Transcript Social Work Curriculum Development for Service Delivery

Social Work Curriculum Development for
Service Delivery and Collaborative
Multidisciplinary Practice
Elaine T. Jurkowski, MSW, PhD
School of Social Work
Charla J. Lautar, RDH, PhD
Department of Health Care Professions
Tsukasa Okino, MSW
Rehabilitation Institute
Southern Illinois University Carbondale
Carbondale, Illinois
Collaboration and Partnerships



Multidisciplinary collaboration is suggested in a
variety of sources including Healthy People
2010 and the Surgeon General’s Report.
Healthy People 2010 objectives related to
collaboration
The Surgeon’s General 2004 “Call to Action”
 Adresses health disparities through
collaboration.
 Views the mouth as a mirror to body
Purpose
- To determine if professional academic
preparation makes a difference in perceptions
and confidence for service delivery and
collaborative interdisciplinary practice.
- To investigate the differences in perceptions
regarding various health issues and
multidisciplinary practice among groups of
social work and dental hygiene students in
order to develop multidisciplinary
collaboration.
METHODS
Sampling Frame, Subjects
-
-
-
Convenience sample solicited from students
within the Social Work and Dental Hygiene
programs at Southern Illinois University
Carbondale
Students solicited for feedback during the
first two weeks of classes in January, 2004
Dental Hygiene: n=78
Social Work: n=120
Other: n=19
Survey Instrument

Demographics






Age
Gender
Ethnicity
GPA
Major
Student status (Class)
Instrument (cont.)

True/False - Yes/No Items and Open Ended Questions


Likert Scale Items



Assessment, referrals and health relationships
Questions which related to comfort level of participants
Seven items ranked from 1– 5 (not at all-very much)
Definitions

Students wrote definitions for health care providers, dental
team members and professionals in the social work arena
Findings
Demographics of Sample

Gender:



7.9%
92.1%
Major:




Males:
Females:
Social Work
Dental Hygiene
Other
55.3%
35.9%
8.7%
Age
- Mean age 24.5, Range 19-56 years
Demographics (cont.)

Ethnicity




Caucasian
African American
Other
78.6%
14.9%
6.4%
Sophomore
Juniors
Seniors
1st year MSW
Graduating MSW
15.7%
21.8%
48.1%
8.8%
5.6%
Status





Demographics (cont.)


Breakdown by program
GPA







4.0
3.75-3.99
3.5-3.74
3.0-3.49
2.75-2.99
2.5-2.74
Less than 2.5
9.7%
17.1%
22.1%
27.6%
12.9%
6.5%
4.1%
Similarities Between Groups
(Undergraduate Students)
Q14: If I were to receive a referral for a person who needed
health care, I would be comfortable in referring him/her to
a local provider for care.
Mean DH= 3.71
Mean SW=3.68
Q16: If I had a client who was wheelchair bound, I would be
comfortable in referring him/her to a local provider for care.
Mean DH= 3.46
Mean SW=3.67
Q17: If I had a client who was an older adult, I would be comfortable
in referring him/her to a local provider for care.
Mean DH=3.49
Mean SW=3.83
Differences Between Groups
Social Work & Dental Hygiene
Differences Between Groups
Social Work & Dental Hygiene


Several items were seen to be
perceived differently when comparing
social work with dental hygiene
students.
Items related to perception of general &
oral health care issues, referrals,
assessment and comfort levels.
Differences Between Groups
Social Work & Dental Hygiene


Q3: If you do not have health insurance, there are absolutely no
resources for health or dental care in S. IL aside from the
emergency room at the local hospital. (false=0, true=1)
Mean SW=.16



Mean DH=.03
T=2.98, df=189, p=.003
Q4: There is a relationship between chronic disease and oral
health. (false=0, true=1)
 Mean SW=.86
 Mean DH=1.0
 T=-4.43, df=119, p=.00
Differences Between Groups
Social Work & Dental Hygiene


Q9a: When you conduct a patient history (i.e., social history) do
you ask questions about general health history? (1=yes, 0=no)
 Mean SW=.95
 Mean DH=1.0
 T=-2.5, df=116, p=.014
Q9b: When you conduct a patient history (i.e., social history) do
you ask questions about oral health history? (1=yes, 0=no)
 Mean SW=.48
 Mean DH=.99
 T=-10.59, df=137, p=.00
Differences Between Groups
Social Work & Dental Hygiene

Q19: Routine dental exams for the screening and
detection of oral cancer is important for those with
and without teeth (Likert 1-5).




