


































Global Research in Higher Education 
ISSN 2576-196X (Print) ISSN 2576-1951 (Online) 

Vol. 6, No. 4, 2023 

www.scholink.org/ojs/index.php/grhe 

15 

 

Original Paper 

Integrating Service-Learning through Practice and Exploration 

in the Second Classroom of Medical School Students, Huzhou 

University, China 

Dong Jianxin
1*

, Gao Yuhang
1
 & Cheng Yiyuan

1
 

1
 School of Medicine , Huzhou University, Huzhou, China  

*
 Dong Jianxin, Medical College, Huzhou University, Wuxing District, Huzhou City, Zhejiang 

Province, China 

 

Received: October 28, 2023   Accepted: November 7, 2023   Online Published: November 30, 2023 

doi:10.22158/grhe.v6n4p15            URL:http://dx.doi.org/10.22158/grhe.v6n4p15 

 

Abstract 

“Service-Learning” is a practical teaching method based on experience, and the “second classroom” 

of medical students also has strong practicality, and the two have a strong convergence. It is of great 

application value to explore the fusion mode of Service-Learning and the second classroom of medical 

students. This paper expounds the concept and connotation of Service-Learning and the second 

classroom, analyzes the necessity of their integration, and takes Huzhou University as an example to 

explore the application of Service-Learning in the second classroom of medical students in local 

universities in China from the aspects of motivation, ideas, practices and effects. The results show that 

the deep integration of service-learning with the second classroom of medical students is of great 

significance for improving the quality of talent training, expanding teaching resources and enhancing 

the effect of social welfare. 

Keywords 

Service-Learning, Second classroom, Medical student, Local university 

 

 

 

 

 

 

 



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1. Introduction  

At present, the functional orientation of the second classroom for medical students in many Chinese 

universities is limited to the general educational functions such as moral education and social training, 

and the integration of the second classroom for medical students with professional courses is not deep 

enough. Service-Learning applies theoretical knowledge to real situations to obtain practical experience 

(Mahasneh & Tawalbeh, 2012, pp. 415-425), so as to promote a deep understanding of theoretical 

knowledge and finally achieve the integration of knowledge, skills, emotions, attitudes and values (Lu 

& He, 2016, pp. 117-119). Integrating the concept of service-oriented learning can overcome problems 

such as one-sided education function, weak learning function and weak professionalism in the second 

classroom of medical students, effectively promote the deep integration of the first and second 

classrooms, and achieve a win-win situation between school teaching and education and social public 

welfare services. Taking the Medical School of Huzhou University as an example, this study has 

carried out many years of reform and exploration on the integration of Service-Learning into the 

second classroom system of medical students, and condensed relevant experiences and practices for the 

reference of similar colleges and universities. 

 

2. Core Concept and Connotation Analysis 

2.1 Connotation of Service-Learning 

Service-Learning advocates the combination of school curriculum and social service, which is an 

educational model with multiple characteristics such as diversity, synergy, reciprocity and reflection 

(Du, 2018, pp. 116-121). Service-Learning advocates the combination of teachers’ teaching, students’ 

learning and social problems, so that students can acquire professional knowledge, exercise social skills 

and improve moral level at the same time, and promote social development. It integrates one-way 

egoistic course learning with one-way altruistic social service, which is a two-way win-win model. 

Service-Learning is different from simple social service, its original starting point is “learning”, 

learning effect is the core goal, social effect is the “by-product” of learning practice process. Schools 

are required to focus on curriculum plans and social needs, carefully design projects, and 

comprehensively consider teachers’ teaching, students’ learning, and social needs, so as to achieve the 

integration of professional learning and social services. There is no consensus on its definition. Robert 

Sigmon (1979) believes that Service-Learning is an effective experiential teaching method. The 

American Association for Higher Education defines it as a way for students to learn and develop 

through planned social services (Liu, Wang & Ma, 2005). The National Youth Leadership Council 

defines it as: an instructional strategy that meets student learning goals and content standards, and a 

new model of philosophical, pedagogical, and community development. Barbara Jacoby (1996) defines 

it as: an experiential learning in which students engage in solving human and social problems. 

