Service Learning Collaborations: A Formula for Reciprocity

Service learning offers opportunities for both educational institutions and the community. To demonstrate the possibilities this pedagogy can offer, this article discusses a service learning experience partnering students with a hospice agency. Using mixed methodology, impact on students, patients, and staff are examined. Results indicate that students improved their attitudes toward the elderly, and death and dying; they also believed the experience caused personal and professional growth. Interviews with patients highlighted the importance of relationships and recognition, and staff identified benefits to students, patients, and the hospice agency. The conclusion is made that service learning is best perceived in a light of reciprocity and that this method of engagement offers opportunities for educators and practitioners. Finally, some tips are given for practitioners interested in developing such collaborations.

I ncreasingly, institutions of higher education are looking for ways to enhance their relationships with their communities. An example of this recent push is demonstrated through the new elective classifications of community engagement developed by the Carnegie Foundation for the Advancement of Teaching. They define community engagement as "the collaboration between institutions of higher education and their larger communities…for the mutually beneficial exchange of knowledge and resources in a context of partnership and reciprocity" (Driscoll, 2008, p. 39). Service learning is one example of how institutions can reach out, and use of this method of teaching was in part responsible for Texas Tech University being among the first 76 institutions to receive one of these new Carnegie designations in December 2006. Texas Tech University defines service learning as pedagogy that links academic study and civic engagement through thoughtfully organized service that meets the needs of the community. This service is structured by and integrated into the academic curriculum, which provides opportunities for students to learn and develop through critical reflection. (Texas Tech University Service Learning Program) From an educational standpoint, service learning offers some advantages. Perhaps most clearly, it provides a hands-on method of engaging students with instructional materials. Further, service learning aims to develop a sense of civic responsibility by engaging students in community projects. Bringle and Hatcher (1996) suggest that using service learning not only teaches students about their area of specialty, but also prepares them for "life as responsible citizens" (p. 221). Service learning is generally meant not only to enhance the curriculum for a particular course but also to move beyond in its impact on students. However, it offers an opportunity to the community, as well as the educational institution, that is not often seen in more traditional teaching methods. This is a particular advantage for the social work profession, which, like others, is always striving to bridge the gap between theory and practice, between educators and community practitioners, and between the university and "real life." While these advantages could be seen as demonstrating a particularly clear connection between service learning and social work, social work educators are not taking a lead in this developing pedagogy. Phillips (2007) suggests that although the field might "expect social work to be a foundational discipline of the [Higher Education Civic Engagement] movement and at the forefront of servicelearning methodological development…the relationship between the three has been tenuous, at best" (p. 6). As an example of the opportunity service learning can offer, this article describes and provides evaluation data for one service learning project (SLP) in an undergraduate, beginning-level social work course at Texas Tech University. The course links a local hospice with students who spend a semester interviewing patients about their life history and making connections between course materials and their service experience. Here, we examine the impact of this project on students, hospice patients, and staff.

Current State of Knowledge
While some authors have pointed out a natural fit between social work and service learning (King, 2003;Phillips, 2007), it is generally agreed that there is limited evidence that social work educators are using this method. It is certainly clear that few evaluation studies of this type of experience are available and most of this research has been limited to impact on students. Lemieux and Allen (2007) conducted a recent review of the available social work literature on the subject published since 1990 and identified only eight studies that met their criteria for service learning, which they identified as those of Bringle and Hatcher's "widely accepted definition" (p. 313). Five of these outcome studies examined the impact of macro level service learning experiences, while only three examined service learning experiences with direct client contact. Nevertheless, the impact of the service learning experiences on students in these studies was overwhelmingly reported as positive. Additional evidence of service learning being used in social work education is offered by Nadel, Majewski, and Sullivan-Cosetti (2007). Their text offers different models of service learning across the social work curriculum; most of the reported evaluations were qualitative and all reported positive outcomes for students.
More specifically, we were unable to locate any literature evaluating a service learning experience in a hospice environment. However, there are examples of comparable efforts with older adults examining student and elder impact. The majority of this research indicates positive outcomes. Results from qualitative data indicate that students see a benefit to service learning and gain personal growth and learning enhancement from such experiences (Ames & Diepstra, 2007;Blieszner & Artale, 2001;Brown & Roodin, 2001;Dorfman, Murty, Ingram, & Evans, 2002;Hamon & Way, 2001;Jarrott, 2001). Quantitative investigations have demonstrated gains in attitudes toward the elderly (Bringle & Kremer, 1993;Dorfman et al.), interacting and working with the elderly (Dorfman et al.; Jarrott), and self-efficacy in working with older adults (Ames & Diepstra). However, Ames and Diepstra found no significant changes in student attitudes toward the elderly, or their interest in working with or learning more about this population. Blieszner and Artale (2001) found no statistically significant changes in personal social values or civic attitudes of students, while a significant decline was indicated on the perception of the magnitude of effect in understanding course material. Researchers have also qualitatively examined impact on the elders and found that most respond positively (Bringle & Kremer;Dorfman et al.;Hamon & Way;Underwood & Dorfman, 2006).

