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Fieldwork rotation: a model for educating social work students for geriatric social work practice.

WITH THE SUPPORT OF THE JOHN A. HARTFORD FOUNDATION, social work education is addressing the urgent need to increase the number of well-trained social workers for practice in the field of aging. The Geriatric Practicum Partnership Program, launched in 1998, is one of several programs in the foundation's Geriatric Social Work Initiative developed to meet the challenge of educating more social workers capable of providing service and care to a rapidly expanding older adult population. The major goal of the Practicum Partnership Program (PPP) is to increase the number of students specializing in aging and to develop enriched field education placements in geriatric social work by fostering partnerships between the academic and practice communities. Through a competitive process, the foundation awarded a 1-year planning grant and 3-year implementation grants to six university-community consortia comprising 11 graduate social work education programs.

The six demonstration programs were mandated to design and implement new models of field education that would provide students with the knowledge and skills required for informed geriatric social work practice. To become competent geriatric social work practitioners, students need to be trained to work in multiple settings with diverse and multi-generational older adult populations (Council on Social Work Education, 2001). They need exposure to the complex geriatric social and health care service system and to acquire the knowledge and skills necessary to practice in various settings across the continuum of care in aging services. This care ranges from wellness and primary prevention to chronic disease management to death and dying services (Pecukonis, Cornelius, & Parrish, 2003). To achieve these educational goals, the PPP implemented fieldwork rotation, defined as the planned and systematic movement of students between two or more field placement settings. During a 3-year period, more than 300 students were trained using the model of fieldwork rotation.

While there has been some experimentation with rotation, it has had limited appeal for social work educators and practitioners. There has been general reluctance to modify the traditional field education paradigm characterized by the one-to-one student-field instructor dyad in a single, year-long field placement. This paper will describe how the six PPP demonstration programs departed from the standard paradigm by designing and implementing fieldwork rotations. It will also report on students' response to rotation and the pedagogical challenges involved. The PPP experience with rotation contributes to the debate about the place of rotation within social work field education and its capacity to educate students for geriatric social work.

Literature Review

Social work has been unique among the health care professions in disregarding the educational potential of rotation in professional internships. In contrast to the standard paradigm of field education in social work, rotation is a central feature in medical education and is routinely incorporated into the education of allied health care professionals (Cuzzi, Holden, Rutter, Rosenberg, & Chernack, 1996). Medical students, interns, and residents regularly rotate through various medical departments and specialties to enhance their acquisition and mastery of the rapid growing body of medical knowledge (Arnold, 2003; Seely, Snell, & Salasidis, 2001). Rotations are also used to attract medical students and interns to various specialties (Al-Asnag & Jan, 2002) and to expose them, as well as residents, to a wide variety of patients, skills, techniques, and emerging subspecialties, such as palliative and end-of-life care (Schwartz, Goulet, Gorski, & Selwyn, 2003). Required clinical rotations were implemented in an urban medical school to improve medical students' attitudes toward geriatric medicine (Fields, Jutagir, Adelman, Tideiksarr, & Olson, 1992) and successfully used to stimulate interest in geriatrics among health care trainees. In addition to physicians and nurses, these included psychologists, physician assistants, occupational therapists, and pharmacy students (Damron-Rodriguez, Kramer, & Gallagher Thompson, 1998). Recently, nursing homes were included in clinical rotations to ensure that undergraduate nursing students gain familiarity with the nursing needs of chronically ill older adults (Chen, Melcher, Witucki, & McKibben, 2002). In the health care professions other than social work, rotations are recognized as efficacious in training competent health care professionals and in stimulating their interest in unpopular and neglected service areas, such as geriatrics.

Rotation in fieldwork education is a radical departure from the reigning social work field education paradigm. Adherence to the standard paradigm can be traced to the early development of the profession and the dominance of the social casework method of intervention. The influence of psychodynamic theory and practice in social work education, with its emphasis on personal growth and development as the necessary condition for quality professional behavior, also reinforced the privileged status of the one-to-one, long-term field instruction model (Schneck, 1991). Students would presumably acquire the skill, knowledge, and self-awareness needed to practice social casework through an intense supervisory relationship. Kaplan (1991) perceptively observed that the tutorial focus in supervision often paralleled the worker-client relationship, which, simultaneously, served as a model for an intensive casework relationship (Dalgleish, Kane, & McNamara, 1976). The long-term clinical relationship of worker and client, assumed to be necessary for successful therapeutic treatment, has its mirror image in the long-term student-field instructor tutorial relationship assumed to be a necessary condition for successful professional education and practice. This ideal of the preferred supervisory relationship has informed deeply the ethos of the profession, and those committed to it are of the firm opinion that the evolving year-long relationship between field instructor and student is sacrosanct and pivotal to the fieldwork experience (Netting, Hash, & Miller, 2002).

