Bridging the Knowledge between Physical Therapy and Social Work
Purpose:
Interprofessional education (IPE), as defined in the Interprofessional Collaborative Practice (IPEC): 2016 Update, occurs when “students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. ”1 IPE has gained momentum over the past few years and is now an integral component of many graduate health programs. Physical therapy is no exception as evidenced by the Commission on Accreditation in Physical Therapy Education (CAPTE) requirements that include standards for IPE inclusion into the physical therapy curriculum.2 Based on recently published research, the push towards IPE within Doctor of Physical Therapy (DPT) curricula has resulted in an overall positive impact on competency and autonomy, teamwork, collaboration, communication, readiness to learn, self-efficacy, and student perceptions of other health care professional students. 3–5 As part of the developing DPT program at Marist College, an IPE activity was created involving first year DPT students and senior students within the undergraduate social work (SW) program.
Collaboration between DPT and SW students is not new to the literature; however, studies are limited as compared to IPE activities between DPT and other health professional programs.3,6 Our goal was to bridge the gap between each discipline and help develop an understanding of how each profession can work together to solve complex case studies spanning a variety of both physical, behavioral and psychosocial needs.
As described by de Saxe Zerden et al, social workers have historically provided behavioral health services; therefore, their integration into the medical health care system has been limited.7 Interestingly, Fraser et al found in a recent systematic review that compared to routine services, integrated primary care provided by an interprofessional team that included a social worker showed significant improvement in behavioral health and care of patients.8 As evidenced by the outcomes of our recent IPE experience and the work completed by de Saxe Zerden, one factor that may be contributing to the disparity of social work in IPE experiences is the misunderstanding of the role of social workers as they fulfill a variety of positions. Fraser et al identified the three core functions of social workers as behavioral health intervention, care management, and community engagement or patient referral.8 Their findings also indicated that many social workers perform a combination of these functions; therefore, increasing the diversity of their roles within an interprofessional collaborative practice. With such a broad scope of practice, we worked to integrate the various roles of social work into our case studies to demonstrate their diversity and the multitude of ways that PTs and SWs may work collaboratively in practice.
Methods/Description:
In an attempt to meet the needs of both programs, the IPE activity was scheduled prior to the DPT students first clinical rotation and at the start of the last semester of the SW students’ undergraduate education. Research suggests that early exposure to IPE may be more valuable9 and potentially minimize the formation of any negative views among students.10 The timing of our activity coincided with the DPT curriculum so that students were exposed to the role of social workers following the completion of their Clinical Decision-Making course and didactic coursework covering the examination of the adult neurologic patient population (including examination of the environment).
The IPE activity included a two-hour, in-person learning exercise that included 14 DPT students and 20 SW students. Students were assigned to one of five groups, each comprised of two DPT and two to three SW students. Groups were then provided with a case study that required students from each discipline to discuss their role in managing the simulated case scenario and to develop a discharge plan including two to three local resources that would be of benefit to either the patient or caregivers. Case studies included various diagnoses that presented with both physical and/or behavioral impairments and psychosocial needs (i.e. multi-fracture/concussion and domestic abuse, traumatic brain injury and substance abuse, spinal cord injury and depression/opioid abuse, elderly individual with positive falls history and new onset dementia). At the completion of the initial assignment, groups then received an “update” on their case study. The “updates” were provided to simulate real-world challenges that both PTs and SWs face when discharge plans need to change at the last minute due to a number of potential factors (physical, behavioral, psychosocial). Students were then provided additional time to modify their discharge plans and reassess their selected resources. Following the completion of small group discussion, students reconvened as a whole and each case was discussed with feedback provided by professors of both the DPT and SW programs. All students were provided with an “Assessment of IPE Experience” questionnaire at the conclusion of the large group discussion. The questionnaire consisted of 15 questions ranked on a Likert-type scale that included ratings that ranged from “Strongly Agree” to “Strongly Disagree” and three open-ended questions to provide specifics about what the students felt was most or least effective about the activity. In addition, the DPT students completed a one to two page reflection paper on the experience post class.
Results/Outcomes:
Using the IPEC’s four core competencies as a guide to classify student responses from the “Assessment of IPE Experience,” the post activity assessment focused on the competencies of Roles/Responsibilities and Interprofessional Communication. Of the 34 participants, 32 completed the post-activity questionnaire. With respect to the area of Roles/Responsibilities (excluding two respondents due to student error), the results showed that 85% of the DPT students strongly agreed the activity helped them to understand the role of social workers. Additionally, 94% of SW students strongly agreed to having a greater understanding of the role of the physical therapist. Not only did the results demonstrate a positive outcome in understanding each other’s disciplines, but 75% strongly agreed and 25% agreed that the activity helped to identify their own role within a collaborative practice. Positive outcomes were also noted in Interprofessional Communication as evidenced by 75% of respondents who strongly agreed and 22% who agreed with the statement that the activity helped develop their ability to communicate across disciplines.
Conclusions/Relevance to the conference theme:
The outcomes of this IPE activity reinforce the importance of interprofessional education and of educating students early in the curriculum regarding the roles and responsibilities of not only their profession, but the multitude of disciplines they will encounter as they enter into the healthcare field. More importantly, this activity supports the integration of social and behavioral health professions into medical based IPE in order to achieve the goal of “patient centered” care. Therefore, the authors feel that this activity is in line with the theme of “IPE in Academic and Workplace Learning” as it explores the direct relationship between the professions of physical therapy and social work.