Critical Thinking and Reflection on Community Service for a Medical Biochemistry Course Raise Students’ Empathy, Patient-Centered Orientation, and Examination Scores

Meta-analyses of findings for nonmedical curricula show that course-based community service, such as service learning, improves students’ academic achievement and their personal, social, and citizenship outcomes. Based on this strong evidence for K-12 and undergraduate higher education, we tested the theory that biochemistry course-based community service would improve first-year medical students’ empathy, patient-centered orientation, and examination scores. Students completed the Jefferson Scale of Empathy and the patient-practitioner orientation scale at the beginning and end of the first of three biochemistry courses. During the course, biochemistry learning teams of six to seven students selected and performed community service projects and critical thinking and reflection about the projects. They then completed a survey of their opinions about the project. To assess their academic achievement in the course, individual students took biochemistry examinations composed of multiple choice questions. Course-based community service was associated with anticipated improvements in students’ empathy (p = 0.04, effect size = r = 0.44) and patient-practitioner orientation scale (p = 0.004, r = 0.61) scores and, more modestly, with examination (p = 0.02, r = 0.27) scores. Most students agreed that their team community service would help them better to see their biases toward patients (79 %) and to be engaged with them (86 %). Team community service and critical thinking and reflection about the service appear to foster empathy and academic achievement in first-year medical students. As for critical thinking and reflection about other topics, critical thinking and reflection on community service also promote a patient-centered orientation in students.