This philosophy of field education has never received the examination it warrants. Regrettably, the effectiveness of any field practicum in producing desired student behavior is difficult to measure, and "even time tested (but not time proved) modes of field instruction have not yet been evaluated in a rigorous way" (Dalgleish et al., 1976, p. 169). Modifications to the standard fieldwork paradigm, such as block placements, group supervision, primary and task (secondary) supervision, and field instruction centers, have been introduced periodically (Lurie & Pinsky, 1973; Spitzer et al., 2001). However, these modifications generally have not altered the modus operandi of most field education departments, in which the standard paradigm continues to exert a powerful hold (Cuzzi et al., 1996). Unlike the social work academic curriculum, which has evolved consistently, fieldwork education remains tied to one field practicum model.

A critique of the traditional fieldwork educational paradigm has been mounting gradually and persistently, and scholars and practitioners are questioning its ubiquitous application (Reisch & Jarmon-Rohde, 2000). Exclusive reliance on one model of field education may be disadvantageous in educating social work students for the demands of contemporary practice, as social workers now are expected to be crisis interveners, middle managers, and program developers (Dalgleish et al., 1976; Jarmon-Rohde, McFall, Kolar, & Strom, 1997). A growing number of social work scholars assert that educating social work students for the transformations in current practice necessitates a concomitant shift in the curriculum and in fieldwork education (Jarmon-Rohde et al., 1997; Pecukonis et al., 2003). Changes in the workplace environment, such as greater client diversity, technological advances, and managed care, have created challenges that require major modifications in social work service methodologies and in the professional education needed to prepare students to meet the new expectations in social work practice (Donner, 1996; Sowers & Ellis, 2001; Sulman, Savage, & Way, 2001; Volland, Berkman, Phillips, & Stein, 2003).

Fieldwork educators have urged greater creativity and innovation through a wider selection of field education models, such as rotation, community-based field instruction, and field education consortia among schools of social work (Jarmon-Rohde et al., 1997). Jarmon-Rohde and colleagues (1997) suggest that the benefits of these alternative models include exposure to diverse settings and various professional roles and supervisory styles, all of which might better prepare students for the realities of current practice. Students require education and training to expand their knowledge and assist them in developing greater skill in such new methodologies as rapid assessment, brief interventions, crisis management, case management, interdisciplinary team practice, and forging community partnerships (Bateman & Whitaker, 2002; Sulman et al., 2001). Alternative fieldwork education models may more effectively advance our educational responsibility to educate students for the evolving and dynamic world of social work practice.

In this vein, more that a quarter century ago Dalgleish et al. (1976) spearheaded the investigation of alternative fieldwork models by introducing and examining rotation in a large, academic health care institution. In their program, students rotated between three major medical departments and were exposed to a variety of services, problems, interventions, and interdisciplinary team practices. The authors concluded that rotation enhanced students' acquisition of the concepts and skills necessary for them to function in the health care system.

Also spurred by the need to prepare students for social work in health care, several studies were conducted in large medical centers comparing student experiences in standard and rotation fieldwork models (Cuzzi et al., 1996; Cuzzi, Holden, Chernak, Rutter, & Rosenberg, 1997). Social work students in these rotations had three distinct 10-week placements with a different primary field instructor at each location (Cuzzi et al., 1996; Cuzzi et al., 1997). The authors concluded that students benefited from exposure to multiple field instructors with different supervisory styles in various service settings. Students were satisfied with the diversity of learning experiences and with the acquisition of short-term intervention skills. In general, rotation increased the value of the students' fieldwork experience and improved their ability to function in the current social work health care environment. Spitzer and colleagues (2001) reported on the fieldwork rotation experience in two large medical centers where students had required rotations through multiple service sites and received supervision from a combination of primary and associate internship instructors. Spitzer and colleagues (2001) concluded that this experience enriched student exposure to multiple practice environments, interventions, and patient/family dynamics. Field instructors concurred that rotation had positive aspects, particularly "the fundamental intent of exposing students to the broadest possible range of patient care settings" (Spitzer et al., 2001, p. 87). With respect to training for geriatric social work practice, Netting and colleagues (2002) described using a systems-based rotation in which students followed clients into various health and human service organizations as needed. In this model, however, students were not assigned to any of these settings for a specific period of time and continued to receive field instruction exclusively through a year-long relationship with a primary field instructor.

