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Service Learning:Meaningful, Community-Centered
Professional Skill Developmentfor Occupational Therapy Students
Anne Marie Witchger Hansen, MS, OTR/LJaime Muñoz, PhD, OTR/L, FAOTA
Patricia A. Crist, PhD, OTR/L, FAOTAJyothi Gupta, PhD, OT(C), OTR/L
Roger I. Ideishi, JD, OTR/LLoree A. Primeau, PhD, OTR
Debra Tupé, MPH, MS, OTR/L
ABSTRACT. The profession of Occupational Therapy advocates fornew and emerging areas of practice that more fully embrace our moral re-
Anne Marie Witchger Hansen is Instructor, Duquesne University, Department ofOccupational Therapy, Pittsburgh, PA.
Jaime Muñoz and Patricia A. Crist are affiliated with Department of OccupationalTherapy, Duquesne University, Pittsburgh PA.
Jyothi Gupta is affiliated with Department of Physical Therapy, College of SaintCatherine, Minneapolis, MN.
Roger I. Ideishi is affiliated with Department of Occupational Therapy, Universityof the Sciences in Philadelphia, Philadelphia, PA.
Loree A. Primeau is affiliated with Department of Occupational Therapy, Univer-sity of Texas Medical Branch, Galveston, TX.
Debra Tupé is affiliated with Programs in Occupational Therapy, Columbia Uni-versity, New York, NY.
Address correspondence to: Anne Marie Witchger Hansen, Duquesne University,Department of Occupational Therapy, 225 Health Science Building, Pittsburgh, PA15282 (E-mail: [email protected]).
Occupational Therapy in Health Care, Vol. 21(1/2) 2007Available online at http://othc.haworthpress.com
© 2007 by The Haworth Press, Inc. All rights reserved.doi:10.1300/J003v21n01_03 25
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sponsibility to address significant social injustices that exist in our com-munities (Kronenberg, Algado, & Pollard, 2005). The service-learningpedagogy is impacted by the philosophical and theoretical influencesof John Dewey, the mission and purpose of American higher educa-tion including Boyer’s (1994) call for an engaged citizenry, and the socialvision of occupational therapy. The pedagogy of service learning providesa natural context for students to experience community practice whilecontributing to reducing existing social injustices. This paper provides anoverview of service learning (SL) as a philosophical and pedagogical ap-proach in occupational therapy education, key processes in developingsuccessful service learning experiences and community partnerships tosupport service learning. Characteristics of effective service learning, as-sessment of community and institutional outcomes of service learning andthe scholarship of service learning are also discussed. Most importantly,strategies for developing service learning scholarship, an important butfrequently neglected requisite to validate any educational practice, are de-lineated. The authors conclude that service learning provides educatorswith an opportunity to provide students with experiences in natural, com-munity contexts while developing life-long commitment to civic engage-ment and social responsibility. doi:10.1300/J003v21n01_03 [Article copiesavailable for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: <[email protected]> Website:<http:/www.HaworthPress.com> 2007 by The Haworth Press, Inc. All rightsreserved.]
KEYWORDS. Educational pedagogy, service learning, civic engagement
INTRODUCTION
Many within the profession advocate for occupational therapiststo consider areas of practice that embrace more fully our moral re-sponsibility to address social injustices that exist in our communities(Kronenberg, Algado, & Pollard, 2005). A natural synergy exists throughservice learning between the need for students to experience practice innatural contexts and the call to contribute to reducing existing social in-justices. The purpose of this paper is to provide an overview of servicelearning (SL) as a philosophical and pedagogical approach in occupa-tional therapy education. Key to developing successful service-learningexperiences are elucidated based on the combined expertise of fiveacademic programs in occupational therapy that have successfully
26 OCCUPATIONAL THERAPY IN HEALTH CARE
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integrated service learning into their respective curricula. The paperdescribes characteristics of effective service learning, the design ofservice-learning experiences, the development of community-universitypartnerships, and the assessment of learning outcomes. Most importantly,strategies for developing service learning scholarship, an important butfrequently neglected requisite to validate any educational practice, aredelineated.
THE CONTEXT FOR SERVICE LEARNING
In July 1999, Thomas Ehrlich, senior scholar at the Carnegie Founda-tion for the Advancement of Teaching and Elizabeth Hollander, ex-ecutive director of Campus Compact and other distinguished educators,drafted the Presidents’ Declaration on the Civic Responsibility of HigherEducation (Ehrlich & Hollander, 1999). This document, signed by over400 college and university presidents, challenged Higher Education tobecome engaged with its communities through actions and teaching. Inpart they declared,
Higher Education is uniquely positioned to help Americans under-stand the histories and contours of our present challenges as adiverse democracy. It is also uniquely positioned to help both stu-dents and our communities to explore new ways of fulfilling thepromise of justice and the dignity for all, both in our own democ-racy and as part of the global community. (Ehrlich & Hollander,1999, p. 1)
The Presidents’ Declaration highlighted serious concern in HigherEducation about a growing national trend toward civic disengagement aswell as its own failings in engaging students as active citizens (Battistoni,2002). In addition, prominent scholars called for American colleges anduniversities to return to their earliest mission of educating citizens fordemocracy (Barber, 1992; Benson & Harkavy, 1997; Bok, 1990; Boyer,1994, 1996). Today, most universities have created mission statementsthat reveal a commitment to service and civic engagement, yet the real-ity on college campuses does not match the rhetoric (Boyer, 1994,Boyte & Hollander, 1999; Checkoway, 2001). Advocates for a renewedcommitment to a civic mission in Higher Education identify threestrategies for achieving this goal of civic engagement: (1) Rigorousfocus on education in democratic values and citizenship, (2) formation
Service Learning 27
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of collaborative community-university partnerships, and (3) promotionof service learning (Hutchinson, 2001, p.1).
