Field Educator: A Scholarly Journal from the Simmons University School of Social Work

Download a PDF of this article

In this issue’s Conversation, Trudy Zimmerman, Assistant Dean of Field Education at the Boston University School of Social Work, talks with Marion Bogo about the current state of field education. Marion Bogo is a Professor of Social Work in the University of Toronto’s Factor-Inwentash Faculty of Social Work. She is also the Associate Editor of Social Work Education: The International Journal and the author of several books, book chapters and journal articles on social work education. In 2013, the Council on Social Work Education (CSWE) presented her with their Lifetime Achievement in Social Work Education Award. —Editor’s Note

Trudy: Marion, thank you for agreeing to participate in the Field Educator Conversation. There is a lot to talk about. I’ll try to focus our conversation on a few critical topics: your thoughts on what we can learn from current research in field education and your perspective in general about the state of field education. What are we doing well? What do we need to improve?

We could talk for three hours about the problems that all schools now face. We’re all struggling to figure out ways of both holding on to the things that we value and that are working well, while also figuring out what new ideas we need to incorporate to ensure our students are learning what they need to learn. It’s not clear to me that students today are learning everything they really need to learn.

Also, I have a particular interest in better understanding how students learn in the field, and then using that understanding to streamline our strategies to help students learn. I hope we can have an open, free-flowing conversation.

To get started, almost a decade has passed since your 2005 article in which you reviewed research pertaining to field education from 1999-2004 ^[1]. What’s new in field education research?

Marion: Quite a lot. First, as background, the basic evidence base for field instruction came out of adult education theory, social work values, and generic practice theory. When I look back at that literature, three field education principles stand out: 1. Learning takes place within a collaborative relationship; 2. Teaching and learning need to target individualized student learning interests and need to be situated within the framework of the particular school; 3. The importance of reflective discussions that focus on use of self.

Increasingly over the last decade or so, there’s been a significant explosion in theorizing and research about learning for professional practice; it originates from general theories of learning, especially learning for the professions. In my more recent work, I’ve been very much influenced by what’s going on in health sciences education.

Another area is implementation science—that is, how do we teach practitioners to offer evidence based treatments? Related to this, there is some very interesting research on how practitioners learn new skills.

Trudy: All very pertinent to learning in field education!

Marion: Yes, in addition, current research in cognitive neuroscience and learning has also changed my thinking on learning and teaching in field education. Specifically, students really need to see and be seen. I won’t go into all of the research, but based on many studies it’s very clear that students need role models. They need to see practice in action to be able to integrate theory—the intellectual ideas, the concepts—with how they actually look on the ground in practice.

Trudy: Could I stop you there for a second? Historically, it’s been a big secret what students are actually doing, right? I remember Julianne Wayne talking with me about this years ago ^[2]. She said the reason it is so difficult to evaluate student performance is that we never or rarely really see students perform. It’s always inferred from the student’s self report, from what they wrote, or sometimes from what other people told us about the student. So what you just said now really flips our traditional way of training students.

Marion: Absolutely. And if we have a competence framework, which we do now with EPAS 2008, competency means you need to see what students are able to do, and you assess what they’re able to do. Now, that doesn’t mean you don’t also assess how they are thinking and how that guides their actions.

But if you’re not observing a student’s practice, it’s always proxy assessments or one-step removed. Similarly, all the theory, all the research says that if you’re teaching a skill or practice, in order to learn it students need to see someone practice the skill, and then they need to be seen or observed. That’s point number one for me.

Trudy: It seems to me this idea of seeing and being seen also has implications for how practice is taught in the classroom.

Marion: Absolutely. Actually, my current program of research is devoted to using simulation in teaching practice and in assessing practice. In the past five years my research has focused on using simulation and the Objective Structured Clinical Examinations (OSCE), which we’ve adapted for social work. The other principle is the importance of practice, and this idea comes from neuroscience. It’s been popularized as the 10,000 hour rule ^[3].

Trudy: That’s right.

Marion: You’ve probably heard about that.

Trudy: Yes.