Despite some positive results with rotation, designing and implementing fieldwork rotations presents challenges. For example, Dalgleish et al. (1976) found that students complained about the frequent changes of field instructors, the limits on opportunities for intensive client contact, and the erosion of self-confidence resulting from frequent new beginnings. Some field instructors expressed ambivalence about field rotation, especially its potentially negative effects on weak students. In the Cuzzi et al. (1997) study, students felt pressure at the beginning of the rotation year and felt stressed by the realization that as soon as they became comfortable with their field instructor and setting, they would have to move on to another placement. Spitzer et al. (2001) reported that some students had difficulty coping with the complexities and pace of a rotation program, while field instructors objected to compressing their involvement with students. In their experience with rotation, Netting et al. (2002) reported that field instructors were concerned that in-depth learning might be lost in the attempt to ensure maximum exposure to the continuum of care.

Rotation does not have to conform to one design and can be applied flexibly to meet the unique conditions of disparate social work programs and field placement agencies. The above-mentioned studies reported on fieldwork rotation within a single organization only. However, depending on how innovative the profession chooses to be, fieldwork rotation can also take place across agencies (Spitzer et al., 2001).

Rotation in the Practicum Partnership Program

During the planning year of the PPP, each demonstration program developed a rotation design consistent with its respective educational philosophy and objectives. Fieldwork rotations varied among the demonstration programs and were modified to respond to the evolving experience with rotation, agency staff availability, concerns about continuity and depth of learning, and the availability of time-limited assignments (see Table 1).

The rotation model of field education was selected for use in the PPP for several reasons. First, learning experiences in more than one program or agency would provide students with first-hand experience in the large and complex service system for older adults--a system that is replete with multiple funding sources and varied eligibility criteria. By having assignments in several agencies or programs, students would become knowledgeable about the system, begin to experience the service system as older clients and families do, and gain skill in connecting clients and their families with needed services and resources. Second, because the older adult population is diverse, students would have the opportunity to work with older adults and their families with differing characteristics, thereby gaining understanding of this diversity. This should counteract the acquisition of stereotypical assumptions that prevent students from working in the field of aging. Third, assignment to different programs and field instructors enables students to have a range of direct practice and interdisciplinary experiences, to engage in program development and advocacy, and to experience a variety of supervisory styles and practice approaches, all of which are critical to successful care in health and social services (Berkman, Silverstone, Simmons, Volland, & Howe, 2000; Cuzzi et al., 1996; Mellor & Lindeman, 1998; Pecukonis et al., 2003).

The demonstration programs developed four additional program components that provided support for the design and implementation of rotation. These were:

1. University-community partnership. Each demonstration program established a university-community partnership that provided leadership and direction for the development, implementation, and ongoing refinement of rotation and other program components. University and agency representatives (classroom and field faculty, program staff, field instructors, and agency executives or middle managers) met regularly as a group and in committees. Directors of field education were either part of the project management staff or functioned as consultants to the partnership. Leadership was shared between university and agency representatives.

2. Competency-driven education. Each demonstration program developed geriatric social work competencies that were used to establish student learning goals, measure student progress, and foster integration of field and classroom learning. Integration was promoted through the assessment of aging content in the curriculum, activities to increase aging content in courses, and the development of educational seminars. Seminars were held in consortium agencies to enhance exposure to the range of agency services and programs and to enable the participation of field instructors and other agency staff, thereby enriching students' knowledge and experiences. Seminar format and content varied, although all focused on teaching best practices in geriatric social work, on knowledge of geriatrics and gerontology, and on integrating field and classroom learning.

3. Expanded field instructor's role. In addition to providing the traditional supervisory activities of instruction, evaluation, and career mentoring, field instructors participated in consortia activities and committees. They contributed to the development of individual students' rotation plans, to the MSW curriculum, to the design and implementation of agency-based educational seminars, to classroom teaching, and to the recruitment of students to the aging field and the program.

4. Focused recruitment of students to geriatric social work. The demonstration programs promoted general awareness of geriatric social work among students through special presentations, publications, publicity, and the infusion of aging content into foundation courses. In addition, students were recruited into the demonstration programs through special presentations, brochures, stipends, and the development of other program features attractive to students, such as the PPP student cohort activities and assistance in finding postgraduate employment.

