Service-Learning in Health Professions Education

Service-Learningin Health Professions Education

© 2001, Community-Campus Partnerships for Health

PresentationOutline

Trends shaping health professionseducation and practice

Service-learning as a curricular responseOutcomes and lessons learnedRecommendationsResources

Data Sources

Health Professions Schools in Service tothe Nation Program evaluation

National study of the communityinvolvement of academic health centers

Review of the literatureService-learning institute evaluationsCampus consultations

Trends ShapingHealth Professions

Education and Practice

Expectations of accountability, involvement, relevanceContinued pressure on costsIncreasingly managed and integrated careNew technologiesAdvances in prevention, diagnosis and treatmentChanging role of health care and education consumerDemographic changesDisparities in health access and outcomesBroadened definition of health

Calls for Change inHealth ProfessionsEducation, 1990-99All advocate a greater emphasis on

community-based learning

Pew Health Professions CommissionCouncil on Graduate Medical EducationIOM Report: Dentistry at the CrossroadsIOM Report: Future of Public HealthAssociation of Academic Health Centers

Report on Mission Management

Pew PractitionerCompetencies

for 21st CenturyEmbrace personal ethic of social responsibilityand serviceRigorously practice preventive careIntegrate population-based care and serviceinto practiceImprove access to careProvide culturally sensitive careAdvocate for policy that promote healthWork in interdisciplinary teams

National InitiativesThat Promote

Community-BasedEducation

HRSA Area Health Education CentersHRSA Interdisciplinary Generalist CurriculumKellogg Community Partnerships in HPEKellogg Community-Based Public HealthRWJ/Pew Health of the PublicRWJ Partnerships in TrainingRWJ Generalist Physician InitiativeCDC Bridges to Healthy CommunitiesCNS/Pew Health Professions Schools in Service to the

Nation

Community-BasedEducation:

Student OutcomesStudent SatisfactionAttitudesStudent Clinical ExperiencesStudent Learning and PerformanceStudent Career DecisionsRelevancy of Training to Actual Practice

Community-BasedEducation:

Community Outcomes

Recruitment and retention of cliniciansand staff

Expansion of services, patient base,capacity

Enhanced imageAccess to health data

Service-Learning

Academically-based community service

A structured learning experience that combinescommunity service with preparation and reflection

Service-learning students not only provide communityservice but also learn about the context in which theservice is provided, the connection between theservice and their academic course work, and theirroles as professionals and citizens

SL is a Type ofExperiential Education

A. Furco 1996

Recipient BENEFICIARY ProviderService FOCUS Learning

SERVICE-LEARNINGCOMMUNITY-SERVICE FIELD EDUCATION

VOLUNTEERISM PRACTICUMINTERNSHIP CLERKSHIP

Points of Departure:SL and Other Forms

of ExperientialLearning

Balance between service and learningEmphasis on addressing community-identified

concerns and broad determinants of healthIntegral involvement of community partnersEmphasis on reciprocal learningEmphasis on reflective practiceEmphasis on developing citizenship skills and

achieving social change

Theoretical Underpinning of SL:Experiential learning theory

D. Kolb, 1984.

Concrete Experiences

Abstract Conceptualization

ActiveExperimentation

Reflective Observation

Accounting—Learning by DoingBiology—Life, Learning & the CommunityCommunication Studies—Voices of Strong DemocracyComposition—Writing the CommunityEngineering—Projects that MatterHistory—Connecting Past and PresentMedical Education—Creating Community Responsive PhysiciansPeace Studies—Teaching for JusticePhilosophy—Beyond the TowerSociology—Cultivating the Sociological ImaginationSpanish—Construyendo Puentes (Building Bridges)

Service-LearningAcross the Disciplines

Titles of AAHE Series

Health Professions Schools inService to the Nation Program

The Pew Charitable TrustsCorporation for National Service

National Fund for Medical Education

HPSISN Grantees

GeorgetownGeorge WashingtonLoma Linda Univ.NortheasternOhioRegisSan Francisco StateUniv. of ConnecticutUniv. of Florida

