Embedding civic engagement in medical education – rationale, process, opportunities and challenge

Civic engagement is a mutually beneficial knowledge-based collaboration between a university, its staff and students and the wider community. It is generally characterised by values such as partnership, reciprocity and respect for diversity. Civic engagement espouses an explicit transformative purpose, for students, staff and/or community partners. It offers a way of fulfilling the core functions of teaching, research and service to wider society, through activities such as community based learning, community engaged research and public engagement (Boland, 2012). The Higher Education Authority, in its recent strategic plan for higher education, has identified engagement as one of the three core missions of higher education. Civic engagement offers a myriad of possibilities for medical education, research and practice. For educators, community based learning (CBL) where students apply discipline specific knowledge and skills to address specific needs in the local community. It offers authentic opportunities for students to develop a humane and ethical approach to healthcare, gain an appreciation of the social determinants of health and a capacity to work effectively with diverse communities. For researchers, community engaged research (CER) enables development and sharing of knowledge which is grounded in community issues. Despite the benefits – for students, the community and the university – a crowded and regulated curricula, busy clinical environment and the pressures of academic life pose challenges for educators seeking to embed civic engagement in their work. We offer models and examples of how CBL and CER can be implemented in medical and health care education, highlighting some key ethical and professional challenges, including sustainability. We draw on a qualitative multi-site case study of the policy and practice of embedding civic engagement within the curriculum in Irish higher education. The paper is also informed by our experience supporting student learning and collaborative research in community settings. We make the case for a strategic, deliberative and critical approach to embedding the principles and practice of engagement into healthcare education, research and practice.