Social Work Curriculum Development for Service Delivery and Collaborative Multidisciplinary Practice

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Social Work Curriculum Development for Service
Delivery and Collaborative Multidisciplinary
Practice

• Elaine T. Jurkowski, MSW, PhD
• School of Social Work
• Charla J. Lautar, RDH, PhD
• Department of Health Care Professions
• Tsukasa Okino, MSW
• Rehabilitation Institute
• Southern Illinois University Carbondale
• Carbondale, Illinois

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Collaboration and Partnerships

• Multidisciplinary collaboration is suggested in a
  variety of sources including Healthy People 2010
  and the Surgeon Generals Report.
• Healthy People 2010 objectives related to
  collaboration
• The Surgeons General 2004 Call to Action
• Adresses health disparities through
  collaboration.
• Views the mouth as a mirror to body

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Purpose

• - To determine if professional academic
  preparation makes a difference in perceptions and
  confidence for service delivery and collaborative
  interdisciplinary practice.
• - To investigate the differences in perceptions
  regarding various health issues and
  multidisciplinary practice among groups of social
  work and dental hygiene students in order to
  develop multidisciplinary collaboration.

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METHODS

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Sampling Frame, Subjects

• Convenience sample solicited from students within
  the Social Work and Dental Hygiene programs at
  Southern Illinois University Carbondale
• Students solicited for feedback during the first
  two weeks of classes in January, 2004
• Dental Hygiene n78
• Social Work n120
• Other n19

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Survey Instrument

• Demographics
• Age
• Gender
• Ethnicity
• GPA
• Major
• Student status (Class)

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Instrument (cont.)

• True/False - Yes/No Items and Open Ended
  Questions
• Assessment, referrals and health relationships
• Likert Scale Items
• Questions which related to comfort level of
  participants
• Seven items ranked from 1 5 (not at all-very
  much)
• Definitions
• Students wrote definitions for health care
  providers, dental team members and professionals
  in the social work arena

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Findings

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Demographics of Sample

• Gender
• Males 7.9
• Females 92.1
• Major
• Social Work 55.3
• Dental Hygiene 35.9
• Other 8.7
• Age
• - Mean age 24.5, Range 19-56 years

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Demographics (cont.)

• Ethnicity
• Caucasian 78.6
• African American 14.9
• Other 6.4
• Status
• Sophomore 15.7
• Juniors 21.8
• Seniors 48.1
• 1st year MSW 8.8
• Graduating MSW 5.6

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Demographics (cont.)

• Breakdown by program
• GPA
• 4.0 9.7
• 3.75-3.99 17.1
• 3.5-3.74 22.1
• 3.0-3.49 27.6
• 2.75-2.99 12.9
• 2.5-2.74 6.5
• Less than 2.5 4.1

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Similarities Between Groups(Undergraduate
Students)

• Q14 If I were to receive a referral for a
  person who needed health care, I would be
  comfortable in referring him/her to a local
  provider for care.
• Mean DH 3.71
• Mean SW3.68
• Q16 If I had a client who was wheelchair bound,
  I would be comfortable in referring him/her to a
  local provider for care.
• Mean DH 3.46
• Mean SW3.67
• Q17 If I had a client who was an older adult, I
  would be comfortable in referring him/her to a
  local provider for care.
• Mean DH3.49
• Mean SW3.83

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Differences Between GroupsSocial Work Dental
Hygiene

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Differences Between GroupsSocial Work Dental
Hygiene

• Several items were seen to be perceived
  differently when comparing social work with
  dental hygiene students.
• Items related to perception of general oral
  health care issues, referrals, assessment and
  comfort levels.

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Differences Between Groups Social Work Dental
Hygiene

• Q3 If you do not have health insurance, there
  are absolutely no resources for health or dental
  care in S. IL aside from the emergency room at
  the local hospital. (false0, true1)
• Mean SW.16
• Mean DH.03
• T2.98, df189, p.003
• Q4 There is a relationship between chronic
  disease and oral health. (false0, true1)
• Mean SW.86
• Mean DH1.0
• T-4.43, df119, p.00

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Differences Between Groups Social Work Dental
Hygiene

• Q9a When you conduct a patient history (i.e.,
  social history) do you ask questions about
  general health history? (1yes, 0no)
• Mean SW.95
• Mean DH1.0
• T-2.5, df116, p.014
• Q9b When you conduct a patient history (i.e.,
  social history) do you ask questions about oral
  health history? (1yes, 0no)
• Mean SW.48
• Mean DH.99
• T-10.59, df137, p.00

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Differences Between Groups Social Work Dental
Hygiene

• Q19 Routine dental exams for the screening and
  detection of oral cancer is important for those
  with and without teeth (Likert 1-5).
• Mean SW4.55
• Mean DH4.94
• T-4.79, df173, p.00
• Q20 Routine self-exams are important in the
  screening and detection of cancers (Likert 1-5).
  
