and clinical scientists have obligations, too. They must make certain that they are available to local and national media to react to and discuss new findings and to report in an appropriate manner new discoveries that they make. We need more scientists to write op eds, more scientists to inform their representatives and senators about reproductive science. Because people are so polarized in their beliefs and understandings so much of reproductive science tends to become political and as scientists, we do not want to make waves so we stay in our labs and offices and do our work, having made a deliberate decision to lay low. This is a mistake. We need to talk about our work and why it is important. We need to lobby for greater scientific education for all students not just for those in STEM.  We need to support our professional organizations in the programs they currently have to reach out and educate the public and to encourage them to do even more. We are doing a fairly decent job of encouraging STEM scholars, now let's do a decent job for non-science students.

The Campion Fund has sponsored educational programs for the non- scientist and non-health professional around our biannual focus topics but we acknowledge that those outreach efforts have been to persons affected by a particular focus such as fibroids, or young persons living in areas with high levels of air pollution for instance. Now we pledge to do more. Our strategies and goals will be that for every scientific meeting we organize we will also design programs to disseminate scientific findings to the public as a whole as well as to the appropriate targeted audiences.  Hold us to this pledge.