Service learning and the medical student affective domain.

Background: The Association of American Medical College (AAMC) requires all students to demonstrate four core attributes: knowledge, skills, altruism and dutifulness. A formal service-learning curriculum may serve to explicitly foster altruism and dutifulness in the affective domain of Bloom's taxonomy as well as proactively improve student well-being. Approach: All Harvard Medical School students enrolled in the Principal Clinical Experience (PCE) programme in the 2018-2019 academic year at Brigham and Women's Hospital were excused from clerkship responsibilities and given the opportunity to participate in a half-day team-based community-service intervention at a not-for-profit organisation in Boston, MA. Following the service-learning initiative, we examined student compassion, civic responsibility, well-being and team cooperativeness using validated survey questions, supplemented by free-text feedback. Evaluation: Forty-five of the 55 PCE students (82%) attended the outing. Overall, 68% of students found the outing to be valuable and 23% somewhat valuable. On a scale of 0-20, students reported very high self-perception of compassion (mean = 19.9), civic responsibility (mean = 19.7) and team development and composition (mean = 19.1), after the event. Students reported lower perceptions of personal well-being (mean = 17.5), but emotional wellness was the most frequently mentioned theme in open response. Implications: Incorporation of a team-based service-learning activity contributes to the students' community understanding, empathy and class team building. Utilisation of a published framework in the development of this initiative likely contributed to its success. Given our findings, we plan further expansion of this service learning longitudinally through the 4-year curriculum to potentially strengthen the affective domain for students further.