Practice Fridays: Developing Holistic Competence through Simulation

Background and Purpose: In 2015 EPAS further conceptualized the competency-based model for social work education (CSWE, 2015). Previously, social work practice competencies were largely taught and assessed in field education and this has posed challenges because students are often inadequately prepared for practicum and they have difficulty linking theory to practice.  Social work educators need effective educational approaches that integrate knowledge, values, skills, as well as cognitive and affective processes.

The present study examined the impact of an innovative simulation-based learning enhancement called “Practice Fridays” that aimed to teach the various dimensions of holistic competence for students pre-practicum. The focus was on micro clinical skills such as forming a collaborative helping relationship and conducting an assessment, as well as awareness of critical thinking, affective reactions, and exercise of judgment.  Simulation-based learning draws from adult learning principles (Knowles, 1968) and experiential learning theories (Kolb, 1984) and creates learning experiences in all dimensions of the holistic competence framework. This qualitative study focused on students’ perceptions of their learning at Practice Fridays.  More specifically we examined student perceptions of what they were learning, as well as their perceptions of how they were learning through simulation.

Methods: Fifty-seven foundation year MSW students provided informed consent to participate in one of nine Practice Fridays approved by the Research and Ethics Board (REB). This was a voluntary learning enhancement and students were recruited via a flyer sent to all foundation year MSW students.  Each Practice Friday consisted of six to 10 students, one faculty member, one field instructor, and one actor (standardized client).  Students participated in simulated interviews with the standardized client and received specific feedback on competencies demonstrated during the interview.  At the end each student completed written reflection questionnaires on their learning experiences.  Their reflection questionnaires were analyzed using thematic analysis (Boyatzis, 1998, Braun & Clarke, 2006). Observer and interviewer questionnaires were triangulated.  Generated themes were named and included rich descriptive accounts and quotes for credibility and confirmability. Trustworthiness was further established through the use of an audit trail, including memos and documenting the research process and decisions.

Findings: The results showed that students participating in Practice Fridays described improved skills and knowledge, as well as an increase in self-awareness and affect regulation.  They also reported learning to think critically about decision making when conducting a client interview.  This learning was facilitated by the actual simulated practice, in combination with focused feedback from faculty, peers and the field instructor, as well as the opportunity to reflect on practice.  Student responses indicated that they were developing holistic competence that included skills and knowledge, as well as awareness of their cognitive and affective processes.

Conclusion and Implications: Findings highlight the importance of deliberate practice in the development of holistic competence.  Deliberate practice consists of repetitive observed practice with clear focused feedback, and an opportunity to reflect on practice.  The results show that holistic competence can also be developed in the classroom to better prepare students for practice.