Showing, Not Telling: Using Simulation Research to Bridge the Gap between the Workforce and Policy Makers

Policy makers who support the implementation of evidence-based or informed interventions are faced with the task of implementing such interventions in contexts which differ substantially from those in which the interventions were developed. The research literature suggests that contextual match between an intervention and the context can only be recognized and defined by those providing or receiving the intervention. Yet, frontline social workers tasked with providing the intervention are often not a structured part of the decision-making process when such interventions are selected or adapted for implementation.

Simulation-based research methodologies (SBRM) can offer a structured opportunity for clinicians and policy makers to engage in a structured process of anticipating, observing, and adjusting for the impacts (intended and unintended) of an intervention in a specific context prior to full implementation. Doing so allows for adjustment of the intervention as well as selection of appropriate strategies to address barriers and facilitators of implementation.

Utilizing a research study examining the implementation of the Child and Adolescent Needs and Strengths (CANS) assessment in a Medicaid system as a case example, this workshop will propose a specific stepwise approach for SBRM to anticipate, observe, and adjust for the impact of implementing an evidence-informed intervention in an already operating behavioral health system. The proposed methodology includes scanning existing research and data on the intervention, a structured environmental scan, methods to engage stakeholders in the process of developing test cases, the development and dissemination of live simulations that are recorded for deployment to the workforce, developing a mixed methods approach to gathering data on the simulations, and an overview of approaches for analyzing and presenting the results to policy makers. The discussion will include the presentation of results from the Medicaid case study and an overview of the resulting changes to the intervention itself and the regulations governing the process of its use.

Three panelists will provide their unique perspective on the case study, including a member of the clinical workforce, an improvisational actor who participated as a simulated client, as well as the academic team that designed the study and summarized the results for policy partners. Panelists will each offer their impressions for the benefit of the learners, exploring the practical considerations of such work, including the costs and time, and suggestions for managing the challenges of bridging the gap between policy makers and the behavioral health workforce.

The workshop will conclude by offering participants an opportunity to design a similar study specific to a case example posed by our team and/or one of their own, following the steps outlined in the workshop. A facilitated discussion will highlight both the possibilities and limitations of this approach for aligning social work practice with policy and research.