TEACHING EXCELLENCE DATABASE

We decided to design the project "Small thing for us, big deal for them" because we wanted to cooperate with a certain group of people, and in this case, they were homeless people and people of lower financial status. The Student Catholic Center “Palma” (SKAC) association was too able make this idea possible for us because they help this group of people through various volunteer actions, organizing food distribution, and others. Students had never been in contact with this group of people before, so it was a challenge for us to design the project. They had thought carefully about how they could use their knowledge to help them. They found that their main problem is the high incidence of chronic diseases and lack of knowledge regarding prevention, treatment, recognition of symptoms, and complications of some diseases that occur frequently and can be controlled or prevented in time. They have decided that they will make the best use of their knowledge through the assessment and education of users about diabetes, heart attack and stroke, and hypertension. They also added information to users about the possibility of free vision control and patients' rights. The general objective of the project was to increase the number of students with acquired practical knowledge and skills for solving specific social problems and community development. Furthermore, strengthening the capacity of civil society organizations to implement service-learning and establish and implement a sustainable program of service-learning in cooperation between students and civil society organizations. The main goal was: prevention of chronic diseases in the homeless. Specific goals were assessment of the need for education in: • Patients' rights, hypertension, complications of diabetes, vision control and stroke, and heart attack. • Screening users who suffer from hypertension or recognize the symptoms of diabetes or want to know more about their rights, free vision control or stroke and heart attack. • Educating users about each assessment point. • Evaluation of what has been learned and the usefulness of educating the users themselves in the form of a short questionnaire.

Methodology

For the first time, service-learning in healthcare was offered as a course to undergraduate nursing students in the academic year 2018-2019. 30 students chose this course. After 10 hours of lectures, they were followed by 10 hours of seminars and 10 hours of direct contact with users. They were divided into 3 groups and each group chose its leader and the association in which they would like to carry out the activity. Since UAHS was part of a project together with 3 associations, they chose between the three according to some personal preferences. The leader was the coordinator and the link between the teacher and the coordinator in the association. After deciding on the audit, they had to study what the association does, which users it gathers, what its mission and vision are. As the first task they had to make a summary of the project activities. This was a challenge for them because they had to plan the activities, the goals they want to achieve, make a Gantt chart and plan the budget accurately. In addition to Gantt charts, for the first time, they worked on a responsibility matrix, a checklist and had to keep a detailed activity log. They also had to assess the risks in detail. After that, they went to meetings in the association where they assessed with the coordinator. They decided to carry out activities on a group of homeless people and people of lower income status, users of the soup kitchen. The brainstorming method uses various ideas on how to contribute to the user population. In the end, they decided that they would like to assess their health, and educate them about preventive measures, and educate them about their rights as a patient. The seminars were based on the ERR framework (Evocation, Realization of Meaning, and Reflection) E- First we assessed the target group, how to reach them, how, where, and when to access them. As measurable results, I would cite the business cards they made. We started the activity in the soup kitchen where we made 80 sandwiches, coffee, and tea and distributed them to them between 8 pm and 9 pm at the Central Station. In addition to the sandwiches, we handed out business cards as a kind of invitation to join us the next day for the education. R- project core-workshop. They spent a good part of their time working directly with the users, assessing their health, needs, attitudes, and knowledge. The students made 5 stations (diabetes, stroke and heart attack, hypertension, visual impairment, patient rights). One of the evaluations + education was performed at each station. Later, everyone was invited to a joint (promised) dinner. Everything took place on the premises of the Association. A total of 15 users responded. R- after collecting all the data, they made a brochure in which they listed everything relevant to their health, which they collected by hanging out with them. We handed out the brochures to them again one Tuesday at the Central Station with sandwiches. As measurable learning outcomes, business cards were made inviting them to socialize, as well as brochures describing preventive measures, a map of the city of Zagreb with all hospitals marked and contact numbers of emergency services and services that protect patients’ rights. We made and distributed 80 sandwiches and conducted a direct assessment and training of 15 users. Obstacles to project implementation: at the very beginning, the biggest problem was the adaptation of terminology, which despite the efforts of all of us was too professional. Another problem was the establishment of communication, given that so far none of us have met directly with this marginalized group. This service-learning proved to be extremely good because it encouraged teamwork, specific tasks, and encouraged organizational skills with the team leader. By making brochures and business cards, we got an insight into their creative engagement. And the most important of all is that we have contributed to the target users. They called us from the Association and conveyed greetings and inquiries from users when we will come again to socialize. I am extremely glad that I was the one who guided the students in designing and creating these projects because I followed their work from the beginning. At the very beginning, they had a lot of questions, they were confused, they weren’t sure how it would turn out. As we spent more and more time in the rehearsal and as we approached the end, their motivation and satisfaction grew. All ratings, in the end, were more than positive. They want to invite other fellow students who did not enter this course to attend the final presentation because they were extremely proud and wanted to share their results with everyone. All planned project activities were successfully completed according to plan so we can conclude that this was one well-designed project.

