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At the heart of every MSW internship is a sincere desire to contribute to the future excellence of our profession. An internship that provides a rich and supportive learning environment is most beneficial. At the Children’s Hospital of Michigan, we have aspired to create a well-considered placement process and a multi-layered internship experience. Our design gives interns the benefit of a primary assignment, allowing for mastery; a secondary experience set, allowing for exposure to multiple practice environments; and a series of monthly intern meetings, offering education and support. The experience culminates with practice interviews and program evaluation.
The Placement Process
The intern placement process is designed to reflect the challenges of the internship experience. Due to the pace and complexity of our setting, we only consider MSW interns entering their final field placement. The majority of our interns are enrolled in MSW programs at the University of Michigan and Wayne State University, but we have accepted interns from other MSW programs in Michigan, Canada and Ireland. Interns are accepted for either twelve-or nine- month internships, depending on the terms of their academic program. All interns, regardless of their academic program, are required to be in placement for a total of twenty-four hours over the course of three days per week throughout their internship.
The number of interns considered for placement for a particular term varies with student interest. We have interviewed as few as three interns, and as many as sixteen, for a given term. Generally, we have eight to ten interns on-site at any given time. We consider an intern’s interests, temperament, strengths and challenges; we also consider compatibility both with the various field instructors and with our setting. In addition, only licensed social work staff act as field instructors.
We provide prospective field instructor biographies to each intern as the first component of the placement process. Subsequently, field instructors are given resumes and goal statements prepared by the interns. We then arrange and conduct face-to-face interviews, lasting approximately three hours. The interview begins with an extemporaneous handwritten assignment, which interns have fifteen minutes to complete. These are then distributed to field instructors for review, allowing us to evaluate their writing skills.
While written assignments are being reviewed, a program coordinator welcomes the intern candidates, explains the expectations of the internship, and provides an outline for the remainder of the interview process. Prospective field instructors then join the interns and provide a brief explanation of their practice areas. They also explain their base schedule and any expectations specific to their work areas.
The face-to-face interviews follow in ten-to-fifteen minute rotations, during which each field instructor meets with each intern. We do not allow interns or instructors to pick whom they interview, as experience with this process has taught us that the “best fit” is often not decided on work area alone. The interviews are also designed to be mutual, in the sense that interns interview field instructors as much as field instructors interview interns.
Once the rotation is complete, the interns and field instructors enter separate rooms and rank their preferences in written format. We allow discussion among both groups as it naturally occurs. Once all preferences have been submitted, the interns are dismissed, with the knowledge that internship offers will be presented to them as soon as possible, no later than a week from the interview date. The program coordinators then meet with the prospective field instructors and preferences are reviewed. In matching interns to field instructors, the highest priority is given to matches where both the field instructor and the intern have ranked each other first. The goal is to make as strong a match as possible, increasing the chances of a successful placement.
Orientation
Once internship placements are determined, offered and accepted, incoming interns are provided with a date for a mandatory orientation. This orientation utilizes a multidisciplinary team, including social workers, nurses, administrators, and existing interns; the goal is to provide incoming interns with all they need to begin to function within the agency. Interns are expected to comply with our department’s standards and are informed of these. As ours is a hospital setting, they are also formally educated regarding HIPAA standards and Universal Precautions. Administrative details are managed as interns receive parking assignments, intern badges, a tour of campus and orientation to our main social work office procedures.
Additionally, we have developed an internship manual which interns receive during orientation. This manual is designed to provide interns with knowledge of basic universal procedures and expectations within the department. It contains a complete staff list, common procedures, primary resource information and descriptions of each work area within the department. Interns are encouraged to refer to this manual throughout their internship, and are expected to be familiar with all policies therein.
The final aspect of orientation is evaluation. Interns are asked to complete an evaluation of their orientation experience; their feedback allows for continual improvement of the orientation process. Finally, field instructors begin orienting interns to their primary work areas.
The Primary Internship Assignment
For the first two months of the internship, an intern’s time is spent exclusively with their primary field instructor as they become acclimated to their practice area. They become familiar with operating procedures and social work practice skills, while beginning to function within the multidisciplinary team. Over the course of the internship period, interns become increasingly independent in their function.
