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The author would like to acknowledge the generous financial support received from the Bertha Rosenstadt Trust Fund in Health Research, administered through the Factor-Inwentash Faculty of Social Work, University of Toronto, to carry out this research. She would also like to thank the social workers at Sunnybrook Health Sciences Center for participating in this research.

Introduction

Field education is considered the “signature pedagogy” of the social work profession (Council on Social Work Education, 2008) and has been identified as the most significant component of the social work curriculum in preparing competent, effective and ethical social workers (Bogo, 2015). However, despite its primacy, field education continues to face considerable challenges, especially in terms of how to encourage professional commitment to training and to generate sufficient numbers of student placements. This has been a long-standing issue for universities and the field alike. This paper describes an innovative and highly effective approach that was developed and implemented by the social work service at Sunnybrook Health Sciences Centre, Toronto, to ensure that every social worker is regularly involved in offering student placements. This strategy has widespread relevance and application for all agencies employing social workers, as well as for other professions.

Challenges to Field Education

Field education in social work occurs through the voluntary participation of community agencies, and depends on this collaborative partnership of service organizations and universities (Bogo, 2005).  The challenges to field education have been well documented in the growing body of social work scholarship and research on this subject (Bogo, 2010, 2015; Homonoff, 2008; Jarman-Rohde, McFall, Kolar, & Strom, 1997; Lager & Robbins, 2004; Raskin, Wayne, & Bogo, 2008; Wayne, Bogo, & Raskin, 2006, 2010).  As social work education programs have proliferated and increased their admissions, there has been an increased pressure on the practice community to offer more placements. This comes at a time when social work agencies have experienced a consistent reduction in staffing and resources, resulting in higher caseloads for many social workers. Health care settings, and hospitals in particular, have faced considerable challenges that have negatively affected their capacities to generate field placements, especially due to greater client volumes, the acuity and complexity of caseloads, and the restructuring of hospitals resulting in the loss of a social work infrastructure (Globerman & Bogo, 2002).

Faculties of social work require accreditation through the appropriate accreditation body, which delineates requirements for social work supervisors and for social work students.  Social workers undertake student placements in accordance with the respective university’s field education policies and procedures. In addition, the profession has various regulatory bodies that oversee the practice of social work and promote the excellence of practice according to clearly defined standards. However, a scan by the author of social work in North America reflected no standards requiring social work professionals to participate in the training of the next generation of practitioners. The provision of social work student placements is largely reliant on the individual agency’s approach to student education and its relationships with schools of social work, as well as on the willingness and initiative of its individual staff members. This compounds the challenges of generating sufficient student placements within social work, and constitutes a major factor responsible for the critical shortage that remains pervasive across the social work profession today.

Field Education at Sunnybrook Health Sciences Centre (SHSC/Sunnybrook)

SHSC is a 1325 bed academic health sciences center that is fully affiliated with the University of Toronto, and has a staff of 72 MSW social workers. The hospital operates within a program management model; without a centralized social work department, so that social workers are accountable to their respective medical programs. While SHSC is committed to the field education of MSW students from the Factor-Inwentash Faculty of Social Work (FIFSW), University of Toronto, historically it has been a challenge to offer adequate numbers of placements commensurate with the size of its social work service. In general, SHSC averaged 10 placements per year that involved approximately 13 staff. It tended to be the same cohort of staff offering placements each year, with little accountability or consistency in regard to teaching activities within the profession. For the last 17 years, the author has served as the social work educational coordinator, who develops and administers the student education program; this role constitutes 20 percent of her workload. One of her goals has been enhancing the professional commitment of SHSC social work staff to training social work students.

A First Step: The Rotational Model of Placement

For many years, the University of Toronto held to a traditional model of field education, with student placements (usually semester- or year-long) in one agency or unit, with one supervisor. SHSC was one of the agencies that encouraged the University to consider a rotational model of placement, with interns moving through several units of the hospital, with two, three or even four supervisors. In addition to exposing interns to a wide variety of experiences and supervisory styles, the rotational model (common to training of other health professionals) was seen as a way to increase staff commitment to social work training. Staff would be more willing to make a commitment to six or twelve weeks of supervision rather than five or eight months.

The introduction of the rotational model in 2008 did not add appreciably to the number of social work placements at Sunnybrook, but it did lead to an increase in the number of staff involved in supervision of social work interns.