Tools, equipment, technology used

Pressure gauge, stethoscope, hall with computer and projector, A4 papers for printing questionnaires, visual board, material needed for making business cards and brochures. We borrowed it all from the UAHS. Sandwiches, tea, dinner, and space for the implementation of central activity provided by partners-association.

Outcomes and outputs, main results

LEARNING OUTCOMES • Explain the difference between service-learning concerning volunteering and practice • Identify individuals and groups in need • Identify the problems of people in need in the community • Apply the acquired knowledge and skills for the development and implementation of activities needed in the community • Suggest solutions to problems/needs in the community • Evaluate, plan, organize, and implement a project that solves a problem in the community TOOLS OF LEARNING • Fabular pyramid • Problem tree • Project design - project summary • Gantt chart • Activity log • Checklist • Responsibility matrix The specific objectives of the project were: Develop a socially beneficial learning program at UAHS; Strengthen the capacity of civil society organizations to implement service-learning; Establish and implement a sustainable service-learning program in cooperation with the UAHS and civil society organizations. Through conversations with users, we have proved: - 57% of users have measured their blood pressure in the last month - 85% of users have experienced headaches and fatigue for a month - 57% of users noticed visual disturbances in the past month - 100% of users have a supplementary health insurance card - 50% of users know that they have the right to health care regardless of work and property status - for 100% of users, going to the doctor caused discomfort - 25% of users know they have the right to a second opinion - 100% of users were admitted to the hospital - 75% of users claim that the attitude of the medical staff was extremely good and confidential - 25% of users claim that the attitude of the medical staff was bad and harsh - 75% of users claim to have been referred to all diagnostic tests - 75% of users claim that the instructions on diagnostic tests were clear and understandable - 50% of users rated the work of health professionals with 4 out of 5 - 25% of users rated the work of health professionals with 3 out of 5 - 25% of users rated the work of health professionals with 5 out of 5.

Lessons learnt

As there is currently no systematic support for the social inclusion of young people in solving social problems, nor is the cooperation of civil society organizations with higher education institutions carried out systematically and limited to a small number of organizations and faculties, young people are often not motivated to engage in socially sensitive issues. Also, civil society organizations are not able to provide students with adequate engagement in their activities, except for volunteering, which does not have to be related to their profession. In such a disincentive system, young people do not have enough opportunities to develop social sensitivity and a sense of responsibility for the community, thus losing the opportunity to build a socially sensitive system. Even with a small positive change in the education system, young people can be encouraged to become more actively involved in solving problems in the community and encourage their social sensitivity in direct contact with groups at risk. In the field of health care, employees need to be sensitive to social issues because people seeking help and health services are already at a disadvantage due to their health conditions. Members of groups at risk of poverty and social exclusion are even more disadvantaged due to the lower education of members of these groups, lower motivation to perform therapy, and poorer financial opportunities to invest in specialized health services. Also, in these groups, there is significantly lower awareness of the availability of social and health services, which limits access to these services, and ultimately leads to the poorer health status of members of these groups. Through service-learning, students applied proven knowledge and skills to projects that solve a specific social problem, which activates students to think about social problems, and gives them a sense of doing something good and positive and gaining experience for future careers. Students became more competent in working with users, gained self-confidence, learned group work, and developed project planning and verification skills. Also, many of them continued to cooperate with civil society organizations with which they connected during the implementation of the project and after the project activities were completed. Finally, through this way of working, students develop skills of critical thinking about the knowledge acquired in college and become more sensitive to social issues.