• Mean SW4.65
• Mean DH4.94
• T3.93, df171, p.00

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Perceptions of Comfort Level

• Q15 If I had a client who required oral health
  care, I would be comfortable in referring him/her
  to a local provider for care. (Likert 1-5)
• Mean SW3.53
• Mean DH4.13
• T-3.69, df183, p.000

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Perceptions of Comfort Level (cont.)

• There were no differences in the following areas
• Referring to local providers for health care
• Referring wheelchair bound individuals (Mean3.6)
• Referring older adults (Mean3.4)
• Referring homebound individuals (Mean3.1)

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Open Ended Questions for Assessment

• What is the purpose of a client/patient
  assessment when dealing with a homebound/community
  based individual? (Q10)
• What would be an example of a question you would
  ask related to overall health in the assessment
  process? (Q11)
• What would be an example of a question you would
  ask related to oral health in the assessment
  process? (Q12)

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Q10 What is the purpose of a client/patient
assessment when dealing with a homebound/
community base individual?

• Social workers are more inclined to look at
  needs, background information, and resources.
  
• Dental hygienists are more specific to health and
  mental health.

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Q11 What would be an example of a question you
would ask related to overall health in the
assessment process?

• Social work students were more likely to be
  interested in feelings, health history and
  eating.
• Similarities in questions between the two groups
  existed between last doctors appointment,
  previous hospitalization and medications.

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Q12 What would be an example of a question you
would ask related to dental health in the
assessment process?

• Dental hygienists will ask questions related to
  pain and self-care.
• Social workers are more inclined to ask about
  last dental appointment and self- care.

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Definitions

• Case Managers
• Social Workers
• Dental Hygienist
• Physician
• Primary Care Provider
• Dentist

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Social Worker

• Dental hygiene students consistently do not have
  any idea about what social workers actually do.
• Dental hygiene students perceive a social
  workers role as solving client problems, while
  social work students perceive a social workers
  role as counselors, case managers, advocates,
  providing information and assistance for
  assessment.

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Case Managers

• Dental hygiene students have a limited idea of
  what case managers do, however, health care
  management was identified in the majority of
  cases where a definition was provided.
• Social work students view the role of the case
  manager as involved in assessment, health care
  management, and service co-ordination.

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Dental Hygienist

• The social work students view the dental
  hygienists as cleaning teeth and dental
  assistants.
• Dental hygiene students view their role as
  educators, health care providers or involved in
  the prevention of disease in addition to
  cleaning teeth.

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Physician

• Social workers see physicians as a medical
  doctor, while hygienists perceive them as
  providing general health care.

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Primary Care Provider

• These are seen equally as health insurance or
  health care providers by both groups.

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Dentists

• Oral health care provider is perceived more so by
  dental hygienists.
• Oral hygiene is perceived almost equally by
  social workers and dental hygienists, as is
  diagnosis and treatment.
• Social workers are more inclined to perceive as
  providing treatment, and as a doctor.

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Roles and Responsibilities

• Themes from definitions of
• case manager
• social worker
• dental hygienist

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Conclusion

• Findings from this study suggest that there are
  some similarities and differences in perceptions
  and confidence for service delivery for oral
  health issues.
• If you are a hygienist vs a social worker, there
  are differences in how cases are assessed.

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Conclusions (cont.)

• Need for both disciplines to understand each
  others roles and relevance as well as
  contribution for ones overall health.
• Need to address the roles of various health
  professionals.

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Implications for Collaboration

• Need to discuss roles within different
  professions (i.e., oral health) throughout the
  practice curriculum.
• Need to expose faculty and students to the range
  of roles that other disciplines such as the roles
  that dental hygienists assume.
• Need to expose students to dealing with
  wheelchair bound and aging clients.

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Further Comments

• Dont perceive self as doing things you will not
  be able to do them.
• If other health professionals are unaware of your
  multiple roles, they will not include you in the
  multidisciplinary process.

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Contact Information

• Dr. Elaine Jurkowski
• etjurkow_at_siu.edu
• [phone] 453-2243
• Associate Professor
• School of Social Work, SIUC
• M/C 4329, Carbondale, Illinois 62901