title: Enhancing student perspectives of humanism in medicine: reflections from the Kalaupapa service learning project.
abstract: BACKGROUND
  Service learning is endorsed by the Liaison Committee on Medical Education (LCME) as an integral part of U.S. medical school curricula for future physicians. Service learning has been shown to help physicians in training rediscover the altruistic reasons for pursuing medicine and has the potential to enhance students' perspectives of humanism in medicine. The Kalaupapa service learning project is a unique collaboration between disadvantaged post-baccalaureate students with an underserved rural community. This study was conducted to determine whether the Kalaupapa service learning curricula enhanced student perspectives of humanism in medicine at an early stage of their medical training.
  
  
  METHODS
  Program participants between 2008 and 2014 (n = 41) completed written reflections following the conclusion of the service learning project. Four prompts guided student responses. Reflections were thematically analyzed. Once all essays were read, team members compared their findings to condense or expand themes and assess levels of agreement.
  
  
  RESULTS
  Emerging themes of resilience and unity were prominent throughout the student reflections. Students expressed respect and empathy for the patients' struggles and strengths, as well as those of their peers. The experience also reinforced students' commitment to service, particularly to populations in rural and underserved communities. Students also gained a deeper understanding of the patient experience and also of themselves as future physicians.
  
  
  CONCLUSIONS
  To identify and address underserved and rural patients' health care needs, training programs must prepare an altruistic health care workforce that embraces the humanistic element of medicine. The Kalaupapa service learning project is a potential curricular model that can be used to enhance students' awareness and perspectives of humanism in medicine.
authors.affiliation: The University of Hawai'i at Mānoa - John A. Burns School of Medicine, MEB 306H, 651 Ilalo Street, Honolulu, HI, 96813, USA. winonal@hawaii.edu.
authors.forename: Winona K
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Native Hawaiian Health, John A. Burns School of Medicine, 677 Ala Moana Blvd, Suite1016B, Honolulu, HI, 96813, USA.
authors.forename: Chessa C D
authors.initials: CCD
authors.lastname: Harris
authors.affiliation: The University of Hawai'i at Mānoa - John A. Burns School of Medicine, MEB 306H, 651 Ilalo Street, Honolulu, HI, 96813, USA.
authors.forename: Kawika A
authors.initials: KA
authors.lastname: Mortensen
authors.affiliation: Department of Psychiatry, Research Division, The University of Hawai'i at Mānoa, Suite 301, 677 Ala Moana Blvd, Honolulu, HI, 96813, USA.
authors.forename: Linsey M
authors.initials: LM
authors.lastname: Long
authors.affiliation: Department of Psychiatry, Research Division, The University of Hawai'i at Mānoa, Suite 301, 677 Ala Moana Blvd, Honolulu, HI, 96813, USA.
authors.forename: Jeanelle
authors.initials: J
authors.lastname: Sugimoto-Matsuda
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D003153:Community Health Services; D003479:Curriculum; D004501:Education, Medical; D005260:Female; D006254:Hawaii; D006808:Humanism; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D012424:Rural Population; D055815:Young Adult
keywords: Diversity; Healthcare workforce; Humanism; Native Hawaiian; Service-learning