V OCATION AND S ERVICE L EARNING : F OSTERING
R
EFLECTION AND
C
ITIZENSHIP IN AN
I
NFORMATICS
C URRICULUM
Nathaniel J. Brown, Anji E. Wall, John P. Buerck
Saint Louis University
This paper proposes a new definition of vocation that honors the concept’s ancient roots, is consistent with how the term is used in modern contexts, and also expands the concept for greater versatility. We discuss the centrality of service in the concept of vocation locating it as part of the bridge between a student’s core values and their embodiment in community life. The commitment to one’s profession begins before independent status as a practitioner of that profession. It begins in training during which service-learning is a laudable and increasingly popular way to connect to the charitable aspects of professionalism. We further discuss how the concept of vocation is especially appropriate in the context of citizenship. Citizenship is a way of belonging to a community. It is a relationship that requires giving and taking. Service-learning is an ideal way to practice good citizenship on a local scale, and prepare future professionals for understanding their communities and commitments more broadly. We discuss how these concepts are being emphasized in the medical informatics master’s degree program at Saint Louis University through the incorporation of a service-learning module. We describe the module, discussing how it can be applied to curricula at other institutions and modified for inclusion in other types of courses.
V OCATION
Vocation is best understood as a broad concept applicable to all walks of life. It is part of how we identify our roles in the communities we inhabit. Understanding vocation more broadly can influence our views of citizenship by helping us grapple with what it means to contribute to a community. The usual use of the term vocation is narrow: it is generally used to describe religious orders and some of the more ancient
37

38 Teaching Ethics, Spring 2010 professions, such as law and medicine. The word vocation comes to English from Latin where it originates in the verb vocare, which means ‘to call.’ Traditionally, God was understood to be the one doing the calling, and He called entire peoples (e.g. the Israelites) as well as individuals
(Schuurman). The contemporary understanding of vocation, on the other hand, is almost entirely focused on individuals-on personal vocation, the feeling a person has of being called to perform a certain task or fill a certain position. Because of the religious nature of situating God as the one who calls, vocation has come, in contemporary parlance, to be commonly associated with religious orders: if one has a vocation, it is to priestly or monastic office, or perhaps to missionary or charitable work
(Alphonso). Though religious life is perhaps the most common understanding of vocation, it is not the only one. When not thought of as strictly religious, vocation refers to certain professions such as counseling and medicine (Loxterkamp). These professions have some similar attributes to ministerial work, most significantly a devotion to serving others.
The concept of service unites these specific understandings of vocation.
In the past few decades, vocation has taken on an even broader meaning. Most importantly, it has come to include the idea of devotion to a pursuit that is especially loved. This cherished pursuit might be a job, or a hobby, or something else one does outside of work. Another important difference is that vocation is not only thought of as a calling from God
(Kincaid). The source of the calling is often left purposely vague. These changes in the concept of vocation broaden its usefulness especially for medicine and other non-religious professions. It makes the concept more inclusive, not only of various jobs but also of activities that individuals engage in outside of work.
With this brief historical backdrop in mind, we offer a new definition of vocation consistent with how the term is coming to be used in modern contexts and also honoring the concept’s ancient roots. On this new understanding, vocation is more than a calling; it is a way of integrating deeply considered life-values with what one does in day-to-day life. In our new definition, vocation means “pursuing one’s life in a way that honors one’s values as holistically conceived and embodied in community life.” There are three important concepts in this definition: core values, holism, and community life. Core values are arrived at through reflection.
They are revisable, and always applicable to what one is doing. Holism refers to the application or integration of these values into what one is doing. Community life refers to relationships with others that refine and

