WELCOME!!!

1. WELCOME!!! Disclosures: Suzanne Cashman – no financial disclosures Barbara Gottlieb – no financial disclosures

2. Service-LearningCCPH Annual ConferenceHouston, TexasApril 18, 2012 Suzanne Cashman University of Massachusetts Medical School Barbara Gottlieb Brookside Community Health Center Harvard Medical School and School of Public Health

3. Today’s Agenda 1:00-1:30 Introductions and plan for the day Definitions – Service, Service-Learning 1:30-2:10 Partnerships 2:10-2:50 Reflection BREAK 5 minutes 2:55-3:35 Evaluation 3:35-4:00 Summary, Service-learning in perspective, wrap-up, feedback

4. Learning objectives Describe the theoretical basis and key components of service-learning Articulate the varied ways in which service can be viewed Apply the principles of partnership to service-learning Explain the key role of reflection in service-learning

5. Learning objectives Demonstrate a variety of reflection modalities Understand how to evaluate service-learning activities and programs Articulate the place and role of service-learning in the context of community-engaged scholarly activities

6. Introductions

7. I slept and dreamt that life was joy. I awoke and saw that life was service. I acted and behold, service was joy. Rabindranath Tagore

8. What is service? What are some examples of service?

9. A type of economicactivity that is intangible, is not stored and does not result in ownership. A service is consumed at the point of sale. Services are one of the two key components of economics, the other being goods. Examples of services include the transfer of goods, such as the postal service delivering mail, and the use of expertise or experience, such as a person visiting a doctor.Basically, when you engage in an unpaid activity intended to benefit others, that’s service.

10. What makes service service? Brainstorming exercise

11. What is service-learning?

12. What is Service-Learning? Service-learning is a structured learning experience that combines community service with preparation and reflection. Students engaged in service-learning provide community service in response to community-identified concerns and learn about the context in which service is provided, the connection between their service and their academic coursework, and their roles as citizens. (CCPH Website)

13. Service-Learning Strives to balance service and learning objectives Addresses community concerns and broad determinants of health Integrates community partners Emphasizes reciprocal learning - traditional definitions of "faculty," "teacher" and "learner" are intentionally blurred

14. Service-Learning (cont’d) Emphasizes reflective practice - fosters critical thinking and self-awareness Integrates reflection at all stages of learning Develops citizenship skills and focuses on achieving social change Provision of health services is not often the most important factor; students place their roles as health professionals and citizens in a larger societal context

15. Service-Learning (cont’d) Focus is on partnerships Quality of service-learning opportunities develop and evolve over time

16. What Distinguished Service-Learning from Other Forms of Experiential Education? Recipient Beneficiary Provider Focus Service Learner Service-Learning Community Service Field Experience Volunteerism Practicum, Internship, Clerkship Furco, Service-Learning. 1996

17. Distinguishing service-learning with other types of experiential learning(CCPH, 1999)

18. Points of Departure: S-L and Traditional Education Balance between service and learning Integral involvement of community partners Emphasizes : Importance of addressing community-identified concerns and broad determinants of health Strength/asset-based approach Reciprocal learning Reflective practice Developing citizenship skills and achieving social change

19. The Yoder Wheel 19

20. Evidence: HPSISN Health Professions Schools in Service to the Nation (HPSISN) Program, 1994-98 Three-year grants to 17 health professions schools Program goals: Strengthen partnerships between health professions schools and communities Address unmet community needs Instill ethic of community service and social responsibility in health professions schools, students and faculty Equip next generation of health professionals with community- oriented competencies necessary to practice in a changing health care environment.

21. HPSISN Partnership Focus School-based health education Health promotion and disease prevention Teenage pregnancy Domestic violence Oral health Worksite-based health education Companionship Case management Mentoring and tutoring Rural access to care

22. Findings: Students Transformational learning experiences Clarification of values, sense of self Taken more seriously when it’s required Greater gains when non-clinical: Awareness of determinants of health Sensitivity to diversity Knowledge of health policy issues Leadership development

23. Findings: Community Partners Service, economic and social benefits  awareness of institutional assets/limitations High value placed on relationship with faculty Eager to be seen as teachers and experts Campus involvement limited Benefits of SL outweighed the burdens Concerns re: communication, logistics, needs-based and expert approaches

24. Findings: Faculty Stronger relationships associated with: Joint planning Partners being offered specific and active roles Genuine sense of reciprocity Student preparation and orientation Single point of contact Consistent, accessible communication

25. Findings: Institutional Capacity Link to mission and strategic goals Clear definition of service-learning Supportive leadership at all levels Effective institutional structures and policy Investment in faculty development Integration of SL into existing courses Long-term community relationships Ongoing assessment and improvement

26. Lessons Learned Service learning is powerful pedagogy SL can contribute to competencies needed for health professions practice SL can benefit students, faculty, the community and community-university relationships Community can be effective educators Community assets are often overlooked SL requires schools to give up “control”

27. Why Service-Learning?

28. 21st Century Challenges for Educators Knowledge explosion Cost, resource constraints Multiple stakeholders in education Demand for new paradigms Recognition of multiple learning styles and “intelligences” Complex problems, but historical constraints on innovation Educated consumers/public Disparities and inequities Demand for equity and social justice

29. Are we meeting these challenges? Do our teaching methods … promote and develop the thinking skills that our students will need to work compassionately, safely and effectively? speak to multiple learning styles and intelligences? provide the skills and encourage a commitment to life-long learning? promote the exploration of values that are consistent with social justice and equity? promote altruism and help students learn that they can do well by doing good? promote teamwork, collaboration, communication skills?

