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, 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 Assessment, referrals and health relationships Likert Scale Items 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: Males: 7.9% Females:92.1% Major: Social Work55.3% Dental Hygiene35.9% Other 8.7% Age - Mean age 24.5, Range years

Demographics (cont.) Ethnicity Caucasian78.6% African American14.9% Other 6.4% Status Sophomore15.7% Juniors21.8% Seniors48.1% 1st year MSW 8.8% Graduating MSW 5.6%

Demographics (cont.) Breakdown by program GPA % % % % % % Less than %

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

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)

Social workers are more inclined to look at needs, background information, and resources. Dental hygienists are more specific to health and mental health. Q10: What is the purpose of a client/patient assessment when dealing with a homebound/ community base individual?

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 self- care.

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 (618) ; Associate Professor School of Social Work, SIUC M/C 4329, Carbondale, Illinois 62901