Understanding the Goals of Service Learning and Community-Based Medical Education: A Systematic Review

Service Learning in Medical Education

Authors

  • Marina Khan Department of Medical Education, Gandhara University, Peshawar, Pakistan
  • Hanzala Waqar Department of Medical Education, Khyber Medical University, Institute of Dental Sciences, Kohat, Pakistan
  • Farida Pervez Department of Medical Education, Frontier Medical College, Abbottabad, Pakistan
  • Palwasha Zahid Department of Physiology, Peshawar Medical and Dental College, Peshawar, Pakistan
  • Muhammad Abbas Khan Department of Medical Education, Jinnah Medical College, Peshawar, Pakistan
  • Syeda Sanaa Fatima Department of Medical Education, Pak International Medical College, Peshawar, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i11.3518

Keywords:

Service Learning, Undergraduate Medical Students, Empathy, Professional Identity, Social Accountability

Abstract

Service learning (SL) and community-based medical education (CBME) are increasingly integrated into undergraduate medical training to prepare students for socially accountable practice. While many programs report benefits for students and communities, the specific goals emphasized across contexts remain inconsistently defined.

Objectives: To provide a comprehensive understanding of how SL and CBME contribute not only to student learning but also to community engagement and institutional development. Methods: Following the PRISMA 2020 guidelines, PubMed, Scopus, and the Cochrane Library were searched for English-language studies published between 2019 and 2024. Eligible studies included those involving undergraduate medical students participating in SL or CBME interventions. Data on study design, participants, interventions, and reported outcomes were extracted. Quality appraisal was conducted using the CASP, MMAT, and JBI tools. A thematic synthesis approach was used to categorize findings into educational, community, and institutional domains. Results: Sixteen studies were included, spanning Africa, Asia, North America, and the Middle East. Most studies reported educational outcomes such as improved clinical competence, empathy, reflective capacity, and professional identity formation. Community-level goals included increased access to care, health promotion, and stronger partnerships. Institutional goals, such as enhancing curricular relevance and social accountability, were less frequently documented. Few studies evaluated long-term sustainability or objectively measured community outcomes. Conclusions: SL and CBME consistently promote student growth while fostering community engagement. However, systematic evaluation of institutional impact and program sustainability remains limited. Future research should adopt longitudinal, multi-institutional approaches to capture durable outcomes and guide curricular reforms aligned with social accountability.

Author Biographies

Marina Khan, Department of Medical Education, Gandhara University, Peshawar, Pakistan

 

 

 

Hanzala Waqar, Department of Medical Education, Khyber Medical University, Institute of Dental Sciences, Kohat, Pakistan

       

Farida Pervez, Department of Medical Education, Frontier Medical College, Abbottabad, Pakistan

   

 

Palwasha Zahid, Department of Physiology, Peshawar Medical and Dental College, Peshawar, Pakistan

 

 

   

Syeda Sanaa Fatima, Department of Medical Education, Pak International Medical College, Peshawar, Pakistan

     

References

Reeb RN and Folger SF. Community Outcomes of Service Learning: Research and Practice from a Systems Theory Perspective. In Research on Service-Learning. 2023 Jul; 389-418. Routledge. doi: 10.4324/9781003446767-5. DOI: https://doi.org/10.4324/9781003446767-5

Plessas A, Paisi M, Ahmed N, Brookes Z, Burns L, Witton R. The Impact of Community Engaged Healthcare Education on Undergraduate Students' Empathy and Their Views Towards Social Accountability: A Mixed Methods Systematic Review. BMC Medical Education. 2024 Dec; 24(1): 1490. doi: 10.1186/s12909-024-06367-1. DOI: https://doi.org/10.1186/s12909-024-06367-1

Ishisaka M, Hanamoto A, Kaneko M, Kato D, Motomura K, Kataoka Y. Association Between Undergraduate Education for Community-Based Medicine and General Practice Majors: A Longitudinal Study in Japan. Korean Journal of Family Medicine 2023 Jun; 44(4): 215. doi: 10.4082/kjfm.22.0189. DOI: https://doi.org/10.4082/kjfm.22.0189

