Service learning for health students: do it the French way

Service learning is a pedagogical approach, in which the format of the course contributes as much to the training of students as the content itself.1Mason MR Dunens E Service-learning as a practical introduction to undergraduate public health: benefits for student outcomes and accreditation.Front Public Health. 2019; 7: 63Crossref PubMed Scopus (13) Google Scholar There has been a substantial increase in interest in service learning in various fields, including for medical students and public health courses.2Stewart T Wubbena ZC A systematic review of service-learning in medical education: 1998-2012.Teach Learn Med. 2015; 27: 115-122Crossref PubMed Google Scholar 2023 marked the fifth anniversary of service-learning implementation for health students in France. As an important part of the National Health Strategy 2018–2022, the French Government decided to introduce service learning by decree in June, 2018, to achieve two goals with one action: to train future health-care workers in prevention and health promotion, and to carry out prevention activities targeted at vulnerable groups in wider communities and contribute to the fight against health inequalities. In practical terms, each year 50 000 health students across France deliver 1–35 h of prevention activities in multi-professional teams. These actions target specific audiences, with priority given to primary schools and colleges in priority education areas and health and medico-social establishments, on the themes of addictive behaviours, nutrition, physical activity, hygiene, emotional and sexual life, self-esteem, screen addiction, and sleep health. 5 years later in 2023, the question of whether service learning in health studies is feasible was unanimously answered yes by the 220 managers who met in Angers, France on March 16–17, for the first national meeting since its implementation. Through plenary sessions and thematic workshops, the heads of service-learning departments have endorsed this teaching method and expressed the hope of strengthening it further, given its many benefits. All service-learning department heads agreed that service learning has been a major force for developing interdisciplinarity and bringing together students from different disciplines in the same lecture hall, creating a common culture for these future actors in the health system. Several avenues of development have emerged for the coming years, including the development of actions targeted at new audiences or towards emerging health issues (eg, environmental health, One Health, and mental health). National surveys and studies showed a positive effect of service learning; among the 11 623 health students who responded in a 2021 survey, the satisfaction rate was over 88%. Substantial development of health students’ skills has also been observed,3Le Roux E Mari Muro M Mognon K et al.A governmental program to encourage medical students to deliver primary prevention: experiment and evaluation in a French faculty of medicine.BMC Med Educ. 2021; 21: 47Crossref PubMed Scopus (6) Google Scholar including a strengthened understanding of community health and determinants of health.4Leblanc P Occelli P Etienne J Rode G Colin C Assessing the implementation of community-based learning in public health: a mixed methods approach.BMC Med Educ. 2022; 22: 40Crossref PubMed Scopus (6) Google Scholar Some data showed a direct impact on beneficiaries, notably on primary and college students, that could be linked to the so-called peer-to-peer approach permitted by the French format of service learning.5Nuttall A Mancini J Lizin C et al.Multidisciplinary peer-led sexual and reproductive health education programme in France, a prospective controlled-study.BMC Public Health. 2022; 222239Crossref PubMed Scopus (2) Google Scholar However, overall evaluation of the effect on beneficiaries remains a difficult issue to tackle.2Stewart T Wubbena ZC A systematic review of service-learning in medical education: 1998-2012.Teach Learn Med. 2015; 27: 115-122Crossref PubMed Google Scholar Service learning for French health students, which was set up in a short period of time and carried out throughout the COVID-19 pandemic, has proven successful. Service learning is a powerful driving force for the transition from a care-centred system to a global health system, making health promotion compulsory in health professional training courses. We declare no competing interests.