Adaptability and sustainability of the best practice (for other institutions)

Evaluations of existing service-learning programs around the world show that students like this way of working, that it encourages them to better adapt the teaching content and gain more comprehensive experience for their future profession. Since civil society organizations are the ones that contribute the most to the development of young people as socially responsible and active citizens in society, it is important to train them to implement service-learning programs to attract young people and encourage them to reconsider how they can actively participate in society. The responsibility for this goal lies with the universities as well. Namely, according to the Act on Scientific Activity and Higher Education (Official Gazette, 123/03, 198/03, 105/04, 174/04, 02/07, 46/07, 45/09, 63/11, 94/13, 139/13, 101/14, 60/15 and 131/17) higher education is based on interaction with the social community and the obligation of universities, colleges, and public scientific institutes to develop social responsibility of students and other members of the academic and scientific community. Precisely because of this common goal, civil society organizations should be more directly connected with higher education institutions, to jointly strive for shaping pro-social behavior and activating volunteering among students. Service-learning is one of the recognized and proven effective ways of connecting students and higher education institutions with civil society organizations and throughout society and serves as an important incentive to find the first job by connecting students with organizations in the world of work. With good presentation, visibility, and promotion, we can be a model for other higher education institutions to implement this type of course in their curriculum.

Promotion of best practice

We held a public presentation where we promoted the project activities. We participated in several different conferences, gave several interviews to student newspapers. We also promoted ourselves on social media. We presented the course to other students in the lower years and thus interested them in subscribing to this elective course.

Scope and impact

• Course/department level
• Faculty level
• Institutional level

The development of the service-learning program at UAHS, as well as the training of mentors (UAHS employees and representatives of partner civil society organizations), created the basis for more active involvement of students in socially sensitive issues. In this way, UAHS has become a more active participant in the local community, its activities have contributed to the education of socially responsible and active citizens, and thus improving the quality of life in the community.

6.1 Digitalization

• Novel digital solutions (tools, frameworks, devices, tasks to enhance efficiency and motivation)

Reasoning: When planning project activities, students learned how to make a Gantt chart, responsibility matrix, designed checklists, and how the implementation of all of the above in the project itself can contribute to better monitoring of project activities.

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6.2 Internationalization

• NOT RELEVANT

Reasoning:

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6.3 Inclusion and diversity, universal design

• Senzitivizing students to consider special needs when practicing their profession
• Course includes hints on how the services/products of the profession could be universally designed/inclusive

Reasoning: Through the implementation of service-learning college, students were allowed to work directly with users of different profiles and needs, think about social problems and ways in which they can get involved in solving them to contribute to the overall development and community development. In this way, there was a direct sensitization of students working in the health sector for social problems.

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6.4 Sustainability

• Social entrepreneurship projects, service-learning in the topic

Reasoning: Following the Strategy of Education, Science, and Technology, as well as the National Strategy for Creating a Stimulating Environment for Civil Society Development 2012-2016, this project contributed to connecting UAHS with three civil society organizations, to establish a sustainable service-learning program as part of its curriculum. Through the implementation of service-learning programs, students were allowed to work directly with users.

3.3 Public contact datas

Name	Email address	Website
Ana Marija Hošnjak	anamarija.hosnjak@zvu.hr	https://www.zvu.hr/drustveno-korisno-ucenje-za-studente-zdravstvenog-veleucilista/