 



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2.2 The Connotation of the Second Classroom 

The second classroom is an important carrier for colleges and universities to cultivate the 

comprehensive literacy of college students and promote the all-round development of college students 

(Liu & Gao, 2022, pp. 106-111). The second classroom has five elements: From the time point of view, 

the second class uses the extracurricular time, does not occupy the first classroom time; From the 

content point of view, the second classroom is different from the first classroom, is the extension of the 

first classroom; From the perspective of requirements, the second classroom comes from but is not 

limited to the teaching material, generally does not need to test, but is an indispensable part of the 

complete education; From the form point of view, the second classroom is more vivid than the first 

classroom, the carrier is more abundant; From the perspective of learning space, its scope is very wide, 

both on campus and off-campus. The second class can not only strengthen the understanding of the 

theoretical knowledge of the first class, but also broaden students’ horizons, improve their practical 

level, cultivate their independent thinking ability, and enhance their social adaptability. In short, the 

second classroom is a kind of educational learning way to acquire knowledge and skills from 

extra-curricular carriers and comprehensively improve students’ comprehensive quality(Hu & Li, 2018, 

pp. 758-761). 

 

3. The Necessity of Integrating Service-Learning into the Second Classroom of Medical Students 

3.1 Social Service Is an Indispensable Part of Higher Education 

Teaching, scientific research and social service are recognized as the three functions of universities, 

which not only promote each other, but also complement each other. The purpose of “teaching” is to 

cultivate excellent talents, and the purpose of “research” is to help better production. In fact, whether it 

is training talents or assisting production, its ultimate goal is to better serve the society. From this point 

of view, serving the society is the ultimate goal and the most fundamental task of colleges and 

universities. On the contrary, knowledge comes from society, and the inspiration of research also 

comes from society. Only when knowledge and research are deeply integrated with society, can 

knowledge be deeply understood and reflected, and research propositions of more applied value be 

explored. Therefore, social services can better promote “teaching” and “learning”. From this point of 

view, social service is the initial link and original power of university work. In summary, from the 

beginning to the end, social service runs through every link of colleges and universities, and is an 

indispensable and important content in higher education (Jiang, 2023, pp. 96-98). 

 

 

 

 

 



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3.2 The Traditional College Second Classroom Is Not Effective 

At present, the effect of the second classroom is not good at both the university level and the student 

level (Xiao, Dong & Liu, 2022, pp. 56-61). The main manifestations at the university level are as 

follows: first, the university lacks systematic planning for the second classroom, mainly focusing on 

voluntary service and social practice, lacking unified norms and one-sided content; Second, the 

coverage of the second class is not extensive enough, the carrier capacity is limited, the lack of rigid 

requirements, and the full participation has not been realized. Third, the second classroom is relatively 

disconnected from the first classroom, and the two are not effectively integrated. The second classroom 

is strong in practice and service, but weak in learning. At the student level, the main manifestations are 

as follows: first, some students lack attention to social problems, have low enthusiasm to participate in 

the second class, and lack the ability to combine theory with practice; Second, the quantitative 

assessment and effect evaluation system of the second classroom is not perfect, and students are easy to 

breed negative psychology such as perfunctory coping; Third, students have blindness in the second 

classroom activities, and the acquisition of knowledge is not systematic. 

3.3 The Second Classroom for Medical Students Is Complementary To Service-Learning 

The Outline for the Reform and Development of Medical Education in China emphasizes that both 

“teacher teaching” and “student learning” should be integrated into service. In the “Several Opinions 

on Further Strengthening the Practice of Educating People in Colleges and Universities”, it is also 

emphasized that higher education must be combined with productive labor and social practice, and 

theoretical education, innovative thinking and social practice must be unified. Medicine is a practical 

discipline that attaches great importance to service, and the second classroom in colleges and 

universities has obvious characteristics of practicality, service and sociality, etc. The second classroom 

in colleges and universities needs medical service as the carrier, and medical education also needs the 

second classroom to make up for the lack of practicality in the first classroom. Therefore, for medical 

students, Service-Learning and the second classroom have a very obvious complementary and 

promoting effect. 

 

 

 

 

 

 

 

 

 

 



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4. The Basis and Motivation of the Reform 

4.1 The Basic Conditions 

The Medical School of Huzhou University is the only medical college in Huzhou City, Zhejiang 

Province, with 8 affiliated hospitals, 1 affiliated community health service center, 4 community 

practice bases and 56 internship hospitals. The Medical School of Huzhou University has two master’s 

degree authorization points in nursing and clinical medicine, and offers three undergraduate majors in 

clinical medicine, nursing and stomatology, and the clinical medicine discipline entered the top 1% of 

ESI in the world in November 2020, with more than 2,500 full-time students. The School attaches great 

importance to the cultivation of practical medical talents at the grassroots level. The Medical School of 

Huzhou University attaches great importance to the training of practical medical talents at the 

grass-roots level. As early as 2007, it took the lead in training rural community general practitioners in 

Zhejiang Province, and has been established as one of the three community general practitioners 

training bases in Zhejiang Province. In 2012, it was selected as the first batch of national pilot 

universities for excellent doctor education and training program. Focusing on the training needs of 

practical medical talents at grassroots level, the college attaches special importance to the construction 

of the second classroom for medical students. At the same time, the college has in-depth cooperation 

with local governments and social organizations, with abundant resources and carriers, and good basic 

conditions for carrying out the second classroom (Yao, Fang & Xu, 2021, pp. 113-116). 

