Supplementary Educational Model (SEM) in Social Work Education for Health Care Settings

ABSTRACT

A supplementary educational model (SEM) was developed and evaluated in order to expand educational opportunities for social work students, to enable a professional interaction for field instructors and to connect the academia teachers to the field. The study highlights the importance of SEM to update the current academic curricula to meet the ongoing changes and challenges in health care settings. One hundred thirty-seven B.A. students and 58 field instructors employed in health care settings participated in the project. Results indicated that 90% of the participants rated the knowledge contributions of the study days and study day satisfaction positively. The results suggest that SEM has potential as a tool to complement traditional field instruction programs.     

A model for teaching about interdisciplinary practice in health care settings

The authors describe a continuum of collaborative interdisciplinary professional practice which can be used for teaching students in health care settings. Choices about the nature of interdisciplinary practice can be made not only on the imperatives of patient care but also on the interpersonal characteristics of health care providers as well as their needs for professional autonomy. This model can enable students to make clear career decisions about the types of interdisciplinary practice best suited to their interpersonal style and professional needs.     

The Challenges of Health Care Reform for Hospital Social Work in the United States

This article examines the potential impact of the Patient Protection and Affordable Care Act (ACA) of 2010 on the practice of hospital social work in the United States and its implications for social work education and training. It briefly traces the history of hospital social work, outlines some contemporary issues in the health care field, particularly those that create persistent health disparities, summarizes the major provisions of the Act that have implications for social work practice, and discusses how social workers in hospital settings might respond effectively to the changes produced by the legislation.     

Professional Competencies and Training Needs of Professional Social Workers in Integrated Behavioral Health in Primary Care

The Affordable Care Act has led to a widespread movement to integrate behavioral health services into primary care settings. Integrated behavioral health (IBH) holds promise for treating mild to moderate psychiatric disorders in a manner that more fully addresses the biopsychosocial spectrum of needs of individuals and families in primary care, and for reducing disparities in accessing behavioral health care. For behavioral health practitioners, IBH requires a shift to a brief, outcome-driven, and team-based model of care. Despite the fact that social workers comprise the majority of behavioral health providers in IBH settings, little research has been done to assess the extent to which social workers are prepared for effective practice in fast-paced primary care. We conducted a survey of social workers (N = 84) in IBH settings to assess the following: (1) Key competency areas for social work practice in IBH settings and (2) Self-rated preparedness for effective practice in IBH settings. Online snowball sampling methods were used over a period of 1 month. Results indicate that social workers feel prepared for general practice in IBH settings, but would benefit from additional training in IBH-specific competency areas identified in the survey. Findings can help guide social work training to improve workforce preparedness for practice in IBH settings in the wake of health care reform.     

Issues and dilemmas of developing a new faculty practice plan

Due to changes in health care and increased knowledge of the public concerning health care, faculty need to assume a more active role in practice settings. Faculty involvement in the practice of their disciplines allows them to remain on the "cutting edge" as well as be models for their students. Most faculty practice plans will provide some external funding but more importantly will allow additional educational opportunities for the students as they work with the faculty. These plans allow faculty to interact with the community and strengthen the ties of the community and the academic institution. However, there are dilemmas in establishing faculty plans, for the quality of teaching cannot be threatened, and most universities expect their faculty also to be involved in scholarly activities. This article discusses 1) the process used in planning and developing a faculty practice plan; 2) details of the plan, to include faculty incentives, administrative cost, etc.; and 3) strategy for implementation.     

The AIDS epidemic: professional and personal concerns of graduate social work students in field placement

Social work educators and health care practitioners have been increasingly concerned about the cognitive and affective preparation of graduate students for practice with AIDS-related issues. A pilot study of students from six graduate schools of social work was conducted in an effort to address these concerns. This article focuses on the affective experiences of students who worked with AIDS in field placement. The study questionnaire provided information about: (1) the concerns of students working with AIDS populations; (2) the nature and effectiveness of the help students required in coping with concerns; and (3) students' recommendations for future AIDS-related field placements. Study findings revealed that while the frequency of reported concerns was low overall, those concerns elicited revolved around clients' reactions, and knowledge and skills for practice. Students sought diverse resources for support in coping with their concerns, but other professionals and staff groups in field placement were the most helpful resources. A large percentage of students at least conditionally recommended future AIDS-related field placements. Recommendations for field education in health settings are offered.     

Goodness of fit: social work education and practice in health care

This study addresses the fit between social work education and practice in health care. A random sample of NASW members identifying with health care (N = 179) responded to a mail survey about the utility of core knowledge and roles that we had identified by reviewing seven commonly used health care social work texts. Quantitative data revealed knowledge and roles most frequently used in health care settings as well as differences in roles used dependent upon department name; and different professionals supervising social workers. Qualitative data from four open-ended questions provided suggestions for what knowledge and skills should be taught in social work programs, the best forums/methods for teaching this content, and topics for continuing education. Findings are discussed in relation to six key areas of the peer-reviewed literature: vulnerable populations/diversity, ethical dilemmas, interdisciplinary collaboration, mental health, managed care/accountability, and advocacy. Implications for social work practice, education, and research are discussed.     