Table 1: MSW Placements and Supervisors at SHSC, 2001-2010

Year # of Students # of Supervisors
Sept 2009 – Jan 2010 12 20
Sept 2008 – Jan 2009 8 15
Sept 2007 – Jan 2008 9 13
Sept 2006 – Jan 2007 12 17
Sept 2005 – Jan 2006 9 12
Sept 2004 – Jan 2005 15 8
Sept 2003 – Jan 2004 12 13
Sept 2002 – Jan 2003 13 15
Sept 2001 – Jan 2002 11 12
Sept 2000 – Jan 2001 8 11

 

The Social Work Student Education Standard (SSES)

In 2010, SHSC educational coordinator sought to further increase staff commitment to social work student training by creating the Social Work Student Education Standard for social work staff. The idea for its creation evolved from her work in developing numerous social work standards within the hospital, such as those related to Assessment, Documentation, and Discharge Planning. She realized that a standard for student education appeared to be missing, not just within social work at her organization, but across all agencies and all professions. The major development and implementation of the SSES occurred over an 18-month period. This included a literature search, discussions with many colleagues at other agencies and with the FIFSW, and developing the written Standard. The author followed the initial draft of the SSES by multiple discussions and feedback with the social work service at SHSC, as well a process of engagement and collaboration with the various constituents within the hospital administration.

Briefly stated, the SSES identifies the key components in field education in which social workers at SHSC are involved, and delineates the respective indicators and activities related to performance. The components include: field placements, opportunities for students to shadow staff, student seminars, inter-professional clinical education, and teaching on-site and at the university. Fundamental to this Standard is the specification of the frequency for staff to offer social work student placements, stated in the SSES as: “Staff is expected to offer an MSW practicum a minimum of once every two years if it is undertaken in a rotational model, or once every three years if it is the duration of a full placement. Part time staff is included in this expectation and encouraged to speak to the educational coordinator to discuss reasonable options for their participation in such practicum opportunities”.  The educational coordinator is responsible for monitoring compliance with this minimum requirement for offering student placements, utilizing an Excel spreadsheet for continuous data collection.  This involves regular individual follow-up with the various social workers as well as reporting on their involvement in the Standard annually, as a standard component within their performance appraisals.

Two key aspects proved critical in facilitating the implementation and integration of the Standard in the hospital. Firstly, considerable effort was made to engage the social work staff in reviewing the draft content of the SSES and to incorporate their feedback in making revisions to it prior to its finalization, particularly in regard to the component of the frequency of offering placements. This level of participation was important in enabling the staff’s sense of comfort with and ‘ownership’ of this Standard. Secondly, multiple small group meetings were held with the various social workers and their respective patient care managers at the local unit level to enable information dissemination and dialogue related to the implementation of the Standard and its potential impact on their areas of practice. While the latter process was extremely time consuming and involved considerable organization to set up the 30 + meetings that were involved, t it was particularly key in promoting compliance and support for the adoption of the Standard into daily practice across the hospital.

The SSES is now firmly established as an integral component in the hospital’s “Social Work Standards of Practice” document, and sets out the minimum standards of professional practice, expectations, and accountability for all social workers at SHSC related to participating in the realm of student education. In essence, the expectation is that if one works at Sunnybrook, one commits to educating students and to offering student placements on a consistent basis. The Standard aims to ensure consistency, equity and participation by each social worker in teaching activities, and specifically in terms of regularly offering student placements.

Results of Implementation of the Standard (SSES)

The educational coordinator monitors the effects of the Standard in three ways: calculating the number of students in placement and the number of supervisors involved on an ongoing basis; creating an anonymous online survey of 52 participants; and interviewing three respondents in person.

Number of Placements and Supervisors.

The numerical results of the Standard are fairly impressive. The implementation of the Standard in 2010 has led to a significant annual increase in the number of staff participating in the training of social work interns, to a high number of 37. However, there has not been an appreciable increase in the number of students placed, except in September 2015-January 2016, when the largest number of students ever (17) was placed.

Table 2: MSW Placement and Supervisors at SHSC, 2010-2016

Year # of Students # of Supervisors
Sept 2015 – Jan 2016 17 37
Sept 2014 – Jan 2015 13 27
Sept 2013 – Jan 2014 13 26
Sept 2012 – Jan 2013 11 20
Sept 2011 – Jan 2012 10 22
Sept 2010 – Jan 2011

       *SSES implemented

14 24

Social Work Activities in Supervision.

The online survey had a high response rate of 84% (n=52). (Interestingly, 67.5% of the respondents had been placed at SHSC in the past.) The survey offered a view of the many supervisory activities in which the social work staff participated from 2011 to 2014. It was notable that 81.8% of the staff had offered a student placement in that three-year period.

Table 3: Social Worker Activities in Student Education Components 2011-2014

Satisfaction with the Standard.

The online survey in 2014 also inquired about staff satisfaction with the Standard.  Most respondents indicated that they were satisfied or very satisfied.