Brown, Wall, Buerck: Vocation & Service-Learning: Fostering Reflection and Citizenship 39 test our values and ultimately, through this process, tell us who we really are.
On this understanding, vocation is more than something one tries to discern when deciding what to job to pursue. It is a continuing process that can be started at any time, and that can enrich our lives at any point in their trajectory. It can help us define and modify our goals, and it can help us know when we are on the right track. It also guides us in interactions with our communities. Communities test our values and are the framework in which we define our core values. Vocation is thus more than how we see ourselves individually; it is how we see ourselves as part of something larger and also how others see us and our contributions.
This concept of vocation leads to a commitment to bettering community life, since the success of the community is integral to the success of its individual members. An excellent way for students to begin exploring their vocation is to interact with their communities through servicelearning.
S ERVICE -L EARNING
Service-learning has gained significant attention in higher education as an important addition to traditional curricula. According to Jacoby et al., “service-learning is a form of experiential education in which students engage in activities that address human and community needs together with structured opportunities intentionally designed to promote student learning and development.”(5) Because service-learning has the explicit goal of student learning and development, it goes beyond simple community service. The two essential elements of service-learning that differentiate it from community service are reflection and reciprocity (Jacoby et al.). Reflection in the setting of service-leaning occurs before, during, and after the service activity, and is part of what makes service-learning a perfect activity for students to explore their understanding of vocation through action. It can take many forms: written, oral, within a group, or individually. The key concept in reflection is to engage in a conversation about core values and how they should be applied to the world around us. Before the activity, the focus of reflection is on the goals of the activity and what students hope to learn from it. During the activity, the focus of reflection is on what is being learned and how this activity is helping the community. Finally, after the activity, the focus of reflection is on whether or not the goals were reached and what students learned from the activity. The concept of reciprocity in service-learning emphasizes the

40 Teaching Ethics, Spring 2010 role of the people being served in the determination of what the service project should be. By actively engaging members of the community in the determination of the project, participants in the service-learning experience ensure that the needs of the community are defining the services that will be performed.
Signon describes five critical elements of thoughtful community service that should be incorporated into every service-learning experience:
(1) community voice; (2) orientation and training; (3) meaningful action;
(4) reflection; and (5) evaluation. The voice of the community is elicited through the exercise of reciprocity: the solicitation of ideas about what service should be done from community members. The orientation and training is focused on students, giving them information about the community, organization, or agency in which they will be serving. This element is essential in that it provides students with background knowledge that gives them a better understanding of why the project is important and how to define the goals with respect to the individuals being served.
The element of meaningful action emphasizes the importance of the service being both necessary and valuable for the community itself. By emphasizing the community voice and orienting the students to the needs of the community, it should follow that the service will be meaningful to the community. Reflection, as discussed above, is an element that should be incorporated into all aspects of the experience. It is essential in moving the project beyond community service to service-learning.
The final element, evaluation, should be executed by students and the agencies, organizations or communities that were served. This allows the students to determine how effective the project was in furthering their knowledge, and the agencies, organizations or communities to determine how effective the project was in serving their identified needs.
Service-learning allows students to engage in thoughtful community service that puts the concept of vocation into action. Through productive interaction with their communities, students engaged in servicelearning are given the opportunity to reflect upon and revise their core values. The service that students provide to their communities puts core values into action, thereby demonstrating to students how to act holistically. Because service-learning requires students to interact with members of their communities, they learn how to refine and revise their core values through relationships with those around them. Ultimately, servicelearning, when approached though the lens of vocation, encourages students to become engaged and productive citizens.

Brown, Wall, Buerck: Vocation & Service-Learning: Fostering Reflection and Citizenship 41
Active citizenship is essential for the maintenance of a strong democracy, and a central aspect of active citizenship is civil engagement
(Morgan and Streb). Service-learning encourages students to take an active leadership role in creating projects that engage and involve the surrounding community. By actively engaging students in the community, service-learning fosters the development of students as engaged citizens, both during their college years and beyond.
C OURSE C ONCEPT
While in college, many students take advantage of the opportunity to interact with their communities through campus organizations, campus ministry, and national organizations. The service activities that they participate in encourage them to become engaged citizens as they move into their professional lives. Service-learning creates an additional avenue to allow students to serve their communities, while at the same time gaining valuable knowledge. In order to provide students with an opportunity to interact with their community in an environment of mutual learning, we designed an in-class module for an introduction to informatics class.
Before describing the module, the following section describes what the field of informatics involves.
I
NFORMATICS
Informatics is the multidimensional use of technology to support knowledge discovery and dissemination, assisting the decision maker across a variety of academic disciplines and professional fields. It incorporates the way data is collected, organized, analyzed, represented, filtered and managed. Figure 1 graphically presents the process that informatics uses to combine the interaction of technology with the human and organizational structures to support knowledge discovery, management and dissemination.

