Abstract
Community partnerships provide an invaluable and practical teaching opportunity for undergraduate public health education programs. This is especially true when working with Generation Z students who desire meaningful, effective learning experiences. The continued strong interest of Generation Z undergraduates in public health and health promotion, combined with their skills and learning preferences, provides a strong rationale for utilization of community-based learning strategies. It could be argued, however, that programs must go beyond providing service learning and reflection opportunities. Indeed, experiential learning has come under criticism for lack of engagement with community-based organizations served by students and a lack of evidence on the quality or utility of the “services” provided. In this light, we constructed a transformational model of learning, where students complete tangible, timely projects with community partner organizations. In this model, all parties benefit: The students experience an often-profound learning opportunity through project execution; the community partners benefit from the skills, insight, time, and talents of the students; and the undergraduate program is able to assess a novel marker of student achievement—evaluation of a real-world application of public health skills and knowledge.
Developers of undergraduate health promotion and public health programs strive to design challenging and engaging courses that correlate with students’ interests, needs, and learning styles. Each new generation of students, however, introduces new issues to consider, causing reflection on pedagogical methods. As Generation Z continues to matriculate to college, undergraduate public health and health promotion programs are proving to be popular choices for majors and minors (Leider et al., 2015). The influx of this new generation of students in such great numbers has served as an impetus for instructional innovation. While much of the research and commentary on Generation Z originates in the United States, there are indications that many of the insights are applicable on an international level as well (Kubatova, 2016).
Currently, individuals enrolled in higher education could originate from one of several generations or cohorts: the greatest generation (those born between 1922 and 1945), the baby boomers (those born between 1946 and 1964), Generation X (those born between 1964 and 1977-1980), millennials (those born between the late 1970s and the early 1990s), and Generation Z (those born from the early 1990s through 2010; Seemiller & Grace, 2015; Turner, 2015). The generation representing the majority of students in higher education is currently changing from the millenials to Generation Z (Seemiller & Grace, 2015; Turner, 2015; Williams, 2015). Recent studies reveal some interesting insights about this cohort. They are uniquely diverse, compared to previous generations, and are “digital natives,” having never experienced life before the Internet. Studies have revealed that Generation Z values education, tolerance of others, compassion, professional flexibility, networking abilities, and a sense of responsibility (Seemiller & Grace, 2015, Turner, 2015). They appear to be achievement-oriented, and this can translate to passion for higher education and self-reliance. However, they also value face-to-face interaction and collaboration, especially as they learn to achieve in a rigorous undergraduate environment. Seemiller and Grace (2015) write that this generation is committed to those around them and motivated by making a difference. Other research indicates that Generation Z students also possess a desire to be involved in social causes and initiatives for social change (Vallone et al., 2016). Furthermore, they want be challenged and to learn through real-life experiences (Irwin, 2016; Seemiller & Grace, 2015). These preferences reinforce collaborative, self-directed community-based projects as effective teaching strategies for this cohort.
The continued strong interest of Generation Z undergraduates in public health and health promotion, combined with their skills and learning preferences, provides a strong rationale for utilization of community-based learning strategies. Community-based learning is not a new concept in undergraduate public health education. Indeed, Cashman and Seifer (2008) have argued, “Public health is well served in using service-learning as a pedagogic modality to enrich and deepen student learning and skill development” (p. 276). It could be argued, however, that programs must go beyond providing service learning and reflection opportunities. Indeed, experiential learning has come under criticism for lack of engagement with community-based organizations (CBOs) served by students and a lack of evidence on the quality or utility of the “services” provided. In a review of community-based programs in medical schools, Hunt, Bonham, and Jones (2011) find limited examples of “community accountability.” Rather the authors conclude that there is an emphasis on the student experience of providing services. The process of developing an intentionally and overtly reciprocal relationship with a community or CBO was not discussed in the studies reviewed.
There is a growing body of evidence on the effectiveness of service learning from the perspective of the CBO. Costs incurred by CBOs include the resources needed to integrate and train students and the actual risks to the organization (Blouin & Perry, 2009; Bushouse, 2005). Risks include breaches in confidentiality, unmet expectations of the clientele served (Blouin & Perry, 2009), and issues involved in poor cultural competence and the lack of reciprocity and partnership with the CBO (Peterson, 2009).