The Pew Health Professions Commission Report (1995) struck asimilar chord of advocacy for civic engagement when it recommendedthat health care practitioners of the twenty-first century demonstrate thefollowing core competencies: care for the community’s health, under-standing of the role of the environment, participation in racially and cul-turally diverse society, involving clients in decision making, practicingprevention, promoting healthy lifestyles, and continuation of learning(Connors, Cora-Bramble, Hart, Sebastian, & Seifer, 1996; Shugars,O’Neill, & Bader, 1991). The premise of occupational therapy rests onhuman dignity and equality. Out of this premise stem a number of offi-cial documents which explicitly support the core competencies identi-fied by the Pew Commission Professions Report. These include theOccupational Therapy Code of Ethics (2005), Core Values and Atti-tudes of Occupational Therapy Practice (AOTA, 1993), The Philosophi-cal Base of Occupational Therapy (AOTA, 1995), and the OccupationalTherapy Practice Framework: Domain and Process (AOTA, 2002).Our professional beliefs of person-centered practice, enablement, em-powerment, and participation fit perfectly with the call to address socialissues and to collaborate with communities to address their needs. Law(2002) underscored this fit when she defined participation in the Occu-pational Therapy Framework as, “a vital part of the human conditionand experience–it leads to life satisfaction and a sense of competenceand is essential for psychological, emotional, and skill development”(AOTA, 2002, p. 641).
The primary objective of service learning is the enhancement of aca-demic learning through engagement in authentic community service(McGowan, 2002). As occupational therapy practitioners, we are wellaware of the value and benefits of engagement in activity and occupa-tion. Service learning provides occupational therapy educators with aninnovative approach to education and skill development that supportsoccupational therapy’s core tenets of engagement, social participation,and learning by doing. Dewey (1938) and Kolb (1984) assert that expe-riential learning is superior to abstract learning and richest when itinvolves experience, reflection, and comparison. These philosophersalso provide a link between community-based learning and academicenhancement suggesting that hands-on experience in service to othersnot only contributes to the holistic development of students but alsocultivates civic mindedness, an essential element of social participation.
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Service learning embedded in occupational therapy education is aneducational pedagogy that helps students reap the benefits of participa-tion. We have the knowledge, skills, attitudes and professional respon-sibility to promote health and well being through participation in a justand inclusive society along with working toward social change. Town-send (1993) has urged a social vision of occupational therapy thatincludes promotion of social justice in order for individuals, with orwithout disabilities, to fully participate as members of society. Servicelearning is an approach that can help the profession’s graduate entry-level practitioners to understand and enact a social vision of occupa-tional therapy that has been developed through thoughtfully plannededucational experiences of community engagement.
CHARACTERISTICS OF SERVICE LEARNING
Service learning is a type of experiential learning. Community-Cam-pus Partnerships for Health, an organization focused on this educationalapproach for health professional students, clearly articulates a compre-hensive definition for service learning.
Service learning is defined as a structured learning experience thatcombines community service with preparation and reflection.Students engaged in service-learning provide community servicein response to community-identified concerns and learn about thecontext in which service is provided, the connection between theirservice and their academic coursework, and their roles as citizens.(Seifer, 1998, p. 274)
In keeping with occupational therapy tradition, for students to be en-gaged as learners, learning must be made meaningful, purposeful, con-textual, and empowering. When students participate with communitymembers in person-centered collaborative endeavors to address issuesof common good, they apply abstract classroom knowledge to commu-nity issues. Such positive experiences are an impetus for life-long learn-ing, civic engagement for the common good, and “a larger view of theworld as articulated through their own voices and insights” (Mintz andHesser, 1996, p. 36). When planning these experiences, occupationaltherapy educators consider the best practices for service learning (seeTable 1) as well as the various approaches to SL.
Service Learning 29
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Service-Learning Approaches
Approaches to curriculum-based service learning are integrated, com-prehensive, or programmatic (Marstellar & Kowalewski, 2005). Each ap-proach requires that the course instructor clearly defines the parametersof the SL activity, identifies host sites, and designs a learning experiencethat is meaningful and relevant to the community agency while meetingcourse objectives. An integrated approach incorporates community ser-vice as only one of several required or elective components of the course.In some cases, the SL experience counts as extra credit or is taken foradditional course credit. The service activity clearly relates to the courseobjectives and requires more than one visit to the community site. Forexample, in a course on sociocultural diversity one course objectivereads, “Demonstrate an increased awareness of institutional barriers thatmay prevent persons from diverse backgrounds from using occupationaltherapy and other health or rehabilitation services.” In this course astudent may spend time at a local health clinic with the expectation thatthey survey or interview consumers about their perspectives on services.