4.2 The Reform Motivation 

Although the resources of the second class of medical students in the college are rich, they have not 

been effectively integrated with the main teaching work of the college. Firstly, the management system 

is not standard, which is manifested as incomplete system, non-integration of resources, unsystematic 

planning and lack of evaluation mechanism. It is urgent to establish a mature and perfect management 

system for the second classroom of medical students from the aspects of training programs, 

management institutions, rules and regulations, credit recognition and platform construction. Second, 

the education effect is not ideal, manifested as: the integration with the first classroom is not close, the 

participation of teachers is not active, the engagement of students is not wide; emphasizes practicality 

and service, not learning. It is urgent to transform the relatively single education function of the 

traditional second classroom, making it closely connected with the medical courses, and effectively 

promoting the in-depth integration of the first classroom and the second classroom. Based on the above 

problems, the college began to explore the integration of Service-Learning into the second classroom of 

medical students, in order to achieve the integration of learning and service, as well as the win-win 

situation between the school and the society. 

 

 

 



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5. The Overall Framework and Ideas 

The overall framework and ideas of The Medical School of Huzhou University to promote the 

integration of service learning into the second classroom reform of medical students can be 

summarized as follows: a platform, two main lines, three functions, four in one, five communities and 

N carriers. A platform: closely combine professional background, fully integrate the second classroom 

resources, to build an integrated Service-Learning platform; Two main lines: take teaching and public 

service as the two main lines to achieve a win-win situation between school talent training and social 

public welfare needs; Three functions: Focusing on the three functions of talent training, scientific 

research and social service, vigorously carry out practical teaching, medical ethics education, student 

research and public welfare services; Four in one: integrating university student work, teaching work, 

local service work and scientific research competition work, forming a multi-functional complex with 

full cooperation of multiple departments. Five major associations: the establishment of New medical 

Association, Nursing Association, Dental Association, Qhuang Association and Youth Health Peer 

Association five college student associations, combined with departments, majors and courses to carry 

out targeted second classroom activities based on service-oriented learning, forming an effective 

supplement to the first classroom teaching. N carriers: Further integrate social resources, build a group 

of activity carriers based on projects, maximize the coverage of students, and formalize, normalize, 

scale and systematize the second classroom education. 

 

6. Practice Methods and Paths 

In order to further promote the in-depth integration of service-learning and the second classroom of 

medical students, since 2017, the School has carried out a series of reforms in terms of management 

mechanism, credit system, departmental linkage and teaching methods, and the specific methods and 

paths are as follows: 

6.1 Mechanism Reform 

Organize the Student Affairs Office, Teaching Affairs Office and the departments to set up the second 

classroom management steering Committee and the Service-Learning expert guidance team of the 

medical school, hold thematic meetings and academic seminars regularly, and establish and improve 

the management mechanism of the second classroom for medical students and the Service-Learning 

teaching system. 

6.2 Credit System Reform 

Systematically sort out the content system of the second class for medical students, modify the training 

plan, formulate and introduce credit management measures for the second class for medical students, 

incorporate the activities of the second class into the credit system management system, take the credit 

system as the starting point and professional-oriented, carry out assessment and evaluation regularly, 

fully mobilize the enthusiasm of medical students to participate in the second class, and improve the 



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quality of Service-Learning. 

6.3 Linkage Reform 

The departments of learning, teaching, scientific research and external liaison work together to promote 

the participation of professional teachers in the second classroom, the embedding of professional 

courses into service projects, and the integration of professional practice into social practice, so as to 

open up the way for the deep integration of the first classroom and the second classroom, further 

enhance the professionalism and learnability of the second classroom, and effectively build the second 

classroom into an effective extension and supplement of the first classroom. 

