Anyone with their ear to the medical education ground in the past year will know that service learning is a very, very hot topic. Ever since the Committee on Accreditation of Canadian Medical Schools (CACMS) endorsed service-learning as an important (but optional) element of the education of future physicians, medical schools across the country have sought to incorporate this as a feature of their curriculum. However, service-learning, by its very nature, can leave students feeling uncomfortable: it’s structured but open-ended.
Consulting with community members to set goals and design projects is not always as straight forward as mastering the objectives of a standard medical course. Unlike other curricular and co-curricular activities, service-learning projects often start with pretty broad objectives. Add in consultation with multiple community stakeholders and the projects themselves can seem quite nebulous at the start.
We’ve written about service-learning on the blog before (here and here) as we’ve continued to develop our approach to encouraging and supporting our students in engaging in service-learning. Service-learning projects are one way our medical students (and pre-medical students, in the case of QuARMS) enhance their understanding of working with community members, explore intrinsic physician roles, and contribute in a very real way to our medical school’s social accountability to our communities.
On a national level, the Canadian Alliance for Community Service Learning (CACSL) provides support and networking opportunities for students, educators and communities engaged in these endeavors. At their recent biennial conference held in Calgary, multiple presenters addressed students’ issues with the ambiguity of service-learning projects compared to other learning activities.
When students have the autonomy to define what is happening with a project in cooperation with an organization, they can feel a little lost, one presenter, Chelsea Willness, an assistant professor at the Edwards School of Business at University of Saskatchewan, noted.
“Students are very uncomfortable with the ambiguity: ‘What do you mean, I don’t know what I’m going to be doing?’”
They want templates and checklists because that’s familiar, she added.
It’s clear that while many students are excited about the opportunity to engage with community partners, they both need and want support. Equally important is providing them with reassurances that each project will have its own path – which includes some levels of uncertainty.
Here’s the Queen’s UGME operational definition of service-learning (as there are multiple interpretations of this term):
“Service-learning is a structured learning experience that combines community service with preparation and reflection. Medical students engaged in service-learning provide community service in response to community-identified concerns and learn about the context in which service is provided, the connection between their service and their academic coursework, and their roles as citizens and professionals.”
One key word in that definition is structured. Providing as much structure as possible can help ease students’ discomfort with some of the ambiguous nature of service-learning. To that end, the Teaching, Learning, and Integration Committee (TLIC) has been assigned oversight of service-learning for undergraduate medical students and has implemented three possible avenues students may use to have a service-learning project recorded on their MSPR.
To launch this, a one-hour session on service-learning was added to the first-year Professional Foundations course earlier this year. This learning event included information on why we’re deliberately supporting extra-curricular and co-curricular service-learning activities as well as information on potential service-learning avenues. As part of this session, members of the Class of 2019 were polled to see what types of service-learning projects they might be interested in and how these might fit in the three paths.
Here are the three paths to a recognized service learning project:
- Participate in an existing student-led volunteer initiative and complete the additional tasks necessary to extend this to a service-learning project
- Complete an individual service-learning project, which meets the requirements (including consultation and reflection)
- Take part in a service-learning pilot project brokered by the TLIC
Dr. Lindsay Davidson (Director of the TLIC) and I have met with representatives from several established student groups whose existing activities were quite close to our service-learning definition and threshold to map out ways their participants could extend their volunteer service into a service-learning project (this is always optional). Typically, this meant documenting some form of consultation and implementing some form of reflection on learning. These groups include SwimAbility (formerly Making Waves) and Jr. Medics. Other groups can be added to this list (email me: firstname.lastname@example.org to set up a meeting about this if your group might fit).
The two initial pilot projects are with Loving Spoonful (an organization with the goal of enhancing access to healthy food) and the Social Planning Council (with a focus on social housing in the Kingston area). These will be longer-term projects with sequential groups of students completing phases of a larger, continuing project. (The first participants have already been identified through the PF class poll. Recruitment of UGME students will be through the TLIC, not through the agencies).
For each of the three paths, students must submit evidence of meeting the threshold for each aspect, using forms provided by the TLIC. These will be made widely available in September using a MEdTech community page. Here are the requirements for any project to be recognized:
- The project must serve the needs of a group in the wider community (i.e., not medical school-focused)
- Complete some form of consultation with community participants and/or stakeholders (this will look different depending on the type of project and service)
- Complete between 15-20 hours of service (with no more than 20% devoted to training)
- Completed a required reflection on learning
In the future, as more students engage in formal service-learning projects, students’ reflections on their learning may be presented at a service-learning showcase, similar to the Undergraduate Research Showcase that is held each year.
While having three different routes to recognized projects may seem to add to the ambiguity of “what does a service-learning project look like”, providing multiple avenues for recognition was important.
“Our students have many different interests and we wanted to leverage that by providing multiple avenues for service-learning projects to be completed and recognized by the school,” Dr. Davidson said.
We’re never going to completely eliminate the ambiguous nature of service-learning projects, but we’re working to put structures in place that can meet a variety of students’ interests and community needs.
With thanks to Dr. Davidson for her contributions to writing this post.