In a comprehensive approach to service learning, the community-based activity is the central focus of the course and evolves during thesemester in concert with the student’s learning. Student assignmentsand experiences reflect the developmental progression of the coursepedagogy. The course may offer one service experience in which theentire class participates or several service opportunities from which the
30 OCCUPATIONAL THERAPY IN HEALTH CARE
TABLE 1. Best Practice in Service Learning
1. Engages students in responsible and challenging actions for the common good.2. Provides structured opportunities for people to reflect critically on their service
experience.3. Articulates clear service and learning goals for everyone involved.4. Allows for those with needs to define those needs.5. Clarifies the responsibilities of each person and organization involved.6. Matches service providers and service needs through a process that recognizes
changing circumstances.7. Expects genuine, active, and sustained organizational commitment.8. Includes training, supervision, monitoring, support, recognition, and evaluation to meet
service and learning goals.9. Insures that the time commitment for service and learning is flexible, appropriate, and
in the best interests of all involved.10. Is committed to program participation by and with diverse populations (Porter Honnet &
Poulsen, 1989).
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faculty assigns or lets the students choose. In all cases, the SL project isbased on a community-identified need, and not driven by the need forstudents to develop practice skills and grow professional as in field-work. For example, in a two-semester sequence of clinical reasoningcourses, students work with staff and consumers at a local elder daycarecenter to design and implement meaningful individual and group activi-ties on site based on the community agencies’ identified needs. Thefrequency and duration of this type of SL approach can challenge or en-hance students’ communication and decision-making skills, understand-ing of the community context, advocacy, professional ethics, teamworkand develop leadership abilities, too.
The programmatic approach views service learning as a fundamen-tal component of the program’s mission and incorporates required SLexperiences at multiple points throughout the curriculum. In this ap-proach, faculty meet to carefully consider a series of SL experiencesthat meet curriculum objectives and which are graded to match thestudents’ levels of personal and professional development. When em-ploying a programmatic approach, a specific community site may be se-lected to meet course objectives across several courses or curriculumobjectives are met through SL experiences at a variety of communitysettings. Successful programmatic service learning is supported by thefaculty’s inventory of community partners and identification of courseswithin the curriculum that are good candidates for community-basedlearning. However, the programmatic approach may also be threatenedby a shortage of community partnerships or lack of faculty support(Marullo, 2005). When choosing a SL approach, educators carefullyconsider institutional issues such as management of the relationshipwith community agencies, liability, funding, student off-site supervision,faculty load and productivity, and programmatic support. If institu-tional support for service learning is not available, educators often seekadvice of colleagues in other institutions with SL experience.
Service Learning and Fieldwork
Service Learning is often mistaken to be equivalent to volunteerismand/or fieldwork. SL differs from volunteerism in that the service activ-ities are clearly linked with academic course objectives. In fieldwork,service is guided by professional learning outcomes and accreditationrequirements. In volunteerism, the benefit of the service to the commu-nity is emphasized over benefit to the learner. Similarly, in fieldwork, thebenefit to the learner is emphasized over the benefit to the community.
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In service learning, the benefit is reciprocal to both students and com-munity. Although students often verbally share their volunteering andfieldwork experiences, they usually are not required to complete exten-sive assignments that connect learning goals with the service experi-ence or to complete guided reflections which are at the heart of servicelearning. Perhaps the most striking difference between SL and field-work is that SL is created to address community-identified needs. Thischaracteristic is not fundamental to volunteerism or fieldwork. Althoughfieldwork is complementary to SL, it cannot substitute for authentic SLexperiences (O’Brien & D’Amico, 2004).
However, SL experiences can be organized as community-basedFieldwork I when the fieldwork coordinator plans an experience whichfollows the characteristics of service learning as well as professionallearning outcomes and fieldwork accreditation requirements. For exam-ple, the first author organizes SL experiences for students in ClinicalReasoning I and II that spans across two semesters. Students are given aSL assignment to work in pairs in local community agencies during thefirst semester to understand the community context, assets, and needs aswell as meet with consumers to develop clinical reasoning skills. In ad-dition, during this semester, each student participates in Fieldwork IAfor four hours each week at a traditional acute care or rehab setting. Dur-ing the second semester, students initiate a weekly group intervention atthe community agency based on the community-identified needs (fromthe first semester) to enhance their developing clinical reasoning skills.Because students are addressing community-identified needs based inreciprocity with the community agency staff and consumers, follow spe-cific learning and service objectives, and write weekly guided reflec-tions, this is service learning. Additionally, the course instructor weavesinto the group projects, the appropriate professional learning outcomesand fieldwork accreditation requirements thus fulfilling fieldwork IBrequirements. With a good understanding of best practices in servicelearning as well as the expectations for fieldwork, creating a fieldwork/service-learning project is possible.