The operational principle of rotation in the PPP was the planned and systematic movement of students across two or more programs or agencies. Rotation designs were similar but not identical among the demonstration sites. Students had rotation assignments either within a single organization or across two or more distinct organizations. Rotation within one organization involved rotating students between two or more different services or departments, such as an inpatient geriatric unit and an outpatient home care program in one large hospital or medical system. Rotation between organizations involved assigning students to two or more separate agencies, such as an outreach program of a community agency and a hospital's mobile crisis team. In both patterns of rotation, services offered were varied because of the nature of the population served, specific client problems, and intervention modalities.

Timing (concurrent or sequential) and duration (allotted time in each placement site) were important aspects of the programs' rotation designs. Most programs used concurrent rotations in which students remained at one field placement site for an academic year, while rotating to an associate site either for a year, semester, or several weeks. Several programs used sequential rotations in which students were assigned to a field site for a longer period of time or an entire semester and then moved to another site for the subsequent rotation period. The duration of time students spent in each site depended on whether students were in concurrent or sequential rotations. In the former, students spent more time in the primary than in the associate placement site; whereas in sequential rotations, students spent an equal amount of time in each internship site.

In the PPP, students received supervision from field instructors and task supervisors or preceptors. Most field instructors and task supervisors/preceptors were MSW-level social workers. Two demonstration sites employed university-based field instructors in field sites lacking qualified field instructors. Field instructors were affiliated with the primary field placement site and had overall responsibility for student supervision and evaluation. Task supervisors/preceptors were affiliated with the associate site and provided on-site supervision. Field instructors and task supervisors gave students their fieldwork assignments, monitored their daily activities, provided supervision, and evaluated their performance. They shared field instruction responsibility, exchanged information about appropriate field assignments, and jointly evaluated students' progress. Each PPP site developed mechanisms, such as telephone calls, emails or meetings, to facilitate and maintain channels of communication between field instructors and task supervisors/preceptors across rotation sites.

Field liaisons or faculty advisors monitored student rotations across field placement sites. They collaborated with field instructors, task supervisors, and agency-based educational coordinators to individualize fieldwork rotation placements in alignment with students' educational interests and needs. They also helped field instructors and task supervisors develop appropriate student learning experiences. The faculty advisor provided students with individual or group advisement in which they focused on issues in rotation, provided opportunity for reflection, helped students integrate classroom and field learning experiences, and assisted with career planning.

The demonstration programs made independent decisions about the length of their programs and the criteria for accepting students. Three programs developed 1-year programs for 2nd-year MSW students only. One demonstration program developed a 1-year program for 1st- or 2nd-year students and two developed 2-year programs beginning in the foundation year and concluding with the concentration year. Another program included undergraduate senior social work majors who participated with the foundation-year students. These students were eligible to apply for advanced standing in the MSW program and the 2nd year of the PPP after completion of their undergraduate degree.

Although the demonstration programs independently developed criteria for selecting students, the criteria were notably consistent: expressed interest in geriatric social work, some previous experience with older adults, a successful academic record, and good recommendations. Student applicants were required to complete a formal application and have an interview with program and agency staff. Accepted students participated in an orientation, which usually consisted of intensive meetings but in some programs included visits to or pre-rotation assignments in agencies.

The rotation model required that field placement rotation sites be selected to provide students with multiple learning opportunities and to afford them maximum exposure to the continuum of care (see Table 3). This continuum included three categories of older adults: well-elderly, functionally impaired elderly, and older adults at the end of life. Agencies represented in the continuum of care provided a wide range of services. This encompassed social/recreational programs, home and personal care services, legal aid, housing, physical and mental health programs, long-term care, advocacy, and spiritual engagement programs and services. Demonstration programs were developed and implemented to provide learning experiences with various types of agency programs (prevention to end-of-life services), different aging populations (well-elderly, functionally impaired to terminally ill), and micro and macro interventions.

Student Responses to Rotation

As a part of the cross-site evaluation of the PPP, participating students were asked to rate their satisfaction with their PPP internship upon completion of their program. A seven-item questionnaire consisting of statements to be rated on a 5-point agree--disagree scale was developed to assess student satisfaction. These items explored students' perceptions of various aspects of their rotation experience. The seven items consisted of positive statements about achieving personal learning goals, the worth of rotation, knowledge concerning the range and diversity of services and populations of older adults, the benefits to be had in learning from more than one field instructor, confidence in working on interdisciplinary teams, and recommending the program to other students in the field of aging.

Between academic years 2000-2001 and 2002-2003, more than 300 graduate social work students participated in rotations in the demonstration sites. The written satisfaction scale was administered to students only in the 2nd and 3rd program years (n=226). The demonstration programs administered the satisfaction items as part of a written questionnaire containing other measures to assess knowledge of aging, skill in working with older adults, and career interests. A total of 160 students responded to the questions for a response rate of 71%.

