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Open Collection of Student Writing (OCSW)

Literature Review III

LITERATURE REVIEW PAPER

STUDENT PHARMACISTS’ PERSPECTIVES ON SERVICE-LEARNING EXPERIENCES IN FREE CLINICS

By

Student Name

An Assignment

Submitted in partial fulfillment

Of the requirements for

DH 1400 Dental Hygiene Theory II

Salt Lake Community College

April 22, 2020

 

Title

Student Pharmacists’ Perspectives on Service-Learning Experiences in Free Clinics

Authors

Jennifer Ko, Sharon Connor, Lauren Jonkman, Olufunmilolia Abraham

Overview

It was recommended that service-learning should be incorporated into the curriculum of health care professionals by the United States healthcare system.  The purpose of this was to bring awareness to health disparities. “Service-learning provides the unique opportunity to address disparities in care while providing a dynamic experiential environment to strengthen student skills” (Schlesselman, Borrego, Bloom, Mehta, Drobitch & Smith, 2015, article 116).

Purpose

The purpose of this study was for the student pharmacists to gain knowledge and perspective on the effectiveness of a service-learning experience that was related to their future profession. It was hoped that by providing community service for underserved populations, students would become more aware of the social and economic indifferences within their desired career field.

Method

Pharmacology students who attended University of Pittsburgh Medical Center, University of Pittsburgh School of Pharmacy, and the University of Wisconsin-Madison School of Pharmacy had the opportunity to provide service-learning within free clinics.

The students selected were within the second and third years of pharmacology school, 422 students were assigned to complete three hours of service-learning per year. This service would be completed within a free community health clinic. The clinics mentioned within this study provided free healthcare services to the uninsured, underinsured or homeless.  Specifically, a women’s shelter, and two Health Care for the Homeless clinics in Western Pennsylvania. The clinics provided medications and medical services free of charge to patients who qualified.

Once the students completed their service-learning experience, they had to submit a brief written reflection of their volunteer experience. Before the students began at the free clinic, learning objectives and prompts were used to help direct their reflections. The specifics of the essay assignment guidelines included a one to two-page response to five insightful questions posed by course instructors.

The content of the students’ service-learning reflections were thematically analyzed according to an established list of codes used to represent specific student observations.  These observations began in September 2015 and concluded in May 2017.  The coding system utilized was the NVivo version 10 (Ko, Connor, Jonkman & Abraham, 2019, p. 2013).  The codes were then used to identify common themes within the essays.

Reliability

The NVivo coding system was a qualitative data analysis produced by, “QSR international based in Melbourne, Australia” (Ko, Connor, Jonkman & Abraham, 2019, p. 2013). For this study to be reliable the essays presented were multi-coded in order to cover the occurrence of multiple themes. To guarantee reliability, “coders used a consistent codebook that was collaboratively developed” (Ko, Connor, Jonkman, Abraham, 2019 pg. 2013).  If coding discrepancies arose, they were inspected and solved in order to assure the continuance of reliability. The themes were acknowledged by using a coder consensus.

Validity

The participants used for this study were all pharmacology students. The study used a convenience sample- all students in the course were required to participate. It was not a randomized study. They were aware of the assignment and fulfilled it. This study is an example of qualitative research because opinions, attitudes, and thoughts were analyzed. When analyzing the results of this study, two independent coders coded and read all of the reflective essays that were submitted.

The purpose within this study was to present the pharmacology students’ perspectives.  This was accomplished throughout this study in particular. However, this cannot be generalized throughout all pharmacology students who may have participated in a similar community service experience.  Other pharmacology students may reflect opposing attitudes.  This is could be due to the location, attitudes of the participants and the population served. Such as; irritated customers, negative volunteers, or lack of supplies. Other students could have had a negative experience due to the circumstances, while others gained a more positive one.

Because the reflective essay was a required assignment, students could have sugar-coated their experience to comply with the grading criteria. This could skew the results due to the student being more motivated by a grade.  This, in turn could make it more difficult to determine if the research actually measured the honest perspectives of the students.

Results

The results consisted of 422 reflection essays.  There were 222 analyzed from the second-year students and 200 from the third-year students. A consensus was concluded on four general themes that focused on the research objectives. In addition, two themes were found during the review process, making a total of six themes.