PROMOTING SOCIAL RESPONSIBILITYAND PROFESSIONAL DEVELOPMENT
Educational experiences that facilitate students’ engagement withmarginalized populations are reported to improve students’ capacities topractice in a more culturally responsive manner (Whiteford & Wright St.
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Clair, 2002). These experiences may also increase students’ awareness ofissues of aging with a disability (Green 1998; Lohman & Aitken, 2002)and expand their understanding of disability as a lived experience. Envi-ronmental and societal conditions which impinge on the lives of peoplewith disabilities are also revealed (Gitlow & Flecky, 2005). Through SLexperiences, students learn how social responsibility calls them to ad-dress these conditions through encounter and action.
Service provision is viewed on a continuum of charity to socialchange. The charity model emphasizes giving as a civic duty and is, atbest, an additive to any learning experience. The social change model,on the other hand, is about caring, social reconstruction, and trans-formation (Kahne & Westheimer, 1996). Students are challenged tomove from a perspective of giving to one that explores the root causes ofsocial problems and builds relationships with people in the communitiesin which they serve. Morton (1995) asserts that students who are open tobecoming transformed by these new relationships and understanding ofsocial issues are often moved to work for social change. Mezirow(1990) states that lifelong transformational learning in adults occurs inthree phases: “critical reflection on one’s assumptions, discourse to val-idate the critically reflective insight, and action” (Merriam & Caffarella,1999, p. 321). Service learning engages all three of these transformativeprocesses. Reflection plays a key role in student growth, transforma-tion, and is instrumental in promoting civic engagement for socialchange. Consistent guided reflection that is contextualized and whichconnects community experience with learning is associated with appli-cation of curriculum-based concepts to new situations, enhanced prob-lem solving, critical thinking, and student openness to new ideas andperspective transformation (Eyler & Giles, 1999). Effective facultymentors facilitate student growth by providing the right level of chal-lenge in an authentic and appropriate context, emotional support, andguided reflection exercises that help students process their experience.
DESIGNING AND IMPLEMENTING EFFECTIVESERVICE-LEARNING PROGRAMS
Designing SL opportunities with authentic community engagementrequires occupational therapy educators to consider all aspects of theSL pedagogy, including developing trusting relationships with commu-nity agency. These relationships are key to successfully designing and
Service Learning 33
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implementing community-university partnerships for service learning(see Figure 1).
Service-Learning Pedagogy
Conceptualization and operationalization are essential pedagogical ele-ments in designing successful community-learning experiences. McGowan(2002) describes conceptualization of service learning as the process inwhich the connection between community experience and advancementof course objectives is established. This process entails linking specificcourse objectives with community service. For SL to be successful, theconceptual link between the service activity and the desired learning isclearly articulated and agreed upon by both the community partners andfaculty.
To operationalize service learning, the course instructor identifieslearning activities for both inside and outside the classroom that connect
34 OCCUPATIONAL THERAPY IN HEALTH CARE
1. Instructor
Service Learning Implementation
Researches mission,purpose, assets, needs ofcommunity agencyDevelops relationship withcommunity agencyDiscusses all aspects ofservice learning pedagogywith community agency
2. Instructor &Community Agency
• Determine if servicelearning is feasible
5. Instructor &Community Agency & Students
• Determine focus ofproject, timeline,responsibilities &liability
3. Instructor & StudentsIntroduces course objectivesto students as well as serviceobjectives to students
Clarifies specifies of agencyneeds, service learningproject focus, goals,assignments & timeline,evaluation methods Instructor
Community Agency
Students
Keep in touch with students to ensureproject focus in keeping with need
Communicate weekly regarding project
Evaluate the experience
Continue dialogue and find ways tosustain partnership
Plan final presentation/celebration
4. Community Agency & Students
Orientate student to community agencyIntroduce agency staff to pedagogy ofservice learning & to studentsSupervise students as they carry outservice learning project
•
•
•
•
•
•
•
•
••
••
•
FIGURE 1. Service-Learning Implementation
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the service experience to course objectives. Written essays, in-classdebriefings, and guided reflection questions for journaling are examplesof learning activities that ensure the conceptual connection between thecommunity experience and advancement of course objectives. Assessmentof these SL experiences is essential to sustaining the operational con-nection between service and learning.
Eyler and Giles (1999) suggest other design components that play arole in effective SL experiences and which contribute to student learn-ing. These include placement quality, opportunities for student reflec-tion, and designing an experience that provides students with the “justright” challenge, that resonates in occupational therapy practice. Com-munity placements in which students take responsibility and work aspeers with community members is associated with student interpersonaldevelopment and is a positive predictor of diversity tolerance (Eyles &Giles, 1999). A primary challenge is to encourage students to developmore complex ways of viewing the world and of applying academicknowledge without being overwhelmed by the demands and novelty ofthe SL experience. For example, a service-learning component of a com-munity health course requires that students spend four to six hours aweek at a community site for a 10-week period. During this time theycollaborate with the program director, staff, and consumers to completea needs assessment, design and propose an occupational therapy pro-gram that addresses a facility-defined need, and draft a possible basicgrant proposal to fund the implementation of the program (Munoz,Provident, & Witchger Hansen, 2005). Such a challenge is inappropriateif students have not been equipped with the requisite knowledge andskills to complete such tasks.
