Challenges in Implementing an Additional Practicum Experience in Primary Care Settings for Advanced MSW Students

Background and Purpose:  Interprofessional education is gaining momentum within social work programs with varying approaches being undertaken as interprofessional concepts and practices are incorporated into classroom and practicum settings.  Introducing interprofessional practicums can be challenging making it important to explore challenges. 

This study sought to answer the research question: “What are student perceived challenges in engaging in an additional primary care practicum experience?” in order to the knowledge base regarding challenges of implementing interprofessional education opportunities for MSW students.  Having a better understanding of these challenges, recommendations will be provided so improvements can be made. 

Methods: Participants consisted of advanced placement MSW students accepted into ab fellowship program designed to train students to work with transitional age youth.  Two semi-structured, hour long focus groups were conducted – one for each cohort resulting in 13 participants (8 from cohort 1, 5 from cohort 2).  Participants varied in age but all participants were female and all were Caucasian except one who was African American.  While not very diverse, they were representative of the program. 

Interview questions asked participants to share their experiences within primary care settings and perceived challenges.  Data were coded using the coding methods of grounded theory.  After data were initially coded line-by-line, focus coding aided in organizing codes into larger themes.  Axial coding facilitated in creating subcategories defining the characteristics of emerging themes.  Finally, theoretical coding aided in determining potential relationships among categories. 

Results:  Though students appreciated the opportunity to engage in primary care settings, a major theme was “wanting more” form the primary care experience indicating strong challenges.  One such challenge, “lack of work,” resulting from lack of tasks and client contact. 

Another major theme, “placement issues” included issues with the social worker, the site, and the schedule.  Some days and times were simply not busy and students had the same schedule throughout placement.  Other students perceived their workers’ burnout due to heavy student loads which were required at each site.  As a result, students felt guilty about asking questions and their presence in general.  Students also felt that they were not being fully invested in because of their limited time onsite. 

The final challenge was “lack of clear expectations” which refers to outcomes and goals of the experience.  Students also reported that their sites expressed this as well.  In some cases, this provided flexibility for students to create their own experiences but in the majority of the cases it hindered the overall experience. 

Conclusion and Implications:  Based on findings, there are two recommendations regarding implementing a primary care element into advanced practicums.  1) Great efforts need to be made to ensure that all those involved, including students and placement sites, have a clear understanding of learning objectives and general expectations.  2) There must be ample time to recruit a diverse and sufficient amount of placement sites staffed with enough dedicated social workers to provide beneficial learning experiences for students.