Our Hospice Experience
Just prior to the start of the fall semester in 2006, the volunteer coordinator at a local hospice agency contacted Texas Tech University's social work program about developing a partnership. More particularly, she was interested in reproducing a project (Mahood & Romer, 2001) which involved high school students interviewing patients about their life history and creating a product to celebrate their lives. While senior social work students had been placed with the agency in the past for their field placements, the field director had determined that this project idea was inappropriate for that level of students. Instead, she suggested that the volunteer coordinator contact the first author who taught some lower-level courses. Upon discussing her idea, the instructor thought this would best be conducted as an SLP in a course that examines human behavior across the lifespan. In addition to enhancing student learning through hands-on experience, she hoped that the SLP would increase students' exposure to diverse life experiences.
Service learning is differentiated from other pedagogies by the clear presence of three components. The first requires that the service be identified as a need by a community partner. As indicated previously, our community partner identified the need and nature of the SLP. Regarding the service, hospice staff members provide two 50-minute class sessions of training, which includes what to expect when working with patients and issues of confidentiality. Students sign a release of liability for the university and complete a volunteer application for the agency, including a background check. Then groups of two or three students meet with a patient for about an hour approximately once a week over the course of the semester. These sessions are loosely structured but are primarily devoted to talking about life experiences in different phases of life. With differing levels of input and cooperation from the patients, student groups create a product for each patient that celebrates the life of the patient and is generally intended to be a memento for the family. Time spent with patients as well as the creation of the life history product varies widely between students, but 15 to 20 hours per student per semester is typical.
Secondly, to be accurately classified as service learning, the service should be clearly applicable to the academic material. Finally, opportunities for reflection on the experience should be provided to students. In this course, these requirements are fulfilled in the context of class. Several sessions during the semester offer students an opportunity to share feelings about the experience and stories they hear from patients, as well as apply lecture content. More formally, students write papers that require them to (a) connect academic content with the life history information, (b) practice writing and APA-style skills, (c) reflect on their experience so far, and (d) compare and contrast their own life experiences with those of the patient. At the end of the semester, the products created for the patients are set up in a poster session format, and guests are invited to view the products and talk with the students about their patients and the service learning experience. Held during a regular class session this experience gives students a final opportunity to reflect on the overall experience.
For the evaluation of the project, our general research question was: What is the impact of the SLP in a hospice setting? Testable hypotheses included: (a) Students' attitudes toward the elderly will improve following the SLP, (b) Students' attitudes toward death and dying will improve following the SLP. Additionally, using a qualitative approach this study explored students', patients', and staff impressions of the partnership. The research was approved by the Texas Tech University Institutional Review Board. All research participants consented to the research and had the option to not participate without repercussion.

Methods
Procedures. Student participants were undergraduates enrolled in the Human Behavior and the Social Environment-Lifespan course during one regular semester of 2007. Students completed pre-and posttest written surveys, which included open-ended questions, some general and demographic items, and two attitudinal scales. To assess attitudes toward the elderly, we used a modified version of the Aging Semantic Differential scale (Polizzi, 2003). Our scale included 24 polar opposite adjective pairs (e.g., generous/selfish) and asked students to rate, on a 7-point scale, a person aged 70-85 in general. In our sample, this scale showed adequate reliability with an alpha of .67. To assess attitudes toward death and dying, we used a modified version of Bugen's (1980/1) Coping with Death scale. Our modified scale asked students to rate their level of agreement (7-point scale) on 27 items, such as "I feel able to handle the death of others close to me." In our sample this showed good reliability with an alpha of .94.

