The Journal of Texas Medicine: December 2013

Using Community Service to Promote Awareness of Health Care-Related Resources, Volunteerism, and Teamwork in an Incoming Medical School Class

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The Journal of Texas Medicine — December 2013

Tex Med. 2013;109(12):e1.

By Jacqueline Guidry, BS; Arindam Sarkar, BS; Amanda Little, BS; Toi Harris, MD; and Mary Brandt, MD

From Baylor College of Medicine, Houston, Texas. Send correspondence to Jacqueline Guidry, Baylor College of Medicine, Office of Student Affairs, One Baylor Plaza M-220, Mail Stop M368, Houston, TX 77030; email: jaguidry@bcm.edu.

Abstract

Community service has a documented correlation with improved medical school performance. To promote community service and awareness of community resources, a Community Service Day was integrated into orientation for incoming first-year students at Baylor College of Medicine. One hundred seventy-five first-year medical students and 31 second-year leaders volunteered at 11 community sites. We hoped this early introduction to community service would make students more aware of community resources and motivate them to continue volunteering throughout their medical training. 

Students were surveyed about their experiences. Seventy percent of responding students reported the service day helped them learn about the community's resources related to health care, and 92% reported it helped them get to know their classmates. We concluded that integrating a Community Service Day into medical student orientation is a successful way to expose students to community resources, while simultaneously encouraging camaraderie and teamwork among classmates.

Introduction

Medical education is both complicated and comprehensive. Students and educators are responsible for learning and teaching, respectively, a vast expanse of medical knowledge; however, the goals of medical education are not limited to solely learning the science of medicine. The Association of American Medical Colleges (AAMC) Medical Schools Objectives Project suggested that all medical students demonstrate four core attributes: altruism, knowledge, skill, and dutifulness.1

Altruism in medicine can encompass such qualities as compassion, service to the community, cultural awareness, and strong interpersonal interactions. Hennen in 1997 argued that it is necessary to teach medical students social obligation, which he defined as the responsibility "to direct … education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve."2

Community service has been shown to correlate with better performance of medical students. In 2006, Blue et al documented that students with the highest amount of voluntary community service (>18.5 hours) outperformed their peers with no service as demonstrated by higher medical school grade point averages, US Medical Licensing Examination Step 2 Clinical Knowledge scores, and ratings on two types of residency director assessments.1

We hypothesized that early exposure to community service might foster medical students' further participation in service activities throughout medical school. Accordingly, we integrated a Community Service Day into the medical student orientation. Our primary goal was to introduce newly matriculating medical students to available service opportunities in the community and, thus, to encourage a positive attitude about participating in future community service opportunities.

Furthermore, we hoped to broaden the student body's cultural awareness through this event. Albritton in 2002 suggested that a partnership among students, faculty, and the community could provide a mechanism to thoughtfully develop and integrate cultural issues and experiences into the curriculum.3

Because of the demonstrated correlations between medical school performance with service and service with cultural awareness demonstrated in the literature, we decided to create a Community Service Day that would not only enhance these competencies but would also encourage awareness of resources related to health care and promote camaraderie and teamwork among classmates. 

Methods

Objectives

The Baylor College of Medicine (BCM) Community Service Day was designed and organized by 3 student representatives to the AAMC as an initiative to promote community service.  Orientation for BMC first-year medical students is a weeklong event that includes on-campus introductions to deans and faculty, administrative offices, and classrooms, as well as educational expectations. Also included is a 2-day retreat, during which team building and class camaraderie are emphasized to help new students develop social support before embarking on a rigorous medical education. The authors wanted to maintain this focus on team building and class cooperation but to direct it so that both the incoming students and the Houston community would benefit. For the event, the authors had four distinct objectives: to increase awareness of health care-related resources in the community; to promote service in the community; to encourage camaraderie within the class; and to promote cultural awareness

Planning the Event

BCM has an existing course in the third-year clinical curriculum that highlights health care-related resources in the Houston community. Called Longitudinal Ambulatory Clinical Experience (LACE), this course has been an established part of the curriculum since 1998, allowing third-year medical students to spend one afternoon per week visiting sites that provide ancillary services in the community. The authors wanted to provide BCM students with earlier exposure to these resources, so that, if desired, they could continue to individually volunteer as well as refer their future patients during their clinical years. Using this list of established resource contacts, we initially emailed the LACE site coordinator and then followed up 1 to 2 weeks later with a phone call to invite these sites to participate in this Community Service Day. Three of the 11 total service day sites were also LACE sites. 

The other 8 sites were found by a combination of recommendations from some of the LACE sites, Internet searches for team service activities in Houston, and community service directors at BCM-affiliated hospitals. 

A total of 11 sites (see Table) participated in the inaugural BCM Community Service Day, and 175 first-year students and 31 second-year leaders volunteered for from 3 to 5 hours on the Saturday morning between medical school orientation and the first week of classes. 

Surveying the Students

Following the event, the authors wanted to gauge how well an online survey to measure the success of our objectives and gain student feedback by asking the following 10 questions: 

  1. Where did you do your volunteer work?
  2. How easy was it to find the location?
  3. How easy was it to find parking?
  4. Did you have everything you needed?
  5. To what extent did the service day help you learn about health care-related resources in the Houston community?
  6. To what extent did the service day help you get to know your classmates?
  7. Please describe what you accomplished for your project and the impact you think it will have.
  8. Should we do this next year for the incoming class?
  9. Assuming we do this again next year, do you think the time could or should be extended to allow more significant volunteer work? Other thoughts?
  10. Please let us know any way you think this experience could be improved, any glitches you identified, or any other comments you want to make. 

