Benefits of service-learning in contemporary nursing education

Service Learning and Nursing Education

Service-learning is described as a learning experience that is structured in nature and in which community service is provided following concerns in the community being identified. Service learning "strives to achieve a balance between service and learning objective" and "places an emphasis on addressing community concerns and broad determinants of health principle-centered partnership between communities and health professions schools."(1) Service-learning may take many forms and as well may take place in many different settings. The work of Bailey, Harrington and Carpenter (2002) relates that service-learning, while new to the field of nursing has actually been in development for a historically notable period-of-time and is known to require several components if it is to be successful. Those components are noted as being: those as follows:

a) institutional support;

b) interested faculty;

motivated students;

d) a potential for strong community partnerships; and e) an ongoing orientation and development component. (2)

This work in writing reports an extensive review of literature in the area of service-learning as it applies to the contemporary field of nursing and nursing education and specifically with a focus on the benefits of service-learning in nursing.

I. SERVICE-LEARNING as a TOOL

The Community-Campus Partnership for Health document entitled: "Building Partnerships Into All Aspects of Service-Learning: A Tool for Service-Learning Programs" sets out examples of methods the school can use to build partnerships into service-learning. This work relates that schools should query their students concerning their past community involvement and as well should have a community health fair at the beginning of the school year to acquaint students with the various community resources and with the opportunities that are present for community service and service-learning. (3) the work of Callister and Hobbins-Garbett (2002) entitled: "Enter to learn, Go forth to Serve" published in the Journal of Professional Nursing reports the recommendations of the Pew Health Professions Commission (1998) which states recommendations that community-based service-learning become a critical component in educating nurses. It is stated as well that benefits students derive from service-learning include the following benefits:

a) a sense of personal satisfaction;

b) professional growth;

higher level of critical thinking skills;

d) preparation for nursing practice in a dynamic and diverse health care delivery system; and e) an increased awareness of unmet needs in clients, families, communities, and populations (4)

Gassner and Wotton (1999) acknowledge the existing gap between practice, education and service as being the driver of the difficulty experienced by nursing students in their transition from college to the clinical setting and states that the primary strategy for overcoming these difficulties is collaboration between colleges and clinicians in providing undergraduate education.(5)

II. IDENTIFICATION of BENEFITS of SERVICE-LEARNING

The work of Tang, et al. (1999) relates that the role that nursing faculty and students play in promoting adolescents health programs at the community level is a vital one and states however, that few nursing education programs have developed programs such as this which make the provision of skills and hands-on training experiences nursing students need to working in these community settings. The study reports a program that was developed by the faculty of nursing school at Medgar Evers College Department of Nursing in Brooklyn New York. It is stated that two components of the program are those of: (a) classroom-based health instruction taught by teachers and assisted by nursing students and faculty; and (b) community youth service" in which middle schools students spend approximately 3 hours per week providing assistance in health-related facilities under the guidance of nursing faculty and student nurse mentors." (5) Evaluation of this program was accomplished through conduction of focus groups with students in the nursing program in what was a survey administered before and after the intervention for assessment of participation benefits. The report states that when compared to the control group of nursing students the participants in the program "reported increase skills and comfort working in school and community settings and with young adolescents, their teachers and their parents." (5) These students benefited from gaining a better understanding of the adolescent's health issues and developmental needs. Additionally, the students, through their service to the community, "gained the skills and experience needed to be effective in community health provision efforts."(5)

