University of Texas El Paso 4th Sun Conference Proceedings (2005)
Service Learning: Building Bridges Between the Student World and the Real World.
Bender, D.G. & Robinson, C.A.; University of Oklahoma Health Sciences Center; College of
Allied Health; Department of Rehabilitation Sciences
Corresponding authors:
Denise G. Bender, JD, PT, GCS
University of Oklahoma Health Science Center
College of Allied Health
Department of Rehabilitation Sciences
Program in Physical Therapy
801 N.E. 13th Street
Oklahoma City, OK 73104
denise-bender@ouhsc.edu
Cyndy Robinson, M.S., OT/L
Occupational Therapy Interim Program Director
Assistant Professor
University of Oklahoma Health Sciences Center
Department of Rehabilitation Sciences
P.O. Box 26901, CHB 235
(405) 271-2131, ext. 47139
Introduction
Few would argue with the concept that service should play an important role in the postsecondary education of students. Service offers a chance for students to bridge the gap between
the isolated academic world and the real-life community in which the university is located.
Questions are raised when activities typically identified as volunteer work are reconfigured as a
‘service-learning’ component of the curriculum, rather than remaining an extracurricular option.
Does service really result in ‘learning’? (Kahne & Westheimer, 1996)
Service learning defined
Before this question can be answered, it is important to develop a clear definition of the
term. Service learning is not a synonym for volunteerism. Although both terms refer to the
process of encouraging students to perform a service in the community, the intended outcomes
are very different. As community volunteers, students fill the role of expert givers who bestows
some benefits upon the community. The community members function as the recipients of the
student beneficence. Student volunteers provide a service but remain detached from the
community recipients. Their relationship generally remains top-down in nature, with the student
as the donor and the community as the recipient (Furco, 1996). Afterward, student volunteers
often complete assignments based on their community involvement, recording an accurate
recitation of the quantity of activities performed, along with a self-assessment of the quality of
their individual performance of these activities. These volunteer projects may be enjoyable,
uplifting, or even spiritually satisfying, but there is no deliberate attempt to reflect on these
feelings or to extend the self-assessment component beyond the boundaries of the project.
In service learning, the emphasis is on a two-way exchange between the student and
community partners intended to result in a lasting change for all participants. “The watchword
here is reciprocity: there must be an agreed upon balance of benefits and responsibilities on both
sides.” (Zlotkowski, 1999 p. 82). Although the community still learns and benefits from the
students, the learning process goes both ways. Quinn, Gamble, and Denham (2001) discuss that
the relationship should involve a reciprocal sharing of resources and decision-making. Both sides
must speak frankly about what they expect to gain from the relationship to avoid unrealistic
expectations.
As with volunteerism, students become involved in participation in an activity but the
difference lies in how the activity is selected. Community partners do not assume that the
university is automatically in the best position, by virtue of its expertise, to know what the
community needs. Instead, the community generates a needs assessment to self-identify unmet
needs, and the community and the student become partners in the service-learning endeavor. The
community has the expertise and is clearly in the best position to find its voice and identify its
own needs (Eyler & Giles, 1999).
The other major difference between volunteerism and service learning lies in the
reflective component. As with volunteer activities, students may complete activity logs and selfanalysis of their performance of the required activity, but service learning requires them to look
inwardly and think about the lessons learned from their actions. It is well accepted that servicelearning projects must include an educational component that challenges participants to reflect;
not only on the activity itself, but also on how the participant’s thinking and beliefs about future
practice were changed by participation in the experience (Mayen, 2002; Bringle & Hatcher,
1996). According to Mayen (2002), students who engage in service learning activities during
their educational process gain a better awareness of what their responsibilities are to their
profession, themselves, and the community. They further propose that reflecting on service
learning transforms students and better prepares them to assume multi-faceted roles as health
providers with deeply felt ties to the community.
According to a definition offered by Georgetown University HPSISN Program Office
(1997), service-learning activities offer something that goes beyond the provision of a service to a
targeted community. Bringle and Hatcher (1996) also offer a perspective on the question of
whether any actual learning ultimately occurs in service learning. “We view service learning as a
credit-bearing educational experience in which students participate in an organized service
activity that meets identified community needs and reflect on the service activity in such a way as
to gain further understanding of the course content, a broader appreciation of the discipline, and
an enhanced sense of civic responsibility.” (1996, p. 222)
Developing a community based service-learning project
Service learning may seem redundant in health professions curriculum, since these students
are already preparing to become service providers. Research suggests that professional program
students can benefit from involvement in service learning (Cauley et al, 2001). In the late 1990’s,
the Health Professions Schools In Service to the Nation (HPSISN) program conducted research at
multiple academic health centers to determine the significance of service learning activities for
students from health professions. According to its final evaluation report, “… service-learning
was found to be a powerful tool for influencing student attitudes toward the role of service in
their lives as health professionals.” (CCPH, 2005) According to the Georgetown University
HPSISN Program Office the HPSISN results noted that the impact of service-learning was more
evident when service -learning was both imbedded as a required component of a course and
where it required students to engage in ongoing reflection about their personal changes as a result
of participation in the project (1997).
