Examining student perceptions of a COVID-19 service-based learning elective

Introduction

Currently, we are in the midst of an ongoing viral pandemic associated with the novel coronavirus, also known as COVID-19 or SARS-CoV2. However, on December 9^th, 2020, thanks to improvements in science and technology, Canada had a collective sigh of relief as a vaccine was authorized for use in Canada.¹ With a vaccine in-hand, a new challenge emerged, how do you vaccinate an entire country with a one or two-stage vaccine? In particular, how do you vaccinate people when the nearest doctor practices over 100 km from your home?² In many rural and remote regions in Northern Ontario, this is the current challenge. This problem is further complicated as many of the residents of these more rural and remote regions are Indigenous peoples of Canada, and historical trauma exists between Indigenous communities and the Canadian government and healthcare systems.³ To ensure these communities' safety, the Ministry of Health reached out to a number of organizations and institutions, including the Northern Ontario School of Medicine (NOSM), to help with the delivery of these vaccines.⁴

NOSM was opened in 2005 with a social accountability mandate.⁵ Social accountability is “the obligation [of medical schools] to direct their education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve.”⁶ This means that NOSM is devoted to improving people’s health in Northern Ontario.⁵ However, it is often challenging to teach and evaluate a student’s understanding of the importance of these concepts in a classroom or hospital setting.^7–9 One way to teach the importance of these concepts is through service-based learning.⁹ Service-based learning is a type of experiential learning that occurs through a cycle of action and reflection. At NOSM due to the COVID-19 pandemic, students have the unique opportunity to participate in a service-based learning opportunity where they will be part of numerous teams dispensing the COVID-19 vaccine across Northern First Nations fly in/remote communities. The purpose of this study is to examine the linkage between social accountability and student experiences with a unique service-learning experience.

Research design and methods

Data will be collected through an already planned post-placement activity (refer to Appendix A for activity). The placement activity was designed by a team of content experts, instructional designers, and faculty members. The activity will consist of a reflective response passage. The response passage will be de-identified by the Undergraduate Medical Education Assessment office. Once the data has been de-identified it will be sent to the research team and will be analyzed for themes, which will be derived using a six-step, content-driven, thematic analysis approach. These themes will then be examined in relation to existing literature in social accountability and medical education. Ethics for this project was waived by Lakehead University Research Ethics Board as data meets the criteria of the Tri-Council Policy Statement 2, Chapter 2, Article 2.4. We are currently open to collaboration with other educators and/or students who have also had the chance to do something similar.

Summary

Little research has examined the connection between service-based learning and social accountability.⁹ The main goal of this study is to examine the linkage between social accountability and an in-field service-based learning experience. In collaboration with the Undergraduate Medical Education Assessment office a reflective response passage was created for students to complete after their service-based learning experience. The results of this study will help medical education programs understand the link between a school with a social accountability mandate and students’ perceptions and experiences in a service-based learning experience.

Appendix A

Placement Activities

1. Learners will be required to complete a 500-word written reflection to be submitted to their elective supervisor

   Reflection questions

   1. What did you learn from this experience? Please comment on any or all of the following
      1. About social accountability or social justice
      2. About Indigenous health
      3. About advocacy
      4. About leadership
      5. About yourself
      6. About transport medicine and an integrated remote health care system
   2. What is something from the experience that has reinforced some of your prior learning?
   3. What is something that has left you thinking or will change your future practice?