Attitudes Toward Community Service Among Higher Health Sciences Students ^†

Abstract

University Social Responsibility (USR) integrates academic goals with ethics, civic engagement, and sustainability. This study assessed community service attitudes among 529 higher health sciences students using the Portuguese Community Service Attitudes Scale. Although 52.9% reported prior volunteer experience, 75.2% had not participated in community service during university. An association was found between academic programme and prior involvement, particularly among Dental Medicine and Physiotherapy students. While no sex differences were observed, programme-specific trends suggest that practical training fosters stronger civic responsibility. Integrating structured, discipline-specific community service into curricula may enhance civic identity and better align education with sustainable development goals.

1. Introduction

Higher education institutions (HEIs) are increasingly challenged to extend their traditional roles beyond teaching and research to address broader societal concerns [1,2]. In Portugal, a growing emphasis on the social dimension and community engagement of HEIs has emerged as a central concern. The Observatory for Social Responsibility and Higher Education Institutions (ORSIES) in Portugal has developed a strategic vision for social responsibility in higher education and established a framework of social responsibility indicators to support self-assessment and continuous improvement among HEIs [3]. Within this context, USR is seen as a crucial commitment, aiming to prepare students not only for their future professional careers but also as critical and engaged citizens [1,3]. This is particularly relevant in the field of health sciences, where higher health schools are increasingly expected to align their education, research, and service activities with the priority health needs of the communities they serve [4]. Despite the recognised potential of USR projects to foster active citizenship and transversal competencies among students [1], there remains a scarcity of studies exploring students’ direct conceptions of and engagement with USR, particularly concerning the impact of their involvement in such initiatives [3]. For instance, a study involving Portuguese universities revealed that nearly half of the surveyed students had not heard of USR in their university, pointing to the need for clearer communication on the topic [1]. Furthermore, although there has been overall progress in the implementation of social responsibility indicators in Portuguese HEIs, some areas still show persistently low levels of formalisation and implementation [3]. Despite efforts, a deeper understanding, greater formalisation, and broader stakeholder involvement in the concept of USR remain necessary across Portuguese HEIs [3]. Furthermore, a significant gap persists in the literature regarding robust and generalised measures for assessing the effectiveness of community service programmes, particularly in relation to the attitudes students develop [5]. Understanding these attitudes is vital, as today’s students will be future professionals and citizens responsible for addressing societal challenges [6]. The aim of this study is to evaluate the attitudes of higher health students at Egas Moniz School of Health & Sciences toward community service within higher sciences education.

2. Materials and Methods

2.1. Study Design

A descriptive, observational, and cross-sectional design was used.

2.2. Participants

This study included 529 university health students at Egas Moniz School of Health & Sciences, recruited using a convenience sampling method. The inclusion criteria were students enrolled in a health sciences course at a Portuguese higher education institution, aged over eighteen years, able to understand Portuguese, and able to provide informed consent. All incomplete questionnaires were excluded.

2.3. Instrument, Data Collection, and Management

Participation in the study was voluntary and anonymous, with informed consent obtained from all participants. The research was approved by the Egas Moniz Ethics Committee (Process No. 1106, 30 June 2022). Data was collected via Google Forms from March to July 2024. The questionnaire was disseminated via institutional email, with the support of colleagues collaborating on the project, as well as through formal and informal student networks. Participants completed a 15 min questionnaire that included the Portuguese version of the Community Service Attitudes Scale (CSAS), along with demographic (age and sex), academic (course, studies’ year, and level of study), and community service experience data, following previous studies [4,7]. The CSAS is a 46-item tool based on Schwartz’s model of altruistic helping behaviour, organised into four stages and ten dimensions: Perception of the Need to Respond (Awareness, Actions, Ability, and Connectedness); Moral Obligation to Respond (Norms and Empathy); Reassessment (Costs, Benefits, and Seriousness); and Engagement in Helping Behaviour (Intention to Become Involved). Responses are rated on a 7-point Likert scale [8,9]. Dimension scores are calculated by summing the item responses. The Portuguese version showed strong psychometric properties, with Cronbach’s alpha values above 0.80 across all dimensions (total score α = 0.97; subscales α = 0.88–0.95) and high test–retest reliability (ICC = 0.96 for total score; 0.86–0.94 for subscales) [10].