An additional element to consider in planning and designing SL pro-jects is liability. In managing risk in SL partnerships, faculty should beaware of policies and procedures already in place on campus and ask thecommunity partners to identify the risks and relevant policies and pro-cedures of their agency. To reduce risk, faculty and agency staff provideorientation to the community site, clearly delineate learning objectives,create a learning plan or contract, and meet with university risk managerand community partners to discuss liability issues and develop a riskmanagement policy (see Table 2). Efforts should be made to define theagency’s role in student oversight and determine the instructor’s flexibil-ity to accommodate the agency’s needs.
Service Learning 35
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Developing Community Partnerships to SupportService Learning
Occupational therapy educators locate agencies whose goals matchthe goals and outcomes of the course. Although the vast majority of theauthors’ collective SL experiences have been with agencies that addressneeds of underserved populations, Zlotkowski (1999) asserts that au-thentic service learning can also be created with “organizations whoseprimary purpose is the common good” (p. 98). Designing effective SLexperiences requires attention to developing strong community-univer-sity partnerships and integrating host agency priorities with course objec-tives. Development of a mutually committed working relationship withan agency is key to sustaining successful and meaningful community-learning experiences and to the enhancement of student learning andadvancement of course objectives. Development of the relationship re-quires partnering and collaboration with the host organization groundedin ongoing dialogue with a clear understanding of respective needs. Ef-fective community-university partnerships “are mutual, collaborativerelationships that bring individuals from both academia and the com-munity together to work on a common goal, that result in benefits to boththe university and community partners” (Suarez-Balcazar, Muñoz, &Fisher, 2006). Collaboration is a creative process that recognizes and re-spects the complementary skills and knowledge of each partner. Schrage
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TABLE 2. Considerations for Reducing Liability
Agency Responsibility1. Provide orientation for students2. Generate an orientation checklist3. Notify other staff about service learning
Instructor and Agency Responsibility1. Determine service learning site supervisor2. Discuss learning and service objectives3. Document a learning plan/contract for learning4. Discuss risk management University Risk manager and with partners5. Conduct site reviews (before, during, and after)6. Create a site-visit checklist
Instructor Responsibility1. Offer alternative placement if necessary2. Require student activity log to verify activity3. Maintain emergency contact information on every student
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(1991) has eloquently captured the essence of collaboration in the fol-lowing passage:
Collaboration is the process of shared creation: two or more indi-viduals with complementary skills interacting to create a sharedunderstanding that none had previously possessed or could havecome to on their own. Collaboration creates a shared meaning abouta process, a product, or an event. In this sense, there is nothing rou-tine about it. Something is there that wasn’t there before. (p. 140)
Community-university partnerships for service learning require fac-ulty and community partners to communicate effectively, building asense of trust as they work together. Through the sharing of informationabout their programs, these partners develop an understanding of theirpartners’ respective mission, goals, assets, and needs and determine afocus for the service-learning partnership based on these needs. Tobuild a sustainable partnership, the community and university partnersdevelop a common vision, involve staff and students on every level ofcommunication, develop ongoing communication, define shared out-comes, implement evaluation methods, and continuously reflect on theevolution of the projects. Characteristics of an effective community-university partnership include a shared commitment to address complexsocial problems, mutuality, and a participatory, shared approach to theservice, education and research activities of this partnership. Facultyand community partners further accept joint responsibility for effectivecommunication, recognizing, utilizing and assimilating change, sus-tainability of the project, and working toward student development ofcultural competence.
After faculty identify an appropriate SL site, they begin to develop anagency profile by assessing the assets and needs of the local agency andpopulation they serve. This profile is created in advance of the course bythe faculty member in collaboration with the community partner, or theassessment is conducted by the students in partnership with the commu-nity agency as part of the course and service-learning assignment. Todevelop a community profile, SL faculty or students collect and assesshealth status data, conduct a walking or windshield tour of the commu-nity, develop an assets map, and interview key community leaders. Tocreate an organizational profile, faculty or students research the history,mission and organizational structure, profile of current services, referralbase, staffing, and job descriptions.
Service Learning 37
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Challenges
There are challenges in creating an SL project. Although the courseinstructor is crucial for continuity of projects and effective communica-tion between the community partner and students, one of the challengesis facilitating the establishment of student relationships with commu-nity members with each new semester, and/or reestablishing relation-ships with the community members with each new group of students.There is a period of developing and evolving expectations with eachnew semester and each new student group, too. The students need timeto learn about the social norms, facilitators, resources, strengths, andbarriers of the setting. In addition, faculty need to spend time guidingstudents to be pro-active in problem solving and breaking down barriersto creating a successful project, such as identifying clear learning andservice objectives, as well as dealing with staff, service-learning partici-pants, university time versus community time, and issues of power shar-ing, just to name a few. While the challenges of service learning arenumerous, so too are the benefits. The community benefits directly fromthe service students provide to improve the overall health, wellness, andquality of life of its members. The university benefits as its reputation isenhanced by the students’ positive contribution to the common good.And, finally, students benefit from SL as they grow professionally, aca-demically, and personally through their service as engaged, socially re-sponsible citizens who have contributed to the common good.
