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Category: Professional practice
Teaching and Learning Forum 2008 [ Refereed papers ]
Transforming professional education: The lost art of service and global citizenship

Trevor Goddard and Kit Sinclair
School of Occupational Therapy
Curtin University of Technology

Traditionally the university sector was charged with the public duty of educating professionals to serve the very community investing in them. University service played a vital role in community development throughout the 19th and 20th centuries; however the 21st century higher education sector is a different beast. This paper identifies the current challenges presented to university service by globalisation and rationalism that sees a shift towards a student as customer focus in education and demise in university community engagement. The authors propose service is a vital component of education, and indeed research and leadership, in preparing graduates for global citizenship and reconnecting universities with communities.

The Curtin University China Occupational Therapy abroad program is restructuring curriculum around a service learning model to prepare for graduates of 2015. This paper identifies how the program meets evolving global demands and addresses Morin's complex lessons for education. Global citizenship is critiqued within Bell's model of reflective practice, with the Oxfam global citizenship ladder and the internationalised curricula and service learning literature demonstrating the outcomes service learning can deliver.

Rejuvenation of the service function should form an integral component of curricula, enhancing the political and social awareness of students to graduate more informed and competent global citizens. Engagement with international issues such as human rights through the United Nations Global Compact enables students to develop into future community leaders. This paper presents the descriptive theoretical background to further research identifying the capacity of international service learning to enhance graduate global citizenry.


Universities are a hub; incubators for ideas that stimulate debate and action leading to community development of the community of which the university is a part. The higher education sector is not an end in itself, as the rationalist model appears to view it, but a means to achieving aspirational ends. Bok (1986) believes the important brief given to this sector is in creating the means to imbue students with a sense of commitment and civic duty that enables them to devote skills throughout life to address critical and complex social issues.

Colin Bundy (Warden of Green College, Oxford), then Vice Chancellor of the University of Witwatersrand in South Africa, advocates the importance of service in higher education;

No university is an ivory tower -even if it wishes to be. Universities are deeply implicated in the modern state and are key agents of modern society. This means that they should be conscious of, and make choices about, the terms of that involvement. Higher education must be critically engaged in the needs of communities, nation and the world (cited in Berry & Chisholm, 1992: p.10).
Educational sector interest in global issues is not new. The Council for Education in World Citizenship (formed in the 1930's) and the University of London development of a global dimension through 'world studies' programs in the 1960's are historical markers of a commitment to understanding the world (Hicks, 2003). In the latter part of the twentieth century higher education became inwardly focussed on its own advancement, without a corresponding heightened awareness of the sense of responsibility that might be afforded to the broader community (Berry & Chisholm, 1992). Max Weber saw this gradual rationalisation of society as undermining the capacity of citizenship throughout civil society (Ulrich, 2000). Universities have concurrently become obsessed with internationalisation of curricula; incorporating internationalisation into strategic planning processes and placing students into a variety of international experiences (Taylor, 2004; Stone, 2006).

Citizenship transcends nationalism, seeking unity through a shared humanity; this is consistent with the philosophies of the traditional professions; law, medicine and theology that are underpinned by service to the community. The current emphasis on individualism is divorced from a collective responsibility, often focusing on rationalist market forces rather than social policies as solutions to social problems, driving society (and universities) away from democratic citizenship (Kelly, 1995). Service provided through education has the capacity and opportunity to develop individual potential through a humanistic perspective built into the philosophical underpinnings of professions such as occupational therapy (Richardson, 1990). Without this promotion of service as an integral part of teaching and learning Morin (1999) fears the genuine humanism and awareness of our global place might be lost to future generations of students who will become guardians of the professions.

Universities have the potential to reshape the humanitarian values of future leaders. Curtin University School of Occupational Therapy is reforming the educational process by directing energy towards connecting the campus, staff and students with the global community through an international service learning program based in China. This program develops the leadership traits extolled by Berry and Chisholm (1992): humane values and cross cultural communication skills by promoting active citizenship and connecting theory with practice.

Tye's (1999) exploration of global education identified human rights as the common thread enabling the citizenship function. The professional education of occupational therapists correlates well with this through an alliance of the World Federation of Occupational Therapists with the United Nations Global Compact, the World Federation position paper on Human Rights and a professional statement of ethical principles that values Human Rights (World Federation of Occupational Therapists, 2004).

