Student Initiative Enhances Service Learning and Community Engagement in a Health Professions Microbiology Course

INTRODUCTION

Service learning and community engagement (SLCE) are now common buzzwords in undergraduate education, partly because students learn and retain information better when they are able to connect learning with application (1–3). Use of SLCE in microbiology education has been relatively more recent and limited to highly structured student volunteer activities requiring much planning and direction from the course instructor, and coordination with outside institutions (4). The most common examples have been students volunteering at medical clinics and health fairs (5, 6), but these have tended to involve everyone in the class doing the same activity or volunteering in the same setting. Many other SLCE activities exist, however. I report here on the combination of student initiative and instructor guidance in a health professions microbiology course to create a much broader range of service activities and opportunities to engage the community.

PROCEDURE

The SLCE project is described in Appendix 1 and required students to seek out their own community contacts and, after the activity, complete a reflective essay. Though projects were limited to areas or topics at the intersection between microbiology and public health, students had flexibility in choosing their projects. This ultimately culminated in 14 project categories. Students were expected to include a reflective component in their reports. Key words and phrases from these reflective comments were analyzed and grouped into project themes using grounded theory (7) as done previously (8, 9). Students worked singly or in small groups and presented a total of 90 SLCE projects in the course of the study. Student essays were graded using a rubric (see Appendix 2) adapted from an earlier version (10). This service-learning activity was part of a group of course homework assignments reviewed and approved by an institutional review board.

Project categories

The project categories are listed in Table 1 and show a diversity of options available to students. These categories were grouped into the following broader supercategories.

TABLE 1.

Service learning/community engagement project categories.

Project Category	% of Total
Educating public about infectious diseases using web-based methods	10
Educating public about infectious diseases using other methods	9
Teaching handwashing	38
Teaching oral hygiene	8
Teaching both handwashing and oral hygiene	3
Teaching handwashing and sneezing/coughing etiquette	2
Teaching hygiene in a gym	2
Volunteering at an animal shelter or veterinary hospital	6
Volunteering at a dental office	4.5
Volunteering in an emergency room or with emergency medical services	4.5
Volunteering at a health fair or organization	3
Volunteering at a medical clinic, nursing home or pharmacy	7
Volunteering at a clinical lab	2
Contacting a government official or agency	1

Educating the public using web-based methods (category 1)

Students used social media or web platforms such as Weebly.com, Tumblr.com, and Facebook.com to discuss particular infectious diseases [e.g., flu, methicillin-resistant Staphylococcus aureus (MRSA), human papillomavirus (HPV), and other sexually transmitted diseases (STDs)].

Educating the public using other methods (category 2)

Students used other methods to educate the public: 1) they hosted a faculty speaker on malaria and organized a fund drive for mosquito nets, 2) they gave their own oral presentation to high school students on community-acquired infections, 3) they discussed tick-borne diseases with hikers at a state park, 4) they displayed a poster and handed out brochures about rabies at a fair, and 5) they organized a flu vaccination drive on campus.

Teaching hand, oral, and general hygiene (categories 3 to 7)

These were the most popular categories. Students taught dozens of small groups of kids (and in a few cases some adults) proper handwashing and/or oral care. Settings ranged from day care and community centers and schools to restaurants and food processing establishments.

Volunteering while shadowing (categories 8 to 13)

Shadowing is an important component of health professions microbiology in its own right, as discussed previously (10). Here, students combined shadowing with actual participation, as these were students with prior healthcare experience or who had associations with practitioners who could provide access and supervision.

Contacting the government (category 14)

This was the least favored category, possibly because students didn’t expect to get a timely enough response.

Project themes

Despite varied reflective comments in student reports, five common themes emerged (Fig. 1). “Raising awareness about infectious diseases” was the most common theme, expressed by 31% of projects, followed closely by “reducing infectious diseases” (27%) and “helping kids learn about hygiene” (21%). With these three themes, it is clear that most students had practical public health motives and altruistic concerns driving their efforts, i.e., they were most concerned with the public benefit of their SLCE activities. The fourth theme, “learning from the experience” (18%), indicated that personal growth was most important to these particular students. In contrast, in only 3% of projects did students express any concern about “applying course content.” This surprising result may indicate that most students did not look at the service or engagement activity as simply an assignment, but as something personally important (helping others, helping themselves). A somewhat similar observation was made in a study where many medical microbiology and cell biology students, when surveyed after doing a service-learning assignment, didn’t believe the experience had enhanced their learning of course content but felt it had benefited the community (5). Yet, in another study involving introductory biology students performing service learning (8), the most common theme was “biology knowledge/skills.” Somewhat overlapping both themes, allied health microbiology students involved in a directed service-learning activity (6), when specifically surveyed, commented positively on the career relevance and altruism of their service as well as the relevance to course content. The different themes among these studies may reflect differences in the types of students: freshman biology majors (8) versus sophomore–junior students focused on healthcare careers as in the current study and others (5, 6). The different themes may also be a consequence of the mode used to express comments. Students were more likely to promote altruistic themes when freely expressing themselves, whereas they tended to mention course content more when responding to specific questions on a survey.

FIGURE 1.

Analysis of reflective themes: comparison of student comments. Reflective student comments expressed in project reports were grouped into the five themes above according to key words or phrases.

CONCLUSIONS

A class service project that engages the entire class in the same activity usually requires much planning and coordination with an outside institution. While this approach may stimulate student interest and provide needed public services, it also limits student creativity and exposure to other service opportunities. Health professions microbiology students should be encouraged to seek out SLCE activities and should be provided with direction regarding various options. Instructors of general microbiology or biology courses may suggest examples mentioned in this study and/or direct students to explore other possibilities (see Appendix 2). While some students may see the application of course concepts in doing such activities or see the benefits of service and engagement to their own professional and personal development, most health professions students want opportunities to help others and to make a positive impact on public health.