ASSESSMENT OF STUDENT LEARNING
Effective assessment of student learning requires that faculty developmethods and strategies reflective of the course objectives and the pur-pose for the SL experience. Faculty define the key learning objectivesfor the service experience and determine how to assess student achieve-ment of objectives. The assessment of course objectives tends to be asummative process. For example, summative course objectives mightbe “understanding the types of preventative health” (knowledge) or“analyzing the type of preventative care offered by different communityagencies” (skill).
Service-learning objectives tend to be formative or process orientedto help students focus on the continuous and changing nature of theirlearning process, value and belief inquiries, or professional attitudesand behaviors. For example, a course objective such as “appreciating
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approaches to family and culturally centered care” is achieved through aservice-learning experience such as creating a family and culturallycentered community health fair in an impoverished neighborhood. Thestudent’s summative learning of this course objective is assessed if thehealth fair was successfully completed through a health fair participantsurvey. Assessment includes evaluation of logistics, scheduling, travel,and agency preparation.
Choosing the type of reflective activity and assessment strategiesrequires thoughtful planning. Characteristics to be considered includethe needs of the community, type of service setting, the frequency ofcontact at the setting, the duration of the experience and the nature,depth, and sophistication of the service experience (Delve, Mintz, &Stewart, 1990). For example, an episodic, simpler, and shorter serviceexperience with less frequent exposure may require a more outcomes-oriented assessment process. Whereas, a longer, more complex serviceexperience with more frequent exposure may allow for thoughts and re-flections to be challenged and evolve over time. In addition, whether thefocus of the objective is knowledge, skill, or values also impacts whichtype of assessment strategy is the best fit (see Table 3).
Reflective activities and documentation are used to assess achieve-ment of process-oriented objectives and to document a student’s transi-tions and insight into a situation. Reflection involves critical thoughtprocesses such as elaborating, differentiating, reinforcing, and creating
Service Learning 39
TABLE 3. Assessment Strategies
Focus of Objectives Sample of Assessment Strategies
Knowledge • Pre/post tests based on course objectives• Pre/post surveys based on preconceived concepts related
to the course objectives, community/social barriers, andfacilitators, service-learning, community-based education
• Reflection journal or paper• Self-assessment and goal setting
Skill • Reflection journal or paper• Self and peer assessments• Service project or product completion• Student portfolios• Professional behavior rubrics
Value • Pre/post surveys• Focus and discussion groups• Writing an issues paper• Peer assessment• Reflection journal or paper
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new meaning and the interpretation of frame of references in order totake informed action (Mezirow, 1990; Bringle & Hatcher, 1996, 1999).Guided reflection, that is reflection that responds to instructor-generatedreflection questions, is often preferred rather than open-ended reflection.Guided reflections involve an interactive communication that is con-nected, continuous, challenging, coached, and contextualized (Kesler-Gilbert, 2003). Guided reflection often helps students to focus andnotice elements of a novel experience, as compared with having stu-dents reflect on anything that may or may not be relevant to the courseobjectives. A variety of reflective activities can be found in Table 4.
Not all students will like service learning. For example, some feelthat it is too much work outside of the classroom and the outcomes areunpredictable from the onset. However, as teachers we are often facedwith facilitating learning even when the student’s learning style doesnot match the teaching. Inherently, assessing student learning withservice-learning experiences has a certain degree of ambiguity and un-certainty. When instructors present service learning with the caveat of“expecting the unexpected” in a community setting, however, studentstend to be more flexible and willing to deal with the uncertainties. Thecontextualized learning approaches, reflection activities, and assess-ment strategies are designed to provide a record of valuable personaland professional growth and development throughout the experiencethat students can use to promote lifelong learning.
ASSESSMENT OF COMMUNITYAND INSTITUTIONAL OUTCOMES
Because SL programs have a dual emphasis on service and learning(Giles, Honnet, & Migliore, 1991), student evaluation needs a dual fo-cus. Evaluation moves beyond assessing the effects of service learningon students and their learning to consider additional effects on commu-nity partners and their clients, and on the faculty and the academic insti-tution itself. Accordingly, assessment of community and institutionaloutcomes consist of process and outcome indicators in the areas of com-munity partners, clients, and professional education. Effects of SL pro-grams on health professional education is examined further in termsof the educational system, the educational curriculum, and faculty de-velopment and involvement. Potential indicators of community andinstitutional outcomes and their data sources are provided in Table 5.
