Background
This study was conducted in Chiayi County, which has the highest proportion of senior citizens out of all counties in Taiwan. Older adults comprise 20% of the total population in Chiayi. Chiayi has become a super-aged society by the end of March 2022. Older adults are expected to comprise more than 20% of the population in several rural areas. In June 2020, approximately 8,146 older adults aged >50 years lived in Chiayi, accounting for 1.6% of the population of the region. In 2019, the government of Chiayi established 29 community dementia service centers for individuals with dementia. From 2017 to 2019, as evidenced by presentations given by college students participating in service-learning programs and by feedback records from case managers and social workers at community dementia service centers, college students lacked sufficient knowledge of predementia, did not design appropriate service activities, and demonstrated a lack of understanding regarding the pressures faced by family members caring for individuals with dementia. Therefore, this study established community partnerships with medical units and community dementia service centers to jointly design cross-disciplinary community service-learning courses.
Research Purposes and Questions
This study investigated the effect of an instructional design intervention on learning outcomes among college students in a community-based service-learning course involving older adults with dementia. This study explored the effectiveness of the service-learning program and the transformation of learning. This study investigated whether (1) prior knowledge of dementia moderated the effects of the intervention on learning outcomes, (2) the reflective transformation learning situation of college students in the experimental group participating in community service-learning for older adults with dementia, and (3) the intervention affected overall learning outcomes.
Research Methods and Design
This study adopted a mixed-methods-embedded experimental design. First, a quasi-experimental investigation of service-learning among college students was conducted using various teaching designs. Second, differences in pre-existing knowledge and service-learning effectiveness between the experimental and control group were analyzed. Finally, student perceptions of the intervention were analyzed to explore their transformative learning.
1. Research Objective
Through intentional sampling, 35 college students who enrolled in the community service-learning for older adults with dementia course in 2021 were recruited into the experimental group and 35 college students who participated in the certified service learning in the current semester were recruited into the control group. The two groups were each divided into five subgroups of seven students each.
2. Experimental Design
Independent variable: Students in the experimental and control groups were divided into five subgroups of seven students each. Using the prior knowledge learning resource platform for dementia-related service-learning, each group completed a problem-based learning course and made a report.
Control variables: (1) Instructional design for the experimental group: inviting dementia specialists, scholars of cognitive processes in older adults, staff of community dementia service centers, and leaders of cognitive promotion activities to share practical examples related to their field; (2) interviews with caregivers of individuals with dementia and staff of community dementia service centers; (3) both groups visited the same community dementia service centers; (4) both groups received guidance in the design of service-learning activities; (5) both groups conducted service-learning activities in the same community dementia service center and were assisted by two teaching assistants.
Dependent variable: (1) Participants completed a dementia service-learning prior knowledge test before and after the intervention; (2) data from group reflections and experience reports were collected and analyzed; (3) participants completed a questionnaire about the effects of service-learning for older adults with dementia.
Results
Covariate analysis revealed significant differences between the experimental and control groups in the basic knowledge, activity design, and website resources domains and overall scores in the dementia service-learning prior knowledge test. The students in the experimental group participated in cross-disciplinary practical activities, in which lecturers shared their experience through dialogue and had interviews with caregivers and dementia service center staff. Consequently, the improvement in the dementia service-learning prior knowledge test was significantly greater in experimental group than in the control group.
A test was conducted to compare the results of the service-learning effects questionnaire between the experimental and control groups and revealed significant differences in knowledge verification, resource application, service-learning experience, future service vision, and overall scores. This finding indicates that the experimental group performed better than the control group.
Qualitative data analysis revealed that the use of various instructional methods can improve the cognitive, affective, and service skills of college students serving older adults with dementia. College students’ experience of participating in service-learning will cultivate their sense of social responsibility, civic literacy, and willingness to continue to participate in serving older adults with dementia.
Conclusions
(1) A cross-disciplinary team designed a problem-based learning website, which was used to provide resources for college students. (2) Practitioners in community dementia service centers participated in teaching, building upon the prior knowledge of college students. (3) Visits to community dementia service centers and interviews with caregivers facilitated increased motivation among college students to engage in the service-learning program. (4) Establishing partnerships between college students and individuals in community dementia service centers promoted reflective transformation learning. (5) Combining service-learning with credit courses for older adults with dementia improved the effectiveness of service-learning for college students.
Recommendations
(1) Invite community dementia service center staff to jointly plan and construct the knowledge learning framework. (2) Provide practical community teaching opportunities and self-learning resources to ensure that students are prepared for engaging in community service. (3) Establish community campus partnerships to promote reflection and transformational learning among college students. (4) Circular reflection can be adopted when engaging in service-learning that involves older adults with dementia to promote transformative learning. (5) Varied instructional methods can be used to increase motivation among college students to continue to care for individuals with dementia.
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