Students completing the questionnaire were young (53% under age 30), female (84%), and diverse (18% African American, 14% Asian, 16% and Hispanic/Latino, and 49% Caucasian) (see Table 2). Almost all respondents were graduate social work students, with a majority in their 2nd year of the MSW program. A few undergraduate social work majors were included in the sample because they participated in one site's demonstration program along with foundation year MSW students. Approximately one half of the students had taken courses in aging prior to the beginning of the internships and almost three quarters reported volunteer or paid work experience with older adults.

Analysis of the responses indicates that students rated their PPP program experience very highly (see Table 4). There was some small variation in the range of the scores with means for the items ranging from 4.3 to 4.6. An overwhelming majority of students agreed or strongly agreed about the positive effects of rotations. The lower mean scores (4.3) were in the areas of achieving personal goals and confidence in interdisciplinary teamwork. The highest mean score (4.6) occurred in recommending the program to other students.

To assess the effect of the PPP on student interest in a career in geriatric social work, these students were also asked to rate their agreement or disagreement with two statements about their future employment: one item related to the likelihood of having a career working with or on behalf of older adults and the other related to employment upon graduation working with or on behalf of older adults. Exposing students to the range of services and diversity of the older adult population through rotations was expected to increase student interest in aging and dispel stereotypes that often prevent students from working in the field of aging. Students were asked to rates these two items at the beginning of their internship and upon completion. Students rated their career interest high at the beginning of their program and upon completion. As students were selected for the internship program based, in part, on their interest in aging, it is not surprising that initial interest was high and remained so, with no significant change during the internship. However, it is important to note that rotations did not decrease their interest.

Discussion

The introduction of fieldwork rotations and the departure from the standard model required time, effort, and a strong university-community partnership. Developing and implementing the rotations demanded intensive work by project management staff, the university field education department, and agency staff. However, over the course of the program this process took less time and effort due to the establishment of an effective university-community partnership and its accumulated experience.

The planning year provided the demonstration programs with the time needed to build the institutional supports and develop the educational plans necessary for successful rotation. The major institutional support was the university-community partnership, which had the dedicated commitment of representatives of constituent agencies who participated enthusiastically to achieve the program's goals. Representatives met frequently at first and then intermittently throughout the planning and the implementation years to discuss issues and make decisions about the specific features of each program's rotation design. Changes in agency personnel determined who the actual partnership representatives were. Increasingly, however, field instructors became part of the stable group of representatives and contributed to the expansion of their role from agency-based field instructors to educational partners.

The university-community partnership was the locus for all decision-making regarding specific rotation plans. In partnership meetings, participants reviewed and considered the various factors that ultimately shaped the final rotation design. Based on their respective educational philosophy and objectives, all programs made decisions on the following design options: (1) whether rotation would be within or between organizations; (2) whether it would be concurrent or sequential; (3) the number of rotation sites to be included in a student's rotation; and (4) the number of field instructors or task supervisors/preceptors to be involved. The partnership structure also afforded partnership representatives the opportunity to address some of the potential problems that have been raised about rotation, particularly how to achieve continuity in learning as students move between sites and how to ensure that field assignments allow for progressive skill development. Careful matching of rotation placements with student learning needs and reconfiguring field assignments to make them suitable for rotation helped to alleviate these concerns. As all students had a primary rotation site in which they spent at least 2 days per week in concurrent rotations or a longer period of time or a full semester in sequential rotations, they had the opportunity to acquire a variety of micro and macro skills in long- and short-term interventions.

The programs' educational plans included multiple field supervisors and enhancing the field-based curriculum. Although students received supervision from more than one field supervisor, the primacy of the student-supervisor relationship was upheld in all demonstration programs. In concurrent rotations and sequential rotations, one field instructor assumed overall field instruction responsibility. Because of the presence of multiple supervisors, mechanisms were established to facilitate regular communication between supervisors across rotation sites to prevent possible problems. Open channels of communication allowed field instructors and task supervisors/preceptors to specify each student's rotation plan, develop and coordinate appropriate assignments, resolve field-related problems, and evaluate student progress. Maintaining and respecting the primacy of the supervisor-student relationship allayed student and agency concerns about the use of multiple field instructors and ensured that continuity in student learning would not be compromised. Additionally, the field liaison/faculty advisor was a constant figure throughout the rotation year, assisting agencies with rotation issues and monitoring students' learning across all rotation sites. These activities served to strengthen the university-agency relationship.

