Longitudinal Service Learning in Medical Education: An Ethical Analysis of the Five-Year Alternative Curriculum at Stritch School of Medicine

Borah, Brian

doi:10.1007/s10912-018-9529-x

Cited by 5 publications

(16 citation statements)

References 30 publications

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“…SL has been argued to transform student perspectives on humanism in medicine, including the perspectives of students who respect and empathise with the struggles and strengths of their patients and peers [38]. For example, the Loyola University Chicago Stritch School of Medicine proposed a 5year Global Health Fieldwork Fellowship track that was grounded in clinical and service learning, doing so to foster the development of prosocial values, such as professionalism, advocacy, and social justice in their medical students [39]. SL programmes involving work with the homeless have also enhanced the professional and personal education of medical students by improving their understanding of biopsychosocial problems and by developing their empathy, compassion, and social awareness [40,41].…”

Section: Introductionmentioning

confidence: 99%

Medical students’ preclinical service-learning experience and its effects on empathy in clinical training

et al. 2021

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Background Service learning (SL) is an educational methodology presumed to help medical students be more empathetic and compassionate. We longitudinally investigated the level of empathy in medical students and how preclinical SL experience was related to their level of empathy in their clinical clerkships. Methods Our cohort comprised fifth-year medical students engaged in clerkships as part of a 7-year medical programme at one medical school in Taiwan. Surveys were conducted at the beginning of the clerkship in September 2015 (T1) to collect data on the medical students’ preclinical SL experience in curriculum-based service teams (CBSTs) and extracurricular service teams (ECSTs) and their SL self-efficacy, demographic characteristics, and empathy level. Subsequently, three follow-up surveys were conducted once every 3 months to determine the empathy level of the students during their clinical clerkships (T2–T4). Seventy students who returned the written informed consent and completed the baseline (T1) and two or more follow-up surveys (T2–T4) were included in our analysis with the response rate of 34%. In total, 247 responses across the 1-year clerkship were analysed. Descriptive statistics, paired t tests, and generalised estimating equations were employed. Results Our study revealed that changes in empathy level in the dimensions of perspective taking, compassionate care, and standing in patients’ shoes in their clinical clerkships. Relative to that at T1, their empathy decreased in perspective taking and compassionate care at T2–T4 but increased in standing in patients’ shoes at T3. Additionally, our study verified the positive effect of medical students’ preclinical SL experience in CBSTs and ECSTs on empathy in terms of compassionate care and perspective taking, respectively, but not on that of standing in patients’ shoes. Conclusions Separate investigations into subconstructs of empathy, such as perspective taking, compassionate care, and standing in patients’ shoes, in medical students may be necessary for exploring the various driving forces or barriers to developing empathy in medical students. Moreover, SL experience through both CBSTs and ECSTs at medical academies may have positive effects on medical students’ empathy in their clinical clerkships and should be promoted at medical schools.

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Section: Introductionmentioning

confidence: 99%

Medical students’ preclinical service-learning experience and its effects on empathy in clinical training

et al. 2021

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“…In addition to nancial resources, some papers recognised the use of other resources. Several papers identi ed that elective students use the supervising clinician's time [2,11,26],…”

Section: Use Of Limited Local Resourcesmentioning

confidence: 99%

“…The second theme which emerged was "negative impact on patient care". When looking at the papers addressing limited local resources, it was found that 6 of them mentioned that visiting students may have a detrimental effect on patient care [2,[9][10][11]25,26]. In a series of interviews with supervisors of elective students in 22 countries, Bozinoff and colleagues found that "host supervisors identi ed potential harms to patient care that might arise in the presence of visiting medical students, including harms associated with differing standards of care, longer wait times, lack of cultural competency, and language barriers between students, patients and staff" [2].…”

Section: Inductive Themes Emerging From the Papers: Negative Impacts ...mentioning

confidence: 99%

A Scoping Review of the Ethical Impacts of International Medical Electives on Local Students and Patient Care

