Training the next generation of community-engaged physicians: a mixed-methods evaluation of a novel course for medical service learning in the COVID-19 era.

BACKGROUND: Medical school curricula strive to train community-engaged and culturally competent physicians, and many use service learning to instill these values in students. The current standards for medical service learning frameworks have opportunities for improvement, such as encouraging students to have more sustainable and reciprocal impact and to ingrain service learning as a value to carry throughout their careers rather than a one-time experience. PEDS 220: A COVID-19 Elective is a Stanford University course on the frontlines of this shift; it provides timely education on the COVID-19 pandemic, integrating community-oriented public health work to help mitigate its impact. METHODS: To analyze our medical service learning curriculum, we combined qualitative and quantitative methods to understand our students' experiences. Participants completed the Course Experience Questionnaire via Qualtrics, and were invited to complete an additional interview via Zoom. Interview transcripts were analyzed using an interactive, inductive, and team-based codebook development process, where recurring themes were identified across participant interviews. RESULTS: We demonstrate through self-determination theory that our novel curriculum gives students valuable leadership and project management experience, awards strong academic and community-based connections, and motivates them to pursue future community-engaged work. CONCLUSIONS: This educational framework, revolving around students, communities, and diversity, can be used beyond the COVID-19 pandemic at other educational institutions to teach students how to solve other emergent global health problems. Using proven strategies that empower future physicians to view interdisciplinary, community-engaged work as a core pillar of their responsibility to their patients and communities ensures long-term, sustainable positive impact. TRIAL REGISTRATION: N/A.

Active Learning and Community Engagement: Pedagogical Synergy through the "Mobile Neuroscience Lab" Project.

The Mobile Neuroscience Lab is a project that facilitates combined pedagogical strategies of active learning and neuroscience outreach as a service learning component of a physiological psychology course. The overall project goals were to improve science knowledge, foster oral communication, and encourage positive science attitudes and beliefs. Of these goals, positive science attitudes and beliefs were assessed. During active learning, university students completed hands-on activities corresponding to the physiological psychology course. Following, during the neuroscience outreach activity ("learning through teaching"), university students and middle school students engaged in small group activities (one university student to five middle school students) using the same hands-on activities. Assessment of the perceived benefit of the active learning showed that university and middle school students responded favorably to the hands-on activities. Students' science attitudes were also assessed (Hillman et al., 2016) using a pre-test, post-test design. Data showed that the neuroscience activity did not change middle school science attitudes and beliefs (p > .05), possibly as the science attitudes and beliefs were already positive (moderate to high) prior to the outreach activity. However, qualitative data showed that the aspect of the neuroscience outreach activity that most assisted the middle school students in their learning was seeing the brain, touching the brain, and social interaction with the university students. Overall, the pedagogical strategies of active learning, and "learning through teaching", were received with enthusiasm by university and secondary education students. Future studies will include classroom teachers' assessment of these hands-on activities.

Digital Literacy Training for Low-Income Older Adults Through Undergraduate Community-Engaged Learning: Single-Group Pretest-Posttest Study.

BACKGROUND: Digital technology is a social determinant of health that affects older people's ability to engage in health maintenance and disease prevention activities; connect with family and friends; and, more generally, age in place. Unfortunately, disparities in technology adoption and use exist among older adults compared with other age groups and are even greater among low-income older adults. OBJECTIVE: In this study, we described the development and implementation of a digital literacy training program designed with the dual goals of training low-income older adults in the community and teaching students about aging using a community-engaged learning (CEL) approach. METHODS: The training program was embedded within a 10-week CEL course that paired undergraduates (N=27) with low-income older adults (n=18) for 8 weeks of digital literacy training. Older adults and students met weekly at the local senior center for the training. Students also met in the classroom weekly to learn about aging and how to use design thinking to train their older adult trainees. Both older adults and students completed pre- and posttraining surveys. RESULTS: Older adults demonstrated increased digital literacy skills and confidence in the use of digital technology. Loneliness did not change from pre to postassessment measurements; however, older adults showed improvements in their attitudes toward their own aging and expressed enthusiasm for the training program. Although students' fear of older adults did not change, their comfort in working with older adults increased. Importantly, older adults and students expressed positive feelings about the trainee-trainer relationship that they formed during the training program. CONCLUSIONS: A CEL approach that brings together students and low-income older adults in the community has a strong potential to reduce the digital divide experienced by underserved older adults. Additional work is needed to explore the efficacy and scalability of this approach in terms of older adults' digital literacy as well as other potential benefits to both older and younger adults.

The Community Health Advocacy Initiative: A Longitudinal Experiential Curriculum in Community Engagement for Preclerkship Medical Students.

