The concepts of community and service are deeply imbedded in the nursing profession. From the classic writings of Florence Nightingale to the current missions of nursing schools across the United States, service and community are concepts that appear time and time again (Poirrier, 2001).
The American Association of Colleges of Nursing (AACN) addressed the importance of community and service in its 1999 position statement. Nursing Education's Agenda for the 21st Century, From emphasizing integrating both service and community into nursing schools' mission statements to discussing including community-based research and service in the structure of nursing education, the AACN (1999) makes it clear that the evolution of nursing into the 21st century requires links between teaching, research, community service, practice, and the external environment.
Community-Campus Partnerships for Health (CCPH) is a nonprofit membership organization committed to fostering health-promoting partnerships between communities and health professions schools (Seifer, 2001). In 1999, the Helene FuId Health Trust, HSBC, Trustee provided CCPH with a generous grant to launch the Partners in Caring and Community: Service-Learning in Nursing Education program (PCC). The program provides a unique mechanism for integrating public service into nursing curricula, while meeting the needs of the community and tapping into the extensive knowledge of community-based practitioners, nursing faculty, and nursing students.
Definition of ServiceLearning
Service-learning has been defined from theoretical and practical viewpoints by many colleges, universities, and servicelearning organizations. Drawing from the common elements of these definitions, service-learning is defined as an educational method that combines community service with explicit learning objectives, preparation, and intentional reflective activities. Nursing students involved in servicelearning are expected to provide community service and to reflect on that service in a way that encourages connections between the context of the service-learning activities, their academic coursework, and their roles as future health care professionals (Seifer, 1998).
The relationship and interaction between service-learning and communitybased education are strong and mutually beneficial (Poirrier, 2001). Communitybased education is an approach to health professional education that exposes students to the health challenges and rewards of their communities early in their academic careers. This exposure may help students become better prepared to cope with the multifaceted health issues of the community in their future roles as health care professionals (Schmidt, Magzoub, Feletti, Nooman, & Vluggen, 2000). The changing health care system in the United States and the demographic trend of an aging population have led to a shift in health care toward community-based care (O'Neil & Pew Health Professions Commission, 1998). Service-learning provides an excellent pedagogical method for training future nurses in community-based care and concepts.
PCC Program Overview
The PCC program models a teambased approach to service-learning in nursing education. A group of nine teams composed of nursing faculty, nursing studente, and community partners were selected through a competitive application process to develop service-learning partnerships related to community needs, community expertise, and nursing education. The goals of the PCC program are to:
* Facilitate the integration of servicelearning into nursing education curricula at the associate, undergraduate, and graduate degree levels.
* Increase the understanding of and support for service-learning in nursing education throughout the United States.
* Disseminate new knowledge and information about best practices and models in service-learning and nursing education.
The teams participated in a training institute designed to introduce the theoretical concepts and practical applications of service-learning and to help the teams develop service-learning curricula. Teams are supported with competitive minigrants, training, mentoring, and leadership development opportunities (Seifer, 2001). The teams represent diverse communities and educational institutions, including urban and rural locations, community colleges, universities, and graduate nursing education programs. The first 2 years of the PCC program were guided and informed by a national advisory board of leaders in the fields of service-learning, community-campus partnerships, and nursing.
Each of the nine PCC teams created projects and focused their energies in a way uniquely oriented to suit the needs of the community, nursing education program, and student population involved in the project. This is consistent with the AACN's (1999) position statement supporting the recognition of each school's unique contribution to its community and the contribution that each community can make to nursing education. Although the projects differ in focus and scope, all share an emphasis on integrating service-learning into nursing education and partnering with the community to provide meaningful educational opportunities to students, while meeting genuine community needs and building on the expertise of the community.
The nine PCC team project descriptions and their reflections on their activities are articulated in greater detail in Partners in Caring and Community: A Team Approach to Service-Learning in Nursing Education (Seifer, 2001).