Chmura

Nagraj

2023

Preprint

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Background: International electives are often considered a valuable learning opportunity for medical students. Yet, as travelling to lower and middle income countries (LMICs) becomes more common following the global pandemic in 2020, ethical considerations of such practices re-emerge. We conducted a scoping review to assess the extent to which five ethical themes were addressed in existing literature about electives, with the aim of investigating the ethical impacts of medical student electives on local resources, patients and clinicians in LMICs. Methods: We systematically searched PubMed, Global Health and Embase databases using the search terms “(ethics) AND (medical electives)”. Thematic content analysis was undertaken using a combination of deductive and inductive themes. The deductive themes included: exceeding clinical competence, use of limited local resources, respect for patients and local culture, collaboration with local community/colleagues, and one-sided benefits in partnership. In addition, we also allowed for emerging themes within the data, and conducted a narrative synthesis of the results. Results: A total of 37 papers discussed ethical issues relating to medical student international electives to LMICs. Most publications were written from the medical student perspective (n=14), rather than by the host-institution (n=5), with several written from third-party perspectives (n=18). Negative impacts on local host students and impact upon patient care, were identified as additional ethical considerations. Conclusions: Our review demonstrated that there is limited awareness in the existing literature of the potential negative impacts of medical electives to local LMIC students’ access to medical education, and patient care. We recommend that these ethical themes should be further explored in pre-departure elective teaching courses, and post-elective debriefs to increase medical students’ awareness of the impact of their presence on host communities.

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“…Given the numerous benefits to integrative service learning cited in previous literature, we hope to expand experiential integrative service learning opportunities for medical students at other local organizations related to food security, such as additional urban farms or food banks. [9][10][11][12][13] After scaling up a pilot program that includes more participants than the current study, our hope is that all medical students at our institution will have opportunities and strong encouragement to participate in service learning related to food insecurity.…”

Section: Rea Almentioning

confidence: 99%

“…10,11 Integrative service learning programs at US medical schools have demonstrated success in teaching medical students professionalism, social justice, advocacy skills, and patient communication strategies. 12,13 It is also recommended that medical education integrates experiential service learning to improve understanding of social determinants of health, including food insecurity, to improve clinical skills and improve population health. 14 The Liaison Committee on Medical Education (LCME) standards require that medical education provides opportunities for service learning activities, yet many schools do not provide structured activities or enforce participation.…”

Section: Introductionmentioning

confidence: 99%

Improving Food Insecurity Education in Medical School Through Integrative Service Learning

Rea

Jarodiya

Berschback

et al. 2022

Journal of Medical Education and Curricular Development

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Introduction The COVID-19 pandemic has left more than 38% of households food insecure in the United States. Improved education of food security topics in medical school can improve screening for food insecurity and improve health outcomes. The first aim of this study was to address if participation in an experiential integrative service learning program improved medical students’ understanding of food insecurity. The second aim was to compare knowledge of food insecurity between the general body of medical students and those who participated in the service learning program. Methods This was a cohort study at a large medical school in southeast Michigan in 2019–2020. We administered the Food Insecurity for Health Professionals (FISHP) survey to medical student participants; higher scores on the FISHP survey suggest higher knowledge and comfort with food security topics. We administered online Qualtrics surveys to the volunteer group before and after volunteering 12 hours at an urban farm. We also administered a one-time survey to a control group of medical students. We performed univariable and bivariable statistical analyses with StataSE 16. The study was exempted by the institutional IRB. Results Medical students in the volunteer group (n = 18) and the control group (n = 66) completed online surveys. Participants in the volunteer group had increased knowledge of food security after volunteering in the service learning program (p = .03). There was a statistically significant difference between the mean FISHP scores for the control group and the volunteer group (p = .001). Conclusion Medical student participation in an experiential integrative service learning program improved knowledge of food security topics and increased comfort discussing food insecurity with patients, compared to students who did not participate. Experiential integrative service learning may improve holistic patient care through physician recognition of food insecurity and other social determinants of health.

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Longitudinal Service Learning in Medical Education: An Ethical Analysis of the Five-Year Alternative Curriculum at Stritch School of Medicine

Cited by 5 publications

References 30 publications

Medical students’ preclinical service-learning experience and its effects on empathy in clinical training

Medical students’ preclinical service-learning experience and its effects on empathy in clinical training

A Scoping Review of the Ethical Impacts of International Medical Electives on Local Students and Patient Care

Improving Food Insecurity Education in Medical School Through Integrative Service Learning

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