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SCHOLARSHIP OF SERVICE LEARNING
Faculty in health professional education programs are increasinglychallenged to manage already existing tensions among their teaching, re-search, and service roles, including the additional responsibility to main-tain their professional competence and incorporate professional practice
Service Learning 41
TABLE 4. Reflection Activities
Reflection Activity Brief Description
Double-entry journal • This method involves both summative and formative as-sessment of the service experience. On one side of thepaper, the student writes down personal reactions to theservice experience. On the other side of the paper, thestudent links key course concepts and information to thereaction and service experience (Bringle & Hatcher, 1999).
Three-part journal • This method involves responding to three issues for eachjournal entry (Bringle & Hatcher, 1999). For example:• Describing what happened• Analyzing how the course content relates to the
experience• Applying the learned experience to a personal story
• Bringle and Hatcher also suggest a simpler method byasking, “What, so what, and now what?” This stimulatesthe student to describe:• The experience• What the experience means• How does the experience affect the future of the
student and the community• Other adaptations such as a SOAP note to encourage
students to address different aspects of the service experi-ence can be used as well.
Incident journal • This method involves responding to a particular event dur-ing the service experience (Bringle & Hatcher, 1999).• For example: Describe an incident that created a di-
lemma for you because you did not know how to act orrespond.
• Why was it confusing?• How did you feel about the event?• What did you do?• List three actions that you might have taken and ana-
lyze each action.• Discuss these journal entries with instructor, with class
or on an electronic discussion board with instructor andclassmates.
Web-based journal • Group journaling or discussion boards on Web-basedcourse platforms can promote group cohesion, support,validation, as well as public challenge (Mills, 2001).
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42 OCCUPATIONAL THERAPY IN HEALTH CARE
TABLE 5. Assessment Indicators of Outcomes
CommunityPartnersIndicators
• Number of community partners and differing agency purposes• Duration of community partnerships• Agency service provision
• Number of clients receiving services• Amount/type of services provided
• Agency and staff satisfaction with services• Survey instruments, individual/focus group interviews, faculty/student
fieldnotes• Commitment to the project and its sustainability
• Hiring of new staff• Inclusion in funding applications
ClientIndicators
• Client knowledge, skills, and/or performance• Tests, assessment batteries, survey instruments
• Client satisfaction with services• Survey instruments, individual/focus group interviews• Participation and follow-through such as attendance frequency or
monitoring changes• Client health and quality of life
• Tests, assessment batteries, survey instruments• Frequency of use of community and health care services• Costs for health care and healthier living
HealthProfessionalEducationIndicators
Educational system• Number of students involved• Student development (leadership, cultural sensitivity, commitment to
service, personal and professional development)• Survey instruments, individual/focus group interviews,
faculty/student field notes• Hours and types of community service prior to graduation and after• Number of graduates working in community settingsEducational curriculum• Number of service learning into curriculum objectives into courses• Curriculum content related to practice in community settings• Incorporation into curriculum philosophy and model including periodic
student and alumni learning outcomes assessment• Value placed on service-learning needs observable measure or delete
as really the above are the actions demonstrating this valueFacultyDevelopmentIndicators
• Number of faculty involved• Participation in and leadership of service-learning-related faculty
development activities• Influence on faculty teaching
• Development of new teaching skills• Implementation of new teaching methods• Time spent on service-learning components• Time spent in student mentoring• Student satisfaction surveys and course evaluation
• Influence on faculty scholarship• Number of research projects• Quantity of applications for funding support• Amount of grants awarded• Frequency and quality of conference presentations, and publications
• Influence on faculty practice• Hours spent in community practice
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into their service activities (Arana & McCurdy, 1995; Hanson, Gibson, &Scoggin, 1997). Service-learning programs have the potential to integratefaculty members’ teaching, research, and professional practice activities,and bring their skills in these areas to bear on the real-world problems thattheir communities face (Conners, Cora-Bramble, Hart, Sebastian, &Seifer, 1996; Crist, Muñoz, Witchger Hansen, Benson, & Provident,2005; Muñoz, Reichenbach, & Witchger Hansen, 2005; Kielhofner,2005; National Association of State Universities and Land Grant Col-leges. 1999). The dual focus of SL programs, service to the community,and student learning, raises two very different types of research ques-tions. One question considers effects on participants: students and clients;and the other question considers effects on institutions: educational andcommunity. A wealth of research questions generated by The NationalSociety for Internships and Experiential Education (see Table 6) is foundin the Research Agenda for Combining Service and Learning in the1990s (Giles et al., 1991). Many of these questions are appropriate to oc-cupational therapy education and outcomes including, “What are the ef-fects of service learning on students as learners and as citizens? Does
Service Learning 43
TABLE 6. Research Questions
Students• What are the effects of service learning on students as learners?• What are the effects of service learning on students as citizens?• What knowledge and skills do students gain as a result of service learning?• Does participation in student learning affect students’ perception of self and others and
their view of the world?
Clients• What are the effects of service learning on clients’ health and quality of life?• What knowledge and skills do clients gain as a result of service learning?• Does participation in service-learning affect clients’ perceptions of self and others and
their view of the world?
Educational institutions• What are the outcomes of service learning that contribute to institutional missions?• How can service learning lead to the effective integration of teaching, research, and
service?• How can service learning be used as a vehicle for reform in areas of teaching effective-
ness, curriculum design, and faculty scholarship?