Data Analysis
The researchers compiled and analyzed the quantitative data using SPSS 16.0®. The level of significance used to interpret the results of the paired-sample t-tests was .05. Cohen's d was used to estimate effect size; the guide of 0.2 for a small effect, 0.5 a medium effect, and 0.8 for a large effect was used to interpret the effect size results (Cohen, 1992). Regarding analysis of the qualitative survey items, we independently examined the responses to each question and noted initial impressions of main ideas. Then we reviewed these impressions together and decided upon the emerging themes.
Sample. Twenty students were research participants; both the preand posttest surveys were completed by 17 while 3 completed only the posttest survey. The students were from 19 to 33 years of age (M = 22.1, SD = 4.2), with a median age of 25. Most were social work majors (88%) and White (65%), while 29% were Latino and 6% Black.

Results
To test the quantitative research hypotheses, we used paired sample t-tests. Students' attitudes toward the elderly improved (lower scores indicate more positive attitudes) from pretest (M = 84.0, SD = 12.4) to posttest (M = 75.4, SD = 7.7). The change was statistically significant, t(16) = 3.22, p = .005. The effect size was fairly large (d = 0.78), indicating that the posttest scores were 0.78 of a standard deviation lower than the pretest scores. Attitudes toward death and dying also demonstrated statistically significant change, t(16) = −3.11, p = .007, with students' scores increasing (showing improvement) from pretest (M = 29.0, SD = 28.7) to posttest (M = 140.9, SD = 20.4). This effect was also fairly large (d = −0.75).

Pre-SLP.
We asked students open-ended questions about their impressions of the SLP and their attitudes toward death and dying. Before the SLP, the majority (65%) made some statement suggesting that death is a natural part of life or that it is inevitable. Other themes regarding death included religion, afterlife, and emotions, as well as personal experience with, avoidance of, and preparation for death. A particularly articulate student said: Death is natural; however it is another part of living. Something we can't avoid, there is no reason to fear it, only reason to fear one's own inability to cope with the loss. Death makes me sad, but it also gives me a reason to make sure that my priorities in life are properly calculated so I can live without regrets.
Most students anticipated a positive experience with the SLP. They hoped to learn something about death and dying (e.g., "Insights into what it's like to know that you are facing the end of your life") and about the elderly (e.g., "To better relate to the elderly and their actions and emotions"). Numerous students hoped that the experience would result in a mutual impact, meaning that they expected to gain something themselves, as well as have an impact on the patient through their work with them. One student stated, "It will allow me to get a completely different perspective on life and allow me to meet someone new and hopefully impact that person, as well as be impacted." Post-SLP. Following the SLP, students' responses indicated that most thought they had gained knowledge and experienced growth.
For example, 1 student commented on personal growth, "This experience kind of helped me get a better understanding of myself," while other students noted professional gains: "I was able to relate the bookwork with actual hands-on experience, similar to a lab in a science class," and "This experience, especially with the papers, helped me to connect the concepts learned in class to real situations." About 50% of the students thought their feelings about death and dying had not changed, and the rest of the class suggested that they learned to value the elderly, to live life to the fullest, and to feel more comfortable discussing the topic. One student commented, "I am learning how to discuss death and dying as an open subject. I am no longer uncomfortable speaking about it to others." Almost all of the students thought the project was a worthwhile educational endeavor and said they would recommend a service learning course to other students. What they liked the least about the SLP focused mainly on logistical issues such as scheduling, class requirements, and time commitments. For example, 1 student noted, "writing papers, final project, notes on the patient, visiting the patient. I enjoyed all these things, but there was a huge time commitment."

Methods
Procedures. To assess patients' impressions the research team conducted semistructured, face-to-face interviews with patients (and sometimes spouses) in their own homes following completion of the SLP.
Data analysis. The first author examined the interview data using thematic analysis (Braun & Clarke, 2006). The audio recordings were transcribed, checked for accuracy, and read before generating and labeling the data with initial codes. The data was collated to group extracts with similar codes, and then the grouped data was examined for overarching themes. Initial themes were identified and then refined to better reflect the data.
Sample. Interviews were conducted with 4 of 7 hospice patients who participated in the project during the reviewed semester. The other patients were not interviewed due to decline in health status. Three of the 4 interviewed patients could be considered elderly, while 1 patient would be considered middle-aged. Two of the 4 patients were female and all were White. The 2 male patients coresided with spouses, while the 2 females lived alone. Three of the patients lived in their own homes, while 1 resided in an assisted-living facility.