Urushibara-Miyachi Y, Kikukawa M, Ikusaka M, Otaki J, Nishigori H. Lists of Potential Diagnoses That Final-Year Medical Students Need to Consider: A Modified Delphi Study. BMC Medical Education. 2021; 21(1): 234. doi: 10.1186/s12909-021-02652-5. DOI: https://doi.org/10.1186/s12909-021-02652-5

Geary A, Wen Q, Adrianzén R, Congdon N, Janani R, Haddad D, et al. The Impact of Distance Cataract Surgical Wet Laboratory Training on Cataract Surgical Competency of Ophthalmology Residents. BMC Medical Education. 2021 Apr; 21(1): 219. doi: 10.1186/s12909-021-02659-y. DOI: https://doi.org/10.1186/s12909-021-02659-y

Narapureddy BR, Patan SK, Deepthi CS, Chaudhuri S, John KR, Chittooru C, et al. Development of a Community Orientation Program (COP) as a Community-Based Medical Education Method for Undergraduate Medical Students: An Experience from India. BMC Medical Education. 2021 Dec; 21(1): 626. doi: 10.1186/s12909-021-03069-w. DOI: https://doi.org/10.1186/s12909-021-03069-w

Bakhshi SK, Afzal N, Merchant AA, Rahim KA, Shaikh NQ, Noorali AA, et al. Undergraduate Medical Education Curriculum Reforms in Pakistan: A Mixed Methods Study of Academic Leadership Perspectives. Academic Medicine. 2024 Jul; 99(7): 794-800. doi: 10.1097/ACM.0000000000005683. DOI: https://doi.org/10.1097/ACM.0000000000005683

Ojha N, Khanal S, Karki S, Ojha P, Ojha N. Geographical Distribution and Career Preferences of Nepali Medical Graduates: A Cross-Sectional Study. Nepal Medical College Journal. 2025 Sep; 27(3). doi: 10.3126/nmcj.v27i3.84422. DOI: https://doi.org/10.3126/nmcj.v27i3.84422

Khalid S, Baig LA, Arooj M. Social Accountability in Medical School Curricula in Punjab, Pakistan: A Qualitative Analysis. BMC Medical Education. 2025 Jul; 25(1): 1000. doi: 10.1186/s12909-025-07268-7. DOI: https://doi.org/10.1186/s12909-025-07268-7

Mwangala PN, Kerubo A, Makandi M, Odhiambo R, Abubakar A. Prevalence and Associated Factors of Mental and Substance Use Problems Among Adults in Kenya: A Community-Based Cross-Sectional Study. PLOS Global Public Health. 2025 Jun; 5(6): e0004130. doi: 10.1371/journal.pgph.0004130. DOI: https://doi.org/10.1371/journal.pgph.0004130

Buregyeya E, Atusingwize E, Nsamba P, Nalwadda C, Osuret J, Kalibala P, et al. Lessons from a Community Based Interdisciplinary Learning Exposure: Benefits for Both Students and Communities in Uganda. BMC Medical Education. 2021 Jan; 21(1): 5. doi: 10.1186/s12909-020-02429-2. DOI: https://doi.org/10.1186/s12909-020-02429-2

Adefuye A, Benedict M, Bezuidenhout J, Busari JO. Students' Perspectives of a Community-Based Medical Education Programme in a Rural District Hospital. Journal of Medical Education and Curricular Development. 2019 Nov; 6: 2382120519886849. doi: 10.1177/2382120519886849. DOI: https://doi.org/10.1177/2382120519886849

Ohta R, Ryu Y, Katsube T, Moriwaki Y, Otani J. Students' Perceptions of General Medicine Following Community-Based Medical Education in Rural Japan. Journal of General and Family Medicine. 2019 Nov; 20(6): 236-43. doi: 10.1002/jgf2.274. DOI: https://doi.org/10.1002/jgf2.274

Burton E, Assi L, Vongsachang H, Swenor BK, Srikumaran D, Woreta FA, et al. Demographics, Clinical Interests, and Ophthalmology Skills Confidence of Medical Student Volunteers and Non-Volunteers in an Extracurricular Community Vision Screening Service-Learning Program. BMC Medical Education. 2022 Mar; 22(1): 143. doi: 10.1186/s12909-022-03194-0. DOI: https://doi.org/10.1186/s12909-022-03194-0

