How Virtual Skills Trainings Are Disrupting the Traditional Internship Experiences for Social Workers
Accessing mental and behavioral health care is not easy for everyone. For those who live in rural areas, having a face-to-face conversation with a practitioner may mean driving a couple of hours to their office. Others may have limited mobility as a result of physical restrictions and circumstances out of their hands, like the COVID-19 pandemic.
However, improvements in technology bring improvements in delivery of care. Digital platforms are changing how social workers and other mental health practitioners address and treat mental and behavioral health conditions. In a 2016 review of telemedicine interventions for mental disorders, researchers found that telemental health makes care more accessible to populations with limited resources or special needs, is cost effective and improves patient outcomes for a number of conditions.
But this technological transformation within the field of mental and behavioral health doesn’t have to be limited to improving outcomes for clients. The USC Suzanne Dworak-Peck School of Social Work is using digital platforms to transform social work education through their Virtual Field Practicum (VFP). The VFP offers students enrolled in USC’s online MSW program more than 200 hours of virtual training designed to develop their practice skills before they enter the traditional field setting.
“VFP really prepares them to enter into the work, giving them a robust, real-time experience in an environment that feels very safe to them,” said Laura Cardinal, clinical assistant professor and VFP instructor, in an article for the school’s website.
How Does the Virtual Field Practicum Work?
In traditional Master of Social Work (MSW) programs, students begin their first internship at an agency within their first couple of weeks of the program, where they’ll stay during their second semester, before switching to another agency for semesters three and four. Diving right into agency work can mean interacting with clients who have serious conditions or behavioral challenges. Many students still have limited experience in the field at this point, which can leave them feeling unsure or anxious during these early interactions. The VFP substitutes the first semester of an internship with a 15-week course. Each week, students complete four hours of live virtual classroom activities and about 12 hours of independent activities, designed to provide all students with the same fundamental education.
Within the live virtual classes, students are introduced to the Council of Social Work Education’s core competencies, ethical standards for practice and three evidenced-based interventions: motivational interviewing, problem-solving therapy and cognitive behavioral therapy. Starting at week three, they begin working with a simulated client—an actor who is loosely scripted by USC faculty to present challenging mental and emotional conditions. The conversations take place in real time, face-to-face over the virtual platform.
“Part of the work is learning how to sit with people while they are suffering,” Cardinal said. “It’s really uncomfortable for many people.”
The 10 students in each class build individual relationships with the client over the rest of the semester, with half of the class working with the client one week to provide interventions, while the other half either observes or coaches. The structure gives students the opportunity to observe strategies that work well, learn from their classmates’ mistakes and implement what they have learned in their next sessions with the client. Brittani Morris, LCSW, a clinical assistant professor and lead instructor of the VFP, said learning how to stay neutral and professional, even when they disagree with a client, is one important aspect of this training.
“Students start out wanting to ‘fix’ their clients. They want to tell them to do X, Y and Z, and they’ll be fine,” she explained in the article for the USC website. “But it’s far more powerful if the solution comes from the client. We teach them how to help clients get to the point of wanting to change. That’s where you get palpable results.”
In the live sessions, instructors not only provide feedback on student interactions with the simulated client but also take time to hold group discussions and review lessons from the asynchronous, or independent, activities. The independent activities cover nine topics, including:
- Clinical risk factors
- Ethical dilemmas
- Empathy training
- DSM-5 training
- Case management
- Evidence-based search strategies
- Self-care strategies
- Community activism
Training simulations in the asynchronous content can take a variety of forms, including video and written vignettes, guided study and self-reflective learning tools. For example, students learning about risk management may be presented with a series of vignettes in which clients exhibit risky behaviors. After watching the videos, students are required to complete a number of tasks in a routine risk assessment including identifying the questions needed to complete an assessment and the steps that should be taken to ensure the safety of the client.
The goal at the end of the 15 weeks is to send students into their internship for the next three semesters with a solid foundation of skills necessary to meet clients’ needs.
“Students leave the class feeling confident they know what to say if someone’s angry or if they feel stuck,” Cardinal said.
What Impact Does the VFP Have on Learning?
Research shows that the VFP is providing online students with a number of learning advantages.
In a study published in 2018, researchers compared the core competencies of 100 VFP students and 520 students enrolled in an on-ground program. Field instructors were asked to rate students on 10 competencies at the end of each semester:
- Thinking and judgment
- Cultural competency
- Social justice
- Evidence-based practice
- Person in environment
- Current trends
- Practice skills
The assessments showed that at the end of the first semester, VFP students earned higher mean scores on all competencies than their on-ground peers, although their growth was not as dramatic as they shifted from the VFP to their internship in the second semester. In contrast, on-ground students experienced steeper growth at the end of their first internship in second semester, but that growth dipped as they transitioned to new agencies. By the end of all four semesters, students in the VFP had higher mean scores for every competency with significantly higher scores in the social justice, evidence-based practice and policy competencies.
What does this mean for the field? The authors noted that this research has a number of implications for students, clients, schools and agencies:
- The VFP’s simulated experiences provide students with skills practice that helps them feel more confident as they enter agencies.
- Clients who are paired with first semester interns receive services from students who have a demonstrated understanding of basic skills in applying interventions.
- Schools can take on more of the fundamental skills training from agencies who have increasingly limited resources.
- Agencies who take on interns can develop them for three semesters rather than two, ensuring that they get a greater return on investment of time and training.
Ultimately, the results show that the VFP is helping students feel well-prepared as they step foot in their agencies for the first time—and Cardinal says many of the field placement agencies where her students worked have expressed just that sentiment.
“The VFP experience is not ‘less than,’” Cardinal said. “We believe it is ‘more than.’”
Citation for this content: The MSW@USC, the online Master of Social Work program at the University of Southern California