IV. INTEGRATION of SERVICE-LEARNING & CURRICULUM

The work of Hanmer, Wilder, and Byrd (2007) entitled: "Lessons Learned-Integrating a Service Learning Community-Based Partnership into the Curriculum" reports the partnership between Auburn University School of Nursing (AUSON) and the Auburn Housing Authority (AHA), which provides low-income housing and as well has been providing a weekly nursing care clinic for several years believing that this provision assists all concerned. This provision has been part of process of integration of service learning into the nursing curriculum. The students were actively involved in identification of needs in the community and in goal and priority-setting for the program. Benefits to nursing students include those such as: "...students felt empowered by seeing first-hand the effect of primary and secondary prevention." (9) Service learning also made students to feel like they had actually made a difference. Hanmer, Wilder and Byrd report three major lessons learned in this initiative to be: (a) the need for one consistent faculty present at all clinic activities; (b) having a regular predictable presence for the service; and - persistence and perseverance by all parties involved. (9)

V. SUCCESSFUL IMPLEMENTATION: EDUCATION-PRACTICE PARTNERSHIPS

The work of Stanley, et al. entitled: "Implementing innovation through education-practice partnerships" states: "The pilot Clinical Nurse Leader (CNL™) initiative which grew out of the work of the task forces represents an exemplary national partnership between nursing education and practice. The CNL is a new nursing role being developed and piloted by the AACN in collaboration with education and practice leaders. An AACN task force, comprised of equal representation from education and practice, is currently working with 86 partnerships, including 92 schools of nursing and 191 health care institutions, to implement the CNL initiative. All of the partnerships have committed to collaboratively develop a master's CNL degree program and to transform one or more units within the healthcare institution utilizing the new CNL role."(10) the Clinical Nursing Leader Initiative involves partnerships who have a commitment to collaboratively: (a) develop a Clinical Nurse Leader master's degree program based on a common curriculum framework and set of outcome competencies; and (b)transform one or more units within the healthcare institution utilizing the new CNL role. (10) Stated as a requirement for creation of a successful education-practice partnerships that will sustain innovation is "an ongoing dialogue between the members of the academic institution and the healthcare delivery institution." (10) Stated as an additional requirement in a successful education-practice partnerships is that all partners in the collaboration acknowledge themselves and others as being "both learners and teachers." (10) Effective partnership creation also results in ways of working together that are "new or different" (10) and may result as well in a "radical change in the culture of each organization..." (10) the report of Stanley et al. (2007) states findings "...indicate the potential for experiencing very positive quality and cost-benefit outcomes from this partnership CNL model of care delivery." (10) Stated as a potential barrier to the introduction of this "new nursing role within a care delivery model is the perceived threat to other roles." (10) This threat has been anticipated by reinforcing partnerships and collaborations among other interdisciplinary team members..." (10) the result was "development of a marketing plan that defined the role of the CNL and highlighted the significant contributions of the CNL and interdisciplinary team members." (10) the work of Pohl, et al. (2007) relates that the Academic Nurse-Managed Centers (ANMCs) are sponsored by schools and colleges of nursing and are furthermore "increasingly reaching attention" as their importance is being recognized is the response they provide the particular health care needs of communities. (11) the work of Deal, Fountain, Russell-Broaddus, and Stanley-Hermanns (2006) entitled: "Challenges and Opportunities of Nursing Care in Special-Needs Shelters" relates the challenges that were stated by nurses in providing assistance in a special needs shelter following Hurricane Katrina. Challenges included the varying methods of volunteer recruitment, the operations of the shelter, the availability of supplies, methods of identifying patients and their locations, organization of medication for those unable to self-medicate, patient privacy and a lack of continuity in the maintenance of medical records as well as issues involving confidentiality. Arising from this study are findings that will serve well to inform future nursing initiatives during times of disaster.

SUMMARY and CONCLUSION

This work has reviewed literature relating to service-learning of nursing students and integration of service-learning into the nursing school curriculum. The benefits derived from service-learning on the part of nursing students have been noted to include those such as the student having a sense of personal satisfaction as well as professional growth during service learning. Service learning has been found to promote a higher level of critical thinking skills as well as preparing the nursing practice in a health care setting that is both "dynamic and diverse. (4) Additionally the service-learning experience is one that results in the increase in awareness of the unmet needs among individuals throughout the community in the location of the nursing practice.