Abstract
Teaching sexual and reproductive health in general, and contraceptives in particular, presents instructors with diverse challenges. While instructors need to cover textbook concepts, the classroom setting does not offer much context for a significant, experiential learning opportunity. We have developed and implemented a Contraceptives Scavenger Hunt assignment, designed to facilitate experiential learning and put class concepts into real-life context. Students were provided with three groups of sexual and reproductive health items that were discussed in class (contraceptives for males, contraceptives for females, and other interesting items). They had to choose one item from each group and hunt for it in local stores, pharmacies, sex shops, and so on. They reported on their overall experience and identified barriers they would not have thought of in class (e.g., transportation, cost, ease of access). Variations to this activity, its implications for experiential learning, challenges to its implementation, and its impact on student learning outcomes were discussed.
The need for sexuality and sexual health education in the United States is evident. The prevalence of sexually transmitted infections (STIs) among 15- to 24-year-olds continues to increase, with half of all new STIs occurring among this age-group (Centers for Disease Control and Prevention, 2014). School-based sexual and reproductive health (SRH) education purports to inform pupils about unintended pregnancies, STIs, gender, sexual orientation, and consent, among other topics. In secondary schools, SRH education generally takes one of three forms: abstinence only, abstinence-plus, or comprehensive. Florida, where this teaching practice occurs, is one of the many states where comprehensive SRH education is not included in the high school curriculum. Even though Florida instructors acknowledge teaching some SRH content, this information is not accessible to all students; is taught in a narrow time period without standardization of facilitators’ training, content accuracy, or quality assurance; and may not adequately address the realistic needs of students (Dodge et al., 2008). Instructors at the college level face the challenge of addressing the dearth of SRH knowledge in undergraduate cohorts. The demand for comprehensive SRH courses at the college level continues to grow, demonstrating the need to expand the coverage of this type of education (King, 2012). Given the high prevalence of STIs and the continued demand for comprehensive SRH education from college-aged students, there is an increased need to reinforce existing methods and develop new and innovative ones for teaching SRH education.
One content area in which innovative teaching methods could be applied is contraceptives. Peer-led education has been increasingly used (Beshers, 2007; DeMairo, Dischell, Jouthe, & Horner, 2007), along with role-play activities (Taverner & Brick, 2006), games (Gilliam, Jagoda, Heathcock, & Sutherland, 2014; Rosenthal, 2010), and video clips (Herrman, Moore, & Anthony, 2012), to teach students about contraceptives. Although previous research has shown the utility of these methods, there is still a disconnect among students knowing how to use contraceptives compared to where they can obtain them.
Experiential Learning
To improve overall student learning, experiential learning methods are employed to bring a real-life context to classroom-based learning. Experiential learning engages students in cognitive, sensory, emotional, and tactile experiences that enrich learning and transform educational experiences into growth opportunities (Beard, 2010). Students reflect on experiences with their internal environment, external environment, and senses, to fully explore learning opportunities. For example, students who visit local pharmacies to see which contraceptives are sold, where they are located, and how much they cost can glean an environmental understanding of contraceptive purchasing not learned in a classroom setting. In addition, experiential learning opportunities have the ability to take on transformational learning. Transformational learning “changes the way people see themselves and their world” (Baumgartner, 2001, p. 16). By engaging with their environment, students can gain alternative perspectives and understand how people obtain sexual health resources in their day-to-day lives. Experiential and transformational learning experiences afford students opportunities to develop deeper understanding of course content through personal exploration.
Scavenger Hunts
Game-based learning is being increasingly incorporated into the classroom setting, regardless of the age of learners (Gillam, Heathcock, Dudley, Saper, & Jagoda, 2013). There are reports of scavenger hunts used in various contexts with different learning objectives, including getting students acquainted with library materials (Maris, 1979), getting community partners to identify available resources (Virgin, Goodrow, & Duggins, 1996), having staff learn about physical locations of new hospital buildings (De Amaya, Canola, Guzman, & Martin, 2015), and introducing foundational pharmacological concepts and ethical concerns (Tinnon, 2014).
Regardless of participants’ diverse backgrounds, Virgin et al. (1996) reported that participants who engaged in the scavenger hunt ended up bonding with the community and their available resources. In their own words,
An important element of the scavenger hunt as a learning experience is its versatility. A careful selection of each required item could just as easily emphasize agriculture, business, economics, political structure, or components of the healthcare system. The scavenger hunt can be customized to match almost any curricular content while the process for interactive learning remains constant. (p. 33)
Maris (1979) reported that the use of scavenger hunts increases students’ familiarity with physical objects and, at the same time, gets them acquainted with resource availability. Gillam et al. (2013) published a short report of scavenger hunts applied to learning SRH in eight-graders, acknowledging that this is the only report of a scavenger hunt applied to SRH in an educational setting.
