"Enter to learn, go forth to serve": service learning in nursing education

Veterinary and Pharmacy Students' Expectations Before and Experiences After Participating in an Interdisciplinary Access to Care Veterinary Clinic, WisCARES

This pilot survey study describes student expectations and experiences at WisCARES, a low-cost veterinary medical teaching clinic where students from multiple disciplines collaborate. We hypothesized that prior to the workday, students would describe different expectations of working in an interdisciplinary access to care clinic than what they ultimately experienced. We surveyed 62 students from the School of Veterinary Medicine (46) and pharmacy (16) who spent a clinic day at WisCARES. Before introductory rounds, students completed a short survey consisting of four open-ended questions about their learning expectations; at the end of the day, they reviewed their initial responses and added what they actually learned. Qualitative information was categorized and analyzed using descriptive statistics. Thirteen major themes emerged: diversity, confidence, communication, case lead/case management, financial experience, helping people, teamwork, technical skills, inter-professional experience, mentoring, non-specific positive regard, appreciation for resources, and rounds. Students reported improved confidence in managing and leading cases with specific positive outcomes in communicating with clients, particularly regarding leading financial conversations. Developing greater insight into diversity was a common theme expressed in students' expectations but was less frequently noted as an end-of-day outcome. Veterinary students less frequently described the value of the inter-professional environment and collaboration, but this was a major theme noted among pharmacy students. Student feedback was positive overall. The current study is useful in identifying areas for improving collaborative instruction and access to care professional student learning opportunities.

Using Critical Service-Learning Pedagogy to Prepare Graduate Nurses to Promote Health Equity

BACKGROUND

Despite calls from professional organizations to prepare a nursing workforce with the requisite skills to address social determinants of health (SDOH), there is little guidance for nurse educators about how to actively promote student learning of these complex issues.

METHOD

We applied a critical service-learning (CSL) pedagogy to enhance graduate public health nursing curriculum and support learner skill building in approaches to combat health disparities by addressing the underlying social conditions.

RESULTS

Course content and critical reflection activities were built incrementally across four courses and semesters to introduce and apply antioppressive frameworks, encourage students to examine their personal identities of privilege and oppression, and examine historical context and systems of power in public health settings.

CONCLUSION

CSL supports student development of structural competence and their understanding of approaches that can dismantle inequitable systems by addressing SDOH that contribute to health disparities. [J Nurs Educ. 2021;60(1):38-43.].

Conceptualisation of knowledge construction in community service-learning programmes in nursing education

BACKGROUND

Practices in higher education have been criticised for not developing and preparing students for the expertise required in real environments. Literature reports that educational programmes tend to favour knowledge conformation rather than knowledge construction; however, community service learning (CSL) is a powerful pedagogical strategy that encourages students to make meaningful connections between the content in the classroom and real-life experiences as manifested by the communities. Through CSL, learning is achieved by the active construction of knowledge supported by multiple perspectives within meaningful real contexts, and the social interactions amongst students are seen to play a critical role in the processes of learning and cognition. This article reflects facilitators’ perspective of the knowledge construction process as used with students doing community service learning in basic nursing programmes.

OBJECTIVES

The aim of this article was to conceptualise the phenomenon of knowledge construction and thereby provide educators with a shared meaning and common understanding, and to analyse the interaction strategies utilised by nurse educators in the process of knowledge construction in community service-learning programmes in basic nursing education.

METHOD

A qualitative research approach based on a grounded theory research design was used in this article. Two nursing education institutions were purposively selected. Structured interviews were conducted with 16 participants.

RESULTS

The results revealed that the knowledge construction in community service-learning programmes is conceptualised as having specific determinants, including the use of authentic health-related problems, academic coaching through scaffolding, academic discourse-dialogue, interactive learning in communities of learners, active learning, continuous reflection as well as collaborative and inquiry-based learning. Upon completion of an experience, students create and test generated knowledge in different contextual health settings.

CONCLUSION

It was concluded that knowledge is constructed by students as a result of their interaction with the communities in their socio-cultural context and is mediated by their prior concrete experiences. The implication of this is that students construct knowledge that can be applied in their future work places.

Service-Learning in Undergraduate Nursing Education: Where is the Reflection?

