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

Abstract

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.

Application of project-based service-learning courses in medical education: trials of curriculum designs during the pandemic

“…Our students reported that their interpersonal communication skills, ability to learn and grow from work, and professionalism improved significantly as a result of their participation in the course. In contrast to previous research indicating that service-learning activities contribute to enhancing medical ethics and core competencies among healthcare professionals [ 2 , 3 ], the present study found that students did not perceive significant improvement in their medical knowledge, system-based practice, and patient care. The absence of reported improvements in the aforementioned aspects is related to the characteristics of our students.…”

“…Service learning provides medical students with opportunities for early clinical exposure [ 1 ] and improves the professional competence of medical personnel [ 2 , 3 ]. During service learning, service providers gain experience and learn as they provide services that address community needs [ 4 – 6 ]; that is, students learn while they serve.…”

“…Service learning can not only help solve community problems but also aid students in building their medical knowledge, skills, and attitudes [ 8 ], thereby creating a win–win situation for both the community and the student. Service learning has also been reported to improve the medical ethics and competence of medical interns [ 3 ] and the eight core competencies of nurses [ 2 ].…”

“…To overcome this obstacle and still provide students with valuable related experience, medical educators, such as those in Taiwan and Hong Kong, have used non-face-to-face service-learning activities, such as online services and phone calls focused on health education [ 14 , 15 ]. Although researchers claimed that non-face-to-face service-learning courses have the same learning effectiveness as face-to-face service-learning courses [ 2 , 3 , 15 ], medical students at China Medical University in Taiwan have emphasized their desire for face-to-face service-learning activities in their classrooms to receive feedback and opinions. They contended that non-face-to-face service-learning activities lack direct interaction with individuals, resulting in a deficiency of immediate feedback and opinion from service recipients, which in turn leads to a lack of students’ motivation in service-learning courses.…”

A hybrid educational approach to service learning: impact on student attitudes and readiness in working with medically underserved communities

“…Despite very limited in-person opportunities to connect with community members in the hybrid format, student qualitative feedback highlighted an increased eagerness and preparedness in working with MUC. As transportation and limited time are commonly reported student and community partner barriers to community engagement [ 24 , 25 ], the adoption of hybrid experiential and service learning curricula in the post-pandemic setting has the potential to maximize these learning opportunities for medical students. The use of virtual platforms places less burden on community organizations to provide adequate space and resources for student volunteers, while also expanding the geographic scope of organizations available to partner with medical schools.…”