In this light, we constructed a transformational model of learning, whereby students experience profound personal learning and insight through engaging with and assisting social service and public health organizations with important projects (Hoggan, 2016). In this model, all parties benefit: The students experience an enlightening learning opportunity through project execution; the community partners benefit from the skills, insight, time, and talents of the students; and the undergraduate program faculty are able to assess a novel marker of student achievement—evaluation of a real-world application of public health skills and knowledge. Moreover, as this is inherently a transformative course (Hoggan, 2016), we evaluate the students’ work in terms of benefits accrued to the community organization and, when possible, to the target population, in partnership with the CBO. This provides layered feedback to the students, which is especially timely as they begin their professional lives. Indeed, as described by Hoggan (2016), “Transformative learning refers to processes that result in significant and irreversible changes in the way a person experiences, conceptualizes, and interacts with the world” (p. 71). It is hoped that this innovative course design facilitates such a transformation for the students involved—and potentially the CBO staff as well.
The transformational projects are also group projects, and learning not only builds on the students’ strengths of interconnectedness but also challenges them to express their independence. By indicating their preferences for given projects, the students have the opportunity to exercise choice and initiative, key preferences for Generation Z (Seemiller & Grace, 2015).
A Course Model for Transformational Learning
A transformational model for learning requires engagement from all parties—students, faculty, and community partners—and opportunities for relevant assessment by all parties. In 2014, the undergraduate Public Health Program of a midsized private liberal arts university in the mid-Atlantic region of the United States launched a Capstone course, which follows this model. The course has evolved and changed over time, based on student, community partner, and faculty evaluations, but all revisions served to improve the transformational nature and fidelity of the course.
The Public Health Capstone course is a required course for all Public Health majors, taken during the final year of the undergraduate career. In this course, students work in groups to complete semester-long projects for community partner organizations, which are generally governmental or nonprofit organizations. Since 2015, a total of 173 students have collaborated with 30 different community partner organizations to accomplish 41 projects. Students have typically worked in groups of three to five members. The learning objectives of the course state that, on completion of the course, students should be able to do the following:
Assess needs of selected public health organizations and client populations
Apply public health research and program planning principles to solve a current public health-related issue for a nonprofit organization or government agency
Research the role, structure, and function of and the population served by a community-based agency and summarize findings
Analyze the impact of a public health issue on a population
Develop professional projects, interventions, initiatives, communications, measurements, reports, or other material to meet the needs of community partners and, if appropriate, their clients
Write effective and measurable programmatic and participant outcomes/goals, objectives, and competencies
Evaluate the effectiveness and impact of public health policies, programs, and initiatives in influencing health and lifestyle behaviors (and outcomes)
Use the basic concepts of public health-specific communication, including technical and professional writing and the use of mass media and electronic technology
Evaluate personal attitudes and approaches to working with diverse communities
Examine the impact of service on learning and communities
Course activities with the learning objectives and the transformational aspects of the course are shown in Table 1.
Linking Selected Activities, Course Learning Objectives, and Transformational Environment.
Note. SWOT = strengths, weakness, opportunities, threats; CBO = community-based organization.
A Modified Faculty Role in Transformational Learning
Design and delivery of the Capstone course have evolved over time, with repeated revision and enhancement taking place each semester. Consultation with our university’s Center for Community Engagement and Service provided an initial template and structure for the course, as well as insights for later revisions. A summary of the lessons learned, insights revealed, and best practices gleaned follows.
In transformational learning, faculty serve not only as instructors and mentors but also as conveners, resources, coaches, mediators, managers, assessors, and motivators. Typically, faculty begin cultivating projects for the course 4 to 5 months before the semester begins by contacting community partner organizations. Identification of potential community partners through professional contacts has proven to be very successful, but “cold calling” works as well. Many community organizations are eager to partner with college programs when given the opportunity. It is imperative that the faculty member explains the expectations associated with transformational learning to each potential community partner. Partners must commit to being engaged throughout the project, providing direction, resources, and reliable communication to the students. Project cultivation usually involves several contacts (via e-mail, phone calls, and in-person visits) with each potential partner organization to explain the course and design the project. Each project must be significant enough to engage a group of three to five students for an entire semester, and a clear “final deliverable” must be defined. Projects have included needs assessments, research projects, curricula, social media guides, legislative briefs, case statements, resource guides, infographics, brochures, awareness campaigns, donation drives, and feasibility studies. Typical projects consist of multiple components and activities. Table 2 provides examples of community partners and types of projects executed.
Examples of Community Partners and Projects.
Once projects are determined (ideally, before the semester begins), the Capstone partners are invited to attend a class session to “pitch” their projects to the students. The students then rank their top three choices. The faculty member then assigns a team of students to each project, taking preferences, schedule, work style (determined via an in-class assessment activity), and other factors regarding each student into consideration. The goal is that each project team will be composed of team members who are interested in the partner organization’s work and who provide complementary skill sets for the team. Conveying the expectations of transformational learning to the students is critical at this point, as is coaching them on best practices in project consulting.