Table 4:  Social Workers’ Satisfaction with the Standard

Benefits and Challenges in Implementation of the Standard

Responses to the 2014 survey (n=52), and especially to the one-to-one interviews (n = 3), illuminated a number of benefits and challenges in the implementation of the Standard. From a positive perspective, the impact of the Standard was acknowledged to facilitate an examination of the field instructors’ practice, which student education necessarily does, and to foster a sense of enriched professional development Staff also identified that the SSES provides consistent expectations and enhanced structure related to student education and ensures greater equity across the profession in terms of who offers placements. Participants spoke positively about the Standard in terms of an enhanced sense of responsibility and fulfillment within the profession related to our mandate to educate students. It was also mentioned that the Standard is “leading edge” for our profession.

On the other hand, social workers also shared their concerns related to the accountability, flexibility and impacts of the Standard, which highlighted aspects for further exploration and clarification with the social work service. Some were concerned about equity. Some saw the mandatory Standard as “forcing” staff to supervise or limiting flexibility across all staff, yet another expressed concern about the lack of “consequences” for those who did not meet the Standard. In a 2009 focus group conducted with 60 SHSC social workers on the topic of student education, barriers to offering placements were identified as: caseload demands, the time consuming nature of the social work placement, and the pressure of juggling clinical and teaching roles, particularly in the context of a busy hospital setting. Similarly, several respondents in this study found it difficult to integrate supervision with their other responsibilities. One respondent was overwhelmed with  the time spent with the student and also with administrative aspects related to the placement (such as preparing evaluations), given that there is no reduction in clinical workload during the placement time frame, and that additional work hours are often needed to complete caseload requirements. Participants also worried about not giving an “adequate” experience or sufficient time to students because of competing clinical demands.

Conclusion and Implications for the Field

The issue of how to encourage professional commitment to training the next generation and to develop sufficient student placements has long plagued the social work profession. The literature emphasizes numerous contributory factors including constraints on resources and their impact on student placement opportunities, as well as a lack of training and socialization within schools of social work to prepare practitioners for being field education educators (McKee, Muskat, & Perlman, 2015). These authors suggest a multi-faceted approach to address the challenge of recruiting field educators. The Social Work Student Education Standard has demonstrated to be an effective strategy that targets social workers in the workplace to encourage their commitment to social work training, and particularly to ensure their engagement in offering student placements.

The author created this Standard as an innovative approach to formalize and standardize the student education activities expected from social workers who work at her agency, and in so doing, to hold all social workers accountable for offering social work student placements. These expectations have been woven into the very fabric of SCHC, as part of a clearly defined social work student education strategy. They are articulated in the agency’s social work job postings/descriptions, focused on during social work job interviews, and reviewed within staff performance appraisals. Furthermore, the author ensures that all new hires are oriented to the Standard to ensure their understanding of these requirements.

Evaluation of the implementation of the Standard by monitoring the number of students and supervisors, a 2014 survey of social work staff, and one-to-one interviews of participants, indicated considerable success of the intervention. Since implementing the SSES as SCHC in 2010, the number of social workers involved in offering student placements has increased dramatically, speaking to the success of this Standard. Most participants reported satisfaction with the Standard, and expressed an enhanced sense of commitment and fulfillment in their work with students. Nevertheless, several issues remain to be examined. The most difficult concern is how to balance supervisors’ responsibility to their students with their clinical and administrative duties at the hospital, especially without workload reduction. The educational coordinator offers intensive mentorship, especially to new supervisors, in informal consultation and formal onsite sessions. She is currently developing a survey to explore the needs of supervisors and develop increased supports and rewards for them.

One consistent theme in the research, related to what motivates social workers to become, and to remain field educators, is the role of the employing organization in stimulating and supporting individual workers in this realm (Develin & Mathews, 2008). In this process, they emphasize the importance of a culture that encourages placements and supports staff training in generating and maintaining field educators. It is unequivocal that implementation of the SSES at SJSC has been pivotal in turning the tide of staff involvement in offering student placements, and has created a culture shift within our social work service to view social work student education less as a requirement of employment, but rather as a privilege of working for the hospital in training the generation of tomorrow. To increase student placements, social work schools and professional organizations will need to collaborate with agencies like SCHC in supporting successful programs like the SSES. The SSES appears to be the first of its kind in North America, and the author believes it holds great promise to benefit other agencies with its potential for ease of replication. In this process, the gains for students, practitioners and the profession as a whole can be considerable.

Note: Copies of the Standard can be requested from the author directly through email at illana.perlman@sunnybrook.ca

References

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