Medical students as service learners: opportunities, risks and recommendations

Service learning is a form of experiential education that is being implemented internationally within undergraduate primary care, with the potential to significantly enhance clinical practice whilst simultaneously facilitating medical students' learning. Though the benefits of service learning are widely acknowledged within the literature, there is little documentation of the associated challenges. Drawing on reflections from our own practice, and those of colleagues from a variety of institutions across the UK, we propose four key areas of risk associated with the integration of service learning into undergraduate medical education: unsafe encounters, patient disempowerment, inequality of experience and misalignment of service and learning priorities. Considering each area in turn, we identify contributory factors alongside practical recommendations to mitigate these risks. Acknowledgement of this subject is timely as medical schools develop their curricula to reflect evolving service and patient priorities in light of the COVID-19 pandemic. We aim to encourage discussion and debate amongst the medical education community at a time where emphasis is being increasingly placed on medical students as being active participants in the delivery of patient care. In doing so, faculty may reduce associated risks and maximise the benefit of opportunities for all stakeholders.