Results
Relationships. The most commonly found theme throughout the interviews was the relationships formed between the patients and students. Patients noted their enjoyment of the students' visits, the personal information they shared, and the little gifts they brought. The visits appeared most important. A woman, when asked what the project was like, said: Oh, it was totally enjoyable. I think they were very hesitant at first, but it didn't take very many visits at all to get us going, working and laughing with each other, and enjoying the company and getting the questions answered.
When asked what she liked about the project, another woman stated, "First of all, having students come every week. People are the main thing….They wanted to make me enjoy my experience which I did…. It was just fun….They shared lots of nice stories too with me that I enjoyed." An older man, interviewed with his wife, stated, "Well, just for them to come out. I'm here all the time, you know. I'm kind of bound… but I just love to talk to people." His wife, commenting on her husband's need to talk about his life, goes on: "I think the last 2 years, he's learned to talk more. Because, I don't know, I think talking to each other makes the loneliness go away more." This exemplifies the agency's purpose for initiating the project.
During each of the interviews with patients we learned about the personal information that students had shared during the project, including anything from the students' hometowns to goings-on in their personal lives. In addition, all of the patients noted the little gifts that students brought for them. For example, an older man explained, "The first day they came they brought me a card they had made. It had their names on it. We kept that card the whole time here, you know." A female patient described how she and her students had a potluck dinner to celebrate her birthday. It seemed to be important to the patients to note their knowledge of the students and these little tokens that the students had given; both appeared to demonstrate the significant and positive relationships that existed between them.
Recognition. In this study the word "recognition" is used to refer to another important theme that stood out. The patients had stories to share and these appeared important either in themselves or in relationship to their understanding of life. For example, 1 older man had served in combat and noted, "I did go through an ordeal….I forget everything [else]…but I still remember that….I went through heck." Stories about his combat experiences seemed significant in themselves and telling them to others, especially young people, seemed to be important to this patient. It was his perception, as well as his wife's, that many young people have little or no understanding of the experiences of service men and women, particularly in combat. Another older gentleman described in detail the accomplishments he had made during his work as a farmer, returning frequently to particular methods and technologies he used. He said, "What I did, people don't do it that way now." This comment seems important and related to other patients' comments about how their life experiences were often different from those of the students. Sometimes patients commented on how their stories surprised the students, such as an older man who told the students he had 11 siblings or a couple who related that, as members of the Church of Christ, they did not attend dances during high school. They appeared to enjoy sharing these experiences and the students' surprise, as well as hearing from students what it is like to be young today.
Other stories seemed to be told in order to demonstrate or highlight attitudes or knowledge about life. In three of the four interviews, patients noted the importance of being tolerant of other people. One gentleman related a story about his rehabilitation after major surgery. He explained how he had inadvertently offended the staff member he was working with and after being forcefully admonished he had thought not to return: "But anyway I started back, you know, I went and I really got to like that woman and she liked me too, real well." An older woman spoke more plainly about tolerance saying that her family "never cared about race or religion and everything. As long as you have religion, they're all good….I don't worry about the color of the skin or their nationality or which church." Another woman said that she hoped that the students learned that it "doesn't matter the age difference…the gap isn't as wide as it seems" when it comes to having relationships with other people. Other important advice about life included learning from mistakes, making choices, and being persistent. An older man said, "The advice is always be steady with what you do. What you start, finish it, you know. Each project, do it right," and he then went on to share a story about his children demonstrating this quality.
One patient discussed the telling of stories in an additional way unnoted by the other patients in the interviews. A particularly introspective person, she commented: Well, I think it lets you look back and say, "Oh well, gee, that's just one little section. " You kind of forget, hard to get past, because you are living, you're forced to live that kind of future in a little ball... and most everybody has…a past [that is] good or bad, pleasant or unpleasant.…Looking at those pictures again and you're, "Oh gee, I forgot about that. " That was something that you did and that brought something else back of a friend or something. This perspective offers a different way of looking at recognitiona more personal way. This patient was suggesting that the students' interviews helped her recognize aspects of her own life that she had forgotten or overlooked. This idea, while not represented in the interviews with other patients, has been noted anecdotally by students, the hospice volunteer coordinator, and the instructor as well. For example, as noted by this woman, we now suggest that students look at pictures with patients in order to bring up memories or life stages that seem difficult to retrieve.

