Table 1. Study characteristics of service-learning in medical school.

Study	Course type	Service required	Participants	Aim or objective	Methods or intervention	Student assessment	Results or outcomes
Averill et al., 200712	Elective	32 hours	M1 (N = 7)	Health behavior education	Needs-assessment, health education intervention, interviews and questionnaires	Reflective essay	• Developed collaboration skills • Improved communication skills • Increased sex education knowledge • Identified community needs • Exceeded required service hrs.
Buckner et al., 201013	Required	1 year	M1	Health behavior education	Needs-assessment, health education intervention, presentations of outcomes, and policy recommendations for community	Reflective essay, reflective discussion, multiple-choice test, attendance	• Developed collaboration skills • Implemented health behavior interventions • Learned clinical skills related to dementia and Alzheimer’s • Addressed health-needs of underserved community • Developed teaching skills
Burrows et al., 199914	Required	20 hours	M1 and M2	Identify and address needs of community	Select project at school fare: clinical services, education, fund-raising, behavior interventions, obtain feedback for qualitative analysis	Hour-tracking of service, questionnaire (open-ended)	• Increased communication skills • Developed compassion, respect, and comfort working with underserved population • Learned clinical skills: taking blood pressure and testing for tuberculosis • Served as role models for youth • Exceeded volunteer hours
Elam et al., 200315	Elective	18 hours (each year)	M1 and M2	Health behavior education	Address community needs by using community assets	Reflective essay, questionnaire	• Identified community assets • Used community assets to address community health needs
Jefferson et al., 201216	Elective	1 year	M1 (N = 45)	Alzheimer’s education	Paired students with early-stage Alzheimer’s patients, conducted pretest-posttest of knowledge related to Alzheimer’s disease and dementia	Reflective essay, specialty test (Alzheimer’s disease and dementia knowledge)	• Increased communication skills • Developed clinical skills related to dementia and Alzheimer’s • Increased future likelihood of providing geriatric care • Learned about personal factors (e.g., family) affecting patients with Alzheimer’s disease
Leung et al., 200717	Required	6 weeks	M1 (N = 249)	Attitudes toward healthcare and knowledge of health issues	Participation in two-week training, live in underserved community while providing home-based and clinic-based healthcare	Reflective essay, reflective discussion, questionnaire	• Increased leadership skills • Increased communication skills • Developed students’ sense of social justice • No increase in critical thinking • Less confidence providing healthcare independently
Long et al., 201118	Elective	8 weeks (data over 5 years)	M1 (N = 62)	Leadership skills and community advocacy	Students paired with faculty mentors and community-based organizations. They completed an advocacy course, internship, and scholarly activity.	Questionnaire	• Increased leadership skills • Increased teaching skills • Developed an understanding of health disparities that could be addressed by health education interventions, community partnerships, and changes to policy/legislative mandates
McConnell et al., 201019	Required	1 year (data over 3 years)	M1 (N = 301)	Pediatric knowledge	Lectures on health topics, provide physical exams to students from inner-city schools	Pediatric exams, questionnaire	• Learned to identify and address the health-needs of an underserved community • Increased teaching and presentation skills
McNeal et al., 201220	Selective	2 to 3 months	M1, M2, M3, and M4	Health behavior education	Mini-grants awarded to student groups, groups conducted needs-assessments, held health a fare, and developed summer projects to address community needs	Poster presentations, questionnaire	• Developed leadership skills • Increased understanding of the social determinants of health • Developed understanding of health disparities that could be addressed by health education interventions, community partnerships, and changes to policy/legislative mandates
Meili et al., 201121	Selective	2 years	M1 and M2 (N = 14)	Develop social accountability	Service-learning program rotates through urban, rural, and international locations (students learn foreign language), qualitative data analysis conducted on open-ended questionnaires	Reflective essay	• Increased importance of patient-physician relationships • Developed multicultural understanding of community • Increased understanding of the social determinants of health • Increased sense of social justice • Recognized need to affect unhealthy habits of communities • Mixed results on students selection of medical specialty
Packer et al., 201022	Elective	4 days	M3 (N = 53)	Community development	Visit homeless clinics and shelters, engage in street outreach, results analyzed quantitatively and qualitatively	Reflective essay, reflective discussion, questionnaire	• Greater understanding of the legal issues and bureaucratic barriers facing healthcare • Increased sense of social justice • Exceeded volunteer hours • Mixed results on students selection of medical specialty
Sakai et al., 200223	Elective, Selective	1 year	M1 (N = 5)	Health behavior education	Students created curriculum, lessons on health topics at a high school, pretest-posttest design	Specialty test (sex education)	• Increased sex education knowledge • Increased teaching and presentation skills • Increased sense of social justice
Steiner et al., 200024	Elective	1 week	M2 (N = 71)	Natural disaster mobilization and relief	Community needs-assessments developed by not-for-profit organizations used by student groups to provide various relief efforts after a natural disaster	Reflective essay, reflective discussion, questionnaire	• Improved teamwork • Increased leadership skills • Improved communication • Identify other health-needs of underserved community • Understanding of challenges facing community organizations • Understanding of the social determinants of health problems • Understanding of communities coping with natural disasters
Stearns et al., 200025	Selective	1 year	M4 (N = 112)	Health factors of a rural community	Longitudinal design, students wanting to work in family healthcare located in a rural area	Poster presentation	• Identified health needs of underserved community • Increased comfort with using health-related technology • Increased understanding of limitations that affect rural community health
Switzer, 199926	Selective	1 year	M1 (N = 26)	Psychosocial behavior of females who are pregnant	Pretest-posttest, Paired 26 first year med students with pregnant females who were low-income adolescents	Specialty test (prenatal care), questionnaire	• Learned clinical skills: Testing blood pressure and for tuberculosis
O’Tool et al., 200527	Elective, Selective	M1 (pre-clinical 8 weeks) M3 and M4 (clinical 1 month)	M1, M3, and M4 (N = 95)	Community development	Students assigned to a community organization and work with a community mentor. Students developed health projects (e.g., health needs survey, health brochures)	Reflective essay, reflective discussion, questionnaire (open-ended)	• Learned to identify and address the health-needs of an underserved community
Waddell et al., 200028	Required	1 year	M1 (N = 85)	Health behavior education	Identification of resources and development of plans to prevent illness and stabilize of chronic illness.	Specialty test (Genogram tool)	• Improved teamwork • Greater understanding of home-based factors affecting health
Wee et al., 201129	Elective	1 year (optional project swap mid-year)	M1 (N = 824)	Service-learning: home-based vs. clinic-based	Cross-comparison design between clinic-based and home-based service-learning using self-administered questionnaires	Self-administered questionnaire	• Improved teamwork • Improved communication • Developed knowledge of disease management • Greater understanding of the home-based factors affecting health • Increased understanding of the social determinants of health