Service-Learning is recognized as a valuable pedagogy that involves experiential learning, reflection, and reciprocal learning. Reflection is a critical component because it assists students to develop critical thinking and social awareness as they reflect upon their experiential learning with community partners. Although there is a proliferation of literature about service-learning, upon closer examination, it is apparent that some authors do not place emphasis on reflection when reporting on service-learning projects. This begs the question, "Where is the reflection?" The purpose of this article is to provide an overview and describe misrepresentations and exemplars of service-learning. After providing an overview of service-learning, examples of how service-learning is misrepresented in the literature are discussed. Exemplars of service-learning are also cited. Calling attention to how service-learning is reported in the literature will increase awareness about the need to critically evaluate articles for evidence of reflection.

Let's go to camp! An innovative pediatric practice placement

Each year, children living with disabilities escape from their families for 1 week at camp armed with their sun block, sleeping bags and talent-show costumes. In British Columbia, Canada, Easter Seals Camps offer such adventures to over 800 children/teens with physical/mental disabilities, providing free, overnight camping with on-site nurses. Easter Seals Camps offer pediatric placements to nursing students to work with nurses in a multidisciplinary team. In this paper, we describe this partnership, explain the role of camp nurse, portray student learning opportunities and offer recommendations to pediatric nurses who may consider participating in similar innovative placements in pediatric camps.

Undergraduate nursing students' perceptions of service-learning through a school-based community project

Service-learning (SL) is an experiential teaching method that combines instruction with community service, with the aim of enriching students' academic learning, interpersonal skills and sense of responsibility while making meaningful contributions to the community. However, measuring outcomes of service-learning projects is difficult. This article reports on the perceptions of 18 third-year undergraduate nursing students who took part in a pilot service-learning project targeting tobacco use in a local elementary school. Faculty members evaluated the program's outcomes by engaging students in structured reflection on the program about its relevance to their future careers as practicing professionals, especially in community-based settings. The students' perceptions were elicited through three sets of reflective assignments following the project. Findings from the reflective assignments suggest that the pilot program was successful in enhancing the students' academic, social, and personal development while building a partnership between the school of nursing and key players in the community, including school-based nurses, teachers, administrators, families, and community leaders. The author suggests that service-learning projects can help nursing students accomplish key developmental tasks of the college years (such as building their competence, autonomy, and integrity), while helping impart the skills and values they will need as they graduate and seek professional nursing roles.

The Motivation to Serve Others: Exploring Relations to Career Development

The current study explored the relation between service motivation, or the desire to serve others through one’s future career, and vocational outcomes across two studies. In the first study, using a sample of 225 undergraduate students, an instrument was developed to measure service motivation that demonstrated convergent and discriminant validity, strong internal consistency reliability, and strong test—retest reliability. In the second study, with a sample of 265 undergraduate students, service motivation was found to correlate positively with career decision self-efficacy, career adaptability, and career optimism and to correlate negatively with career indecision. Post hoc analyses found career optimism to fully mediate the relationship between service motivation and career indecision. These findings suggest that students who feel a stronger desire to use their future career to serve others will be more optimistic regarding their career future. Implications for research and practice are considered.

Integration of nursing education, practice, and research through community partnerships: a case study

Models demonstrating an evidence-based approach to the integration of nursing education, research, and practice are needed to ensure excellence in the nursing profession. Using a theoretical framework of community-engaged scholarship, this article describes a program developed by the Medical University of South Carolina's College of Nursing linking advanced practice, service learning, and applied clinical research for nurse-midwifery faculty and students, while meeting the perinatal healthcare needs of a group of underserved women. Principles of community-based partnerships and integration of scholarship and research in a clinical discipline provide a pragmatic structure to describe and facilitate replication of the program.

Opening our hearts and minds: The meaning of international clinical nursing electives in the personal and professional lives of nurses

Although international opportunities are the hallmark of nursing education at a large private university, the meaning of participating in such clinical nursing electives has not been described. The purpose of this phenomenological study of nurses was to examine the personal and professional meaning of participating in international clinical nursing electives during their undergraduate nursing studies. Audiotaped interviews were conducted with 20 former nursing students who had had this opportunity. "Opening our hearts and minds" was described by the study's participants, with the following themes: increasing understanding of other cultures and peoples, increasing understanding of global sociopolitical and health issues, increasing the commitment to make a difference, experiencing personal and professional growth, contributing to professional development in the host country, making interpersonal connexions, and developing cultural competence. This study makes an important contribution to the documentation of the meaning of participating in international nursing clinical experiences. Data are being used for long-term curricular planning in the development and refinement of future international clinical nursing electives and to provide outcomes data for professional accreditation. There are broader implications for the movement beyond individual cultural competence to increasing global consciousness and the improvement of global health care.