Marion: This is the idea that students need a lot of opportunity to practice again and again and over again. Students in health sciences, for example, medical and nursing students, are required to repeat the same activity or intervention many times, whereas in some situations, social work students do not have the opportunity to practice enough—they simply do not conduct a lot of interviews or group sessions. Actually, we don’t have any data about how much students practice. It is purely my impression that it’s not enough.

I get the sense students spend a lot of time in meetings, writing reports, writing process records, but they’re not actually doing enough of what they’re trying to learn. However, practice is crucial, practice followed by feedback. And we have developed useful ideas in the social work literature on how to give feedback.
To summarize it’s feedback about what they’re doing followed by the chance to practice again. You’re practicing, you’re getting feedback on your practice, and you keep practicing again and again.

Anne E. Fortune at SUNY Albany has published an excellent article with Mingun Lee in 2013 ^[4]. They found the more that students were involved in learning activities, the better student outcomes—that is, the more they learned.

Trudy: How do we do that? In fact, that’s what we say we expect when a student is in a practicum or an internship: We expect them to have their own cases, to spend a large portion of their time in direct practice. We expect them to carry those cases independently, get supervision on those cases, and so on. Are you saying that model doesn’t work or it’s not enough?

Marion: I’m skeptical about whether that model is being used in day to day field education—we have no published reports on this issue. Do schools collect that data? Do we get information about how much practice students are actually doing? For example, if they’re doing five interviews a week times 40 weeks—that’s 200 hours. That’s a small amount of time if we’re thinking about the 10,000-hour rule.

Trudy: We can also say that students wouldn’t necessarily have to be at 10,000 hours by the time they graduate, right?

Marion: No, I figured out that with the 10,000 hour rule, it took me 10 years before I really felt I knew what I was doing in practice. That made sense to me.

Trudy: Exactly. Intuitively, that makes sense. Absolutely.

Marion: Lastly, all of this doing and watching must be linked to reflective practice. It needs to be linked to a conceptual framework. We’re teaching a professional practice, one that is knowledge informed, theoretically and empirically, and is also value based. It’s not just about doing: It’s about doing and reflecting.

In our own research we found that field instructors really need to learn how to articulate whatever concepts are guiding their practice and are used in the supervision. Field instructors don’t necessarily need to know the current theory or practice approach that’s being taught in the schools. Rather, they need to be able to help students understand whatever concepts they’re drawing on and encourage students to link whatever practice they’re doing to what they’re learning in school, conceptually and empirically.

Trudy: Let’s talk more about field instructors.I have a couple of observations about field instructors. We have some fabulous field instructors who do just the kind of thing that you’re describing. But many of our field instructors are so overworked and overextended that they barely have time to meet with a student, let alone for the two hours we require. In addition, many of our field instructors are second or even third generation graduates, who may not have had this type of field instruction. If you talk about learning by observing and learning by being observed, they have not had the opportunity to experience this individual tutoring that we want our students to get.

Marion: Tutoring that involves observation and coaching.

Trudy: Exactly. How do we change field instruction today given the nature of current practice? This spring at BUSSW we surveyed all students in field placements and all of our field instructors. Our response rate for both groups was 75 percent. The survey focused on several aspects of supervision and included questions on the specific amount of time devoted to supervision and what actually occurred in supervision. The survey also included a question about the use of process recordings. BUSSW requires that students write two process recordings each week. We included that question because we doubt students are doing two process recordings a week, and even if they are, we don’t know what kind of feedback they get or if they are being used in supervision.

We are in the process of analyzing the results. In a very brief scan of the results, we are seeing that students are not getting nearly two hours a week of supervision, and the process recordings for many people have gone by the wayside. That’s the reality of what a lot of our students are experiencing. The question is, what do we do with that?

Marion: It sounds then as if what might be happening is that students and supervisors are wasting the precious time in supervision with reporting— the student telling the supervisor what she thinks is going on, or what the issues are.

Trudy: Right, exactly.

Marion: Whatever input the supervisor is giving is one step removed from what’s actually happening.

Trudy: That’s right.

Marion: The whole model is so inefficient. What if students could be doing some kind of recording with the aid of technology? If they could then transcribe the recording and do some reflective analysis in a structured way and perhaps give that to the instructor beforehand so she or he could read it.