Project.
Patients were asked about the products that had been created by the students. While it was clear that the life history products were not the most important part of the project for the patients, they all appeared to like what had been created. One patient stated, "It was even more beautiful and more meaningful than I expected it to be"; another said, "I was amazed…I was totally surprised." However, 1 patient and spouse reported that while they liked the product it had left out something important. This patient was very focused on occupation and the students had not represented this material well. Nevertheless, all the patients stated that they would recommend the project to other patients who were interested.

Methods
Procedures. Staff impressions were assessed through a written survey with mainly open-ended but fairly structured questions. All staff members with patient contact were invited to participate in the survey regardless of job responsibilities or contact with students. It should be noted, however, that some of the staff's familiarity with the project arose from additional semesters (the project has been conducted each fall and spring semester since Fall 2006). The surveys were provided to staff following completion of the SLP for the semester being evaluated and no personally identifying data were collected. Data analysis. Data from the staff surveys were examined for recurring ideas, within the preconceived categories of purpose, benefits, and overall impressions. Then responses within the question sets were examined and marked with initial codes. The responses were then grouped with similar codes and examined for recurring patterns.
Sample. Of the 16 staff members who returned surveys, 10 reported that they had been a designated team member for a participating patient. Fifteen of the staff members had seen an end product. Seven of the staff members held medical positions (nurses, etc.), 3 provided spiritual care, and 4 were social workers. Professional work experience in hospice ranged from 3 months to 4 years, with a mean of 20 months (SD = 13.7).

Results
Purpose. Six staff members said the purpose of the SLP was related to students, and 10 said it was related to patients (4 mentioned both). Staff members reported that the project had the purpose of bolstering student knowledge and experience. For example, a nurse reported that the purpose was "for students to use the knowledge they have learned about patients and their lives and apply it to their human development course," while another staff member thought that the SLP offered students a chance to "learn more about end of life." Other staff members thought the purpose of the project was related to patients, including assisting in a life review, recording personal history, and celebrating life. For example, 1 nurse reported that the purpose was "to commemorate and celebrate the lives of hospice patients. To provide life review and help patients to share their life history in a therapeutic and meaningful way." Benefits. Staff members were asked about what benefits of the SLP, if any, they saw for patients, the hospice agency, and students. Several of the respondents identified that the patients "look forward to the… students' visit each week" and that "having someone listen to their life experiences and sharing them with others" is important. A spiritual care provider noted that "the patients feel so good that their story is valued by others." Three staff members noted that the project helps patients focus on life, rather than their illness or approaching death. An interrelated idea was expressed by a social worker: This project also serves to enhance patient dignity. In a medical setting, patients are often viewed as their diagnosis rather than a person with a life history. Also, medical personnel often do not have the time to spend with patients getting to know them on a personal level. I think it is therapeutic for them to have this outlet.
This idea was brought out again in how the SLP benefits the agency. A nurse commented that the project "reminds us to focus on the patient as a whole rather than on just health or the decline of the patient. They are valuable, productive human beings who have had meaningful lives." The most commonly reported benefit to the agency was improving the quality of life for patients. A social worker stated, "Anytime [the agency] is able to offer a service to patients that will improve their quality of life and enhance their emotional well-being, that is a benefit to us." The staff saw the project as an opportunity to have "additional needs met" that they would not normally be able to provide. One staff member commented, "It would be something I would like to do with patients. It takes a considerable amount of time and we do not have that time." As a result, several staff members noted that they were able to learn more about the patients who participated. One nurse suggested, "I have been able to use her excitement of this project to get to know her better and find ways more acceptable to her to discuss her disease progression and help her deal with these issues." A spiritual care provider expressed a similar idea that the project can help staff members to provide more advanced services: "It is a great building point for the [agency] staff to help with patient self-esteem and importance." Regarding benefits to students, staff most often reported that the SLP helped students learn about hospice, death and dying, and diversity. A spiritual care provider suggested that the project "helps the students observe the dying process and learn how to be around the terminally ill. They will be better prepared in the future to work with the terminally ill." Seven staff members made statements regarding students' exposure to diversity, particularly related to the elderly. A nurse noted that it "helps them to see the elderly in a different way as a whole person who was once young and who had a lot of wisdom and life experience to share." Another nurse made a similar comment: "It helps to show the student just because someone is 'old' they still have a story to tell and a lot of wisdom to share and give." Overall impressions. When asked about their impression of the end products the staff most often reported positive thoughts; they said the products were "great," "creative and impressive," and "My expectation of it was less than what I saw." However, other staff pointed out that some of the products have been lacking. This thought seems best summed up by a social worker who stated, "End products varied-some very detailed and impressive, others were basic. It appears related to the time the students invested into the relationship with the patients." Staff reported being pleased when asked about their overall impression of the students. A spiritual care provider stated that the students "have been diligent and hard-working and have endeared themselves to our patients." Another said, "My patients loved the students. That gives me the best impression." One staff member noted that "some are more involved than others." Regarding their overall impression of the project the staff again were very positive. A nurse stated, "My patient really enjoyed both the contact from the students and the opportunity to be 'important' and share memories and life experiences." Another staff member reported that the students' experience with the project consisted of "visiting with a patients' wife after the life history project. The patient is now deceased and the wife cherishes the book that was made."

