service-learning in health professions education
TRANSCRIPT
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]