2.4. Statistical Analysis

Data distribution was analysed using the Kolmogorov–Smirnov test. As the assumptions for normality were not met, non-parametric tests were applied. A descriptive analysis was performed to characterise the sample. Chi-square (for ordinal variables) and Mann–Whitney U (for continuous variables) tests were used to analyse potential differences and compare dimensions of the community attitudes scale between two groups (e.g., sex and previous community work experience). The Kruskal–Wallis test with the Bonferroni correction was applied for comparisons involving multiple groups (e.g., degree programme and academic year). The level of significance was set at p < 0.05. All tests were performed using SPSS for Windows, version 29.

3. Results

A total of 529 students responded (mean age 20.7 ± 4.5 years; 74.5% female). Most were bachelor’s students (87.5%), followed by master’s students (12.3%) and PhD students (0.2%). The majority of respondents (55.5%) were in their second or third year of a bachelor’s programme. Participants represented a range of health science disciplines: Dental Medicine (DM) (51.6%), Physiotherapy (PT) (27.8%), Psychology (Psy) (10.2%), Pharmacy (Pharm) (5.3%), Nursing (2.5%), and Biomedical Laboratory Sciences (BMLC) (2.6%). While 52.9% reported previous volunteer experience, 75.2% indicated no participation in community service since the beginning of their academic studies, indicating a drop in civic engagement during university years. Only 4.3% reported weekly participation. Chi-square analysis revealed a significant association between academic programme and prior community experience (p < 0.001), particularly among DM and PT. Although no significant sex differences were observed, programme-specific differences did emerge. Pharmacy students scored significantly higher in Ability (vs. BMLC: p = 0.006; DM: p = 0.022; PT: p = 0.030), Connectedness (vs. PT: p = 0.019; Psy: p = 0.044), and Norms (vs. BMLC: p = 0.007; Psy: p = 0.006; PT: p = 0.004; DM: p = 0.016). Dental Medicine students scored higher in Perceived Benefits (vs. PT: p = 0.040). A marginal association was found between year of study and community involvement (p = 0.064), suggesting a trend toward greater engagement in later years or clinical phases, though this was not statistically significant. These findings suggest that students from Pharmacy and Dental Medicine perceive themselves as more capable, aligned with social norms, and connected in relation to community involvement, compared to students from other programmes.

4. Discussion

This study identified programme-specific differences in university students’ attitudes toward community service and social responsibility, reinforcing findings from the previous literature emphasising the importance of course context and institutional culture in shaping civic engagement among higher education students [1,11]. Despite a higher proportion of female participants—reflecting national higher education trends in Portugal [12]—no significant sex (biological attribute) differences in attitudes toward community service were found. This finding aligns with earlier studies showing a higher number of female participants in USR and volunteering research [13]. However, the literature offers mixed insights on how sex affects perceptions of USR. While some studies found no significant sex differences [1,6], others suggest that female students often score higher on the CSAS [8]. Our results indicate that sex may not be a decisive factor for general perceptions of social responsibility, although it might influence the level of critical engagement or benevolence exacted in assessing university practices. A key finding was the link between academic programme and prior community engagement, with DM and PT students more likely to report previous experience. This supports the idea that certain curricula, especially in “helping” professions, foster stronger attitudes toward social responsibility [8]. While there is no direct evidence explaining why these two fields stood out, the presence of clinical facilities at the university likely plays a role by enabling early interactions with patients. Previous studies have shown that programmes with strong community ties and practical applications tend to encourage more meaningful social engagement [1]. There were notable differences in students’ attitudes toward community service across academic programmes. Pharmacy students scored higher in Ability, Connectedness, and Norms, indicating stronger confidence, civic values, and social ties. DM students perceived greater Benefits than PT students. These differences likely reflect variations in curriculum focus, professional identity development, and early exposure to social roles. The higher scores among Pharmacy students may be linked to most respondents being in later years of education, with a clearer sense of their community role. This supports prior findings that disciplinary context and programme stage influence civic attitudes, especially in fields tied closely to public service [1,14].

5. Conclusions

This study highlights promising indicators of student engagement with community service and social responsibility within our university context. The findings suggest that the current institutional initiatives are already fostering awareness and positive attitudes among students. However, the variation observed across academic programmes points to the need for a more cohesive and integrated approach. Strengthening the incorporation of University Social Responsibility (USR) into curricula—through experiential learning, critical reflection, and interdisciplinary opportunities—can further support the development of socially engaged and ethically responsible professionals. Building on existing efforts, HEIs will be well-positioned to strengthen their leadership role in driving social transformation and achieving a meaningful, sustained community impact. Future studies should aim to include a larger and more balanced sample and consider comparisons with other higher education institutions to enhance the generalisability and depth of these findings.