Evaluation of a Community Engagement Program: What Do Rural Healthcare Students Gain From Experiential Community-Engaged Learning?

Abstract

Evaluation of a Community Engagement Program: What Do Rural Healthcare Students Gain From Experiential Community-Engaged Learning?

Karin Fisher1, Leanne Brown1, Tony Smith1, Nicky Hudson 1

1University of Newcastle, NSW, Australia

Introduction/ Background
Community engagement can enrich the educational and lifestyle experiences of health-care students on rural placements. Exposure of students to diverse community groups, cultures and backgrounds provides foundations for their professional practice and also presents an opportunity to explore the role that they can play in community-oriented health promotion and disease prevention. Hence, it was considered important to establish a community engagement program (CEP) at the University of Newcastle, Department of Rural Health (UoNDRH). Underpinned by an asset-based approach, the CEP was developed around mutually beneficial community partnerships, and engaged students in various health promotion activities in the community. After several years of the program, it was timely to evaluate the initial outcomes of the CEP and build for sustainability.

Purpose
This paper reports on Stage 1 of a formative evaluation to investigate the effect of CEP activities on student learning from the perspectives of both students and staff.

Method
Ninety five UoNDRH undergraduate health professional students engaged in the CEP program in 2011, 2012 and 2013 completed a cross-sectional survey. In addition, 15 in-depth interviews were conducted with UoNDRH staff members involved with the CEP.

Results
Students reported either that they participated in the CEP because of the relevance to their professional practice (38%) or because it was an enjoyable and rewarding experience (37%). Most students (87%) agreed that they gained valuable experience with the CEP as a whole for their overall professional development. Eighty three per cent of students felt that participation in the CEP activities was either a valuable, or a very valuable experience. They agreed that CEP activities increased their ability to communicate with vulnerable groups (70.3%) and increased their knowledge about how to engage with these groups in clinical practice (63%). Students also reported enhanced knowledge of the social determinates of health (75%).

UoNDRH staff members had similar perceptions, adding that the CEP assisted in the translation of learned skills, application of student learning that encouraged creative and lateral thinking about supporting vulnerable populations, and improved community connectedness. Staff also reported that assets such as goodwill, credibility, leveraged partnerships, staff and student personnel, financial and physical resources were pivotal to the success of the CEP. The CEP delivery team found these assets valuable when negotiating and working with the community.

Conclusion
The evaluation suggests that the CEP made several important contributions to students’ professional development. Pleasing findings were the improved student knowledge of the social determinants of health and enhanced ability to work with vulnerable populations. Non-propositional learning addressed the humanity side of their clinical practice, with potential to improve patient understanding. The use of an asset-based approach has facilitated establishment and potentially will help sustain this student-focused CEP in a rural education setting. Stage 2 of the evaluation will investigate the impact of the CEP on the communities in which it operates.

Full text

EVALUATION OF A COMMUNITY
ENGAGEMENT PROGRAM: WHAT DO
RURAL HEALTHCARE STUDENTS GAIN
FROM EXPERIENTIAL COMMUNITY-
ENGAGED LEARNING?
Karin Fisher, Leanne Brown, Tony Smith, (Judith) Nicky
Hudson

This presentation provides a snapshot on Stage 1 of a formative evaluation of
a Community Engagement Program (CEP) conducted at the University
Newcastle Department of Rural Health, Tamworth in 2014.
PURPOSE

•The Community Engagement Program:
–Uses an asset-based approach
–Is developed around mutually beneficial community partnerships
–Engages students in health promotion activities in the community
•After about 5 years of the program, it was timely to evaluate the
outcomes and assess its sustainability
BACKGROUND

Stage 1 of the evaluation aimed to:
•investigate the cost effectiveness, experiences of student learning
and staff perceptions of the dynamics and processes underlying
the CEP.
Stage 2 (currently under ethics committee review)
•aims to evaluate benefits of the CEP from community stakeholder
perspectives members
AIM OF EVALUATION

Survey of UONDRH
undergraduate health professional
students involved in the community
engagement program in 2011,
2012 and 2013 (n = 95)
METHOD
In-depth interviews with UONDRH
staff members involved with the
community engagement program
(n =15)
Concurrent mixed methods

Characteristic n
%
Degree
Bachelor of Medicine 15
16
Bachelor of Medical Radiation Science 8
8.5
Bachelor of Nursing 9
9.6
Bachelor of Nutrition and Dietetics 23
24.5
Bachelor Occupational Therapy 13
13.8
Bachelor of Physiotherapy 13
13.8
Bachelor of Podiatry 1
1.1
Bachelor of Speech Pathology 9
9.6
Master of Pharmacy 3
3.2
STUDENT SURVEY RESPONSES
(Independent Variables)

