Social Worker Integrated Care Competencies Scale (SWICCS): Assessing Student Skills Development for Integrated and Culturally Relevant Care

Background: Integrating physical and behavioral health services has the potential to reduce health disparities and service inequities among persons most at risk; however, integrated care requires behavioral health clinicians possess the relevant knowledge and skills to provide quality care to diverse populations. The Social Worker Integrated Care Competency Scale (SWICCS), collaboratively developed with community health center providers, measures social work students' self-perceptions of knowledge and skills development associated with providing behavioral health services in health care settings. The scale complements the Integrated and Culturally Relevant Care (ICRC) field education curriculum model (Authors, 2015). This study examined the degree to which student perceptions of knowledge and skills development changed throughout their participation in the ICRC field education program.

Methods: We employed a longitudinal study designed to assess change in student knowledge and skills throughout their advanced field practicum. Three MSW student cohorts (n=38) placed in a Federally Qualified Health Center, completed the SWICCS three times: at placement program orientation, at end of the first semester, and at end of the second semester of placement at the health center. The SWICCS is comprised of 37 items (α = .91) scored 1 to 5.  Students’ field supervisors also completed the SWICCS-S (Supervisor) (α = .938) on their students at the conclusion of the second semester. Utilizing Friedman tests (Field, 2013) and Wilcoxon signed-ranked tests (Pallant, 2007), as is appropriate for non-normally distributed data, we examined the differences between each administration of the SWICCS and the difference between student ratings and supervisor ratings.

Results: The difference in student knowledge and skills across each SWICCS administration was statistically significant with a large effect size (r = -0.87). Student SWICCS self-ratings were significantly higher than the corresponding supervisors’ evaluative rankings (p = .046); the difference in student and supervisor rankings is observed with a medium effect size (r = -0.32). Sixty-six percent of the time, students’ self-ratings were higher than the supervisors’ ratings.

Conclusions and Implications: Although the study’s sample size is small, findings suggest student knowledge and skills development improved during their participation in the ICRC field education model.  Hence, the ICRC is a viable model for developing the skills of social work trainees to provide culturally relevant behavioral health care in an integrated care setting. The SWICCS fills a critical gap relative to integrated behavioral health care competencies.  Although competencies have been developed in this area, the SWICCS is the first tool of its kind to assess clinical competence from a social work trainee and supervisor perspective.