HPEC Poster Session 2020

Introduction: Community service is defined as performing voluntary, unpaid work to benefit others (Cnaan et al). In education, it may be in the form of service learning or voluntary community service (VCS). Service learning, which entails structured learning with defined objectives, has been the focus of literature on community service in medical education. In comparison, VCS may range in degree of structure and specific learning objectives. Nonetheless, VCS may play an important role alongside service learning in impacting medical students. Here at the University of Hawaiʻi’s John A. Burns School of Medicine (JABSOM), community service is a part of the curriculum but students often exceed requirements by engaging in VCS.

Objective: This study sought to quantify the number of hours donated beyond curricular requirements, types of service students engaged, and the self-perceived benefits of VCS among medical students.

Methods: Data was collected via a voluntary, non-anonymous online survey distributed to fourth-year medical students. Students were asked to report retrospective hours for VCS performed during the first three years of medical school and to assign VCS activities into categories of Patient Care, Mentoring, Teaching, Donation, Companionship, and Miscellaneous. Ten students with the highest number of hours were further surveyed for comments on perceived impact of VCS. Exclusion of curriculum-required hours and accuracy of unusually large VCS contributions were ascertained.

Results: 63 of 65 students responded to the survey. As a group, students donated 7,430.25 hours of VCS in total. Individually, students engaged four categories of service on average and contributed between 4 to 621 hours with a median of 88 hours over the first three years of medical school. Based on student comments on perceived benefit of VCS for themselves, perspective transformation and citizenship were common themes. For perceived benefit of the community, most common were transfer of knowledge, promotion of healthy lifestyles, and provision of mentorship and companionship.

Discussion: Limitations of this study include self-reported, retrospective data and categorical assignment of community service not accounting for crossover into multiple categories. In regards to individual VCS contribution, Blue et al found that medical students who participated in VCS had significantly higher academic performance and internship ability than nonparticipants (2006). Though academic performance was not included in this study, findings from Blue et al (2006) is relevant as both studies examine VCS. Benefits of perspective transformation and citizenship noted in our study are significant because they highlight the critical role of community service in addressing socioeconomic, cultural, and political causes of health disparity in medical education (Muller et al, 2010) by instilling a sense of social justice in medical students.

Conclusion: VCS allows medical students to serve the community in a flexible and diverse way. The experience at JABSOM suggests that VCS cultivates a sense of their extended roles and social responsibility by connecting them to the community and promoting self-reflection. VCS should be encouraged among medical students and further examined for possible roles in preventing burnout and in increasing self-led learning in medical education. We also recognize the need in literature to standardize how we study the impact of community service in medical education.

Target Audience: Medical education faculty, medical students, community organizations

Background: Senior pharmacy students at the University of Hawai’i at Hilo Daniel K. Inouye College of Pharmacy (DKICP) have a mandatory Ambulatory care six-week rotation known as APPE, Advanced Pharmacy Practice Experience. One of the sites available for these learning rotations is at the University Health Partners of Hawai’i Medicine Faculty Practice in the JABSOM Department of Medicine. As part of their rotation in this clinic, the student does a formal presentation to the entire clinic in the last week. This student teaching experience becomes a great learning activity and serves to foster interprofessional collaboration. The audience includes Internal Medicine physicians, residents, medical students doing their 3rd year Medicine clinical rotation, as well as the staff, including the RN, MA’s, receptionist and clinic manager. Given the above information, our objective was to determine which topics the students were selecting to address in their presentations. A second object was to determine the extent to which the clinical audience found these topics useful.

Methods: In the first few of weeks of the rotation, the student self-selects a presentation topic. These presentation topics require the final approval by the pharmacy preceptor and physician partner. The selected topic must to be both relevant to the student’s career interest as well as the clinical audience. Therefore, creativity is not only encouraged, but required. This is unique in that students in other ambulatory rotations often report being assigned a specific presentation topic by their pharmacy preceptor.
Our intent was to identify and categorize the types of presentation topics that the students selected. We collected two years of data and identified major themes. In addition, we solicited feedback from the clinical staff on the usefulness and relevance of this educational initiative.

Results: Topics fell into 4 general categories which included clinical disease state management, pharmaceutical products, technology, and wellness.

Discussion: Choosing a topic to present provides a growth opportunity for professional maturity of the student. The student has a higher level of responsibility by owning his own topic and expanding his self-directed learning. Recently, additional interprofessional learning requests have resulted in student delivered clinic inservices that embrace audience engagement.
We plan to describe our evaluation of reported clinician and clinic staff feedback for the favorite, most useful and highest interest in future topics.