The current article describes the experiential, pedagogic processes and student experiences after implementing a Contraceptive Scavenger Hunt as a graded assignment in an undergraduate SRH class at a public southeastern university in the United States. This course is offered by the Department of Community and Family Health in a College of Public Health and is a component of the Foundations of Knowledge and Learning Core Curriculum for the university. Within the Foundations of Knowledge and Learning Core Curriculum, this course fulfills a social and behavioral sciences general education course and can be taken by any undergraduate student. Even though this is a freshman-level class, about half of the students are sophomores and juniors. A typical section roughly consists of two thirds female students and about one third Hispanic students, and about half of the class are majors in public health and biomedical sciences. We frame the contraceptives and other SRH-related items discussed in class within a go-get-it, real-life scenario. We conclude by describing our own experiences and how this assignment has implications beyond the course, helping students progress from knowledge and comprehension to synthesis and evaluation, all higher learning objectives in Bloom’s taxonomy (Adams, 2015; Bloom, 1956; Seaman, 2011).
Since the contraceptive scavenger hunt was envisioned, we anticipated short- and long-term learning outcomes. First, students engage in experiential learning with exposure to items related to their own SRH. Second, students retain their “scavenger hunting” skills for the future, either as well-informed consumers of SRH products or, for those following a path in public health and health education, as an activity they can repeat with their own clients and students. Finally, students use knowledge and experience gleaned to better understand opportunities and barriers of SRH within their respective communities.
Activity Description
For this activity, each student is provided a list of items in three distinct groups: (1) contraceptives for males, (2) contraceptives for females, and (3) other interesting items (Table 1). The students choose one item from each list and visit local establishments (e.g., pharmacies, drugstores, supermarkets, convenience stores, sex shops, campus resources, local clinics, etc.) to hunt for these items until they find each item at least twice. This implies the student visits at least two establishments, which eases the critical thinking processes allowing the student to compare and contrast the same item in terms of placement, promotion, and price in two different settings. Students report their experiences hunting for and finding each item in a reaction paper of about 2,250 words. For each item selected, students provide the full name and a short summary, including, but not limited to, type of item, manufacturer and place of manufacture, if it is sold freely over the counter or if the item is locked, and if it is sold with a prescription. For each store visited, students report names, addresses, date, and time visited and also analyze the impact of these contextual observations.
Groups of Items the Students Need to Choose From and Hunt for.
Note. This list is not all-inclusive and should be taken as an example of what the students can hunt for. It does not mean that the authors endorse any particular brand.
Each item found in each store is compared and contrasted. Students report if the item is at the eye level, if it is easy to find and grab, what other brands or types of items are around the item chosen, if they needed help purchasing it, if the staff was helpful or knowledgeable, and a general sense of the environment. We encourage students, if the store allows, to take pictures of the product placement to better help them with the description of placement and promotion. Additionally, we encourage students to include selfies with the product and create their own hashtag related to the product, the store, and their observations. We understand that not all the students will be comfortable sharing these posts in their social media, but if they decide to do so, we also ask them to share screen shots of their posts and the reactions they get from their followers with their assignment submission.
Last, students share their overall impressions from the scavenger hunt activity. They state if they anticipated any of their experiences, how they felt when they could not find the items, how someone without a car can obtain these items, if the staff was helpful and/or knowledgeable, and, from the experience, what can they conclude are some pros and cons for someone who decides to use this particular item for SRH.
The complete assignment description and grading rubric can be found in the Appendix.
Activity Variations
Although this activity is formatted as an individual, short, written report, it can undergo different adaptations. Reporting of results and findings can be done through a photovoice-like oral report on the students’ experiences, with the use of photography to evoke their perceptions (cf. Mamary, McCright, & Roe, 2007).
Other scavenger hunts reported in the literature use a team-based approach, and authors have reported success in promoting a sense of teamwork and establishment of a foundation for future exercises requiring collaboration while creating an atmosphere of both adventure and shared success (Virgin et al., 1996). Although instructors could assign this scavenger hunt as a group assignment, we prefer individual submission given the level of introspection and personal analysis that each student must undergo to make sense of the items found and their context.
Last, depending on factors such as safety around campus and availability of resources, instructors might want to get students acquainted with free or low-cost campus resources, such as a university pharmacy or SRH programs at campus clinics or prevention centers.