30. Service-learning vs traditional learning Traditional Fact-oriented My-side bias Algorithmic Group think Stay in comfort zone Ability to focus may obscure the big picture Existing knowledge may compete with acquisition of new knowledge (Ritchhart, Perkins) Service-learning Process-oriented Diverse perspectives Diverse strands of information Take risks Heightened awareness of experience Big-picture orientation Openness, self-awareness, critical thinking

31. Partnerships

32. Activity Using the word magnets we’ve distributed, compose the following: A sentence or phrase that describes your experiences with community-campus partnerships A sentence that describes your dream partnership

33. Why partnerships? Community-campus partnerships – a strategy for social change Establish missing but critical connections Identify new/better way to solve problems Link complementary skills and resources of diverse people and organizations Plan and carry out comprehensive actions that coordinate reinforcing strategies and systems

34. Partners: Faculty/Campus Faculty & campuses involved in partnerships: Primary motivators: personal values, belief in improved learning, new knowledge Enhanced relationships - students, community Linkage of personal/professional lives  understanding of community issues New career and scholarship directions Concerns re: time, control

35. Partners: Communities Communities involved in partnerships: Service, economic and social benefits  awareness of institutional assets/limitations High value placed on relationship with faculty Eager to be seen as teachers and experts Campus involvement limited Benefits outweigh the burdens Concerns re: communication, logistics, needs-based and expert approaches

36. The Power of Partnerships Initial principles adopted 1998 Revised 2005-2006 (October 2006) Based on practice and feedback CCPH board discussion Community Partner Summit (Wingspread Conference Center, Racine, Wisconsin)

37. Principles of Good Community-Campus Partnerships Partnerships form to serve a specific purpose and may take on new goals over time. Partners have agreed upon mission, values, goals, measurable outcomes and accountability for the partnership. The relationship between partners is characterized by mutual trust, respect, genuineness, and commitment. The partnership builds upon identified strengths and assets, but also works to address needs and increase capacity of all partners. The partnership balances power among partners and enables resources among partners to be shared.

38. Principles (cont’d) Partners make clear and open communication an ongoing priority by striving to understand each other's needs and self-interests, and developing a common language. Principles and processes for the partnership are established with the input and agreement of all partners, especially for decision-making and conflict resolution. There is feedback among all stakeholders in the partnership, with the goal of continuously improving the partnership and its outcomes. Partners share the benefits of the partnership's accomplishments. Partnerships can dissolve and need to plan a process for closure

39. Partnerships - exercise Working in pairs – choose one of the principles of partnership and discuss how you have seen this principle in action What has gone well? Challenges? (if relevant) – what this principle might look like early in a partnership, and how it might evolve in a more developed partnership does this seem like a “core” principle?

40. Reflection

41. Kolb’s learning cycle Inventory of dominant learning styles Cycle of learning (for all learners) Cycle of teaching (for educators)

42. Challenges in higher education Do our teaching methods … promote and develop the thinking skills that our students will need to work compassionately, safely and effectively? provide the skills and encourage a commitment to life-long learning? promote the exploration of values that are consistent with social justice and equity? promote altruism and help students learn that they can do well by doing good? promote teamwork, collaboration, communication skills?

43. How do learners learn best? Experiential Deliberate ecology of learners Mentoring Reciprocal learning Embedded learning Grounded Values-based Developmentally appropriate Guided reflection supports all of these areas

44. Definitions

45. Reflection Slow consideration, serious thought

46. It is one thing to absorb a fact, to situate it alongside other facts in a configuration, and quite another to contemplate that fact at leisure, allowing it to declare its connectivity with other facts, its thematic destiny, its resonance….. Sven Birkerts, The Guttenberg Elegies

47. Reflection • Dewey, 1933: ‘‘active, persistent and careful consideration of any belief or supposed form of knowledge in the light of the grounds that support it and the further conclusion to which it tends” • Bond, 1985: ‘‘a generic term for those intellectual and affective activities in which individuals engage to explore their experiences in order to lead to a new understanding and appreciation” • Moon, 1999: ‘‘a form of mental processing with a purpose and/or anticipated outcome that is applied to relatively complex or unstructured ideas for which there is not an obvious solution

48. Reflection definitions - themes • Critical analysis of experience • Search for deeper meaning • Active construction of lessons and meanings • Guide for future action • Affective processing • 2 dimensions (Mann, et al) • Iterative – new understanding leads to new action or changed response in future practice • Vertical – deepening of understanding and analysis

49. Evidence base for reflection • Commentary/essays • Testimonies • Descriptive studies • Studies with measured outcomes • Comparisons of 2 or more approaches to reflection • Comparisons of reflection vs no reflection

50. Reflection activities