Then they could use the components of field instruction—feedback, reflection, conceptualizing practice. Or the supervisor could accompany the student on an interview. Or the student could accompany or shadow the supervisor and they debrief and consider: “What are you doing? Why are you doing what you’re doing? How are you feeling about what you’re doing? What would you need to do better to be more effective?”

Julianne Wayne, Miriam Raskin, and I wrote about this issue in our signature pedagogy article: the need in social work to take student learning out of the private domain and make it more public ^[5]. Look at the other health science professions like medicine or nursing. Often, the student is learning through practicing with the clinical instructor.

I appreciate however that a model of observing supervisors doing the work and students being observed by supervisors is not going to work in all agency settings due to the nature of the practice; for example, it wouldn’t work in an intensive psycho dynamic program.

Trudy: Although, a lot of therapies, are much more open—family therapy and marital therapy. We do have one way mirror rooms, although I find as I go to agencies, often those rooms are now used as storage rooms.

Marion: I’m sorry to hear that.

Trudy: However, currently, a lot of family therapy is now being delivered through intensive home based family models. Social workers go into people’s homes as members of a team to work with the parents and the children.

There is an opportunity for students to observe each other and for the work to be more public. There are also observation opportunities in schools and other settings as well. The limitations are really in the traditional mental health settings or psychotherapy settings.

Marion: That’s right, but then, is it possible to ask the client and get informed consent to record the session? When we started to do this and explained the reason to clients—that the supervisor would listen to parts in order to help the student provide the best service— clients agreed to the recording. Instructors do not have to listen to the whole recording, just student selected segments, or the student could transcribe and analyze parts. The instructor can determine with the student what segments to present—for example, those where the student was stuck, those where the student felt she had done her best work.

Rather than writing a process recording, instead students could transcribe what was said and then they analyze it. We’ve developed a system with columns where students analyze the recording based on what the instructor is aiming to teach at that stage of the field experience.

For example, if the instructor is focusing on use of self, the student is asked to analyze the transcript highlighting how her thoughts and feelings were influencing her actions at various points in the interview. If they’re trying to link a concept with a model or with empirical findings, the student is asked to focus on that. If you want to get at the student’s own feedback about their own performance, that’s how they analyze it.

We’ve used a four column format with simulations. Then we’ve encouraged people in the field to do that also.

But back to your survey, I’m impressed that you’re actually trying to find out what goes on in the field.

Trudy: It’s very rudimentary, but one of the things that was so pleasing about it was how many people responded. We thought nobody would respond.

Marion: Well, it shows they probably want and need some guidance.

Trudy: Yes, exactly.

Marion: The other thing that I want to mention is the importance of the relationship, because that has really not changed. Susanne Bennett and Kathy Deal have done some interesting research trying to look at attachment issues ^[6]. Their research reinforces the idea that when the student feels that there’s a figure, a person who’s available who can create a positive socio emotional climate, who’s interested in them, who’s going to help them, that student experiences a more positive feeling about their learning.

While their work has been based on attachment theory, the neuroscience literature also supports that view. When we feel calm, we can bring relaxed attention to hearing whatever input we’re getting about our practice and our learning is enhanced. These ideas are similar to enduring social work principles about the importance of relationship as a place for centering and gaining support.

We found in one study on students’ emotional reactions in field ^[7], that some of our participants described very challenging experiences in the organizations—where they witnessed unpleasant power plays or were involved with difficult team members and staff. The quality of the field instructor relationship appeared to mediate whether or not students became preoccupied and distracted with the organizational politics or whether they could separate from them and be freed up to learn.

It really showed us again the importance of that relationship. But I can imagine, given how stressed and overworked instructors are, that they can’t always be these “all giving, all wise, ever present people.”

Trudy: That’s right. The question for us then is, what can we do, in a somewhat limited way? What can the schools do to support the field instructors so that they are going to be available to the students? Do you have some thoughts about that?

