Faculty Perceptions of the Impact of Service Learning on Nursing Students

Background: Service-learning experiences (SLEs) have become increasingly common in nursing education as schools strive to provide socially relevant curricula that improve students’ cultural competence and prepare them to confront and challenge existing health disparities. In an early study (Ivory, 1997), the researcher’s expectation that college students would return from an SLE feeling excited and personally satisfied was upended. Instead, most students in that qualitative study reported a variety of social and psychological difficulties that the researcher labeled “re-entry crisis.” Problems included difficulty explaining their feelings about the experience, strained interpersonal relationships, feelings of uncertainty, and academic dysfunction. Subsequent studies illustrate the impact of nursing student participation in an SLE, many of which frame the narratives in a more positive light. For example, Adamshick and August-Brady (2012) interviewed participants in an SLE to Honduras about their impressions of the experience. The themes that emerged included appreciation for life and family, the need to simplify one’s own life, and a sharper vision of what is truly important. Despite many rich narratives, there is a paucity of aggregate data about the characteristics of SLEs offered in US nursing programs and their impact on students. The purpose of this study was to examine that impact as reported by faculty trip leaders.

Methods: The instrument for this exploratory, descriptive study was developed by the researcher and administered online using Qualtrics® after approval by the university’s institutional review board. Participants were recruited through a survey link emailed to approximately 1600 deans or directors of accredited US nursing schools, who were asked to forward it to faculty who oversee SLEs. Frequencies were tabulated using SPSS (v.24).

Results: The sample consisted of 77 nursing faculty from 32 US states who provided complete data (58% of the 133 who opened the link). Respondents were primarily female (97%), white (86%), and over the age of 50 (72%). Most faculty (75%) were affiliated with BSN programs and accompanied the students to the SLE (47% for the entire time, 31% part of the time). Twenty-three percent of the SLEs were located outside of the US with the majority of those being in the Caribbean, South America, or Central America; 55% were in local communities and 18% were within commuting distance. The table summarizes the results of survey items related to faculty perception of the impact of the SLE on the student participants:

Faculty opinions about how often students report or demonstrate the following after returning home from SLE (n and percent of total 77, ranked in order of frequency)
Impact	Often	Sometimes	Rarely	Never	No response
Being “changed” by the SLE	53 (69%)	19 (25%)	1 (1%)	0	4 (5%)
A change in assumptions and stereotypes held prior to the SLE	55 (71%)	17 (22%)	1 (1%)	0	4 (5%)
Being more likely to advocate for the vulnerable and underserved in the future	51 (66%)	20 (26%)	2 (3%)	0	4 (5%)
Feeling overwhelmed with lack of resources available to host community	32 (42%)	31 (40%)	8 (10%)	1 (1%)	5 (7%)
Feeling overwhelmed with the needs of the host community	27 (35%)	35 (46%)	10 (13%)	1 (1%)	4 (5%)
Feelings of guilt about abundance of resources at home	22 (29%)	32 (42%)	15 (20%)	4 (5%)	4 (5%)
Feeling that family and friends can’t understand the impact of the SLE	8 (10%)	27 (35%)	27 (35%)	11 (14%)	4 (5%)
Feeling difficulty returning to home community/culture	13 (17%)	19 (25%)	30 (39%)	11 (14%)	4 (5%)
Feeling that the SLE impact is difficult to explain	12 (16%)	19 (25%)	34 (44%)	8 (10%)	4 (5%)
Feeling alienated by home community/culture	4 (5%)	22 (29%)	32 (42%)	14 (18%)	5 (7%)

Conclusion: Faculty involved with SLEs believe that students are changed by the experience. Assumptions and stereotypes are altered and students are seen as more likely to advocate for the vulnerable and underserved after they return. Other common feelings, although slightly less frequently reported, relate to noting the disparities in resources between home and the host community. Sometimes students feel that it is difficult to explain the impact of the SLE to others. Less often, students feel alienated by their home community or culture when they return home. In general, SLEs have a positive impact because they open students’ eyes to new cultural norms and increase the probability that they will practice nursing with more cultural insight. However, whether the impact results in sustained behavior change or whether negative feelings of being overwhelmed, guilty, and misunderstood linger is unknown and worthy of future research.

References:

Adamshick, P., & August-Brady, M. (2012). Reclaiming the essence of nursing: The meaning of an immersion experience in Honduras for RN to Bachelor of Science students. Journal of Professional Nursing, 28(3), 190-198.

Ivory, B. T. (1997). The Re-entry crisis of students returning to campus following a volunteer alternative break experience: A developmental opportunity. College Student Affairs Journal, 16(2), 104-112.