Understanding the Goals of Service Learning and Community-Based Medical Education: A Systematic Review

Purpose To understand the educational goals of projects described as "service learning" or "community-based medical education" and to learn how relationships between medical schools and community members are discussed in these projects. Method In 2008, the authors performed a systematic qualitative content analysis of 57 articles, published since 1990, that addressed community placements for U.S. medical students. After the initial analysis, the academic-based authors conveyed their findings to their community partner and coauthor, received input on relevance and priority of themes, and then refined their analysis accordingly. Results The authors identified five main findings: (1) Considerable heterogeneity existed across projects, (2) although medical schools aimed to improve the health of the community, they did not routinely involve community members in the identification of local health priorities, (3) educators were enthusiastic about community-based education as a method for teaching complicated ideas such as social determinants of health, (4) many authors emphasized community placements as being equivalent to traditional curricula, and (5) the articles did not emphasize the concept of reciprocal knowledge transfer. Conclusions The authors found little emphasis on the reciprocal nature of partnerships between communities and medical schools. They propose that the principle of community partnership within medical education could train a cohort of medical students prepared to practice in the rapidly changing health care environment-one that now includes an important new agenda of community accountability.