Impact of Health Promotion Service-Learning for Older Adults in Physiotherapy Students

Overview

Currently, there is a lack of evidence regarding the impact of service-learning methodology (SL) on learning-related outcomes for physiotherapy students, specifically when designing and implementing health promotion programs for vulnerable older adults. The present study aims to compare the effects of an SL program versus a Traditional Learning (TL) approach on Basic Psychological Needs (BPN), motivation, academic engagement, and empathy in physiotherapy students. This study is a randomized clinical trial. Eighty-three physiotherapy students are allocated to an SL group (SLG) or to a TL group (TLG). All students develop a health promotion and therapeutic exercise program for vulnerable older adults, in order to carry out prevention and health promotion activities. The SLG performs the program with real patients by visiting health centers, while the TLG does not meet real patients. BPN, motivation, academic engagement, and empathy, in their different dimensions, are evaluated pre- and post-intervention. This study was registered retrospectively, as the recruitment and/or data collection had already started before registration.

Health science professionals require both technical and interpersonal competencies to provide effective, patient-centered care. In physiotherapy, developing communication skills, empathy, and ethical awareness is essential for addressing patients' needs and situations of vulnerability. However, these interpersonal competencies are often insufficiently emphasized in traditional university curricula. Service-Learning (SL) emerges as an innovative educational methodology that integrates academic learning with community service, allowing students to apply theoretical knowledge to real social contexts. Through direct engagement with community needs, SL promotes experiential learning, civic responsibility, and the development of transversal competencies such as empathy, communication, and teamwork. Aligned with the principles of the Self-Determination Theory, SL fosters the satisfaction of basic psychological needs-competence, autonomy, relatedness, and novelty-enhancing students' motivation and engagement. Previous studies in health sciences suggest that SL improves academic performance, moral development, and self-determined motivation. In physiotherapy, it contributes to the acquisition of professional and interpersonal skills necessary for effective clinical practice. Nevertheless, there is limited evidence on the impact of SL when physiotherapy students design and implement health promotion programs for vulnerable older adults. Investigating this approach is therefore essential to understanding its potential to enhance learning outcomes and foster socially committed future professionals. A randomized, assessor-blinded trial compares a Service-Learning (SL) intervention with a Traditional Learning (TL) approach in physiotherapy students. Eighty-three students from the University of Valencia (Spain) are randomly assigned to either the SL group (SLG, n=39) or the TL group (TLG, n=44). The SL intervention follows six domains: (Domain 1) project introduction and formation of student groups; (Domain 2) identification of the physical, functional, and social needs of vulnerable older adults through direct contact and literature review; (Domain 3) discussion and validation of identified needs with mentor supervision; (Domain 4) autonomous individual work; (Domain 5) collaborative group work; and (Domain 6) final presentation in a clinical setting, including practical implementation with older adults and interactive discussion. Throughout all domains, students engage in guided critical reflection on the personal, professional, and social implications of their participation in the SL program. The TL intervention consists of a parallel six-domain structure but without direct engagement with older adults: (Domain 1) project introduction and group formation; (Domain 2) identification of needs solely through bibliographic research; (Domain 3) review and discussion of findings with teacher supervision; (Domain 4) autonomous individual work; (Domain 5) collaborative group work; and (Domain 6) final oral presentation of the proposed health promotion program to peers at the university. This study was registered retrospectively, as the recruitment and/or data collection had already started before registration.