Factors Influencing Repeat Attempts on the Clinical Social Work Exam: The Roles of Race, Supervision, and Employment Settings

Background and Purpose. The 2022 release of testing demographics from the Association of Social Work Boards has illuminated racial disparities in exam pass rates. White test takers pass the clinical exam nearly two times the rate of Black-identifying test takers. Racial disparities in standardized testing are not new, as structural factors pervasively influence outcomes. However, specific factors that contribute to the preparation of a clinical social worker have not been investigated in relationship to exam pass rates. Thus, this study examines how the clinical supervision relationship impacts pass rates and investigates the relationship between employment setting and clinical exam pass rates.

Methods. Purposive sampling methods were utilized to acquire a diverse sample of Clinical Social Workers (CSWs) licensed in the state of Georgia. Potential participants were recruited via email listservs from state universities and professional social work organizations in Georgia. A sample of 57 Georgia-licensed CSWs engaged in a survey asking about their supervision and employment experience leading up to the clinical exam. A hierarchical logistic regression was performed to analyze the degree to which demographics, supervision experiences, and employment factors influence the odds of passing the exam on the first attempt. Model 1 included only demographic factors and Model 2 included supervision experiences and employment factors. All analyses were utilized within R.

Results. A total of 57 participants completed the questionnaire; most identified as female (84%). The mean age of participants was 41.46 (SD=10.5). Regarding race, most participants identified as being Black (47%), followed by White (44%), and 9% identified as another race. On average, participants took the clinical exam 1.63 times with a range of 1-9 and a SD of 1.57. Model 1 produced a Nagelkere R squared of .30. Within Model 1, Black-identifying patients had significantly greater odds (OR: 1.65, 95% CI:1.12-3.45 , p < .05) of taking the test multiple times. Model 2 produced a Nagelkerke R squared of .60. In Model 2, Black-identifying participants had even greater odds of taking the test multiple times (OR: 4.06, 95% CI: 1.03-8.79). In addition, participants with infrequent supervision had increased odds of taking the exam multiple times (OR: 2.34, 95% CI: 1.10-4.86, p< .05).

Conclusions and Implications. The current findings confirm racial disparities in ASWB exam pass rates at the national level. Unique to this study, the most significant factors associated with passing the ASWB clinical exam were supervision frequency and employment factors. This finding suggests that social workers benefit from frequent supervision while engaging in distinct work activities at their place of employment. Interestingly, having more diagnostic and therapy exposure in the employment setting did not significantly impact exam status, even though over half of the exam questions are based on assessment, diagnosis, and treatment. Within both models, Black identifying participants were more likely to have to take the exam more than once. The implications of this finding suggest there is a barrier to Black test takers receiving frequent supervision. Future research should include a national sample of participants licensed in states with similar licensing requirements.