Introduction: Community partnership is a key strategy for addressing the social determinants of health and achieving health equity. There are few examples of curricula for undergraduate medical education that teach all, rather than self-selected, medical students to collaborate with community members to improve health. We describe the design and implementation of the Community Health Advocacy Initiative (CHAI) curriculum, a new yearlong educational program for medical students at Northwestern University's Feinberg School of Medicine. Methods: CHAI aimed to fill the curricular gap in social determinants of health education by providing medical students with the knowledge and skills to improve the health of patients through collaborations with community partners. This longitudinal curriculum included structured faculty mentorship and an applied community experience. Results: The CHAI curriculum was delivered to 164 second-year medical students in academic year 2021-2022. Faculty mentors rated most students as meeting expectations for application of community partnership principles and demonstration of professionalism. Qualitative analysis of faculty mentor comments demonstrated that medical students exhibited positive outcomes in engaging with community organizations, overcoming barriers, developing feasible and impactful goals, and advancing their own knowledge and skills. Discussion: Implementing a community health curriculum for all medical students is feasible and represents an important model for teaching about the importance of community partnerships in addressing the social determinants of health.

Exploring Factors That Influence Student Engagement in Community-Engaged Learning Activities Within a Pharmacy Context.

Objective. To investigate and identify factors that enhance and restrict Doctor of Pharmacy student engagement in mandatory and voluntary community-engaged learning activities.Methods. A phenomenological study exploring the motivations and barriers faced by pharmacy students in a mandatory community-engaged learning course and voluntary community-engaged learning activities (eg, community outreach) was conducted using semi-structured interviews. Fifteen students were randomly selected to participate in the interviews. Student responses were analyzed using qualitative thematic analysis.Results. Primary factors motivating student engagement in mandatory community-engaged learning included having structured learning activities for students and incorporating reflective learning. Motivating factors for students participating in voluntary community-engaged learning included personal interest in the topic, convenient location and time of activity, opportunity for career development, and the chance to advocate for the pharmacy profession. Overlapping motivations for both mandatory and voluntary community-engaged learning included developing a better understanding of and broader perspective on the diverse populations in the community and having a positive impact. Common barriers identified included having limited information about student responsibilities, being given a limited student role, and feeling unconfident or unprepared.Conclusion. Students perceived benefits from both mandatory and voluntary participation in community-engaged learning activities. However, opportunities exist for identifying and managing barriers to enhancing student engagement in community-engaged learning within a pharmacy program. Additionally, learning tools such as critical reflection can be used to further enhance student engagement with community-engaged learning activities.

An emergency medicine based model for community-engaged learning.

Community-engaged learning (CEL) integrates community service with structured learning to strengthen the knowledge and skills of future physicians while still in medical school. A national model forCEL during medical school does not currently exist. Emergency physicians have the opportunity to play a vital role in medical student education using CEL as a platform. This article elucidates the structure of a bystander cardiopulmonary resuscitation (B-CPR) CEL program developed by emergency physicians that could serve as a national model for community engagement. As B-CPR is a well-known evidence-based community intervention that can be taught by students and implemented by the community, it represents an ideal CEL that can also have a measurable impact on local B-CPR rates. The development and structure of a B-CPR CEL program, lessons learned, and impact on B-CPR in a local area are reported.

From the World to Western: A Community-Engaged Teaching Strategy to Enhance Students' Learning of Cultural Issues Relevant to Healthcare.

Using the transformational learning theory and action research method, this study captured the experiences of students from health-related disciplines in the cultural immersion program From the World to Western. A total of nine students participated in the pilot program with four host families from Culturally and Linguistically Diverse (CALD) backgrounds, and four cultural facilitators who connected the host families and students. The findings of this research showed that it was beneficial for students in health-related disciplines to engage in the cultural immersion program to further prepare them for culturally competent care in their future roles as healthcare professionals. In addition, the students indicated the need for the cultural immersion program to be part of the curriculum for future students to develop cultural skills, awareness and encounters with diverse populations.

Planting seeds of community-engaged pedagogy: Community health nursing practice in an intergenerational campus-community gardening program.

As part of a participatory action research (PAR) study, nursing student participants collaborated with faculty, along with older adults, people with mixed abilities, and preschool aged children in order to 'sow the seeds of social change' and grow a campus community gardening project. The focus of this article is on the community-engaged pedagogy within a community health nursing practice course that supported student learning. Insights were gleaned over the course of four academic semesters (and four student cohort groups) with students as co-developers of the campus-community garden and participants in the PAR. Key themes emerged from student participants in the PAR process including: (1) planning in community to "think global, act local"; (2) discovering 'the people in your neighbourhood' as socially just partnerships; (3) revisiting landscapes of social inclusion; and (4) reflecting on "humble togetherness" across generational gaps. The findings showcased here attest to how community-engaged pedagogy, in conjunction with PAR, can facilitate student learning outside of traditional settings and grow social inclusion, intergenerational connection, and social justice.

