Voluntary Community Service at the John A Burns School of Medicine: Perceived Impact and Benefits on Medical Students

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