Examining professional competencies for emerging and novice social workers in health care

This participatory project identified competencies of social workers in health care, with a focus on entry to the field. Findings reflected discussion groups with n = 24 social workers in health care settings. Identified core competencies were: (a) a core base of knowledge specific to social work in health care, (b) understanding of the health care system and implications for practice, (c) a strong work ethic and confidence working with limited supervision, (d) interpersonal skills for multi-disciplinary teamwork, (e) understanding about complex role and power dynamics, (f) accountability for one’s own work/practice and commitment to professional development, (g) reflectiveness on practice, and (h) an organizational commitment to capacity building.     

Student Process Recording in Practice with Children

ABSTRACT

Written process recording (PR) is a traditional means of teaching social work practice in field agencies. However, schools of social work and field supervisors do not sufficiently differentiate the process of recording adult sessions from the process of recording sessions with children. Social work students and their supervisors are sometimes uncertain about how PR of child interviews should be written. This study examines the experiences of four supervisory pairs (students and supervisors) who wrote and used PR of child sessions in field supervision. The four pairs were drawn from different social work field practice settings, a residential treatment center, two outpatient mental health services, and a public school. The findings of interviews reveal four key points: (1) PR reflects a stage-wise learning process; (2) students' strong emotions are revealed in PR; (3) PR provides opportunities to teach theories and techniques relevant to a child perspective; and (4) outcome-driven expectations do not negate the usefulness of PR. These findings are useful for students and supervisors interested in practicing with children.     

SOCIAL WORK EDUCATION FOR HEALTH CARE PRACTICE

The probably future developments in social work education for health care practice are viewed from a systems perspective. The developing needs of social work in health care are examined within the context of the developing needs of the broader field of social work practice, since changes in this larger system cannot but impact upon the health care social work subsystem. Similarly, education for health care social work practice is seen within the perspective of the broader system of social work education for practice in general, because developments in this larger system determine the directions that will be taken by the smaller system of educational training. The interfacing of the two systems, social work practice and social work education, is examined.     

Management training in long-term care

The education of health care administrators faces its most dramatic change since the inception of the field. Recent discussions at the national level call for major overhaul of curricula and teaching modalities, including moving education to position students for evidence-based practice. This paper presents recommendations for incorporating training about chronic and long-term care into health care management curricula. It asserts that all health care management students should have a basic knowledge of the fundamental policy, operating, and financing principles of long-term care. The majority of people using the health care delivery system today, and increasingly in the future, suffer from chronic conditions. Long-term care services, although less expansive in structure, far outnumber acute care services and health plans. They will grow in the future to meet the portending demand. To maximize job opportunities and to optimize performance in any job, health care administrators need to know about the long-term care delivery system. This paper delineates critical topics pertaining to long-term care, organized according to 11 fundamental management areas in which the field is developing core competencies. The contents were derived from a year-long process of asking stakeholders in the various facets of long-term care what topics they thought were essential for administrators to know. The topics delineated in this document represent the consensus about essential knowledge that all health care administrators should have about long-term care, whether specializing in long-term care or following a more general management career. The education of health care administrators faces its most dramatic change since the inception ofthe field. Recent discussions at the national level call for major overhaul of curricula and teaching modalities, including moving education to position students to perform according to evidence-based practice. It is thus timely to consider content, as well as educational format. This paper presents recommendations for incorporating training about chronic and long-term care into health care administration curricula. It asserts that all health care administration students should have a basic knowledge of the fundamental policy, operating, and financing principles of long-term care.     

The Impact of Changes in Health and Social Care on Enteral Feeding in the Community

This paper examines the impact of the changes to health and social care on enteral feeding in the community, outlines implications for practice and offers recommendations to ameliorate the challenges. It is now clear that there have been significant changes especially in the last 10 years in health and social care provisions in the UK with an overarching effect on enteral nutrition in the community. Advances in technology, increasing demand and treatment costs, the need for improvement in quality, economic challenges, market forces, political influences and more choices for patients are some of the factors driving the change. Government’s vision of a modern system of health and social care is based on initiatives such as clinically led commissioning, establishment of Monitor, shifting care from acute hospitals to community settings, integrating health and social care provisions, Quality, Innovation, Productivity and Prevention (QIPP) program and the concept of “Big Society”. These strategies which are encapsulated in various guidelines, policies and legislation, including the health and social care Act, 2012 are clarified. The future challenges and opportunities brought on by these changes for healthcare professionals and patients who access enteral nutrition in the community are discussed and recommendations to improve practice are outlined.     