Discussion
Results indicated that the service learning experience had a positive impact on the participants. There was a quantifiable improvement in student attitudes towards the elderly and death and dying. These changes appeared to be confirmed by the qualitative data; the students suggested that the experience caused them to value the elderly and be more open about discussing death. This result offers evidence in support of Lemieux and Allen (2007) who suggest that service learning can prepare students to work with diverse groups, as well as Bringle and Hatcher's (1996) assertions that service learning can help students gain career-oriented knowledge and an increased understanding of the responsibility for human well-being. It also meets these authors' professed need to introduce these kinds of experiences earlier in students' education, as this course is usually taken in the first or second semester of our social work program. In addition, the students' responses indicated that the experience facilitated personal and professional growth, offering support for King (2003) who suggests that students' sense of professional efficacy can be built through service learning.
The patient data also appear to indicate a positive impact and several connections with the data from students. The patients enjoyed the interaction with students. Some of the students had hoped for a mutual impact; the emerging theme of the importance of the relationships with students suggests that this expectation was fulfilled. The patients valued the time, the giving of small gifts, and the sharing of personal information which the students provided during their service hours. One student indicated that she hoped that the patients might help students "understand something in life" and in the interviews the patients shared some of the life lessons they had told to students. A patient noted that she hoped the students had gained an appreciation for relationships with people of all ages, that it "doesn't matter the age difference;" both the quantitative and qualitative data from the students appear to suggest that they made such gains.
Results from the staff surveys suggested that the SLP benefitted the agency, patients, and students. Several staff members saw the purpose of the project as helping patients review their lives, and they noted the importance of the patients sharing their stories with others; this result also emerged from the patient data through the theme of recognition. Staff clearly saw the mutual impact that some of the students hoped for prior to the experience. Staff thought the project benefitted the students who learned something about diversity issues such as the elderly, death and dying, and tolerance; the student and patient data appear to confirm their impressions. Staff also suggested that patients benefitted by receiving companionship and recognition, which was hoped for by students and confirmed by patients. Finally, staff added to the idea of mutual impact by suggesting that the project benefitted agency employees who learned new information about patients, were reminded of the foundation of their work (i.e., people), and in some cases were able to base more clinical intervention on student work.
Looking at the data as a whole and the connections between the three perspectives on the project (students, patients, and staff), an overarching theme of reciprocity emerges. Reciprocity involves action and influence that proceeds in multiple directions; it implies interdependence, a concept central to the value system of the social work profession. In fact, the idea of reciprocity is important from the pedagogical (service learning), professional (social work), and organizational (university) perspectives. The students were provided with an opportunity for learning that was afforded by both the educational institution and the hospice agency. Students were influenced by the patients with exposure to a new perspective on life. The patients shared with the students a critical juncture in their lives-the end. Therefore, we can see that the students benefitted from their relationships with the patients.
Students also gave in the service experience. They provided patients with companionship and recognition by listening to their life histories and creating products celebrating their lives. The time they devoted to patients was at a critical time during which many people are engaging in a life review. In addition, the data suggests that students also contributed to the agency. The students' activities reminded staff that patients are more than their illnesses, provided a foundation for more clinical work delivered by staff, and completed volunteer hours toward federal rules requiring a "minimum investment of volunteer time into the service of the hospice program" (Mahoney, 1998, p. 142) for reimbursement under Medicare/Medicaid. Students gave something to Texas Tech University as well by providing the person hours for connecting the university to the community.
The reciprocal relationship can also be seen between the agency and the university. The agency provided an opportunity for students to augment their learning. The university provided the agency with access to a special kind of volunteer which allowed them to expand or enhance the services they provide in the community. More personally, reciprocity can be seen in the relationship between the instructor and the volunteer coordinator at the hospice agency; each helped the other to conduct her duties. The volunteer coordinator initiated the project, facilitated ongoing training, and provided support to the students and instructor. The instructor assisted the volunteer coordinator by helping in the recruitment of new volunteers (sometimes with long-term commitments) and assisting in documentation and support.