Competency-driven education provided the educational guidelines by which programs enriched the curriculum and field-based learning. It was particularly important that all the demonstration programs held agency-based educational seminars for students from all the rotation sites. These seminars focused on specific geriatric and gerontological topics usually not covered in the curriculum, thereby adding further depth to the field education experience. Additionally, these seminars afforded students the opportunity to share and reflect on their rotation experiences, which served to strengthen their learning.

Pre-rotation planning with students was essential for successful rotation. Students were oriented to the rotation program and participated in selecting specific rotation placements to meet their educational level and expectations. Field liaisons worked in collaboration with the agency-based educational coordinators or field instructors to customize each field rotation to meet individual students' learning objectives and agency preferences. Careful attention to students' fieldwork rotations plans and matching these with field placement learning opportunities contributed to student satisfaction with rotation.

Students responded very positively to the rotation experience and without reservation said they would recommend the PPP to their peers. Students were satisfied with the range of learning opportunities offered by multiple fieldwork placements, which contributed to their sense of competency and self-confidence as future geriatric social work practitioners. Students also responded positively to having multiple supervisors. Their reactions indicated that supervision from more than one field instructor did not interfere but rather enhanced their learning experiences. They benefited from the opportunity to observe and adapt to different supervisory styles, and learning from multiple supervisors augmented their acquisition of knowledge and skills. Although students were positive about rotation, their reactions could have been affected by the selection process for acceptance into the PPP and from the effect of participating in the program.

The PPP's successful experience with rotation supports several important points: (1) fieldwork rotation can be implemented with sufficient support and effort; and (2) rotation is a flexible and versatile field education model (Spitzer, 2001). The effectiveness of the university-community collaboration also underscores the observation that achieving the educational goal of educating future social workers depends on productive university-field relationships (Bogo & Globerman, 1995). Fieldwork rotation also demonstrated that it could maximize student exposure to an array of services and programs without compromising in-depth learning experiences.

Several features converged to contribute to the success of fieldwork rotation. First, the university-community partnership brought together classroom faculty, field education faculty, and agency representatives regularly for 4 years. Throughout this period, they considered serious field education issues that might impede or enrich student learning. Regular meetings also fostered mutual respect and appreciation. Second, students' educational experience became the concern of at least three concerned and attentive professionals. They could problem-solve jointly to ensure that students received a quality field education learning experience. By doing so, rotation provided agencies with more attention and assistance than they usually receive in student training (Donner, 1996). Third, students received agency-based educational seminars, which extended and added depth to the field curriculum. The implementation of rotation galvanized all participants to attain a high standard of field education by finding creative and innovative ways to provide students with a variety of learning opportunities.

Conclusion

Rotation is not a panacea nor is it being proposed as a replacement for the standard model of fieldwork education. Systematic examination of fieldwork rotation in comparison with the standard model is needed to help social work educators more fully understand which model best suits a particular field of practice or student. Additional studies should also explore field instructors' and task supervisors' reactions to fieldwork rotation, for without their full cooperation and participation, no fieldwork education model can be successful. The experience with rotation to date, however, strongly indicates that it is a field education model that merits serious consideration. There may be fieldwork situations in which rotation may not be suitable and students for whom it may not be appropriate. At the same time, there are fields of practice, such as health care and geriatrics, in which rotation can effectively prepare students for the demands of current practice, and there are students who welcome the educational challenges and stimulation that rotation can provide. The PPP's experience, together with those of previously reported studies, provides growing evidence that fieldwork rotation is a viable alternative to the standard model. Field education departments and agencies should be encouraged to forge formal university-community partnerships to develop fieldwork rotations, which have demonstrated potential to enrich and advance student knowledge and skill. Rotation is a field education model that can help geriatric social work achieve its educational goal of preparing competent social workers for the realities of current and future practice.

Acknowledgments

The Practicum Partnership Program is funded by the John A. Hartford Foundation. The authors wish to acknowledge Patricia J. Volland, MSW, MBA, principal investigator of the PPP, and the principal investigators of the six demonstration programs: Hunter College School of Social Work/Brookdale Center on Aging, the City University of New York, Joann Ivry, PhD, and Rose Dobrof, DSW; University of Albany, State University of New York, Anne E. Fortune, PhD; University of California at Berkeley; Barrie K. Robinson MSSW, and Andrew E. Scharlach, PhD; University of California at Los Angeles, JoAnn Damon-Rodriguez, PhD, and June Simmons, MSW; University of Houston, Virginia Cooke Robinson, MSW; University of Michigan, Ruth Dunkle, PhD, and Lily Jarman-Reisch, MSW. The authors also wish to acknowledge the contribution of Nadine P. Gartrell, PhD, of the New York Academy of Medicine.