Community institutions• To what extent does service learning address real community needs?• To what extent does service learning build capacity of community partners to meet
clients’ needs?• What are the benefits and costs for community partners as a result of service learning?
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participation in student learning affect students’ perception of self andothers and their view of the world? What are the effects of service learn-ing on clients’ health and quality of life?”
Scholarship of service learning is initiated and transformed easily bycareful consideration of student assessment of learning processes de-scribed in previous sections of this paper. For instance, systematic analy-sis of students’ reflective journals, especially ones that are faculty guidedcan not only measure student learning but also provide outcomes-orientedscholarship. Additionally, documenting and reporting the outcomes fromservice learning may influence best practices to be emulated in practice.
STRATEGIES TO SUPPORT THE SCHOLARSHIPOF SERVICE LEARNING
Service-learning programs are natural settings for collaborative ac-tion research or community-based, participatory research models thatcreate partnerships between scholars and practitioners. There are sev-eral strategies that facilitate the development of effective partnershipsto support scholarship within service-learning programs (Giles et al.,1991). First, choose research-oriented questions that are of mutualinterest and benefit to scholars and the communities in which the ser-vice-learning program is being conducted. Second, ensure that bothinstitutional partners (educational institutions and community organiza-tions) are represented on the research team and that they are involved inall stages of the research from initial planning through project comple-tion. Third, it is important that the members of the research team arecommitted to managing immediate logistical issues that arise within theprogram without losing sight of the larger research questions. Fourth,adequate time for a needs assessment and the planning process to meetthese needs must be built into the research timeline. Fifth, recognize andacknowledge that the needs of involved partners and their interests andstakes in the program will differ. Sixth, for the scholarship of practice tonaturally and smoothly occur, incorporate research questions and de-sign into early program development stages so it becomes an embeddedcomponent of program delivery. Scholarship activities and outcomeswill result earlier and meet with less resistance. And, finally, presentpartnership opportunities to scholars and practitioners as a source ofintellectual and career renewal and rejuvenation (Giles et al., 1991).
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Institutional support for SL programs and their concomitant scholar-ship opportunities is essential for their success (Bringle & Hatcher,1996). Educational institutions demonstrate this support when servicelearning is included in their institutional mission statements and whenSL programs are identifiable features of their educational curricula. Ad-ditional indicators of institutionalization of SL programs are hard-linebudget commitments and evaluation of these programs through institu-tional assessment processes. Faculty members’ involvement is maxi-mized when their accomplishments in SL programs are recognized,publicized, and endorsed, particularly by inclusion in personnel deci-sions, such as hiring, annual review, promotion, and tenure practices.Finally, faculty participation in service learning is enhanced when edu-cational institutions support faculty development through offering work-shops and mentoring programs related to service learning (Bringle &Hatcher, 1996). When institutional support is not present, faculty findinsight from service-learning colleagues in other institutions of highereducation, benchmark comparable universities that have institutional-ized service learning, and cite the growing body of research that sup-ports the pedagogy of service learning.
CONCLUSION
Service learning is a philosophical and pedagogical approach in oc-cupational therapy education that is grounded in the philosophical andtheoretical influences of John Dewey. Service learning is consistentwith the mission and purpose of American higher education includingBoyer’s call for an engaged citizenry, and the social vision of occupa-tional therapy. In this paper, the authors argue that service learning pro-vides a natural context for students to experience community practicewhile contributing to reduction of existing social injustices. The peda-gogy of service learning provides students with a structured learning ex-perience that combines community service with academic learningobjectives to address community-identified needs. Reflection throughoutthis pedagogy gives students an opportunity to consider the connectionbetween their academic coursework and their role as citizens. While pro-viding students with an opportunity for skill development, service learningalso supports occupational therapy’s core tenets of engagement: socialparticipation and learning by doing. Developing strong community-uni-versity partnerships characterized by trust and mutuality are essentialto supporting effective service learning. Together, faculty, students and
Service Learning 45
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community partners accept joint responsibility for effective communica-tion, sustaining the project and working with students to develop cross-cultural awareness and at times cultural competence while addressing acommunity-identified need. Assessment of service learning moves be-yond understanding the effects of service learning on the students to as-sessing the community and institutional outcomes of service learning.These assessment indicators may include the following:
• Community-partner indicators such as number and duration ofcommunity partnerships,
• Client indicators such as client satisfaction with services, health,and quality of life,
• Health professional-education indicators such as number of stu-dents involved and student leadership, personal and professionaldevelopment; and
• Faculty-development indicators such as influence on faculty teach-ing and scholarship.
Service-learning programs also provide faculty the opportunity to in-tegrate their teaching, research and practice activities by addressingcommunity-identified problems. Developing SL scholarship is a fre-quently neglected necessity to validate this innovative educational prac-tice. From its inherent benefit of enhancing academic and service goalsto address community-identified concerns and problems, service learn-ing provides educators with an opportunity to present students with ex-periences in natural, community contexts. At the same time, servicelearning develops life-long commitment to civic engagement and socialresponsibility.
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