Limitations
The small sample size and the lack of a true control or a comparison group are definitely limitations in this research. Our power of analysis and our ability to generalize is limited by the small number of participants. As only one small section of this course is taught each semester, a control group was not possible. Without a control group, we cannot rule out the possibility that students' attitudes may have been impacted by the course material or their work in other courses rather than this service learning experience. Only 4 patients were able to be interviewed and they did not share much information about the students that might be considered negative, and this brings up the issue of social desirability. The small sample size and social desirability could also have been an issue with the staff. Although all staff members were invited, it may have been those who had a more positive perception of the project who filled out the survey. However, staff did appear more willing to share less than glowing reports of student work.

Challenges
Incorporating a service learning experience into a content course can be challenging. Arranging the details of the service, integrating the experience with academic content, and supporting students requires significant investment on the part of instructors. Service learning can be challenging for the agency as well. Students can be inconsistent, limited in their level of skills, and agency and instructor expectations can be different. The instructor for this course considers herself to be extremely lucky in the support of the volunteer coordinator from the hospice agency. She has handled the majority of the logistics by conducting training with the students, matching the students with patients, introducing the students to the patients, and providing ongoing support. Interestingly enough, the volunteer coordinator expresses similar feelings. The instructor collects documentation for the agency, and she provides weekly support for and keeps on top of the students regarding the project. Together, the instructor and volunteer coordinator keep in regular contact throughout the semester, working out details and issues that crop up.
More specifically to our SLP, conducting a life history project with hospice patients offers advantages as well as some difficulties. Most hospice patients are older, with a wealth of life experience to share, making the project similar to other life history projects. However, working with hospice patients does offer an additional benefit of exposing students more immediately to end-of-life issues. Further, the project may be more meaningful for the hospice patients than for other elders. Such a life review is considered an important developmental task at the end of life (Jenko, Gonzalez, & Seymour, 2007) as was noted by the hospice staff members' survey responses. On the other hand, hospice patients are ill and their health may deteriorate over the course of the semester which can cause predicaments that may not be seen as often with other elder projects. In addition, students have the extra task of dealing with the illness and impending death of someone they have come to know and in many cases care about deeply. Nevertheless, from our perspective the advantages do appear to outweigh the difficulties.

Conclusions and Implications
This evaluation does contribute to the growing body of evidence about service learning despite the challenges of arranging this type of collaboration and some weaknesses to this research design. This service learning experience in a hospice environment appeared to benefit all involved: the students, the patients, the agency, the instructor, and the university. However, service learning experiences in other environments are likely to offer similar advantages. While certainly not the only way to engage with students or the community, we would agree with Phillips (2007) and Lemieux and Allen (2007) and suggest that this pedagogy offers remarkable opportunities and that more educators should consider its inclusion in the curriculum.
Perhaps more importantly, as social work educators do not appear to be taking the lead, practitioners and agencies may consider initiating a service learning experience in order to expand or enhance the services they provide and to expose students to their particular field of practice or population. Interested practitioners might contact their local social work educators with an idea about a possible collaboration. No doubt there are numerous ideas that social work practitioners might generate. Some institutions of higher education have offices to facilitate this type of arrangement. At Texas Tech University the Service Learning office facilitates the process by linking needy agencies with interested faculty and then supports both through the experience. A social service agency might be interested in students providing a direct service similar to the one in this project; however, there are many other options as well. Students from across Texas Tech University participate in service-learning-just a few examples include business students solving marketing problems (McDonald & Mercer, 2005), art students helping local at-risk youth build "tricked-out" bicycles (Akins-Tillet & Machk, 2009), and sports studies students developing and managing fitness programs for elementary school children (Meaney et al., 2008).
Most institutions of higher education should be a resource to fulfill their mission. A true opportunity for reciprocity, service learning offers one example of how local agencies and universities can collaborate in order to better serve the people in their communities.