Global citizenship

Global citizenship is enabled through a curriculum identifying global issues, events and perspectives. It allows students to be citizens of the global community, and appreciate cultural diversity (Hicks, 2003). The Curtin China program assists students to move along the global citizenship ladder (Oxfam, 1997); progressing from gaining knowledge to skills and understanding that enable action. This engagement with community issues enhances student social and political awareness. Action based citizenry is bound up in the process of a health professionals education, as action learning occurs through clinical educational placements. The seven week China clinical education program is an international service learning capstone curriculum experience. Ulrich (2000) proposes that citizenship competency includes critical systemic thinking so the China curriculum extends students towards the synthesis and evaluation level of Blooms (1956) taxonomy.

Support for global citizenship in the education literature identifies the need to equip students with the knowledge, understanding, skills and values to respond to the increasing complexity of global health issues (Hicks, 2003; Robbins, Francis, & Elliott, 2003). Key elements for developing responsible global citizenship are knowledge and understanding of social justice within and between societies (Oxfam, 2007) and values and attitudes that show a commitment to fairness and readiness to work for a more just world (Oxfam, 1997).

While occupational therapy curricula do not traditionally use the term global citizenship the concept is represented through learning objectives and graduate outcomes that focus on fairness, social justice, respect for democracy and the value of global diversity. Dower describes global citizens as having a global moral perspective that "all human beings have certain fundamental rights and all human beings have duties to respect and promote these rights" (2003: p.7). So the curriculum must ask, does a global ethic exist and if so, what kind of ethic is it? The subsequent reflection on ethical practice throughout the clinical placement challenges student to critically reflect on their practice and the practice of occupational therapy in an international context. This links the professional practice of being an occupational therapist with becoming a global citizen.

Global citizenship requires a commonly understood language. For health professionals this is provided by the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF). This tool identifies the physical, social and attitudinal environments in which people live as influential over health (World Health Organisation, 2001). At a global level, this includes systems in the community or society that have an impact on individuals through community activities, government agencies, communication and transportation services, and informal social networks as well as laws, regulations, formal and informal rules, attitudes and ideologies (World Health Organisation, 2001).

A 'Professional'

The capacity and character to behave appropriately as a professional implies students have learnt to recognise pre reflexive professional assumptions and organise effective, normal and accepted conduct within the social world of their profession, clients and broader community (White, 2006). The China program stimulates professional skill development through critical thinking, the ability to argue effectively, challenging injustice and inequalities and the development of respect for people and the broader ecology. These professional skills are acquired by instilling "a knowledge of public affairs and a sense of belonging, a concern for the whole, a moral bond with the community whose fate is at stake" (Sandel, 2000, p.271).

Occupational therapy students entering the profession learn from the rules governing analytical rationality (beginners) to the fluid performance of meta level tacit skills to become virtuous (Bourdieu, 1977). These meta level skills of critical analysis enable students to display true human expertise in a the community development context (Dreyfus, Dreyfus, & Thomas, 1986). Sterling (2001) argues that these changes must be fundamentally personal, and achieved through service engagement before they can be successfully used in professional life. So the pedagogy approach for this occupational therapy citizenship program includes action and issues-based learning.

The China program draws on both social critique (Fien, 1993) and transformative ideology (Hicks & Holden, 1995; Sterling, 2001) in an attempt to stretch students. The philosophical approach adopted is from Hicks and Holdens (1995) education for the future and the use of education as an agent of change, recognising that un-learning, re-learning and new learning are the essence of reform (Sterling, 2001). The curriculum aims to graduate students into a global profession displaying cultural competence (Wittman & Velde, 2002), advanced leadership skills (Lester, Tomkovick, Wells, Flunker, & Kickul, 2005) and an acute awareness of international issues (Thibeault, 2006). Unfortunately, as Thibeault states,

... [OT] curricula rarely incorporate global issues: the threat posed to life by pollution, social inequalities, nuclear peril and other conflicts is remarkably absent, and very few universities have agreed to make such exposure compulsory (2006: p.160).
The social model of disability promoted by the ICF sees disability as socially created. Disability is not an attribute of an individual, but a complex collection of conditions created by the social environment. So service learning management requires social action by accepting collective responsibility for society to make the modifications necessary for the full participation of people with disabilities. This requires attitudinal change, which in the political environment is a human rights issue (World Health Organisation, 2001) and can be achieved through service learning. The World Federation of Occupational Therapists is signatory to the United Nations (2001) Global Compact, supporting principle 1 support and respect the protection of international human rights.