The PCC team members have articulated the lessons they learned from their involvement in the PCC program. These are presented as case studies on the CCPH Web site at http://www. futurehealth.ucsf.edu/ccph/pcc.html. The program's evaluation component aleo includes having each team member complete pre-training and post-training institute surveys and a longitudinal survey of their partnership's characteristics. From these assessments, common lessons learned have been identified, which may serve as a guide for future nurse educators seeking to become service-learning practitioners. These lessons include:
* Service-learning is not the same as volunteering. Service-learning is focused and intentional, with an emphasis on meeting genuine community needs in a way that is tied to student curricula. Students engaged in service-learning learn critical course concepts, while providing service to the community.
* Service-learning improves the quality of nursing education when planned with input from all parties. All stakeholders must be involved when planning service-learning experiences. Students can play in integral role in this process.
* Representatives of communitybased organizations can act as nurse educators. In addition to more traditional community partners (e.g., community clinics), faith-based agencies, public schools, and voluntary associations (o.g., American Red Cross) are excellent partners in nursing education.
* Service-learning requires time and commitment. No one participant in a service-learning program can do "all the work." Sharing and delegation are key concepts in successful service-learning programs.
* Service-learning can enhance students' vision of what it means to be a nurse, a citizen, and a community member. Often, students involved in the program articulate an ability to see the "big picture" of their work in the community and gain an understanding of the relationship between health care and social justice issues.
* Institutional support is critical for service-learning to be sustained. This support can include verbal and financial support from deans and department chairs, faculty development in the form of minigrants and training workshops, and faculty promotion and tenure policies that reward innovative community-based scholarship.
Special Issue of the Journal of Nursing Education
The lessons learned from the PCC program are described in greater detail in the articles in this issue of the Journal of Nursing Education. The articles were written by both PCC team members (i.e., faculty, community partners) and PCC advisory board members. Their articles reflect not only the wide range of experiences and knowledge gained from PCC projects but also the increasing serrice-learning scholarship in nursing education. From a discussion of the use of service-learning in associate, undergraduate, and graduate nursing degree programs to an analysis of reflection methods in service-learning, each article provides readers with an opportunity to learn the value of servicelearning in nursing education. In addition, book reviews of emerging literature in the field of service-learning in nursing education provide readers with further resources for in-depth discussions of the theory and practice of serrioe-learning.
As national trends in health care delivery shift to community-based settings, the integration of service-learning into health professions education becomes an increasingly important issue for health professions educators, students, and communities (OTSíeil & Pew Health Professions Commission, 1998). The PCC program is one model that can inform nurse educators, students, and communities as they work together to transform nursing education and solve community problems. The articles written by PCC team members are a resource for nurse educators who seek to transform and enhance their own curricula to reflect community-based education and practice. Given the nursing profession's historic commitment to community, the articles in this issue demonstrate the contributions the profession can make in the service-learning movement underway in other health professions and in higher education as a whole (Zlotkowski, 1998).
- American Association of Colleges of Nursing. (1999). Nursing education's agenda fi>r the 21st century. Washington, DC: Author.
- O'Neil, E.H.. & Pew Health Professions Commission. (1998). Recreating health professional practice for a new century. San Francisco: Pew Health Professions Commission.
- Poirrier, G. (20011. Service learning: Curricular applications in nursing. Sudbury, MA: Jones and Bartlett.
- Schmidt, H., Magzoub, M., Feletti, G., Nooman, Z., & Vluggen, P. (20001. Handbook of community-based education: Theory and practices. The Netherlands: Network Publications.
- Seifer, S.D. (1998). Service-learning: Community-campus partnerships for health professions education. Academic Medicine, 73, 273-277.
- Seifer, T. (Ed.). (2001). Partners in caring and community: A team approach to servicelearning in nursing education. San Francisco: Community-Campus Partnerships for Health.
- Zlotkowski, E. (EdJ. (1998). Successful servicelearning programs: New models of excellence in higher education. Bolton, MA: Anker.