Marion: I do. We conducted a number of studies on assessing student learning and had over 100 people in focus groups and individual interviews. We were exploring issues related to evaluation, and field instructors talked about how they sign up to take a student because they want to be generative, because they love working with younger people. They want to empower them and they use a strengths perspective in practice and in field teaching.

But then the school asks the field instructor to take the major role in gatekeeping. The article was called “When Values Collide.”^[8] What they were saying is we really want the school to take on more responsibility for evaluating students but also for teaching students how to practice. Our findings from this study led us to begin to develop a stronger practice focus in our MSW courses, including using an articulated view of competence and simulations with trained, standardized actors in our classes to teach about practice.

We’ve always, in social work, used a lot of role-play. But once you start working with simulation with standardized actors, it’s very impressive how the experience becomes very authentic, because actors really are trained to portray a wide range of emotions and to respond differently based on what the student is offering.

I think teaching with simulation provides our students with some foundation knowledge and skills. My team has researched this approach and it is proving very effective in teaching and in assessing student learning and competence ^[9]. Right now we’re doing a small study to see how our teaching with simulation can facilitate students’ learning in the field. While I think using simulation is very promising, I don’t have the data yet from the field to see if students can transfer their learning to real situations.

Trudy: Are you doing this simulation prior to the students entering the field or while they’re in the field?

Marion: Both. We have a delayed entry model, so we do it in the first semester, September to December. Very intensive. Then they go into the field in January. A number of colleagues are also starting to use this systematic approach to simulation in advanced and specialized courses.

Trudy: This simulation is expensive, yes?

Marion: Well, yes and no. You can do the Honda Civic version or the Lexus version. I have a colleague in California—Mary Rawlings at Azusa Pacific University. She does it on a shoestring, She hires unemployed L.A. actresses, and she trains them, and she brings them in to assess student learning. With hand-held mobile devices, video recording is now easy to do. The students do a tremendous amount of work on their interview. They record the interview, transcribe it, and then review and analyze it. It’s a significant assignment, and the school is taking responsibility for teaching practice.

Which then leads to another problem, which is who is teaching in the schools of social work?

Trudy: Talk about that. That’s interesting.

Marion: You need faculty who know how to practice as well as know the literature and the research. We have been able to hire such people as full-time faculty members and they are doing clinical research. We’re also lucky in Toronto—we have a lot of PhD graduates who are expert clinicians and work as sessional instructors.

Trudy: We do as well, and in our clinical practice, and actually even in our macro practice departments, they’re basically non tenure track positions. These are people who have PhDs, many of them, some just masters, but many, many years of experience in practice, and they’re fabulous teachers.

I can only speak here for BU. I think here we’re not so much at the simulation stage yet, but we definitely are using the clinical courses to do lots of in class practice.
For example, when I teach Introduction to Clinical Practice, the students do lots of role-plays.

I really do agree with you, and I appreciate the sense of immediacy and doing it over and over again. “How would you do it next time?” and “What would you do differently?” and “Why does this work, and would something else work?” That kind of thing.

Marion: Students are not getting enough of that kind of supervision in field placements anymore. At the University of Toronto, we’ve been very successful with securing funds from a private donor to support the use of simulations in practice classes. We’ve been able to offer our students simulations of high quality. For schools that are doing private fundraising, funding simulations for classroom learning makes sense to donors.

Social work schools affiliated with a medical school or a nursing school should seek out collaborations with these schools. They have been using simulations for decades. We should be promoting this method of teaching as a way to promote client safety. We don’t use the language of safety the way they do in social work in the UK and the way they do in the health professions.

I think we should—our students are working with some of the most vulnerable populations. We should be concerned about safety. We should be concerned about students being able to do a suicide risk assessment properly, being able to do a child maltreatment assessment, or working with an elderly person who may be at risk living alone. Simulation is an excellent, safe way to teach that.

Trudy: These ideas turn our tried and true—or not-so-true—ways upside down. How do you imagine, or how do you envision, making this kind of culture shift and belief shift in the world of professional social work education?

Marion: The group at CSWE who designed the 2008 EPAS, the group led by Phyllis Black, Stephen Holloway, and Dean Pierce—I think they set us on the right path.

