Guests, hosts, and teaching the ethics of service learning in medicine

Abstract

Within medical education, there is an increasing need to provide ethics education for learners embarking on service learning. The concept of hospitality, as illustrated in Homer’s classic epic the Odyssey, has the potential to underpin such ethics education. This paper describes the implementation and evaluation of an ethics education session for medical students, built on the concept of hospitality, before they embark on a three-year longitudinal service-learning home visit program. In preparation for their household visits, second-year students at a medical school in Miami, Florida, participate in weekly didactic sessions. One of these classes consisted of a two-hour ethics session, involving a brief introductory large-group lecture, followed by self-administered small-group discussions of a series of case scenarios. An innovative web-based platform called Rise allowed the students to run their own small group activities. To assess the impact on the students’ ability to identify, and on their confidence in handling, ethical dilemmas, we administered pre- and post-session surveys. Students indicated statistically significant improvement in median responses to all questions, for two consecutive years. Students also listed three adjectives, both before and after the session, that they associated with good and bad hosts and guests. The consistency of the terms listed suggests that hospitality is a robust concept for the learners. In our experience, the concept of hospitality provides a robust framework for the students, and the mixed large-group and self-facilitated small-group format offers a valuable tool for ethics education related to service learning in medicine. Our study supports the utility of the concept as a teaching tool, and the format facilitates a session using minimal faculty. The notion of hospitality seems particularly fruitful for various ethical considerations in medicine, even beyond those that involve home visits.