Is Community-engaged Learning Possible During a Pandemic: A Call for Culturally Competent Medical Education.

This article was migrated. The article was marked as recommended. Previously, medical school curriculum focused on faculty or physician-led basic science and traditional clinical experiences, with medical students only gaining experience of the community in which they practice during residency. In an effort to enable students to understand US healthcare disparities, the introduction of public health topics regarding marginalized communities and underrepresented individuals have been included in the classroom. However, missing from this shift is the inclusion of authentic public health educational experiences for medical students. These learning experiences are vital to truly understanding the marginalized and discriminated patient populations physicians will encounter. The recent COVID-19 pandemic has brought forth challenges for medical educators in numerous ways including how to effectively prepare students in understanding cultural competency through community-engaged learning for a new set of patient population; the pandemic patient. Due to health disparities, each patient experienced this pandemic differently based on their individual, cultural and community setting; also highlighting the importance of community-engaged learning. Here, the authors posit the role and importance of community-engaged learning in medical education and its utilization during the changing medical landscape due to COVID-19.

Service-learning Curriculum Design and Implementation at the University of Toronto Faculty of Medicine.

This article was migrated. The article was marked as recommended. Community service-learning is an integral component of the undergraduate medical experience, as it provides students with the opportunity to respond to and address societal issues. Students at the University of Toronto, Faculty of Medicine have traditionally participated in a service-learning curriculum that required them to choose placement opportunities from a centrally- developed catalogue of options, with no continuity between the university and the community from year to year. The mandatory service-learning placement was re-designed under the advisement of long-standing community partners, community-engaged physicians, and academics. The new model centralizes the relationship between faculty tutors and community partners, who act as co-educators for the medical students, with tutors serving as the primary link to community organizations. The University of Toronto's Faculty of Medicine is the first Canadian medical institution to implement this innovative curricular model.

Benefits and challenges of a nursing service-learning partnership with a community of internally-displaced persons in Colombia.

Service-learning partnerships between nursing programs and health care settings in vulnerable communities may be challenging to initiate, but can offer multiple benefits for students, faculty, and the community served. The aim of this qualitative descriptive study was to explore the benefits and challenges of establishing a service-learning partnership between a university nursing program and an isolated community of internally-displaced persons in Medellin, Colombia. Semi-structured, in-depth interviews were conducted with 10 nursing professors and nine students who participated in the service-learning partnership. Interviews were audio-recorded, transcribed and analyzed using qualitative content analysis. Main benefits identified were: learning about the social determinants of health, development of compassion, appreciation for the community nursing role, professional growth and development, community engagement and increased access to care for community members. Challenges related to the service-learning experience included feelings of moral distress, lack of value for community nursing, and conflict with traditional biomedical approaches to care. Several threats to program sustainability were also identified. Professors and students offered several recommendations for program improvement, including interdisciplinary collaboration, documentation and dissemination of the service-learning experience, increased community autonomy and capacity for self-care, and curricular changes to enhance recognition of the importance of community nursing.

A Convergent Mixed-Methods Exploration of the Effects of Community-Engaged Coursework on Graduate Student Learning.

OBJECTIVE: To examine the impact of a community-engaged assignment on graduate student learning in the nutritional sciences. DESIGN: Convergent mixed-methods design with parallel data collection and terminal merging of data. Data were composed of grant proposals, reflection papers, and informal course evaluations from 2 semesters of the same course. Fall students wrote proposals on behalf of a community partner whereas spring students wrote fictitious grants to improve nutrition on their campus. SETTING: A large public university in northeastern US. PARTICIPANTS: Students enrolled in the fall (n = 19) or spring (n = 14) semester of the same graduate nutrition course. PHENOMENON OF INTEREST: Grant quality, student engagement, and collaboration with peers. ANALYSIS: Quantitative rubric-based rating of grant proposals, emergent and thematic qualitative coding of open-ended responses, and independent-samples t test of Likert-scale questions. Data were compared between semesters and reported in a contiguous narrative approach. RESULTS: Students across semesters experienced academic and personal gains from the assignment. Comparatively, fall students expressed enhanced engagement, improved group dynamics, more frequent application of the assignment to their lives, and a better aggregate grant score. CONCLUSIONS AND IMPLICATIONS: Both experiential and community-engaged coursework can enhance learning outcomes at the graduate level and prepare students for careers in nutrition.