42 Teaching Ethics, Spring 2010
Health Informatics specifically aims towards improving the utilization of health care-related data, information, and knowledge in order to support health care research, education, and practice. It was the betterment of medical practice that spurred the development of the field of medical informatics. From its inception its purpose has been to integrate data in the service of patients by giving physicians the information they need to make and improve treatment decisions.
IF500 - I
NFORMATICS
F
OUNDATION
C
OURSE
C
ONTENT
IF500 - Informatics Foundations was developed as a primer course for graduate level students entering the professional master’s degree program in Health Informatics. The purpose of the course is to introduce students to a survey of technology topics, organizational topics and the social aspects of informatics relationship to today’s environment. The course provides a multidisciplinary-based introduction to the informatics principles that support knowledge discovery and dissemination - the ways data is collected, organized, analyzed, represented, managed, filtered and communicated. Selected topics include basic information representation, processing and analysis; organizational informatics; current applications and trends in informatics; legal issues in informatics; the roles and responsibilities of informatics professionals; and informatics impact on the evolution of society.

Brown, Wall, Buerck: Vocation & Service-Learning: Fostering Reflection and Citizenship 43
I N -C LASS M ODULE
The in-class module that we designed begins with an interactive lecture. This lecture has two components. The first is an introduction to the concept of vocation and how it ties into medical informatics. Much of the material covered in the beginning of this paper is included in this lecture. The lectures are designed to be interactive so as to engage students in critically assessing the concept, and thereby increasing the effectiveness of the learning experience. The lecture on vocation concludes with an introduction to ethical case analysis. These cases are a way to apply the concept of vocation specifically to medical informatics. The cases involve dilemmas that medical informatics professionals could realistically encounter in their careers. The values that clash in these cases are presented as core values and thus directly related to vocation.
The second part of the lecture is an introduction to service-learning.
It describes service-learning, differentiating it from community service and discussing the essential elements it entails. It then situates the concept of service-learning within the mission of Saint Louis University and the five dimensions of the Saint Louis University experience: (1) scholarship and knowledge, (2) intellectual inquiry and communication; (3) community building; (4) leadership and service; and (5) spirituality and values
(“Five Dimensions”). In the lecture, students are asked to reflect on how service-learning can be a part of each dimension of the Saint Louis University experience. The lecture concludes with a discussion of the service-learning proposal assignment. By using an example service-learning project that incorporates medical informatics and community service, it illustrates the specific goal of the proposal as the development of a service-learning project that uses the skills of the medical informatics professional to respond to the needs of the community and engage in active citizenship.
O N -L INE R ESOURCES
The in-class lectures on vocation and service-learning became independent modules by recording them using Wimba. Wimba is a complete collaborative learning system that includes the ability to stream live, record, archive and publish traditional classroom lectures, discussions and demonstrations. The recorded lectures were then made available online via BlackBoard to students for review and reference purposes. In

44 Teaching Ethics, Spring 2010 addition, the recorded Wimba lectures will be incorporated into future sections of the Informatics Foundations course.
S
ERVICE
-L
EARNING
A
SSIGNMENT
As part of the vocation and service-learning module, students were divided into groups of 3 to 5 and asked to develop a service-learning proposal. This proposal was designed to have students reflect on their personal and professional values, and develop a plan for how to integrate them into their communities through service related to the profession of medical informatics. The seven questions that students answered in their proposals are shown in Table 1, along with guidance questions that directed students in each section of the proposal.
Describe the proposed service-learning project.
•What is the mission of the organization you will be partnering with?
•How does the project reflect this mission?
•What are the needs of the community and how were they identified?
• How does this project serve the needs of the community?
What service or service-learning projects does the organization currently participate in and what will be different with the implementation of the proposed project?
•Does it meet a different community need?
•Does is meet a community need differently?.
How does the proposed service-learning project embody the concepts, goals or priorities of the course and of Saint Louis
University?
•How does it incorporate the essential elements of service-learning?
•How does it integrate informatics and service-learning?
•Which of the five dimensions of the SLU experience does this activity address?
•How does it address these dimensions?
Briefly describe the setting(s) in which the proposed servicelearning project will occur.
•Where will the project be done?
•Where will the project be implemented?
•How will the community and/or organization be involved, taking into account the setting of the project?

