Toward Interprofessional Health Service Delivery: Results from a HRSA Behavioral Health Workforce and Education Training Program

Background & Purpose:

This study aimed to assess if a HRSA Behavioral Health Workforce Training program for social work and psychology graduate students led to overall improvement in competency and attitudes in interprofessional behavioral health service delivery. The study aimed to examine students’ changes in four areas: Understanding, strength and importance placed on different interprofessional concepts (A1); attitude and skills towards communication and teamwork (A2); self-efficacy in providing behavioral health treatment in a healthcare setting (A3); and knowledge and skills of multicultural best practices and the awareness of Eurocentric bias in therapeutic relationships (A4).

Methods:

This is a secondary data analysis of a grant funded program at a large, urban public university’s graduate social work program. Each year four Counseling Psychology Doctoral students and 18 Social Work Master students were accepted to the program. Students complete their field education at sites that use interprofessional teams to provide behavioral health services. Students must attend workshops and case conferences that focus on building clinical skills and core competencies in interprofessionalism and in turn, they receive stipends. They completed the surveys at the beginning and end of the year. We assessed data from completed pre and post-tests from all four cohorts (n=68). The following scales were examined:

A1 Interprofessional Self-Assessment Survey (IPSAS)

A2 Entry Level Inter-Professional Questionnaire (ELIQ)

A3 Behavioral Health Self-Efficacy scales (BHSE-1 & BHSE-2)

A4 Multicultural Counseling Knowledge and Awareness Scale (MCKAS)

Data were cleaned and final scores calculated for each subscale. Paired t-tests were run for each subscale.

Results:

Increases in knowledge and skills in interprofessionalism were found: Interprofessional Competency Strength (IPSAS Understanding: (t₍₅₈₎=-10.52, p<.001, mean increase (Δx)=6.85), Strength: (t₍₅₅₎=-11.18; p<.001, Δx=7.96) and Importance (t₍₅₅₎=-4.49, p<.001, Δx=2.27). Growth was also seen in Interprofessional Communication/Teamwork (ELIQ_1 t₍₅₄₎=-3.71, p<.001, Δx=2.16) and willingness to learn from other disciplines (ELIQ_2 (t₍₅₄₎=-3.71, p<.001, Δx=3.67)). Students also reported increases in their self-efficacy to deliver behavioral health services (BHSE-1 (t₍₄₅₎=-10.46, p<.001, Δx=18.76), and BHSE-2 (t₍₆₀₎=-7.65, p<.001, Δx=11.26), and their use of Multicultural Knowledge (t₍₅₆₎=-5.65, p<.001, Δx=4.68) and Awareness (t₍₅₆₎=-5.65, p<.001, Δx=5.50).

The only score that went down from pre to post test was the negative change ELIQ Interaction (t₍₆₃₎=3.34, p<.001, Δx=-1.72)

Implications:

These results demonstrate program success through interprofessional competence, self-efficacy and use of multi-cultural skills among social work and psychology graduate students who completed the Anonymous education and workforce training program. Although students reported increased knowledge and competency working interprofessionally, their scores from pre to post test on the ELIQ indicate that application of interprofessional work may not be as positive for the students. Th ELIQ tool focuses on the interaction between different professions on a health care teams—this includes statements such as “All members of a health and social care professions have equal respect for each discipline”. Similar programs should consider how to foster positive interprofessional field education training sites to better prepare students for team dynamics in the workplace.