Occupational Therapy: Graduating global citizens

Wittman and Velde (2002) ask;
... how can we, as educators, within the short amount of time occupational therapy students spend in the classroom successfully facilitate the promotion of critical thinking skills that will prepare our students to practice effectively in a multicultural, global world? (p.456)
Evidence supports international service based clinical education as a tool to foster an enhanced understanding of how the global nature of economic, political and cultural exchange impacts on an individual's cultural competence, personal and professional growth and practice as a health practitioner (Pawar, Hanna, & Sheridan, 2004; Whiteford & McAllister, 2006; Drain et al., 2007).

The critical perspective of Ngwenyama and Lee (1997) says service learning develops the unfulfilled potential of students, changing their perception of the social environment. International service programs address the declaration of Thibeault (2006) that graduates' reality and knowledge might end with the boundaries of our affluence, but their professional decisions have far reaching consequences, here and abroad. Thilbeault (2006) asks if in this era of globalisation we are preparing students for a new world order? Reflective practice addresses this question, focussing on the consequences that students actions impose on others, systematically question their own values and the implications of making these overt (Ulrich, 2000). In justifying the role of a global ethic Dower (2003) suggests the need arises from an increasingly globalised environment and awareness that the solutions to global problems require a global, rather than national response such as the approach taken in the China program curricula.

There is a synergy between occupational therapists becoming global citizens, the social justice and human rights philosophy underpinning the occupational therapy profession and the service function of universities (Scott, 1999; OECD/CERI, 1994; World Federation of Occupational Therapists, 2004). Changing global health-care priorities as a result of globalisation requires educators to rethink graduate competencies outside the 'local' and for health practitioners to incorporate the 'global' into the local. So the China program aims to graduate contemporary health professionals that possess leadership skills enabling them to work in complex social, health and political systems (Fortune, Farnworth, & McKinstry, 2006; Goddard, 2005).

Internationalising curricula

The Organization for Economic Cooperation and Development (OECD) define international curricula as that aimed at preparing students for performing professionally and socially in an international and multicultural context, outlining amongst other criteria; international content and a comparative dimension to traditional content and cross cultural skills (OECD/CERI, 1994). So the instinctive step taken by the Curtin School of Occupational Therapy was the incorporation of international opportunities for students that forge these criteria together through service learning. Thibeault (2006) identifies the importance of ensuring international perspectives permeate occupational therapy curricula, claiming this exposure is a critical part of the ethical and professional responsibility to clients;
...students in the current education system can go through their whole university training without ever being exposed to the global issues that will shape their future. We train today tomorrow's decision makers with yesterday's obsolete paradigms(p.160).
This is also reflected by Odawara who states "Without more experience gaining different viewpoints, therapists can't fully succeed in integrating the patient's cultural values into therapeutic interventions" (2005: p.326). The China program presents students with opportunities to see the world from the different perspective of their clients, stepping into their world and walking in their shoes, in effect becoming global citizens rather than ethnocentric practitioners with one world view. This important principle is supported by ICF recognition that people in positions of authority (health professionals), decision making ability and socially defined influence exert power over health. Through service, students learn that their individual attitudes in regard to social and political issues also influence health status (World Health Organization, 2001).

Service learning

Fortune et al. (2006) believe occupational therapy clinical education placements should expose students to complex population issues, human service and leadership experiences and competing issues of social justice. Service learning injects these issues into curricula development and support the OECD statement on internationalising a curricula; educating students as responsible global citizens (Goddard, 2005; Thibeault, 2006).

Service learning integrates classroom theory with real world organisational issues. Projects are embedded in a theoretical foundation with clear learning objectives and contain both activist and reflective components (Kenworthy-U'ren & Peterson, 2005; Preston & Symes, 1992). Aligned with the philosophy of occupational therapy educational practice, service learning promotes learning by doing, with students applying theory learnt in the classroom to community social issues. The ICF supports service learning by also recognising that the complex partnerships required to deliver health services requires a broader knowledge of social and economic issues by students to engage with other sectors in the resolution of complex health issues (Goddard, 2005).

Kolb's (1984) work on teaching identifies the important skill of student reflection of their own and others lived experiences in situ, learning to adapt behaviours in the new milieu and apply them to community issues. To facilitate cultural competence, the China curriculum is based on Wittman and Veldes work (2002) that recognising the skills necessary for entry-level practice are not simply learnt on campus through cognitive process, but from interrelationships amongst cultural competence, critical thinking, and intellectual development that must occur in a professional practice environment. Both university and host site learn and grow through the service learning arrangement as students deal with complex social issues and competition for finite resources (Goddard, 2007).