How a Nursing Program Strengthens Community Ties by Providing Health Teaching to Head Start Participants

The University of South Dakota (USD) Department of Nursing and the Sioux Falls, South Dakota, Head Start program have a working relationship that provides educational opportunities for students from USD and Head Start. Head Start provides learning opportunities for a diverse population in South Dakota. This article provides an overview of Head Start. The majority of the article describes the teaching project process and evaluates the benefits of this opportunity as reported by the community and nursing students. The need for graduate nurses well versed in patient education and in providing patient education at the patient’s level of understanding is well documented. This community health clinical opportunity enhances this important skill of nurses.

Students and Senior Citizens Learning from Each Other

A service learning experience in a senior citizen center was planned for first-quarter associate-degree nursing students at a university. Activities were planned that would benefit both student learning and senior citizen health and well-being. Students had the opportunity to interact with well elderly adults before dealing with ill or frail elderly adults, thus preventing the formation of some negative attitudes about elderly individuals. Students practiced interviewing, using observational skills and taking blood pressures in a relaxed environment. Benefits to the senior citizens included having their blood pressure checked and learning about home safety and nutrition. Interactions made the senior citizens feel valued. Evaluation of the experience was positive from the students', senior citizens', faculty's, and center director's perspective. As a result, this service learning experience has been incorporated into the nursing curriculum for the university.

Baccalaureate Nursing Students’ Attitudes Toward Poverty: Implications for Nursing Curricula

Given the link between poverty and health, nurses, in their work in hospitals and in the community, often come into contact with people who are poor. To be effective care providers, nurses must have an adequate understanding of poverty and a positive attitude toward people who are poor. This study examined attitudes toward poverty among baccalaureate nursing students (N = 740) at three Canadian universities. Students' attitudes were neutral to slightly positive. Personal experiences appeared to have an important influence on the development of favorable attitudes. The findings point to several considerations for nursing curricula. Students should not only be provided with classroom opportunities for critical exploration of poverty and its negative effects on individuals and society, but also have clinical learning experiences that bring them face-to-face with people who are poor, their health concerns, and the realities of their circumstances. Thoughtful critique of poverty-related issues and interpersonal contact may be effective strategies to foster attitude change.

Using Polvika's model to create a service-learning partnership

Collaboration can maximize limited resources of universities, school systems, and public health departments by offering learning from experience. Polvika's theoretical model and principles from Community-Campus Partnerships for Health guided development of a service-learning partnership among a university, a county health department, and an alternative school in a large public school district. Of three commonly identified patterns of service-learning, this partnership demonstrated the pattern that equally emphasizes service to a community or agency, and mutual learning by all participants. All organizations in the partnership share a common goal to optimize the health of children in schools, and to provide quality learning for professional students. The partnership is in its fourth year. Formal interagency agreements now exist among all partners. Individuals continue to demonstrate flexibility and mutual awareness of strengths and limitations of respective organizations. Public school students receive more services, many high-risk children achieve better learning outcomes, school nurses offer expanded services in many schools with the help of nursing students, and undergraduate and graduate nursing students gain meaningful learning experiences. Some nursing students state that school nursing has become a career goal. The partnership continues to evolve to meet changing needs of the partners. Members remain satisfied with the collaboration.

Experiential learning as service for others

Experiential learning provides an avenue for educating oneself, others, and communities and can lead to involvement in efforts designed to change social systems and improve conditions that affect a nation as a whole. This article provides an overview of experiential learning related to service and presents an example of one nurse's efforts to contribute to her community through the MERCI: Medical Equipment Recovery of Clean Inventory program at the University of Virginia Health System, Charlottesville.

Effect of service-learning on knowledge about older people and faculty teaching evaluations in a physical therapy class

The major purpose of this study was to identify the knowledge, misconceptions, and bias regarding aging among graduate physical therapy students and to determine whether service-learning modified any of these variables. A cohort of 40 students in a graduate physical therapy program was randomly divided into an experimental (service-learning) or control (no service-learning) group. General knowledge and attitudes about aging were measured by Palmore's Facts on Aging Quiz I. The Wilson Student Evaluation of Faculty tool measured student evaluations of a faculty member at the end of the semester. Two-way analyses of variance with repeated measures revealed that all students increased their knowledge about aging, p < .05. However, students who initially had negative attitudes toward older adults significantly improved their attitudes only after the service-learning experience, p < .05. A t-test revealed that teaching evaluation scores were significantly lower in the service-learning course, p < .05. The results suggest that service-learning effectively enhanced both the knowledge and attitudes of physical therapy students toward the older adult. Although service-learning imparted better learning for the student, there was some risk to the faculty member as evidenced by lower teaching evaluations.