Trudy: You think that the 2008 EPAS was a move in this direction?

Marion: In adopting a competency framework, you need to observe what students are actually doing, not what they say that they’re doing, but what they are actually doing. I think 2008 EPAS was an attempt to engage social work educators to better prepare students for practice. You’re right. It turns it on its head.

Trudy: It really does.

Marion: You begin with the endpoint, and then you have to work backwards and say, “If we want to graduate people who are able to do practice, then what content do we have to teach them? How do we have to teach? What’s our pedagogy? What are the best educational methods to ensure that they will achieve the end outcomes—that is, these competencies—and how will we assess it?”

We’re still in the early days in social work when you compare us to other professions who’ve been using a competency approach for decades – and are still trying to improve their educational approaches. It will take us time to figure out how this can work for social work.

Trudy: It’s interesting. When we first started preparing for our re accreditation under the 2008 standards, we engaged a woman who works here at the university on the medical campus. She works a lot with the dental school and some with the medical school. She has been sort of their guru around competency based education.

One of the things that she said to us over and over again, particularly related to dental training, is you can see how somebody fills a cavity. That’s not a secret. The preceptor stands over the student, shows the student how to do it three, four, 12, 15 times, and then watches the student do it and can see: “that’s a good filling, that’s not a good filling, you made this mistake, you have to redo this.”

It was so clear to us, just from those kinds of examples, that it was a very different way of educating for professional practice. We had that learning. I don’t think we’ve yet made the translation quite to social work the way that we probably need to. Even in education, you do your student teaching, and you’re observed by a master teacher all the time.

Marion: That’s right.

Trudy: We have a lot of work to do.

Marion: We have a lot of work to do, and the fundamental problem is the way we structure social work education, which is to rely on the practice being taught by volunteers—that is, the field instructors.

In the early eighties Michael Frumkin, who was president of CSWE at the time, wrote an article about what he called the “professional commitment fallacy.” In the article he warned the field that social work education could not continue to rely on the goodness of others ^[10]. He raised the question: “How can we continue to rely on the professional commitment of agency directors and social workers who voluntarily provide field education”?

This article is 30 years old. Nobody paid attention. I think it is time for us to get the deans and directors on board. This is too difficult an issue for the field coordinators and field directors to deal with in isolation. There have been a few attempts to tackle this issue; for example, in the New York region where they place over 6,000 students a year, the schools have met together to address the problems.

Also, I think that the National Association of Deans and Directors is trying to pay some attention to the challenges for field education, and we really need a national effort.

Trudy: Can you continue with your thoughts about promising areas for change?

Marion: There’s another idea, and it’s something we’ve been experimenting with at the University of Toronto. Due to the lack of high quality field instructors, we’ve been hiring these highly-experienced social workers to provide additional supervision to students who are in agencies where, generally, the supervision is not provided by social workers.

We’re still trying to work out this model, but again, when you talk about your survey and how little students are getting, there may be a role for the schools to be hiring supervisors or to be offering integrative seminars like the seminars offered in undergraduate social work programs. Nobody’s ever done really good research on this model, but I think there could be some ways of using faculty field liaisons to better support student learning in field. It’s not a course, it’s not supervision in the field, but it’s something in between those two.

Trudy: Julianne Wayne used to refer to that as the third arena: between the classroom and the field, some kind of structured way of learning. BUSSW is hiring a couple of outside supervisors for places that don’t have MSWs but do have what we think are very good learning opportunities.This is the first year we’re doing it. We’re hiring for four or five different settings, and we’re going to see how that goes. For us, as for most schools, the cost is prohibitive.

Marion: Could you hire one of these supervisors who will work with 10 students? Students could bring samples of their work, not process records, not wasting the time with presentations, but something that’s more live. Even if they take an example, and they role-play it, and they video stream it, and everybody watches the video before they come to meet with the supervisor. So it’s, again, going back to those principles of being close to the doing but having somebody who can not only give feedback but can really link to conceptual framework or empirical findings.

Trudy: I think that is absolutely so, so critical.

