Nursing Education and Foundation, Outcomes, and Benefits of Service Learning for Curriculum Design
Theoretical Foundations of Service Learning In Nursing Education
Kolb's (1984) theory of experiential learning has been widely used as a theoretical basis for designing and analyzing service learning programs. Reflective observation about the experience is essential to the learning process. It links the concrete experience to abstract conceptualizations of that experience.
Learning is increased when students are actively engaged in gaining knowledge through experiential problem solving and decision making (Bailey et al., 2002). Use of reflection is built on the work of Kolb (1984) and Dewey (1916, 1933, 1938).
In service learning, reflection is both a cognitive process (Mezirow, 1990) and a structured learning activity (Silcox, 1994). Effective reflection fosters moral development and enhances moral decision making.
Moral decisions involve an exercise of choice and a corresponding willingness to accept responsibility for that choice (Gilligan, 1981). Delve, Mintz, and Stewart (1990) developed a service learning model based on theories of moral decision making and values clarification.
Their model includes five phases of development: exploration, clarification, realization, activation, and internalization. It illustrates that service learning is developmental, providing students with an opportunity to move from charity to justice as they become more empathetic.
Delve et al. (1990) believes that without that empathy, the student will not come to recognize the members of the patient population as valued individuals in the larger society and as sources for new learning. The pedagogy of service learning has powerful flexibility.
It can be based on subject matter or on
learning process; it can connect theory and practice; it integrates several
different approaches to knowledge and uses of knowledge; it encourages learning
how to learn; and it can focus on a wide range of issues, problems, and
interests (Pellietier, 1995). It also lends itself to problem based learning
and case study methodologies.
Outcomes of Service Learning In Nursing Education
Service learning in the curriculum
provides opportunities for students to attain personal, professional, and
curriculum goals. It also contributes to the overall educational experience of
the college or university and thus provides benefits to the institution as
well. Finally, this benefits the community in which it occurs and the clients
it serves.
Benefits to Students Service Learning In Nursing Education
A review of the literature on the outcomes of service learning reveals that students benefit in multiple and integrated ways (Amerson, 2010; Gillis & MacLellan, 2013). Benefits can include personal and professional development as well as mastering course outcomes.
Direct participation in this activity assists with socialization into the profession, introduces new technical or professional skills, increases motivation to learn, encourages self-directed learning, facilitates acquisition of leadership skills, and promotes preparation of nurses who are capable of serving as advocates for social justice (Foli et al., 2014; Gillis & MacLellan, 2013).
Several schools of nursing have integrated service-learning components into the freshman experience as a way to introduce nursing students to the role of the nurse (Baumberger, Krouse, & Borucki, 2006). It can also be an opportunity for inter-professional learning and developing collaborative relationships with other professions.
Although the majority of service learning occurs in undergraduate programs, graduate programs in nursing are beginning to explore community engagement to further develop students' leadership skills and sense of responsibility, as well as enhancement of their critical thinking skills and learning of academic content (Francis Baldesari & Williamson, 2008.
Service learning has been found to provide a more thorough understanding of “self” and provides insight into personal strengths and weaknesses (Batchelder & Root, 1994).It has also been found to contribute to the development of personal vision, moral sensitivity, clarification of values, and spirituality.
Service learning facilitates academic inquiry by connecting theory and practice, enhancing disciplinary understanding and understanding of complex material, bringing greater relevance to course material, and helping students generalize their learning to new situations (Jarosinski & Heinrich, 2010).
Service learning experiences also develop critical thinking, communication, collaboration, leadership, and professional skills. Reising, Allen, and Hall (2006a) found that participating in a blood pressure screening service-learning project in the university community provided skills of blood pressure assessment, history taking, and health counseling.
The social effect includes the development of civic responsibility, increased orientation to volunteerism, increased political and global awareness, development of cultural competence, and improved ethical decision making (Gehrke, 2008; Reising, Allen, & Hall, 2006b). Students also learn the value of community health promotion (Reising et al., 2006a, 2006b).
Benefits to Faculty of Service Learning In Nursing Education
Identifying benefits to faculty are key to obtaining buy-in because of the time commitment involved. Even though faculty may not be on site with students directly supervising the service activities, significant faculty time commitment is required to plan the assignment, obtain community partners, read student journals, and facilitate reflection sessions.
Faculty who link service-learning activities in their courses with their research and service interests have increased commitment to continuing their use. Some universities have adopted the Boyer model of scholarship, which enlarged the scholarship perspective to include teaching, service, and practice, in addition to research.
By extending the scholarship perspective, Boyer (1990) believed that there would be a stronger connection between universities and the communities they served. This scholarship model facilitates integration of service learning into the faculty member's academic role as well as promotion and tenure requirements.
The Carnegie Academy for the
Scholarship of Teaching and Learning in Higher Education provides an online
gallery of interdisciplinary projects, including those that involve service
learning that can be used by faculty to transform their teaching. This gallery
is available on the Carnegie Foundation for the Advancement of Teaching's
website.
Benefits to the Institution In Service Learning In Nursing Education
Service learning also has institutional benefits. These include invigoration of the campus educational culture, development of a strong sense of campus community, increased institutional visibility, enhanced appeal to potential donors, and retention of students.
It invigorates the campus culture by increasing students' engagement in their own learning, revitalizing faculty, and allowing faculty to mesh service projects with research interests.
The interdisciplinary nature of service learning helps the campus regain a strong ethos of community, keeps students and faculty more engaged in the life of the college, and contributes to student retention (Hamner, Wilder, Avery, & Byrd, 2002).
By placing service learning experiences early in the program, for example as a freshman year experience, the student retention rate can be increased because students develop self efficacy and an understanding of the field of study.
Increased institutional visibility contributes to increased student recruitment by providing a visible link between the community and the institution and by providing a perception of access to higher education to community members who have not believed higher education to be within their reach.
Service learning enhances the institution's appeal to potential donors by providing a direct link between the college and the community, and it appeals to donors interested in community service educational reform (Pellietier, 1995).
The mentoring environment that is created between students, faculty, staff, administration, and the broader community becomes a “complex ecology of higher education.” that can provide knowledge, support, and inspiration” (Daloz, Keen, Keen, & Parks, 1996).
Service learning also provides a real-world learning environment in the community that facilitates transfer of knowledge and transition to the practice environment. A smooth transition to practice and increased use of community and public health settings were key recommendations for nursing education in the Institute of Medicine (Institute of Medicine, 2010) report.
The new alliances formed between academic institutions and community service
agencies and organizations eliminate or minimize the traditional separation
between the “gown and the town.”
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