6.4 Reform of Teaching Methods 

In the traditional practice activities of “service as the core”, curriculum, service and reflection are 

combined into the PBL teaching concept to fully mobilize students’ learning initiative and put what 

they have learned into practical use. The specific mode is as follows: 1) Select and train a group of 

Service-Learning tutors to provide teacher’s guarantee; 2) Carry out service-oriented learning youth 

leadership training to train a group of student backbone; 3) The backbone of students will lead ordinary 

students to carry out learning practice activities in accordance with the steps of “raising 

questions—searching materials—group discussion—consulting teachers—application 

practice—reflection and improvement”. 

 

7. Main Achievements of the Reform 

Since the implementation of the reform, the school has greatly improved the quality of talent training, 

the expansion of teaching resources and the effectiveness of social welfare services, and the pilot effect 

of integrating service learning into the second classroom of medical students is very obvious. The key 

results are as follows: 

7.1 The Quality of Personnel Training Has Been Significantly Improved 

First, students’ academic performance has steadily improved. In the Service-Learning program, 

students’ ability to discover, think and solve problems was significantly improved. In the past three 

years, 62% of students participating in service-oriented learning programs have won professional 

scholarships. The pass rate of CET-6 reached 83%; The entry rate of postgraduate entrance 

examination reached 78%; The passing rate of nurse practitioners is 100%; The passing rate of licensed 

doctors reached 96.85 percent, and the employment rate of fresh graduates remained above 97 percent. 

Second, students’ ability to innovation has been significantly improved. Students who participate in 

Service-Learning projects have significantly better indicators of innovation and entrepreneurship than 

ordinary students. In the past 5 years, 18 national college student innovation and entrepreneurship 

projects have been approved, 37 provincial projects, 113 school-level projects, more than 300 papers 

have been published, and 67 prizes have been awarded in provincial and above discipline competitions. 

Third, students’ sense of social responsibility has been significantly enhanced. Students deeply feel the 



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society in the service, deeply understand the sacred mission of saving the dead and helping the 

wounded, and the sense of social responsibility is significantly enhanced. Students have actively 

participated in the fight against the COVID-19 epidemic and voluntary blood donation and other public 

welfare services, and a large number of advanced models have emerged. In the past three years, they 

have won more than 210 outstanding honors or advanced titles. 

7.2 Teaching Resources Have Been Greatly Expanded 

First, the project funding is more abundant. The college has established long-term cooperative relations 

with more than 20 government departments or institutions, developed more than 20 Service-Learning 

projects such as youth and health peer education project, emergency rescue popularization training 

project, and obtained a total of more than 2 million RMB of external support funds, providing financial 

support for the sustainable development of Service-Learning. Second, project mentors have been 

expanded. In the school, more than 40 Service-Learning tutors have been trained from the professional 

faculty group. Off-campus, more than 50 off-campus part-time tutors have been trained from 

cooperative agency. It basically meets the teacher demand of Service-Learning. Third, the venue 

resources are more abundant. The College has established more than 30 Service-Learning project 

venues and bases, such as the Nightingale Education Hall, the Red Cross Life Education Base, and the 

emergency rescue modular teaching, research and training Center, providing a rich carrier for 

Service-Learning. 

7.3 Fruitful Social Welfare Services 

In recent years, it has provided more than 600 rounds of rural and community health services, carried 

out Red Cross emergency rescue training for more than 60,000 people, provided health services for 

more than 10,000 people for the elderly, offered medical guidance services to more than 500,000 

people in medical institutions, assisted voluntary blood donation with a cumulative blood collection of 

1.652 million milliliter, and benefited more than 600,000 people, which was highly praised by society. 

 

8. Conclusion 

The local universities in China, represented by Huzhou University, have always attached great 

importance to the practical education function of the second classroom, but lack the effective 

connection with the first classroom. In order to make up for the shortcomings, in recent years, more and 

more medical colleges and universities have begun to promote the integration of Service-Learning into 

the practical inquiry of medical students in the second classroom, which has achieved good results. 

Through systematic top-level design, the School of Medicine of Huzhou University has coordinated 

and promoted the mechanism reform, credit reform, joint reform and teaching method reform. The 

traditional second classroom activities have been upgraded, the Service-Learning project has been 

promoted rapidly, and good results have been achieved in the quality of talent training, the expansion 

of teaching resources and social welfare services. Its related experience has certain reference and 



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promotion value in similar universities. 

 

Funding 

2023 Humanities and Social Science Research Project of the Ministry of Education: Research on the 

Construction of local medical students’ practical Education Community under the background of New 

medical Science (23JDSZ3018); 2022 “Four New” education and teaching reform research and 

construction Project of Huzhou University: Construction of “Multiple Integration” Practice Education 

System for Medical Students in Local Universities under the Background of New Medicine 

(JG202242). 

 

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