Several factors are critical to successful execution of the Capstone projects. Clear descriptions of projects and desired outcomes are absolutely necessary, as is communication of any changes in those projects. Each community partner organization designates a staff member to serve as a project liaison. This liaison communicates with the student project team on a weekly basis at a minimum and serves as a resource person for the team. As previously explained, both the students and the partner liaisons receive a list of “expectations” at the beginning of the semester from the faculty member (Table 3). These expectations, developed from lessons learned through delivery of the course, clearly outline the responsibilities of all parties (students, community partners, and faculty). In addition to providing the pedagogical elements of the course, the faculty member fulfills roles of coordinator, mediator when needed, mentor, and resource person. He or she also communicates with the community partners each week of the semester. Regular, frequent communication among all parties is absolutely vital for the execution of high-quality projects. Flexibility is needed on all parts, as real-world projects with actual public health partner organizations can be fluid, needing to adapt to change and challenges as they arise.
Expectations of Students and Community Partners.
Source. Adapted from Deb Hinchey’s Public Health Capstone Course, School of Public Health, University of Washington, 2015.
The primary “textbook” for the course is The Community Tool Box (2016), “a free, online resource for those working to build healthier communities and bring about social change. It offers tips and tools for taking action in communities.” The Tool Box provides resources for community assessment, planning, intervention, evaluation, advocacy, and other aspects of Public Health practice. The Community Tool Box was developed by the University of Kansas, in partnership with collaborating public health organizations, as a public service (http://ctb.ku.edu/en). For this course, content on needs assessments, strategic planning, logic models, SWOT (strengths, weakness, opportunities, threats) analyses, leadership, and ethics is assigned to students.
Each team of students completes the following deliverables for their project: (1) a community partner organization overview and SWOT analysis; (2) a project VMOSA (vision statement, mission statement, objectives, strategies, and action plant) and logic model; (3) the final project; and (4) a final group presentation. The final presentation provides each team an opportunity to describe their project and their work throughout the semester. The audience for the presentations consists of all community partner liaisons and interested colleagues, all other project teams, the course instructor and other faculty members, and representatives from the university’s Center for Community Engagement and Service.
Because part of the Capstone course focuses on professional development, students also complete individual assignments throughout the semester. These assignments are designed to prepare students for public health practice. For the first of these individual assignments, each student is asked to prepare a resume and write a cover letter for a public health job opportunity or graduate school admission. One class period is then devoted to a peer review exercise for these materials. All other individual assignments require students to reflect on the following topics: public health service, ethics in public health, and public health leadership. To challenge and engage students’ thinking, several readings are assigned for each topic. The Public Health Capstone experience has revealed that exploration of issues related to service, ethics, and leadership complements and strengthens the projects. Students are called to thoughtfully contemplate the issues and apply new insights to their work. This approach is well suited to Generation Z students, who desire to be challenged and to learn through real-life experiences (Irwin, 2016; Seemiller & Grace, 2015).
Thorough assessment and evaluation are critical to the ongoing success of the Capstone course. Detailed grading rubrics for all project deliverables and individual assignments are provided to the students during the first week of the semester. The community partner liaisons evaluate the final projects and the Capstone experience at the end of the semester. Similarly, the students evaluate their community partner, their team members, the course (at mid-semester and end of semester), and the faculty member. Information and insights obtained from these evaluations have resulted in significant improvements in course content and delivery over time.
To date, our Public Health Capstone course has proven to be a successful vehicle for community-based learning. It is most certainly transformational, as its design provides opportunities for significant engagement from all parties—students, community partner organizations, and faculty. The students are able to apply their academic learning to real-world projects, and they also benefit from engaging with and learning from their community partners. Additionally, the projects encourage creativity, problem-solving, respectful advocacy, and team collaboration, all of which are skills that are absolutely essential in the Public Health workforce. Students comment that they appreciate the projects and the experience of working on behalf of a public health agency or organization. They often report feeling as though they have “made a difference” through their efforts. The community partners routinely praise the innovation of the students and the quality of the projects, often stating how impressed they are with the students and their work (Table 4). Additionally, when evaluating project teams on professionalism, communication, and quality of work, community partners provide an average rating of 4.5 on a 5-point scale (with 5 being excellent) for all three categories.
Comments From Students and Community Partners.
Conclusion
Transformational, community-based learning requires extensive preparation, communication, and diligence. Providing clear expectations for all parties is essential, as are flexibility and consistent interaction. Faculty who engage in this endeavor will find the experience to be incredibly rewarding. With careful planning and execution, the course can be a vehicle through which students gain practical experience and make significant contributions to public health agencies and organizations. The community partners benefit from the skills and innovation of the students in executing their projects. The end result is a symbiotic relationship that ultimately benefits the health of the public.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.