Accepted: 01/05

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Joann Ivry

Hunter College School of Social Work

Frances P. Lawrance

New York Academy of Medicine

JoAnn Damron-Rodriguez

University of California at Los Angeles

Virginia Cooke Robbins

University of Houston

Joann Ivry is associate professor, Hunter College School of Social Work. Frances P. Lawrance is program officer, New York Academy of Medicine. JoAnn Damron-Rodriguez is professor, University of California at Los Angeles. Virginia Cooke Robbins is director of field practicum, University of Houston.

Address correspondence to Joann Ivry, Hunter College School of Social Work, 129 East 79th Street, New York, NY 10021; e-mail: jivry@hunter.cuny.edu.
TABLE 1. Characteristics of PPP Demonstration
Programs 2000-2003, by Site

Site Student Characteristics
 Level of Rotation Plans

 1-Year Programs

Hunter MSW 2 * Students in paid summer
College/ internships 5-6 weeks
Brookdale to become familiar with
Institute agency services and
on Aging populations served

 * Field office matches
 students with paired sites (2)

 * Rotation options: 2-4 departments
 in 1 large agency system or 1
 agency (2 days/wk) and
 1 additional agency (1 day/wk)

 * Seminars meet at agencies;
 staff and other students invited

University MSW 2 * Rotations developed by
at Albany, field supervisor with
State student or planned in advance
University by field education
of New York office with students and agencies

 * Rotation options: 2-3
 divisions/departments in
 1 large agency; 1 primary site
 and 1-2 additional agencies;
 or 2 sites of equal time;
 for 3 days/week

 * Concurrent or block rotations

 * Seminars meet at field agencies;
 staff and other experts invited

University MSW 1 or * Students assigned to a
of California MSW 2 primary program area
at Berkeley (i.e., adult protective
with MSW services) within a county
programs at department of aging services
San Francisco for full academic
State University, year to learn practice skills
San Jose
State University * During 1st term students
 oriented to primary
 program area while completing
 intermittent rotations of
 varying length through 5-6
 secondary program areas,
 participating in meetings,
 conferences, observing and
 shadowing workers, home visits,
 visits to affiliated agencies

 * Internship rotations structured
 by program and educational
 coordinators in each county
 office

Partners in MSW 2 * Students placed in
Care Foundation primary site in 1 of 4 large
in partnership agencies designated as
with University Centers of Excellence,
of California with assignments during
at Los Angeles, final term to 1-2
University of associate sites (different
Southern agencies or departments
California, within agency) for 1 day
California State per week for 2 months
University at (concurrent with 2 days/
Los Angeles, week in Center of Excellence)
California
State University * Each Center of Excellence has
at Long Beach students from each MSW program
 and 1 field instructor for
 all students in agency

 * Field instructor hired by Center
 of Excellence with responsibilities
 for program development, student
 seminars, I university, consortium
 committee

 * Seminars held at Centers
 of Excellence

 2-Year Programs

University Undergrad * Internships for students
of Houston social assigned by consortium
with work members (field instructors)
undergraduate seniors
social work and * Undergrads and 1st-year
program MSW 1, MSWs assigned to
at Texas MSW2 1 agency for the 1st term,
Southern a different agency for
University the next term; 2 days/week

 * 2nd-year MSW students assigned
 to large health agency with
 2-4 rotations to different
 departments; interdisciplinary
 team training for 2-3 days/week

 * Seminars meet at different
 agencies; staff and field
 instructors invited

University MSW 1 * 1st-year MSW students (in
of Michigan and 2 groups) visit agencies
 during first term to learn
 about services and
 identify preferences for
 internships

 * MSW 1 students placed in
 1-2 "satellite" agencies
 for 2nd term, 2 days/week

 * MSW 2 students in "anchor"
 agencies to focus on
 major practice method for
 terms 3 and 4

 * Seminars at university;
 faculty, field instructors
 invited

Site Supervisors/
 Instructors
 Per Student

 1-Year Programs

Hunter * 1 agency instructor with
College/ task supervisors in
Brookdale additional sites
Institute
on Aging

University * 1 agency supervisor with
at Albany, task supervisors in
State additional sites
University
of New York * 2 field instructors in
 separate sites

University * 1 agency instructor with
of California task supervisors in different
at Berkeley departments
with MSW
programs at * 1 educational coordinator
San Francisco in each county office on aging
State University,
San Jose
State University