Brown, Wall, Buerck: Vocation & Service-Learning: Fostering Reflection and Citizenship 45
Provide a timeline for the completion of and implementation of the proposed service-learning project and discuss its feasibility.
•How much time does the group have to dedicate to the project?
•What does the group need from the organization and/or community and how much time is needed for this?
What expenses would there be for service-learning project and its eventual implementation? Please explain thoroughly. Is this project supported by any other resources? Please describe.
•Do you need to buy any materials for this project?
•Are there costs associated with implementing or maintaining the project?
How will you evaluate the efficacy of this program?
•What are the goals?
•How will you determine if each goal has been met?
Table 1: Service-learning proposal questions. Questions in bold are found on the proposal template. Bulleted questions are guides for students in answering the bolded questions.
V OCATION AND S ERVICE -L EARNING IN H IGHER E DUCATION
Vocation can be put into action through service-learning in higher education. While the course module described in this paper was designed, for a health informatics course, these concepts are not specific to health informatics, particularly the idea of vocation as a process of reflection and value-integration and service-learning as a means to promoting active citizenship. The development of the understanding of vocation explored in this paper applies across the academic disciplines.
We submit this new definition of vocation and its relation to service for others to comment on, improve, and incorporate into different settings.
The addition of a broad concept of vocation into service-learning across academic disciplines will challenge students to engage with their communities in new and fulfilling ways, becoming more active citizens.
Vocation and service-learning can be integrated into any curriculum, as our module in the Saint Louis University health Informatics course illustrates. Vocation, by the definition offered in this paper, is important to any walk of life. Because school is a particularly good time to reflect on values, especially as new ones are being learned, it is appropriate to address vocation explicitly in the curriculum. One way to introduce and foster a commitment to active citizenship is through service-learning projects. . Because many universities are already equipped to facilitate ser-

46 Teaching Ethics, Spring 2010 vice-learning experiences, service-learning is a practical and effective method for exposing students to the idea of thoughtful community service, and fostering a commitment to active citizenship through service as they move into their professional careers. This paper demonstrates that service-learning can easily be incorporated into any course as a means of encouraging students to engage in thoughtful interactions with their communities, building and refining their values, and becoming engaged citizens.
W ORKS C ITED
Alphonso, Herbert. Discovering your personal vocation: the search for meaning through the Spiritual exercises. New York: Paulist Press,
2001.
DuBois, James. “Framework for Analyzing Cases.” 25 Aug. 2009. < http:/
/www.EMHR.net
>.
“Five Dimensions of the Saint Louis University Experience.” 25 Aug.
2009 <http://www.slu.edu/opdr//FiveDimensions.html>.
Jacoby, Barbara, et al. Service-learning in higher education: concepts and practices. San Francisco: Jossey-Bass Publishers, 1996.
Kincaid, John. “The American Vocation and Its Contemporary Discontents.” Publius 1 (1971): 115-140.
Loxterkamp, David. “Hearing voices. How should doctors respond to their calling?” New England Journal of Medicine 335 (1996): 1991-
3.
Morgan, William, and Matthew Streb. (March 2001). Building citizenship: how student voice in service-learning develops civic values. Social
Science Quarterly 82 (2001): 154-169.
Schuurman, Douglas James. Vocation: discerning our callings in life.
Grand Rapids.: W.B. Eerdmans Publishing Company, 2004.
Sigmon, R. “Service-learning: three principles.” Synergist 8 (1979): 9-11.