Using journals for community health students engaged in group work

Teaching students concepts integral to community health nursing, such as collaboration and partnership, while providing clinical practica in community agencies, mandates that students address group process and evaluate self-growth. To facilitate reflection on self-learning in the context of collaborative group work, faculty and students use a structured, graded, weekly journal. This teaching and learning tool serves as a mechanism for assisting students with understanding group process.

Making connections: linking generalist and specialist essentials in baccalaureate community/public health nursing education and practice

Nurse educators and potential employers of baccalaureate nursing graduates are challenged by the constant change in health care today. This change mandates competencies for professional nursing practice that preserves the relevant and useful skills and knowledge of the past, yet incorporates skills and knowledge for practice today and in the future. As in previous eras of health system change, identifying essential knowledge and competencies for baccalaureate graduates must begin by collaboration between nursing education and nursing service. This article reports the work of a task force of nurse educators whose charge was to revise "The Essentials of Baccalaureate Nursing Education for Entry Level Community/Public Health Nursing". An overview of their experience is presented with the aim of contributing to current best thinking between one nursing specialty organization and the American Association of Colleges of Nursing.

Integrating principles of community-centered practice in a community health nursing practicum

Using a service learning approach, registered nurse baccalaureate students apply the concepts of community- and population-centered practice through participation in a 10-week clinical practicum. Through this project, students experience community health theories in action, understand the sociopolitical processes that shape health, and think more broadly about clients within their particular clinical practice, and populations beyond those settings.

Partnering with a sister city organization for an international service-learning experience

A partnership was established between Indiana University School of Nursing in Indianapolis and the Bloomington, Indiana-Posoltega, Nicaragua Sister City International organization to provide an international service-learning course in nursing. The course evolved over 4 years from an independent study for a single student to an elective course taken by 10 students. Student-learning activities included the following: developing relationships with community residents, providing prenatal classes, supporting nursing scholarships, and participating as interdisciplinary, multicultural team members. Partnering with our local Sister City International organization provided a rich opportunity for nursing students to learn about and participate with Nicaraguan and international health care workers in meeting population health needs in stable and refugee environments.

Advancing health policy in nursing education through service learning

Knowledge of health policy is an increasingly important aspect of nursing practice and education, especially as nurses strive to improve the rapidly changing health care delivery system. At the same time, many educators, researchers, foundations, and government officials are touting the benefits of service learning. In particular, service learning offers ways to enhance partnerships between academia and community agencies and to extend learning beyond the traditional classroom. We present a model for educating nurses as advanced practice nurses in health policy that links service learning with a framework for the political development of nurses. Under the rubric of service learning, the curriculum is based on the overlap among health policy, the role of the nurse as consultant, and community-based care. After discussing the importance of health policy for graduate nursing education and reviewing the essentials of service learning, we describe a three-semester graduate sequence in health policy service learning. The focus is on the clinical and classroom components of both individual and group practica and their relationship to stages of nursing's political development. The article concludes with evaluation considerations and the implications of our work for nursing theory, research, practice, and education.

Culturally competent care of women and newborns: knowledge, attitude, and skills

In a variety of health care settings throughout the United States and Canada, nurses are caring for women and newborns from culturally diverse backgrounds. In the technologically complex and bureaucratic world of health care delivery, cultural considerations in provision of care often are overlooked and neglected. The purpose of this article is to define ways in which culturally competent nursing care can be implemented. Nursing education and clinical practice guidelines are clear on the importance of gaining cultural competence. Providing culturally competent care includes understanding the dimensions of culture; moving beyond the biophysical to a more holistic approach; and seeking to increase knowledge, change attitudes, and hone clinical skills. Building on the strengths of women rather than utilizing a deficit model of health care is an essential part of providing culturally competent care. The achievement of both measurable and "soft" outcomes related to the delivery of culturally competent care can make a critical difference in the heath and well-being of women and newborns.