Characteristic
Length of placement
Short placement 1-6 weeks 52
56.5
Medium placement 8-12 weeks 15
16.3
Long placement ≥ 13 weeks 25
27.2
Reason for participation in CEP
Volunteered 30
31.6
Part of Placement 30
31.6
Both 35
36.8
STUDENT SURVEY RESPONSES
(Independent Variables)

The community engagement
activity that I participated in
…
1Negative
n (%) Neutral
n (%)
2Positive
n (%)
•… increased my ability to
communicate successfully
with vulnerable groups (e.g..
low-income or identify as
Aboriginal)
2 (3.7) 4 (7.4) 48 (88.9)
•… made me more aware and
responsive to dietary practices
of Aboriginal people 9 (16.7) 12 (22.2)
33 (61.1)
RESULTS: STUDENT RESPONSES
(Closed-ended responses)
1 Negative = Disagree, Somewhat disagree, Strongly disagree
2 Positive = Agree, Somewhat agree, Strongly agree

DEVELOPING PROFESSIONAL CAPABILITIES:
STUDENT RESPONSES
Participation in the
community engagement
program …
1Negative
n (%) Neutral
n (%)
2Positive
n (%)
•… increased my knowledge
about the social determinates
of health (e.g.. socio-
economic status)
1 (1.9) 7 (13.0) 46 (85.2)
•… led to changes in my
professional practice
2 (3.7) 12 (22.2)
40 (74.1)
•… led me to consider working
rurally
1 (1.9) 11 (20.4)
42 (77.8)
•… was valuable experience
for my overall professional
development
1 (1.9) 1 (1.9) 52 (96.3)

RESULTS: STAFF PERCEPTIONS OF THE
DYNAMICS AND PROCESSES UNDERLYING THE
CEP
Making a valuable contribution to the local community that is
mutually agreeable
Fostering
relationships with
people in the
community
Attending to
organisational
requirements
Nurturing
educational
opportunities
Cultivating
programs that re
innovative and
sustainable

FOSTERING RELATIONSHIPS WITH PEOPLE IN
THE COMMUNITY: STAFF RESPONSES
… there's a collective ownership of what
we're doing in the community with what
we do, that we're actually contributing. …
there's a willingness to work together, to
cooperate, to align like we do, to adjust
things so that we can do it.
How?
•Willingness to work
together to obtain
mutual outcomes
•Understanding each
other (students and
community members)
•Providing opportunities
for students to connect
with local people
For the students that are here for a
longer term, … they have these other
opportunities to connect with the
community and I think it does give them
more a sense of belonging

ATTENDING TO ORGANISATIONAL
REQUIREMENTS: STAFF RESPONSE
So we’ve got to remember all the way
along where the funding is coming from …
If we can’t fit it into the reporting
requirements we shouldn’t be doing it …
… my main thing is around the
governance… making sure that what is
delivered meets our KPIs …
… when we find an organisation we want to
work with, we talk to them about it and say
look these are the assets we have, how is it
that we can use those to help you meet
your needs
What?
•Governance matters
•Reporting
requirements
(funding and Key
performance
indicators (KPIs))
•Working smarter
… it’s got to be students being happy with
community, community being happy with
the students - but all to do with health:
healthy eating, healthy exercising.

NURTURING EDUCATIONAL
EXPERIENCES: STAFF RESPONSES
So it’s got an educational benefit. … I
believe that there are aspects to living in
regional communities and a sense of
cohesiveness and resilience that they’re
likely to see being involved in community
projects.
So the value of using this to build up their
competencies and their experience is
something that I think the students really
value …
How?
•Students learning how to
•interact with rural people
from different population
groups
•be competent health
professionals
•gain an understanding of
social norms for rural
people
…it’s giving them the opportunity… get a
bit of teaching ... I suppose getting some
interaction with children, which is going to
be useful for their careers and …to put on
their C.V.

We might be the leader on some [CEP
activities] but we might play more of a
coordinating role in others. … there are
bigger players but they just need the
support to coordinate it until they get up
and running.
CULTIVATING PROGRAMS THAT ARE
INNOVATIVE AND SUSTAINABLE:
STAFF RESPONSES
… we need to build stuff and it has to be
sustainable.
How?
•Supporting people in
the community to
produce ongoing
programs
•Ensuring adequate
resources are
available it was about seeing that they had funds
and capacity to support the community
better and secondly, to get students more
involved.

From this snapshot it can be seen that both students and staff believe there is
value in the CEP.
• Most students agreed that they gained valuable experience for their overall
professional development
•Staff perceived that within the present constraints :
–making a valuable contribution to the local community that is mutually
agreeable are achieved by fostering relationships with people in the
community, attending to organisational requirements, nurturing
educational opportunities and cultivating programmes that innovative and
sustainable.
•This would help to build a stronger sustainable community by ensuring future
rural health professionals are connected and comfortable working with people
in the community
CONCLUSION