Challenges Implementing This Activity
There has been much success implementing variations of this assignment over the past 10 years; however, there are challenges that students and instructors may face. Frequent barriers include availability of specific contraceptives, ability to take photos, discomfort with the content, and transportation restrictions. After each description, we present five anonymous quotes that better illustrate how students reacted to and overcame these challenges.
Availability of Specific Contraceptives
The first time we implemented this assignment, we created the list of items by conducting an Internet search without checking their availability at local stores. We randomly assigned only one item to each student and realized that a handful of students consistently reported difficulty finding specific items. This required assigning the student a new item and having the student start all over again. To reduce student frustration and increase exposure to multiple items, we agreed that subsequent hunts would contain item categories and the students would choose from each category based on personal preference and local item availability.
There are some contraceptives that did not show up on the list and when that happened I just replaced the item.
What really irritated me though was not being able to find the contraceptive that I was looking for a several different stores that in my mind should have plenty in stock especially a huge retail store like Walmart.
My contraceptive scavenger hunt wasn’t as easy as I thought it would be. I originally was assigned to Lifestyle Turbo condoms, however after visiting five different stores, I couldn’t find it anywhere and it was then that I noticed the lack of variety in the types of condoms sold.
This scavenger hunt really gave me some insight on the availability of condoms and differences there can be between stores. I feel like this is a great indicator of how accessible contraceptives can be.
Overall, the experience was beneficial and helped me to understand the different obstacles surrounding contraceptives and their availability to the public.
Photos
We encourage students to document their visit to the store through photographs. The purpose is twofold. First, they can refer to the pictures as a refresher when they report about product placement and its surroundings. Second, it helps the instructor understand the student’s description and verify that the student conducted the assignment in person. Students seldom report challenges in being allowed to take photos in some stores. In these rare cases, some store managers forbade students from taking photos with unsold store products. In these instances, we encourage students to post photos only from the stores that allow them to take pictures. Additionally, provision of photograph is an optional component of this assignment, to account for inherent restrictions.
Unfortunately only CVS allowed selfies/pics so the following selfies are only from there.
The most memorable moment when I was looking for a contraceptive was when I asked an employee at CVS if they sold Plan B One-Step. Once the employee handed me the Plan B, he thought I was going to buy it and then I had to explain to him that this was a school assignment and I needed the Plan B to take a selfie with it. The employee started laughing once I took a picture with it because you do not always see a random female taking a picture with an emergency pregnancy pill on a daily basis.
I knew that I would be put on the spot looking at contraceptives and taking pictures but I didn’t realize how many gawks and stares I would get.
I felt uncomfortable standing with a box of condoms in my hand taking a selfie.
Since I visited during the early afternoon, there were quite a few people roaming around, which made taking selfies with the contraceptives quite interesting.
Discomfort
Some students report that this assignment pushed them out of their comfort zone. Even though sexually active students report having had the experience of purchasing contraceptives, a common narrative in student papers is the feeling of being judged for purchasing contraceptives. Female students report judgmental stares regardless of the items they are hunting for; they also report empowering thoughts to overcome being silently judged. Male students, on the other hand, report judgmental stares only when they are in contact with pregnancy tests and not when researching contraceptive methods. Male students report discomfort browsing female contraceptives, but they also use different strategies to cope, such as going to the stores very early in the morning or visiting stores further away from campus. Once the students figure out what to look for and where, they also report a sense of relief of the initial discomfort level.
During the experience, I tried putting myself in the shoes of a teenage boy. I thought about how embarrassed I would be at each of the stages of purchasing these items. I had to use someone else’s perspective, because I couldn’t have cared less who saw me buying contraceptives at the store. I’m a grown, responsible woman who is taking care of her health.
It was early in the day so there were not any shoppers around. I decided to go early because I didn’t want to be seen in the store taking selfiie [sic] with female items.
In my experience of doing this scavenger hunt, it was especially awkward for me when asking where the Plan B and pregnancy tests were because I was shopping with [classmate] and I am sure the store associate perceived that maybe I was pregnant and [classmate] was the father.
There is still the embarrassment of purchasing contraception, but if you really want to engage sexually with someone else, you have to learn to first be comfortable with sexual topics, especially contraception and safety.
While I did not ask for assistance personally from the employees, the younger work force present at Publix would have made me, as an individual in my 30s, somewhat uncomfortable to ask, “Where do you keep your condoms?” The older employees at Wal-Mart and Walgreens would have reduced this uncomfortable feeling and I would be more likely to approach them.