The results of the themes were consistent within the essays of both the second and third-year students. “The first theme identified in the students’ essays was that they viewed providing care to the underserved and vulnerable as a professional obligation” (Ko, Connor, Jonkman & Abraham, 2019).  Discussed within the essays, both groups of students agreed that providing care to the underserved was an obligation in their professional career.  Furthermore, students expressed a belief that no matter the circumstances, all patients were entitled to receive the best possible care.

The second-year students communicated a larger understanding for low-income patient populations and gained an appreciation for the availability of the free clinic. Whereas the third-year students felt more impacted by the patients who shared an emotional experience with them. However, both groups of students became aware that working with these low-income patients increased the empathy of the students towards that particular group of people, which became the second theme identified in the study.

The third theme was that the students became more aware of the inequalities of the United States healthcare system.  Because of the strong emotions felt by the students regarding the injustice of the healthcare system, some students relayed a negative attitude towards the service-learning experience.

The final three constructs assessed by the researchers related to personal growth of the students involved. The fourth theme identified in the essay reflections was related to valuable experience statements.  Because the students found value in the experience, they aspired to pursue a similar volunteer experience in the future. The fifth theme was associated with growth in interprofessional awareness. “Being exposed to a variety of patient-provider interactions enabled students to assess different approaches to patient care” (Ko, Connor, Jonkman & Abraham, 2019). This developed the students’ appreciation for health care providers. The sixth and final consistent theme found by the researchers was the students’ declaration of personal empowerment felt at the conclusion of their service-learning experience. The students noted that they became more confident in their ability to provide care.

Discussion

Specific limitations were found throughout this study.  Students were required to submit the reflective essays for a grade.  This could have played a role on the response that was relayed.  If the student desired a better grade, they may have been more optimistic towards the experience.  These students were also required to only submit one reflection each year based on a one three-hour clinic volunteer experience.  Because the students were only introduced to one event this limited the students’ learning experience.  If they were required to have more opportunities it would have opened new doors and created new perspectives of the community which was being served. 

Insights Gained

Service-learning is an opportunity that is essential to gain a better understanding of the conditions within a community.  It is used as a teaching factor to guide students to understand the environment of which their career may be involved in. Not everyone always gains a positive experience out of a service-learning opportunity. Some individuals may not enjoy it, while others seek it as a chance to learn more about the underserved populations.

Significance

Service-learning is significant because it teaches students about the poor conditions that can evolve within a community.  By having these experiences required within a school semester, students will be more knowledgeable and prepared when entering their career field. It helps the students acknowledge their civic responsibility.  It is significant to have these experiences because it may fuel the discussion and motivation towards the creation of better health resources.  It can motivate the students to want to make a difference within their community and throughout their career.

Service learning is a critical component of the Dental Hygiene Program at Salt Lake Community College. Opportunities for service learning are included in college curriculums for several reasons.  These reasons include, gaining a passion for serving within the community, learning about the necessities that are being neglected within a community, and becoming better acquainted with the diversity that surrounds them.  Service-learning is a wonderful opportunity to learn and grow while serving the community.

The service-learning curriculum for the pharmacology students is similar to the dental hygiene students enrolled at Salt Lake Community College.  It is similar in the sense that after each service-learning experience, the dental hygiene students are required to write a submission which reflects their experience serving the community.  The reflection criteria is also given with insightful questions posed by the instructors.  These reflections are beneficial because they become a valuable memory for students to reminisce about their accomplishments during their service-learning experiences. The dental hygiene and pharmacology students will have exposure to underserved populations throughout their career.  By participated in service-learning, these students gain experience and knowledge that teaches them of the reality of social and economic indifferences.

In conclusion, this research supports the inclusion of service-learning within an educational curriculum. The pharmacology and dental hygiene students gain empathy for the populations and acquire confidence in their skills.  Because of their involvement with non-profit or educational community associates, the students gain an appreciation for the organizations that make it possible for the underserved to receive care. Service-learning is not only beneficial to students, but the communities involved, and it should be incorporated in applicable courses.

References

Ko, J., Connor, S., Jonkman, L., & Abraham, O. (2019). Student Pharmacists’ Perspectives on Service-Learning Experiences in Free Clinics. American Journal of Pharmaceutical Education, 2011–2020.

Schlesselman L, Borrego M, Bloom TJ, Mehta B, Drobitch RK, Smith T. An assessment of service-learning in 34 us schools of pharmacy follow up on the 2001 professional affairs committee report. Am J Pharm Educ. 2015;79(8): Article 116.

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