How place matters: unpacking technology and power in health and social care

The devolution of care into nontraditional community-based settings has led to a proliferation of sites for health and social care. Despite recent (re)formulations of 'evidence-based' approaches that stress the importance of optimizing interventions to best practice by taking into account the uniqueness of place, there is relatively little guidance in the literature and few attempts to systematically 'unpack' key dimensions of settings most relevant to policy, practice and research. In this paper, we explore how place matters for health and social care. In effect, we propose making place the lens through which to view practice, and not simply an interesting sideline focus. We focus specifically on (a) the emplacement of power relations in health and social care in and across settings; and (b) the pervasive (and often unrecognised) influence of technology on and in place (both 'mundane' and more visible 'high' technologies) as arguably among the most significant and pervasive (and often overlooked) dimensions of place pertinent to health and social care in both traditional (institutional) and nontraditional (community) settings. Drawing on diverse disciplinary literatures, we seek to make visible certain issues and bodies of work that health professionals may not be aware of, and which often remain inaccessible to practitioners and applied researchers on account of their density, complexity, and specialised terminology. In particular, drawing on the rich tradition of cultural studies, we advance the culture of place as a rubric for understanding the complex interrelationship between power, technology, culture, and place. Several fruitful avenues for place-sensitive research of health and social care practice (and its effects) are suggested.     

Community-oriented medical education in Glasgow: developing a community diagnosis exercise

OBJECTIVES: Recent NHS changes have included an increasing emphasis on primary care settings, and hence community needs assessment. This has led to suggestions that medical education should become more community-oriented if today's medical students are to become effective medical practitioners. Recent curriculum reforms in a number of medical schools frequently involve a more student-centred approach, which encourages students to learn by intellectual discovery and critical thinking. We describe one such exercise in community diagnosis that has been developed in Glasgow's new undergraduate medical curriculum. DESIGN: The exercise has been developed as three teaching sessions, each with specific learning objectives. The first session explores the strengths and weaknesses of routine statistics, and reveals the lack of information regarding individual's and community's health and health care needs. The second session is a community-based rapid participatory appraisal arranged by general practitioners. Students interview patients, carers, and local key informants and health care professionals about their perceptions of health and health needs. In the final campus-based session, students combine and present their findings. Development included two pilot exercises involving detailed evaluation. SETTING: University of Glasgow. SUBJECTS: Medical students. RESULTS: Students valued the contrasting perspectives and information provided by different sources. After completing the three sessions, most students and tutors considered it an interesting, enjoyable and educational experience. CONCLUSIONS: This innovative community-oriented teaching programme gave students some insight into how health, morbidity and mortality are measured, why these might vary between different communities, and how different community members' perspectives might differ regarding perceived health and social needs.     

Health care and social work services: present concerns and future directions

This article reviews eight major social-health care issues of the eighties: controlling costs; access to care; changing organizational patterns; solo versus interprofessional care; regulations and accountability; social reform/special interest movements; ethics and values; and changing urban populations. The author formulates how changes in our medical care systems will affect the practice of social work in health care settings.     

Evaluation of social work practice in health care settings

The purpose of this article is to encourage social workers in health care settings to evaluate the effectiveness of their practice. Recent studies of intervention outcome in health care settings are reviewed on four dimensions. Because most of these utilize large group designs and social workers in direct practice rarely conduct this type of research, single-system designs are proposed as a complementary and feasible approach to evaluation. Issues in the use of single-system designs within health care settings and a case example will be discussed.     

The Use of Theoretical Constructs and Research Data to Establish a Base for Clinical Social Work in Health Settings

This article suggests a means for organizing a base for clinical social work practice in health settings. Membership, as a theoretical construct, is used to explore the essentials of social work, to explicate its key practice concepts, and to review characteristics of the health field. Selected findings from a secondary analysis of data from the New England Regional Survey of Social Work Practice are considered with reference to theory and essential concepts of health social work practice. Questions are raised and implications drawn for the practice of clinical social work in health settings and for education for that practice.     

Field Instruction in a Psychiatric Setting

New biological findings, major shifts in family intervention models, the failure of the deinstitutionlization movement to provide humane quality care for the mentally ill and shrinking community-based resources all suggest the need for vigorous social work leadership in the metal health field of practice. Such leadership can only emerge from a social work student body sparked to engage in, grapple with and reframe mental health practice for the future. The field instruction relationship nurtures this spark. This chapter will highlight the challenges and obstacles to teaching in the current psychiatric climate.     

Coordinating In-Patient and Out-Patient Services

It has been observed that there are problems in the conceptual base of social workers' practice with groups in health settings. This article suggests that to develop a sound conceptual base and to improve the integration of work with groups into the operating structures for delivering social work services in health care, it is necessary to distinguish social work groups from other groups. Criteria for social work practice with groups are identified. Criteria are based on fundamental principles of social work practice in health care and principles of social work practice differentiated to take account of group processes.