MSW Students As Interprofessional Team-Members: Knowledge, Attitudes, Barriers and Facilitating Factors

Background/Rationale:

Access to affordable and effective health and mental health care for youth is a growing public health concern. Unmet behavioral health needs have long-term effects on life course outcomes and public expenditures for housing, education, employment, disability, income support, and other social welfare services. To improve population health outcomes, changes in the health care delivery system are moving towards an integrated services framework that treats physical and behavioral health problems holistically through a team-based approach. Social work education has responded to these changes with adaptive curricula and interprofessional (IP) training. This school was funded in 2014 by the Health Resources Service Administration (HRSA) to develop a program for advanced MSW students to work on IP teams in integrated care settings serving transitional-age youth. This study focused on the team skills component of the students’ training. Aims were to determine:  (1) If knowledge and attitudes changed during the year of this specialized program and (2) what barriers students encountered as members of IP teams.

Methods:

We recruited 24 HRSA-funded students and a comparison group of 13 MSW students in similar health care field placements. The HRSA-funded students attended monthly seminars, two workshops, and at least one IP training per semester. Both groups completed a pretest and posttest of two self-report team skills measures: the Interprofessional Socialization and Valuing Scale (ISVS) which assesses beliefs, behaviors, and attitudes about interprofessional socialization and collaborative practice, and the Team Skills Scale (TSS) which measures perceived team collaboration skills. Additional qualitative data was collected on 5 open-ended questions at the end of the year about their experiences on IP teams. Items queried student on: (1) barriers to effective IP practice; (2) individual barriers as team members; (3) factors that might facilitate increased team cohesion; (4) challenges in clarifying role of social work and (5) barriers for patients being part of the team.

Results:

Student survey results showed that the two groups rated their team skills equal at pretest. After the HRSA-funded students received the IP team training, however, they reported significantly more improvement on the TSS scale than the comparison students. The ISVS showed no significant difference. (The analysis sample was 23 treatment and 9 comparison, due to non-response and attrition).

The qualitative questions revealed thematic barriers to IP care: (1) organizational – frequent intern/resident rotations, lack of time and space for meetings, and lack of overall training; and (2) Being an intern with low status amongst professionals whose roles were more clearly defined, lack of familiarity with system practices, and lack of medical terminology. Factors that would facilitate team cohesion included more designated time for team meetings and institutional support for comprehensive training among IP team members.

Conclusions and Implications:

We developed a program of social work education for IP training that resulted in measurable improvements in perceived team skills compared to similar students selecting health care field placements and reporting equal levels of skills at baseline. Understanding barriers that they encountered can help to inform training for future cohorts.