Univ. of Illinois-ChicagoUniversity of KentuckyUniv. of North CarolinaUniv. of PittsburghUniv. of ScrantonUniv. of S. CaliforniaUniv. of Utah (2)Virginia CommonwealthWV Wesleyan College

CommunityPartners

(examples)

AIDS task forceAmerican Red CrossBoys and Girls ClubCatholic ChurchMiddle SchoolsFree ClinicsHead StartHospice

Housing AuthorityPlanned ParenthoodSalvation ArmySenior CenterSheltered WorkshopYouth CenterWilderness on WheelsWIC Program

Project Focus(examples)

School-based healtheducationHealth promotion anddisease prevention

– teenage pregnancy– domestic violence– oral health

Worksite-based healtheducationCompanionshipCase managementMentoring and tutoringRural access to care

Findings:Students

Transformational learning experiences– clarification of values, sense of self

Taken more seriously when it’s requiredGreater gains when non-clinical:

– awareness of determinants of health– sensitivity to diversity– knowledge of health policy issues– leadership development

Findings: Faculty

Primary motivators: personal values, belief inimprovement of overall learning

Enhanced relationships - students, communityLinkage of personal/professional lives

understanding of community issuesNew career and scholarship directionsNew directions and confidence in teachingConcerns re: time, control of curriculum

Findings:Community

PartnersService, economic and social benefits

awareness of institutional assets/limitationsHigh value placed on relationship with facultyEager to be seen as teachers and experts

– campus involvement limitedBenefits of SL outweighed the burdensConcerns re: communication, logistics, needs-

based and expert approaches

Findings:Community-Campus

Partnerships

Stronger relationships associated with:– joint planning– partners offered specific and active roles– genuine sense of reciprocity– student preparation and orientation– single point of contact– consistent, accessible communication

Findings:Institutional

CapacityClear definition of service-learningLink to mission and strategic goalsSupportive leadership at all levelsEffective institutional structures and policyInvestment in faculty developmentIntegration of SL into existing coursesLong-term community relationshipsOngoing assessment and improvement

Lessons Learned

Service learning is powerful pedagogySL can contribute to competencies needed for

health professions practiceSL can benefit students, faculty, the community

and community-university relationshipsCommunity can be effective educatorsCommunity assets are often overlookedSL requires schools to give up “control”

Challenges

Clear vision, definitions, goals, resources, outcomesResistance to changeRigid and over-loaded curriculumDisciplinary boundariesLack of roles and rewards for innovationAccepting the implications of true partnershipsHistory of town/gown relationshipsCulture of needs-based and expert approaches

Recommendations

Review mission and strategic plan - how canservice-learning further both?

Review accreditation requirements - how canservice-learning enable you to meet them?

Review curriculum - where can SL enhance?Assess and build upon strengths and assetsCreate or enhance existing support structuresCollaborate across disciplines and the campus

Recommendations

Examine faculty roles and rewards policies -what constitutes scholarship?

Invest in faculty development

Engage your community partners in a dialogueDevelop and promote principle-centered

partnershipsPromise less…..deliver moreBecome a member of CCPH

Resourcesavailable through Community-Campus

Partnerships for Health

Training and technical assistance– National Conference: May 4-7, 2002 in Miami– SL Institutes: January 2002 and June 2002– Mentor Network: on-site training and assistance

Electronic and printed resources– Listserv and website– Reports on SL evaluation, outcomes, references– Monographs on SL in nursing and medical education

How to Reach Us

Tel. 415/476-7081Fax 415/476-4113Fax-on-demand: 1/888-267-9183Email: [email protected]: http://futurehealth.ucsf.edu/ccph.html

Sarena Seifer can be reached at 206/616-4305or [email protected]