MedEdPublish (Sep 2016)
Getting real in the community: Evaluating the “making a difference” interdisciplinary social engagement project
Abstract
Purpose It is increasingly recognised that medical schools have a duty to the communities they serve, and that there are many benefits to be gained from student social engagement within those communities. There is also ongoing interest in the value of inter-professional working. Social engagement takes many forms, and benefits to student learning are likely to be multi-faceted. We conducted a detailed qualitative analysis of a "Making a Difference" community project; to investigate pedagogic benefits, to identify how students could indeed 'make a difference' with a population with complex health needs, and to explore the value added by inter-professional working. In framing the character of social engagement, we classified activities into community-orientated, community-based and community engaged education and considered our findings within these contexts. Methods The project provided interdisciplinary experiences for student volunteers from medicine and nine other healthcare disciplines (ten professions in total), in attachments to three community-based providers. In addition, students collaboratively organised and delivered a one-day health promotion event for the entire community at a health facility in an area of high social deprivation. Extensive qualitative data were collected from student diaries, interviews and focus groups with students and provider organisation staff. The findings were analysed thematically using NVivo, and as a first level of analysis were mapped onto a modified Kirkpatrick framework of evaluation. Results Students gained new insights, knowledge and skills; these arising from both the community experience and from working with different disciplines. Analysis identified pedagogic benefit at all 4 Kirkpatrick levels. Students were able to contribute in diverse and sometimes unexpected ways. Our data suggest that many other benefits such as development of deeper relationships, opportunities for communication of feelings, breaking down of class and professional barriers resulted from the experience. Conclusions The two activity components of the project (attachments and health promotion event) provided distinct but complementary experiences. It is clear from the data that students enjoyed the often new experience of working with peers from other disciplines. They also enjoyed, but were greatly challenged by, working with service users with multiple and complex needs, such as when they were placed with providers working with homeless persons for example. There was strong evidence of new learning, with clear examples of change of practice resulting from these experiences. We considered that the project provided mostly community-based, but also some community-engaged, experiences. Philosophically, sending healthcare students into communities represents a radical change of practice for medical and nursing schools, and our second level of analysis has included theoretical attention to this idea. Further work is ongoing.