Mean SW=4.55
Mean DH=4.94
T=-4.79, df=173, p=.00
Q20: Routine self-exams are important in the
screening and detection of cancers (Likert 1-5).



Mean SW=4.65
Mean DH=4.94
T=3.93, df=171, p=.00
Perceptions of Comfort Level

Q15: If I had a client who required oral
health care, I would be comfortable in
referring him/her to a local provider for
care. (Likert 1-5)
 Mean SW=3.53
 Mean DH=4.13
 T=-3.69, df=183, p=.000
Perceptions of Comfort Level
(cont.)

There were no differences in the
following areas:




Referring to local providers for health care
Referring wheelchair bound individuals
(Mean=3.6)
Referring older adults (Mean=3.4)
Referring homebound individuals
(Mean=3.1)
Open Ended Questions for
Assessment



What is the purpose of a client/patient
assessment when dealing with a
homebound/community based individual?
(Q10)
What would be an example of a question you
would ask related to overall health in the
assessment process? (Q11)
What would be an example of a question you
would ask related to oral health in the
assessment process? (Q12)
Q10: What is the purpose of a client/patient
assessment when dealing with a homebound/
community base individual?


Social workers are more inclined to look
at needs, background information, and
resources.
Dental hygienists are more specific to
health and mental health.
Q11: What would be an example of a
question you would ask related to overall
health in the assessment process?


Social work students were more likely to
be interested in feelings, health history
and eating.
Similarities in questions between the two
groups existed between last doctor’s
appointment, previous hospitalization and
medications.
Q12: What would be an example of a
question you would ask related to dental
health in the assessment process?


Dental hygienists will ask questions
related to pain and self-care.
Social workers are more inclined to ask
about last dental appointment and selfcare.
Definitions






Case Managers
Social Workers
Dental Hygienist
Physician
Primary Care Provider
Dentist
Social Worker


Dental hygiene students consistently do not
have any idea about what social workers
actually do.
Dental hygiene students perceive a social
worker’s role as “solving client problems”,
while social work students perceive a social
worker’s role as “counselors, case managers,
advocates, providing information and
assistance for assessment”.
Case Managers


Dental hygiene students have a limited idea
of what case managers do, however, health
care management was identified in the
majority of cases where a definition was
provided.
Social work students view the role of the case
manager as involved in assessment, health
care management, and service co-ordination.
Dental Hygienist


The social work students view the
dental hygienists as “cleaning teeth”
and dental assistants.
Dental hygiene students view their role
as “educators”, health care providers or
involved in the prevention of disease in
addition to “cleaning teeth”.
Physician

Social workers see physicians as a
medical doctor, while hygienists
perceive them as providing general
health care.
Primary Care Provider

These are seen equally as health
insurance or health care providers by
both groups.
Dentists



Oral health care provider is perceived more so
by dental hygienists.
Oral hygiene is perceived almost equally by
social workers and dental hygienists, as is
diagnosis and treatment.
Social workers are more inclined to perceive
as providing treatment, and as a “doctor”.
Roles and Responsibilities
Themes from definitions of
case manager
social worker
dental hygienist
Conclusion


Findings from this study suggest that
there are some similarities and
differences in perceptions and
confidence for service delivery for oral
health issues.
If you are a hygienist vs a social worker,
there are differences in how cases are
assessed.
Conclusions (cont.)


Need for both disciplines to understand
each other’s roles and relevance as well
as contribution for one’s overall health.
Need to address the roles of various
health professionals.
Implications for Collaboration



Need to discuss roles within different
professions (i.e., oral health) throughout the
practice curriculum.
Need to expose faculty and students to the
range of roles that other disciplines such as
the roles that dental hygienists assume.
Need to expose students to dealing with
wheelchair bound and aging clients.
Further Comments


Don’t perceive self as doing things you
will not be able to do them.
If other health professionals are
unaware of your multiple roles, they will
not include you in the multidisciplinary
process.
Contact Information






Dr. Elaine Jurkowski
[email protected]
(618) 453-1200; 453-2243
Associate Professor
School of Social Work, SIUC
M/C 4329, Carbondale, Illinois 62901