The Department of Rehabilitation Sciences at the University of Oklahoma Health Sciences
Center developed a service-learning project for entry-level physical and occupational therapist
enrolled in the first year of a three-year masters program. This activity, titled The Community
Visitor Project, met several identified needs of citizens in the state of Oklahoma. According to
the United States (US) Census bureau data, 32% of Oklahomans live in isolated rural areas (U.S.
Census, 2000). This exceeds the US average of 24.8%. When this statistic is combined with the
knowledge that by 2020, 1 in 6 Oklahomans will be age 65 or older (U.S. Census, 2000), the
problems of isolation, especially of seniors, become apparent. The elderly are not the only
Oklahomans in need of community outreach efforts. According to the U.S. Census (2000), and
data from the state fact book (2003), Oklahoma ranks #10 for the number of children living below
the poverty level, with 1 in 4 children living with only one parent.
Our Community Visitor Project’s attempted to address the needs for support and
companionship in Oklahomans. The student participants would gain an opportunity to apply
theoretical information from coursework in an unfamiliar community environment. The
participants would benefit from regular companionship and be empowered by a chance to teach
students about the realities of their lifestyles (See Chart 1).
Chart 1: Curricular content incorporated into the Community Visitor Project
OCTH/PHTH 7123 Concepts in Rehabilitation Sciences
(Semester 1 (Occupational and physical therapist mandatory course)
•Political/socioeconomic/cultural issues facing ends of age spectrum
•Issues of isolation, health, and rural environments
•Understanding link between professional roles and community membership
*Service learning project assigned in this course
OCTH/PHTH 7133 Introduction to the Clinical Process
((Semester 1 (Occupational and physical therapist student mandatory course)
•Interviewing
•Non-verbal interpretation
•Therapist-patient rapport information
•Developing patient-centered approach to service delivery
This service-learning project was imbedded in a mandatory first year course and had an
educational objective related to it. The syllabus for ‘Concepts in Rehabilitation Sciences’
required the first year physical and occupational therapist students to utilize the didactic
principles of interpersonal communication to provide 1:1 companionship and friendship
opportunities for children and/or adults in the surrounding communities. Students identified their
desired urban or rural community, selected their own partners for the project, and mutually
established an ongoing visitation schedule.
As with any other course assignment, the students must have a clear understanding of
deadlines, as well as the documentation and participation expectations. A successful servicelearning experience depends on the faculty willingness to:



establish a feasible timeline for the project,
work with students to help them develop their individual plans
help the students strategize how to identify and approach suitable members of their target
community
Our project began in the first week of the first semester of the eight semester professional
programs with an overview of the philosophical and educational concepts supported by
participation in service learning. By the third week, students submitted a form that described
their partners’ names, a calendar of scheduled visits, and a general idea of the type of activities
planned. Activities included crafts, conversation, community outings, unstructured play, games,
and similar interactions that held meaning for the participants. During weeks three through
fourteen, students engaged in a minimum of ten hours of interactions with their community
partners. At the end of each session, students completed a daily activity form that is signed by
either their partner or by another adult in the community.
At least weekly, or more often if desired, our students reflectively wrote about their
thoughts concerning several open-ended questions (Chart 2). At the completion of the project,
students prepared a scholarly paper that examined the process of initiating and maintaining a
therapeutic relationship in the context of a natural environment containing both internal (student
related) and external (partner) barriers. The reflective process allowed a deeper understanding of
how their interpersonal interactions as a member of a community integrated the purpose of this
service-learning project into their traditional curriculums.
Chart 2: Reflection questions
1. What new learning did you acquire through your participation?
2. How has this new learning influenced your thinking about issues of isolation & community
needs in a rural environment?
3. How will your learning influence your future practice as an occupational therapist or physical
therapist?
4. Based on this experience, establish at least one learning goal/objective for yourself and two
strategies for reaching each goal.
Although the students enrolled in the Community Visitor Program were in the first semester
of their professional program, their coursework, fieldwork, and tutorials had adequately prepared
them to interact appropriately in the community. For grading purposes, students were required to
complete this Community Visitor Project within the first semester. After the assignment ended,
many students chose to informally continue their relationships with their community partners.
Feedback on the project was very positive and students viewed their community time as a chance
to move beyond the student view toward a broader understanding of what it meant to be a part of
a community. The project’s themes of interpersonal-skill development and rapport building
continue to be reinforced and enhanced through participation in subsequent projects over the
remaining seven semesters of their professional programs.