Interns are consistently supervised using brief and extended meetings, both formal and informal in nature. Informal supervision is a constant process, lasting only a few minutes but occurring multiple times a day. Formal supervision varies, but is typically thirty to sixty minutes in length and occurs weekly. In addition, each semester, interns, field instructors and university- based field liaisons meet to review the intern’s progress toward predefined educational goals. The purpose of these supervision efforts is to maximize the learning experience, expand the knowledge base and integrate classroom and field education. Periodically, issues arise during an internship that are not able to be resolved. In these cases, after several contacts and interventions, a final meeting is held with the intern, the field instructor and the field liaison at which the issues and failed interventions are discussed, and the intern is dismissed from placement. This can occur at any point during the internship.
The Secondary Field Experience
We are fortunate to function in a setting where over twenty distinct medical areas and specialties integrate social work into their practice. We are committed to offering our interns the benefit of this experiential depth. Interns are encouraged to spend several days shadowing other social workers in areas distinctly different from their own. We ask that interns “sample” social work in the areas of emergency medicine, inpatient care, outpatient primary care, outpatient specialty care, school-based medicine and an area where home visits are common practice. During this experience, if interns find themselves drawn to a particular setting, they are encouraged to intensify their sample by returning for a full week.
Once interns shadow an Emergency Department Social Worker, they are then invited to report to the Emergency Department when trauma codes occur. Further, we encourage interns to accompany staff members when they are subpoenaed to appear in court. These experiences demystify both situations for our interns, allowing them to observe the integration of practice and theory in a fast-paced, high-pressure environment.
The Intern Meetings
Social Work Intern Meetings (SWIM) are integrated throughout the program. These monthly meetings allow for group education and peer support, and also familiarize interns with other areas of the hospital via case presentations. Organized and facilitated by a program coordinator, the meetings are ninety minutes in duration and are generally divided into three distinct sections.
The initial meeting is held the first month of placement, has its own structure, and is facilitated by our experienced interns who are concluding their field placements. The meeting is conducted without staff presence and allows a peer presentation of “survival skills” to aide new interns in their transition to the hospital setting. It also provides new interns with a non- threatening environment in which they can discuss any fears, questions, or concerns and how to constructively address them. This has proven to be a valuable experience for both the new and seasoned interns.
At all subsequent meetings, we utilize the three-part format outlined above. The meetings begin with an educational presentation by various social work staff members regarding their areas of expertise; the first few meetings surround topics most pertinent to all areas of social work in our setting. Later topics move into areas of particular interest to the group. Topics typically included are child abuse and neglect; public insurance; mental health referrals and access; Michigan minor consent laws; early-on services; immigration issues; HIV /AIDS confidentiality; failure to thrive; lead poisoning; domestic violence; adolescent therapy techniques; and professional social work licensure.
After the educational portion of the meeting, an intern presents a case of particular complexity which may or may not be related to the educational topic. Once presented, interns are encouraged to discuss the case from several perspectives, including clinical management of the issues, practitioner coping strategies and working through intervention barriers. These presentations have multiple benefits, including education, peer support and exposure to social work practice in various areas of the hospital.
The final portion of the meeting allows for a program coordinator to handle intern program details, discuss intern concerns and interests and offer support regarding overall placement issues as needed. By ending in this manner, the interns are able to gain some closure on the multiple facets of the meeting.
Mock Interviews and Program Evaluation
Near the end of the internship, a program coordinator makes arrangements with staff members to hold mock interviews. Interns are matched to one or two staff members who will conduct a professional social work interview. Once completed, interns are given constructive feedback on their interview skills and resume.
The final component of the internship program is evaluation. In the last month of internship, interns are provided with a link to a web-based exit questionnaire. We strongly encourage honest feedback and the web-based format allows for complete anonymity. This step is critical for continuous process improvement. We take all feedback seriously, maintaining the program aspects which work well and improving those which need alteration. To date, we have had full participation in this process and overwhelmingly positive feedback on the internship experience.
Conclusion
The Children’s Hospital of Michigan Social Work Internship Program has evolved over the past six years in a department committed to the education and excellence of future social workers. The program is managed by two staff members who serve as volunteer program coordinators, in addition to their primary responsibilities. While there is no financial support for this program, it thrives on the extraordinary human resources of the social workers on staff, our department manager, the university MSW programs from which we accept interns and the interns themselves. With the structure described above, the program breathes life into the collective educational experience, contributing to the excellence of our profession.