Service-Learning with older adults in care communities: Measures of attitude shifts in undergraduate students

Background: Clinicians' attitudes toward older adults can influence the quality of the care they provide. The purpose of this study was to demonstrate how to measure the impact of service-learning on undergraduate healthcare students' attitudes toward elders and people with dementia using a theory-grounded qualitative and quantitative assessment, beyond the commonly used pre-test/post-test model. Methods: One-hundred forty-five undergraduate students across two midwestern universities participated in service-learning experiences in a long-term care or assisted living environment during one semester. Students completed the Dementia Attitudes Scale (DAS) before they began service-learning and at the end of the experience. Students also completed reflective journal entries throughout their experiences. Results: Significant, positive changes in knowledge and comfort were noted in ratings from pre-to post-assessment on the DAS. Of the 4165 sentences produced by students in three analyzed journal entries, 2045 (49%) reflected the Awareness-Application Attitude theoretical framework. For the first journal entry, the proportion of positive attitude statements was significantly lower than that for neutral and negative statements while the reversed effect was observed for the last journal entry. Conclusions: Service-learning is an evidence-based pedagogy associated with positive attitude shifts for undergraduate students.