Marion: If you’re doing it and if you can organize it in groups and if you could put in some kind of empirical evaluation component, you’d make a great contribution to understanding a new model. So then we come to the question of cost. But the deans need to decide where they will invest the resources.

Trudy: To switch the focus a bit, I want to ask you whether you think there’s anything that’s going particularly well in field education—anything that we have been doing, that we should try to hold onto? Certainly the emphasis on the importance of the supervisory relationship is one.

Marion: That’s where we really know what we’re doing. We really know about the quality and the importance of high support, high expectations, that it’s the foundation for learning. When I read the neuroscience literature that talks so much about what you need in a teacher learning relationship or a learning environment, I always think, “Those early pioneers who wrote about social work education, they really knew what they were talking about.” I think definitely the relationship piece is great.

Trudy: Another related issue is how over-burdened our students are with work and family responsibilities. They are working half-time or even full-time and have families. They don’t want to cut corners, but they are in survival mode all the time.
How is their readiness or openness to learning affected under these circumstances?

Marion: Some students are just depleted by all their multitasking. We need to know whether they’re learning and achieving the levels of competence we’re expecting.

Trudy: So what do you do about that? Do you take that back to admissions?

Marion: I think so. I know there’s a real concern in the US that there are just too many programs, and too many people in the programs who maybe shouldn’t be there. Maybe we have to think differently about our structures. Programs can’t only be two years; they may need to be longer. Again, those may be structural issues.

The other thing that we are doing that’s great, and social work has always done, is recognize the importance of an experiential component in the real world. When I compare to law schools where everything is in the classroom, so many law graduates will say, “Well, I learned how to think like a lawyer, but I didn’t learn anything about practicing law.”

They say it in a critical way, and there’s actually a change effort going on in legal education right now. So the social work emphasis on students being in a practicum, having that experience of practicing; even though simulation is another promising approach, it will never replace learning in the field. I also think we should hold onto the relationship. The dyadic model is a strength and provides the context for learning.

Where I think we haven’t done as well as we could have is in building better inter organizational relationships.

Trudy: “Inter organizational” meaning?

Marion: For example, a school like yours. Are you partnered at the highest level with your major service organizations and hospitals?

Trudy: We’re working on it. It happens. It’s episodic, and in some ways, it’s circumstantial.

Marion: Some years ago I did research on what we had developed called, “The Teaching Center Model.”^[11] We were able, at one point, to place 50 percent of our students in 20 agencies because we had developed strong inter institutional relationships. The dean and the practicum coordinator set this up through negotiating with the CEO of a hospital or Director of a large agency.

There were endless partnerships. They took students. They recognized we were producing their workforce. We were very involved in doing joint research projects with them. We provided continuing education. It was a real quid pro quo. They received something from being allied with us. Now most schools can’t do it, but a school like yours could.

Trudy: Yes, we could.

Marion: It was an enormous advantage because we didn’t have to go and find 150 placements. We had these 20 agencies that took large numbers of students.

Trudy: We do have a few examples like that. In fact, it’s interesting: This past year I asked our dean if she could help us strengthen our relationship with the Boston Medical Center (BMC), which is part of the Boston University Medical School. We had always had a very uneven relationship, partly based on the way that hospital is structured.

She talked to the Dean of the School of Medicine. The Dean of the School of Medicine talked to somebody at BMC. We had two meetings, and lo and behold, we have 10 students going to BMC this year.

Marion: So you know what I’m talking about.

Trudy: I know what you’re talking about, and they are going to be really good placements. I’m very confident about that. If we could have 10 of those kinds of arrangements, it would go a long way to solving our problem.

Marion: You’re in Boston. If anybody could do it, you could do it.

Trudy: You’re right. You’re right. I think that is a very good model that we should be working on developing.

---

[2] Dr. Wayne is former Director of Field Education at Boston University and currently at the University of Connecticut School of Social Work.—Editor’s Note

[3] The 10,000-hour rule states that it takes an average of at least 10,000-hours of dedicated practice at a complex skill to master it. The number is based on studies by a number of psychologists, including John Hayes and K. Anders Ericsson, and was popularized by author Malcolm Gladwell in his book Outliers. —Editor’s Note