Transportation
Very few students report transportation as a barrier to completing the assignment. If they do not have access to transportation, we have recommended using public transportation. Many schools are located in cities with access to county and university buses to visit stores near campus. In fact, many of these transportation systems are free to students with a valid student ID. We have also directed students to campus resources where they can find contraceptives (university pharmacy, wellness services, and the university clinic). Even though transportation can be cumbersome, it gives students insight into the transportation challenges of many Americans, as one of the questions they need to reflect on is “How does a person without a car have access to these items?”
At first I had mixed emotions about the assignment because I felt it was going to be a relatively simple assignment until I found myself visiting multiple locations on different days just trying to find the items to start the assignment which proved to be a little frustrating but eventually it all worked out. Fortunately throughout the process I was able to find people who were willing to take me around and help me successfully complete the assignment as far as getting my pictures taken within the stores.
For me this was all easy because I had a car, however, for someone who needs access to such contraceptives it would be quite hard for them to obtain them.
It was frustrating at first, because I was not driving myself but was being driven by a friend, so I did not want them to have to take me to another place. Without a car containing [sic: obtaining] these contraceptives would be very challenging. Even though the places that I went to were fairly close to the university it is still a half an hour walk away.
Someone without a car could have obtained the contraceptive by public transportation, biking or even walking as all of the locations that I visited were no more than a few miles off of campus.
Florida is notorious for a sub-par transportation system. I would recommend that Florida residents looking to travel to local drugstores contact drivers from the mobile application Uber.
Implementation Insights
Through this assignment, there is increased exposure to new content, flexibility in the provision of SRH education, and promotion of experiential learning to expand traditional education into transformational learning.
Exposure to New Contraceptive Methods
Students often engage in this exercise prior to learning about contraceptives in the classroom. After completing this scavenger hunt, students can comment about their experiences to enrich the class discussion. By doing so, students have an increase in contraceptive knowledge. In addition to gaining knowledge, students may experience a shift in attitudes because they interact firsthand with contraceptives in their environment as compared to hypothetical scenarios.
Flexibility
As instructors, it is important to be flexible when implementing and debriefing this assignment. Some students report personal conflict when searching for certain contraceptives due to their religious background. Thus, being flexible and giving alternative contraceptives is recommended. Additionally, tailoring the debriefing is important based on student experiences. For example, in the past, instructors did not discuss costs of contraceptives in their lectures. However, students wondered why emergency contraception was in a locked cabinet, only to realize that it is expensive. In sum, instructors need to be flexible in modifying class discussions to cover material that students encounter during the hunt.
Thinking Outside the Classroom
Knowledge gleaned in SRH education courses should transcend the classroom environment so students can be knowledgeable and empowered persons. Through this exercise, students can think outside of their comfort zones and consider alternative sources of information for SRH. For example, some students realized that the staff in sex shops is more helpful, more knowledgeable, and less judgmental than pharmacy or grocery store staff. Then, it is important to push students to think of “less traditional” venues when learning SRH.
Long-Term Impact
We have observed the immediate benefit of empowering well-informed consumers of SRH items. Also, this class is offered to all majors but especially marketed among public health and biomedical sciences students. As future professionals in these health-related fields, this assignment fosters health information–seeking skills that will ultimately have implications for their future careers and for the health care system, in terms of structure, health care interaction, and quality of health outcomes (Cline & Haynes, 2001). Health care professionals have a role educating or mentoring community partners, clients, peers, trainees, and students regarding how to access a wide variety of SRH resources. Because students have engaged in this memorable information-gathering exercise, they are better equipped to counsel about access to SRH resources, not only with textbook knowledge but also with the perspective of informed consumers.
Final Notes
This describes the experiential, pedagogic processes and student experiences after implementing the Contraceptive Scavenger Hunt as a graded assignment in an undergraduate SRH class at a Florida university. The course typically enrolls freshmen, Hispanic, and female students majoring in public health or biomedical sciences. Students experienced the process of finding out where to obtain contraceptives and faced potential barriers and obstacles they encounter outside of the classroom. Students were also encouraged to interact with store staff. This process has helped students develop an understanding of the nature of the SRH items through interactions with the items and the store staff (Virgin et al., 1996). This assignment allows students to engage in a transformational learning exercise promoting increased exposure and knowledge of SRH information. This has the immediate benefit of creating well-informed SRH consumers, but it also prepares students as health care professionals to disseminate information about SRH items with real-life perspective and identify nontraditional information sources, which can be helpful in health education, health promotion, and disease prevention efforts.
Footnotes
Appendix - Assignment Instructions and Grading Rubric
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.