Action learning

Action learning occurs through human interactions within the service learning relationship (Lester et al., 2005). Students in the China program do not simply apply theoretical material to practice but question what occurs amongst each other as they tackle 'unfamiliar' problems together. This is vital to critical thinking and use of reflective practice that drives change in individual and group behaviour. Actionable knowledge is created and accessed through service learning. Transcending pure scientific concerns this knowledge enables students to make informed choices about solutions that have cultural relevance (Phillips & Hardy, 2002). Actionable knowledge then leads to behaviour change in the form of choice (guiding decisions) or implementation (guiding action) (Waddell, Cummings, & Worley, 2004). The China service learning program creates actionable knowledge that is reinvested into the curriculum for future students. The use of this international project focusing on community development in the classroom enhances the real world aspect of global health issues and completes a learning loop (Blood, 2006). In order for students to think independently and imaginatively, the university is solely responsible for the development of programs explicitly for this purpose, during this informative period when future leaders are developing (Hongladarom, 1994).

Morin's complex lessons in education: Shaping global citizens

Morin (1999: p.4) states "...education should not only contribute to an awareness of our Earth-Homeland, it should help this awareness find expression in the will to realize our earth citizenship". Morin and the United Nations Educational, Scientific and Cultural Organisation (UNESCO) identified seven complex lessons in education for the future that curricula require to train global citizens. Thibeault (2006) then asks occupational therapy educators to adopt these complex lessons as a template for using the university service function as a means of internationalising the curriculum. In response, this paper now critiques four of Morin's lessons and their role in developing occupational therapy students as professionals and citizens through an international service learning program that requires universities to focus on community service as a means of engaging with community. Of Morin's seven lessons, four are dealt with in this discussion: confronting uncertainties; teaching the human condition; ethics for the human gene; understanding each other.

Confronting uncertainties

Confronting uncertainties assists students in identifying "strategic principles for dealing with chance, the unexpected and uncertain; ways to modify these strategies in response to continuing acquisition of new information" (Morin, 1999: p.3). For students to be able to question their professional practice a strong civil society is required; one that values service. This assists in the development of active, responsible global citizenship; and a sense of student responsibility towards all those that may be affected by their actions (Ulrich, 2000). In service learning the occupational therapy clinical educators role is paradoxically to remove themselves from the placement (Drain et al., 2007). This allows students to take the lead, while the facilitator performs a subsidiary role in the teaching and learning process (Preston & Symes, 1992). This confrontation with uncertainly removes the focus from self expression, requiring the students to engage in deep listening. To believe firmly and strongly in the truth of ones own belief system is not the best way to hone the skill, for when one is convinced, it is not likely to change (Hongladarom, 1995). The departure of the therapy clinical facilitator from the service learning site then allows students to develop a deeper capacity to work with, rely on and assess each others strengths and modify their strategies on a continual basis (Bell, 1998).

Teaching the human condition

Teaching the human condition enhances student "awareness of both his/her complex identity and his/her shared identity with all other human beings" (Morin, 1999: p.2). Service learning assists students to acquire an understanding of global development, an informed understanding of justice and human rights and an ability to establish a future orientation and reflection of the health of the planet. The international curriculum encourages students to recognize that they have a world view not shared universally and develop receptiveness to other perspectives. The experience of studying and serving abroad highlights cultural differences, making students aware that their own values and realities are not necessarily those of others even through they share a common human identity (Chisholm, 2003).

In China students explore their own cultural assumptions, values, and beliefs, which enable them to develop a cultural sensitivity and competence. The exposure to a variety of cultural assumptions allows them to incorporate the implications of culture to the client's illness and clinical experiences (Odawara, 2005). The action learning approach allows students to develop professional leadership skills through a clearer understanding of the complexity of the human condition. This service program enables students to move from viewing the curriculum as a student centric experience to a community centric experience (Goddard, 2007).

Ethics for the human genre

Understanding ethics for the human genre is enhanced in an environment that enables students to see,
through awareness that a human being is at one and the same time an individual, a member of a society, a member of a species joint development of individual autonomy, community participation, and awareness of belonging to the human species (Morin, 1999: p.3).
Through community participation that connects university and society, students themselves are a source of information that can assist to improve local health care services. Being out of their comfort zone assists students to avoid the dangers of intellectual imperialism, which is often the downfall of service based programs. This ensures that students pay deliberate respect to local diversity and identity (Badley, 2000). Students also develop social and political action skills necessary to inject an ethic into the democratic decision making processes surrounding health. International service learning projects expose students to other socioeconomic strata, giving them a wider range of experiences from which to gain an understanding of China and its people, avoiding the trappings of educational tourism that do not allow for sustainable capacity to be delivered to the host community (Goddard, 2007).