Thomson KB, Mirpuri P, Chen M. The Impact of Volunteering with a Student-Run Free Clinic on Medical Student Specialty Selection. BMC Medical Education. 2022 Oct; 22(1): 714. doi: 10.1186/s12909-022-03788-8. DOI: https://doi.org/10.1186/s12909-022-03788-8

Liao SC, Lee MR, Chen YL, Chen HS. Application of Project-Based Service-Learning Courses in Medical Education: Trials of Curriculum Designs During the Pandemic. BMC Medical Education. 2023 Sep; 23(1): 696. doi: 10.1186/s12909-023-04671-w. DOI: https://doi.org/10.1186/s12909-023-04671-w

Suresh A, Wighton NM, Sorensen TE, Palladino TC, Pinto-Powell RC. A Hybrid Educational Approach to Service Learning: Impact on Student Attitudes and Readiness in Working with Medically Underserved Communities. Medical Education Online. 2022 Dec; 27(1): 2122106. doi: 10.1080/10872981.2022.2122106. DOI: https://doi.org/10.1080/10872981.2022.2122106

Van Winkle LJ, Thornock BO, Schwartz BD, Horst A, Fisher JA, Michels N. Critical Reflection on Required Service to the Community Propels Prospective Medical Students Toward Higher Empathy, Compassion, and Bias Mitigation but Are These Gains Sustainable?. Frontiers in Medicine. 2022 Sep; 9: 976863. doi: 10.3389/fmed.2022.976863. DOI: https://doi.org/10.3389/fmed.2022.976863

Hiramine S, Nagata M, Kainuma M. The Impact of an Undergraduate Community-Based Medical Education Program in a Japanese Urban City. Cureus. 2024 Feb; 16(2). doi: 10.7759/cureus.54204.

Sin DY, Chew TC, Chia TK, Ser JS, Sayampanathan A, Koh GC. Evaluation of Constructing Care Collaboration-Nurturing Empathy and Peer-to-Peer Learning in Medical Students Who Participate in Voluntary Structured Service Learning Programmes for Migrant Workers. BMC Medical Education. 2019 Aug; 19(1): 304. doi: 10.1186/s12909-019-1740-6. DOI: https://doi.org/10.1186/s12909-019-1740-6

Lu WH, Pang L, Strano-Paul L. The Impact of COVID-19 Service Learning on Medical Student Professional Identity Formation. Journal of Medical Education and Curricular Development. 2024 Sep; 11: 23821205241262686. doi: 10.1177/23821205241262686. DOI: https://doi.org/10.1177/23821205241262686

Ampofo GD, Osarfo J, Tagbor HK. Medical Students' Perceptions of a Community-Engaged Learning Approach to Community Health in Ghana: The Students' Community Engagement Programme (SCEP). BMC Medical Education. 2024 Nov; 24(1): 1400. doi: 10.1186/s12909-024-06409-8. DOI: https://doi.org/10.1186/s12909-024-06409-8

Ohta R, Kamiyama Y, Makishi T. Inquiry into Short-Term Learning on Japanese Rural Islands: A Qualitative Study. Education for Primary Care. 2019 Mar; 30(2): 88-95. doi: 10.1080/14739879.2019.1570350. DOI: https://doi.org/10.1080/14739879.2019.1570350

Nishikawa K, Ohta R, Sano C. The Perception of Rural Medical Students Regarding the Future of General Medicine: A Thematic Analysis. In Healthcare. 2021 Sep; 9(10): 1256. doi: 10.3390/healthcare9101256. DOI: https://doi.org/10.3390/healthcare9101256

Hiramine S, Nagata M, Kainuma M. The Impact of an Undergraduate Community-Based Medical Education Program in a Japanese Urban City. Cureus. 2024 Feb; 16(2). doi: 10.7759/cureus.54204. DOI: https://doi.org/10.7759/cureus.54204

Yang YS, Liu PC, Lin YK, Lin CD, Chen DY, Lin BY. Medical Students' Preclinical Service-Learning Experience and Its Effects on Empathy in Clinical Training. BMC Medical Education. 2021 May; 21(1): 301. doi: 10.1186/s12909-021-02739-z. DOI: https://doi.org/10.1186/s12909-021-02739-z