A link to the online survey was sent out twice to the student's school-affiliated email addresses via the class Listserv. Their responses were anonymous, and failure to complete the survey carried no penalty. No identifying information was included in the survey. 

Results

Service Projects Completed

During the inaugural BCM Community Service Day, students completed one or more projects at each of the 11 sites (see Table) over the 4- to 5-hour time frame.  Individual sites were responsible for funding and providing materials for the projects. However, we did have a small financial contribution at 2 of the sites in the way of supplies (shovels, rakes, gardening gloves). Local companies donated most of the supplies, and a small portion of funds was contributed from the Office of Student Affairs at BCM. 

Site Feedback

Overall, the feedback the authors received from site facilitators was astoundingly positive. One example from the Ben Taub General Hospital site coordinator reads as follows:

"We had such a great afternoon on Saturday with the BCM med students. They finished in record time and produced 134 waiting room kits, 85 toiletry kits, and assembled 1,000 service recovery gifts for patients who have had to wait a long time in EC [Emergency Care]. WOW! It is great to see the numbers! Please pass on a huge thank you to the 8 students who were here and did so much for the patients of HCHD [Harris County Hospital District]."

Survey Results

We surveyed the first-year medical students who participated (n = 175). One hundred (57%) of the 175 students completed the questionnaire. 

Responding to the question of how much the Community Service Day helped them learn about health care-related resources in the community (see Figure), 26 (26.3%) of students (n=99) reported that it definitely helped; 44 (44.4%), somewhat helped; 16 (16.2%), neutral; 11 (11.1%), somewhat did not help; and 2 (2.0%), definitely did not help. 

Responding to the question of how much the Community Service Day helped them get to know their classmates (see Figure), 40 (40.4%) of students (n=99) reported that it definitely helped; 51 (51.5%), somewhat helped; 6 (6.1%), neutral; 2 (2.0%), somewhat did not help; and 0 (0%), definitely did not help.

When students (n=98) were asked if they would repeat the Community Service Day if they were in charge, 40 (40.8%) said absolutely yes; 38 (38.8%), yes; 18 (18.4%), neutral; 0 (0%), no; and 2 (2%), absolutely no. 

 Students were also asked to describe their experiences. Following are some of the students' responses:   

  • "We did cholesterol screening on over 200 people. Definitely a feeling of accomplishment and education went both ways."
  • "We helped clean the CAC [Children’s Assessment Center] and organize the clothes, art supplies, etc. I think it will help the CAC to run more efficiently, but more importantly, help us to be more aware of the lives of our patients and some of the resources available to them."
  • "Most importantly, I learned about this amazing service for abused children and hope to volunteer there."
  • "I was very pleasantly surprised with how polite the homeless were and made me feel like I should be doing more to help those who need it more than I do."
  • "It helped me feel more integrated in the Houston community to work with the homeless men and women who live just 5-10 minutes away from us."
  • "[We] made packets for the patients at Ben Taub and learned about the Gold Card and how people of Harris County can get health care if they’re not eligible for Medicare or Medicaid."

Discussion

How well did this project meet its objectives? Ninety-one (91.9%) students reported that the BCM Community Service Day definitely or somewhat helped them get to know their classmates, and 70 (70.7%) students reported that it helped them learn about health care-related resources in the community. Therefore, the authors concluded that these two objectives were met by this addition to the orientation schedule.

We strived to include sites that were related directly to the patient population that BCM medical students would serve as health care providers. Some students participated in a health fair where they not only served the community but also gained skills that would be beneficial to them as clinicians. 

Seventy-eight percent of students reported that they would recommend repeating the service day for next year's class. Based on the feedback from both the students and sites that participated, the authors plan to keep the Community Service Day as part of orientation at BCM. 

We did not survey students to ask if their participation in the BCM Community Service Day would make them more likely to participate in a longitudinal volunteer experience during medical school. However one student who volunteered at the Magnificat House soup kitchen said, "Their gratitude and politeness struck several members of my group, and we are likely to revisit in the future." If the students are surveyed following the event in the future, we would like to also ask how motivated they are to participate in other community service projects based on their experience with the Community Service Day.

We created the Community Service Day at BCM to promote an attitude of service within the first-year medical student class and an awareness of health care-related resources as well as camaraderie and teamwork between students. We believe the project accomplished this goal and plan to continue the event in the future.

Acknowledgments

The authors would like to thank each of the sites and their coordinators who participated in this inaugural event and Home Depot, Target, and Murff Turf for providing donations for materials. Also, we would like to thank Baylor College of Medicine and the deans of Undergraduate Medical Education and Student Affairs for their support and enthusiasm.

References  

  1. Blue AV, Geesey ME, Sheridan ME, Basco WT. Performance outcomes associated with medical school community service. Acad Med. 2006;81(10 Suppl):S79-S82.
  2. Hennen B. Demonstrating social accountability in medical education. Can Med Assoc J. 1997;150(3):365-367.
  3. Albritton TA, Wagner PJ. Linking cultural competency and community service: A partnership between students, faculty, and the community. Acad Med. 2002;77(7):738-739.   

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