Understanding each other

Working alongside and understanding each other assists students to see
understanding is both a means and an end of human communication. Teaching mutual understanding among human beings, whether near or far, is henceforth a vital necessity to carry human relations past the barbarian stage of misunderstanding(Morin, 1999: p.3).
Badley's (2000) fear of intellectual imperialism is placated through service learning as the mutuality of understanding requires students to accept the practices of the service learning host in China. International service learning through a succinct model of Curtin University teaching powerfully conveys a built in respect for diversity and otherness; so instead of maintaining unrealistic standards students set more realistic expectations based on their real world experience. Throughout the service learning project students assess their own capabilities to determine how their skills are best utilised alongside those of the host site staff. So instead of being self absorbed, students develop humility and move from a student centric approach to a service centric approach in their action oriented development of leadership (Bell, 1998).

The Curtin program allows students in their final year to think globally and work cross-culturally, preparing them for the leadership the community hopes they will one day assume in addressing local and international problems (Chisholm, 2003). The cultural competence developed is a process that can not be bypassed. It does not happen as the result of reading a book or attending lectures, nor overnight, is it a product of experience that can only be obtained by students travelling in country, sharing life with each other as a means of understanding each other.


Historically the role of the higher education sector was integral to community development. This was achieved through the concurrent development of student critical faculties, creative potential and initiative towards empowering people through education and knowledge. The China occupational therapy abroad program engages with the global health community, creating sustainable projects in which the University can service the global community and provide educational opportunities that make a real contribution to the complex social and health issues facing people around the world. Somewhere in the modernity of the higher institution, the service and leadership function has been overshadowed by the pragmatic and reductionist approach to the teaching and research functions that see economics rationalism the dominant model. This fosters a culture of self and an inwardly directed self interest that often has little regard for the broader community of which the university is a significantly influential part. In light of Morin's lessons for the education sector it appears that service learning, when conducted in an international context is a holistic tool with which to increase the citizenship capacity of graduates and perhaps even the institutions themselves.

Students undertaking service learning travel internationally and apply their professional clinical skills; energy, imagination and knowledge for the benefit of others, becoming ambassadors for their profession, faculty and country. This commences their journey towards global citizenry. Unless universities undertake international service, they will continue to loose connection with the very society which provides them with a license to operate. International service learning has the added ability to bring the service component into the curriculum and embed its philosophical underpinning throughout the student experience. Service learning is a synergistic activity that bonds service, citizenship and professional development and can bridge the nexus between teaching and learning and research, returning the university to its place as a driver of social change, with the interests of its global community of prime importance.


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Authors: TTrevor Goddard is Director of International Relations, School of Occupational Therapy and Research Associate, Centre for Research into Disability and Society, Curtin University of Technology. He coordinates the China Occupational Therapy Abroad program, an international service learning clinical education program. He received a Carrick Institute citation in 2006 for "enabling an international multi disciplinary health and development learning experience that enhances personal, professional and clinical skills and cultural awareness of health science students". Trevor is project leader for the World Federation of Occupational Therapists signature of the United Nations Global Compact.

Dr Kit Sinclair is President of the World Federation of Occupational Therapists and Adjunct Associate Professor at Curtin University. For over 25 years Dr Sinclair has played a pivotal role in establishing the Occupational Therapy profession and clinical education in Hong Kong and mainland China. Associate Professor Sinclair has driven the World Federations commitment to Human Rights and conducted workshops in situ and developed manuals for therapists to assist communities affected by the Asian Tsunami.

Author for correspondence: Trevor Goddard
Director of International Relations, School of Occupational Therapy
Curtin University of Technology, GPO BoxU1987, Perth WA 6845, Australia
Email: t.goddard@curtin.edu.au

Please cite as: Goddard, T. & Sinclair, K. (2008). Transforming professional education: The lost art of service and global citizenship. In Preparing for the graduate of 2015. Proceedings of the 17th Annual Teaching Learning Forum, 30-31 January 2008. Perth: Curtin University of Technology. http://otl.curtin.edu.au/tlf/tlf2008/refereed/goddard.html

Copyright 2008 Trevor Goddard and Kit Sinclair. The authors assign to the TL Forum and not for profit educational institutions a non-exclusive licence to reproduce this article for personal use or for institutional teaching and learning purposes, in any format (including website mirrors), provided that the article is used and cited in accordance with the usual academic conventions.

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