Additional Considerations
Any educational undertaking that removes students from the classroom requires careful
attention to risk management issues. The easiest way for faculty to minimize risk is to accompany
the students during the experience, thus providing assistance with any decisions or situations that
arise. The purpose of our service-learning experience, with the goal of requiring students to
independently develop and maintain equal relationships without relying on the comfort of
therapist-expert status, would be defeated if the students were accompanied by faculty.
Independent projects involving health professional students raise supervision and licensure
concerns. According to Oklahoma state practice acts for physical therapy (2004) and
occupational therapy (2004), the practice of these professions is restricted to either licensed
practitioners or to students who are supervised by licensed practitioners during any service
delivery (Bender & Randall, 2005). Student preparation must include a thorough explanation of
the non-clinical nature of activities authorized during the service-learning project. They received
instruction in how to politely refer their partner to a licensed practitioner whenever any health
related questions or concerns were raised.
In addition to these professional boundaries, basic safety guidelines were enforced. Students
could not interact with community partners under the age of 18 unless in the presence of a family
member. In addition, students were not allowed to provide transportation to partners of any age,
although our students could act as passengers for adult partners who wished to drive. As a final
precaution, students were reminded to immediately leave any environment or situation that felt
potentially dangerous. At present, the Community Visitor Project has existed for two years
without any untoward incidents reported by students or their community partners.
Conclusion
Establishing the Community Visitor Project as ‘a credit bearing educational experience” was
beneficial for the students, the community, and the academic programs (Bringle & Hatcher,
1996). This project facilitated a mutual exchange between students and the real-world
communities. While the former had the chance to apply their academic theories, the latter was
empowered to speak up on its own behalf and provide guidance and feedback to the student
learners. The lessons taught by the Community Visitor Project have enhanced the professional
development of our first year physical and occupational therapy students. We plan to incorporate
additional service opportunities into their coursework to further strengthen the bond between the
students and the communities in which they will serve after graduation.
REFERENCES
Bender, D.G., & Randall, K.E. (2005). Service-learning risk management considerations: The
Community Visitor project. Education for Health: Change in Learning & Practice, 18 (1), 8588.
Bringle, R.G., & Hatcher, J.A. (1996). Implementing service learning in higher education.
Journal of Higher Education, 67, 221-239.
Cauley, K., Canfield, A., Clasen, C., Dobbins, J., Hemphill, S., Jaballas, E., et al. (2001). Service
learning: Integrating student learning and community service. Education for Health: Change in
Learning & Practice, 14(2), 173-181.
Community-Campus Partnerships for Health. National Evaluation of Service-Learning in Health
Professions Education Accessed on April 1, 2005 at
http://depts.washington.edu/ccph/researchprojects.html#eval.
Eyler, J. & Giles, D. (1996). Where’s the Learning in Service-Learning? San Francisco
CA: Jossey-Bass Publishers.
Furco, A. (1996). Service-Learning: A balanced approach to experiential education. In
Corporation for National Service (Ed.), Expanding Boundaries:
Serving and Learning (p. 2-6). Columbia, MD: Cooperative Education Association.
Georgetown University HPSISN Program Office. (1997). Faculty Handbook: Faculty
Development Materials on Service Learning. Washington, DC: Georgetown University HPSISN
Program Office.
Kahne, J., & Westheimer, J. (1996). In service of what? The politics of service learning. Phi
Delta Kappan, 77, 593-599.
Mayne, L. & Glascoff, M. (2002). Service learning: Preparing a healthcare workforce for the
next century. Nurse Educator, 27(4), 191-194.
Quinn, S.C., Gamble, D. & Denham, A. (2001). Ethics and Community-Based Education:
Balancing Respect for the Community with Professional Preparation. Family & Community
Health, 23(4), 9–23.
State Rankings from the Statistical Abstract of the United States. Accessed April 1, 2005 at
http://www.census.gov/statab/www/ranks.html
Oklahoma KIDS COUNT fact book. (2003). State Overview and Findings: Children in their
families. Accessed April 1, 2005 at
http://www.odl.state.ok.us/kids/factbook/kidscount2003/families.htm.
Oklahoma State Board of Medical Licensure and Supervision. (2004). Physical Therapy Practice
Act Title 59 O.S., Sections 887.1 - 887.18. Accessed April 1, 2005 at
http://www.okmedicalboard.org/
Oklahoma State Board of Medical Licensure and Supervision. (2004). Occupational Therapy
Practice Act Title 59 O.S., Sections 888.1 - 888.16. Accessed April 1, 2005 at
http://www.okmedicalboard.org/
US Census Bureau. (2000). Accessed February 28, 2005 at http://us.census.gov.
Zlotkowski, E. (1999). Pedagogy and engagement. In R. Bringle, R. Games, & E. Malloy,
(Eds.), Colleges and universities as citizens. Boston: Allyn & Bacon.