Kamal Z, Ali MM, Ali MZ, Rustam MN, Khan SZ. Community Based Medical Education: A Learning Experience of Pakistani Undergraduate Medical Students at Medical Camps. The Professional Medical Journal. 2021 Nov; 28(12): 1857-61. doi: 10.29309/TPMJ/2021.28.12.6165. DOI: https://doi.org/10.29309/TPMJ/2021.28.12.6165

Rodriguez TM, Dirani K, Arsenault SM, Freedman RL, Guest JM, George K, et al. Community Outreach Vision Screenings with Student-Led Eye Health Education Improves Student Eye Health Knowledge and Ophthalmic Health Disparities Awareness. Journal of Academic Ophthalmology. 2024; 16(1): 6. doi: 10.62199/2475-4757.1031. DOI: https://doi.org/10.62199/2475-4757.1031

Shikino K, Yamauchi K, Araki N, Shimizu I, Kasai H, Tsukamoto T, et al. Understanding Community Health Care Through Problem-Based Learning with Real-Patient Videos: Single-Arm Pre-Post Mixed Methods Study. JMIR Medical Education. 2025 Jan; 11: e68743. doi: 10.2196/68743. DOI: https://doi.org/10.2196/68743

Kalistratova VS, Nisanova A, Shi LZ. Student-Run Free Clinics May Enhance Medical Students' Self-Confidence in Their Clinical Skills and Preparedness for Clerkships. Medical Education Online. 2024 Dec; 29(1): 2348276. doi: 10.1080/10872981.2024.2348276. DOI: https://doi.org/10.1080/10872981.2024.2348276

Mazander M, Rumenapp J, Lee D, Ong C, Floramo E, Benjamins M, et al. Quantifying the Educational Value of a Student-Run Free Clinic. Family Medicine. 2024 Jan; 56(3): 176. doi: 10.22454/FamMed.2024.568265. DOI: https://doi.org/10.22454/FamMed.2024.568265

Isano S, Grace IN, Uwimana A, Ndangurura D, Renzaho JN, Bitalabeho FA, et al. Exploring the Impact of the Global Community-Based Education (G-CBE) Program at the University of Global Health Equity (UGHE), Rwanda: Insights from the Inaugural Cohort. BMC Medical Education. 2024 Dec; 24(1): 1447. doi: 10.1186/s12909-024-06418-7. DOI: https://doi.org/10.1186/s12909-024-06418-7

Scala JJ, Cha H, Shamardani K, Rashes ER, Acosta-Alvarez L, Mediratta RP, et al. Training the Next Generation of Community-Engaged Physicians: A Mixed-Methods Evaluation of a Novel Course for Medical Service Learning in the COVID-19 Era. BMC Medical Education. 2024 Apr; 24(1): 426. doi: 10.1186/s12909-024-05372-8. DOI: https://doi.org/10.1186/s12909-024-05372-8

Kim S, Cha B, Kyung SY, Yune SJ, Park KH, Park KH. Current Status and Needs of Community-Based Practice in Public Healthcare Institutions Among Korean Medical Schools: A Cross-Sectional Study. Journal of Yeungnam Medical Science. 2025 Jan; 42. doi: 10.12701/jyms.2025.42.21. DOI: https://doi.org/10.12701/jyms.2025.42.21

Aljafri A, Abba P, Sedghi A, Conte A, Jerjes W. Evaluating the Impact of Community-Based Medical Education on Health Literacy and Patient Empowerment in Underserved Populations: A Pilot Cohort Study. Clinics and Practice. 2025 May; 15(6): 97. doi: 10.3390/clinpract15060097. DOI: https://doi.org/10.3390/clinpract15060097

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Published

2025-11-30
CITATION
DOI: 10.54393/pjhs.v6i11.3518
Published: 2025-11-30

How to Cite

Khan, M., Waqar, H., Pervez, F., Zahid, P., Khan, M. A., & Fatima, S. S. (2025). Understanding the Goals of Service Learning and Community-Based Medical Education: A Systematic Review: Service Learning in Medical Education. Pakistan Journal of Health Sciences, 6(11). https://doi.org/10.54393/pjhs.v6i11.3518

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Systematic Review

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