Partners in * 1 field instructor with
Care Foundation preceptors in associate sites
in partnership
with University
of California
at Los Angeles,
University of
Southern
California,
California State
University at
Los Angeles,
California
State University
at Long Beach

 2-Year Programs

University * 2 primary field instructors
of Houston for undergrads and MSW
with 1 students
undergraduate
social work * 1 field instructor with
program preceptors in rotations
at Texas
Southern
University

University * 2 field instructors
of Michigan
 * 1 field instructor with task
 supervisors

 * University-based field
 instructor with task instructors

TABLE 2. Demographic and Program Status
Characteristics of Students in the
Practicum Partnership Program (N=190)

 n %
Age
21-29 100 53
30-39 47 25
40 and over 42 22
Not specified 1 0

Gender

Male 30 16
Female 100 84

Ethnicity

African American 34 18
Asian American 26 14
Caucasian 93 49
Hispanic/Latino 30 16
Other 6 3
Not specified 1 0

Educational Level During PPP

Undergraduate social work 11 6
1st-year MSW 52 27
2nd-year MSW 104 55
Advanced standing MSW 2 1
Not specified 21 11

Completed Courses in Aging Prior to PPP Internship

Yes 88 46
No 91 48
Not specified 11 6

Prior Volunteer or Paid Work Experience With Older Adults

Yes 137 72
No 46 24
Not specified 7 4

Note. Range=21-69; M=32.5; SD=10.1.

TABLE 3. Examples of Practicum Partnership
Program Individual Student Rotations

Student Student Rotation
Level Placement Type

MSW 2 Jewish social Inter-agency
student service agency concurrent
 (in partnership direct
 with nursing practice
 home and focus
 community senior
 services agency)

MSW 2 Community Inter-
student organization agency
 serving block
 Hispanics in rural rotation
 area (in (sequential)
 consortia with macro
 acute care focus
 hospital, senior
 service
 agency, church
 social service
 agency,
 nursing home)

MSW2 Veteran's Inter-agency
student Administration concurrent
 Medical rotations
 Center direct
 practice
 focus

MSW County Inter-agency
1 or 2 department block
student for aging sequential
 services rotations of
 approx 1 week
 during first term
 only; rotations
 intermittent with
 return to primary
 program area
 direct practice
 focus

MSW 2 Community-based Inter-agency
student geriatric concurrent
 mental health direct practice
 program and macro focus
 and elder law
 clinic

Student Site Student
Level Learning
 Assignments

MSW 2 * Jewish * Supportive in-home
student family services counseling for
 elderly clients
 * Senior * Case management
 services to seniors in
 housing project
 * Nursing home * Individual counseling
 with residents

MSW 2 * Community * Outreach to
student organization Hispanic elders

 * Hospital * Participate in crisis
 mobile outreach team offering case management,
 program clinical assessment and
 intervention
 * Office on aging * Needs assessment of Hispanic
 elderly in county

MSW2 * Inpatient * Information, referrals,
student geriatric supportive counseling to
 unit patients and families;
 discharge planning
 * Adult day program * Information, referrals,
 counseling to day program
 clients
 * Home-based primary care * Assessments, referrals,
 counseling to patients
 referred by MDs

MSW * Adult protective * Casework; one case at least
1 or 2 services/financial of: self-neglect, physical
student abuse unit abuse, financial
 (primary placement abuse, neglect, care
 for 1 year) management
 * Area Agency on Aging
 (rotation) * Home visits/shadowing
 * Public guardian unit workers; attend staff
 (rotation) meeting and relevant community
 * In-home social services and organizational meetings;
 unit (rotation)
 * Multi-purpose senior * Same as above; attend
 service program a court hearing
 (rotation)
 * Same as above; attend
 public authority meeting

 * Same as above

MSW 2 * Community-based * Casework counseling
student geriatric mobile crisis with individuals
 team (2 days) and families; case
 management; home
 * Elder law clinic in visits
 university-affiliated * Interdisciplinary
 law school (1 day) team practice
 social work and law.

TABLE 4. Student Responses to Rotation (N=190)

 n Range M SD

1. My personal goals in 159 1-5 4.30 0.80
 learning to work with
 older persons and their
 families were achieved
 in my field practicum.

2. I feel my participation 156 1-5 4.40 0.80
 in rotations
 was worthwhile.

3. The rotation enabled 156 1-5 4.40 0.80
 me to learn about the
 range of services
 to older people.

4. Having experience 158 1-5 4.50 0.80
 in more than one
 field agency or
 department or program
 was useful in learning
 about diverse
 populations of
 older people.

5. Having the opportunity 159 1-5 4.50 0.80
 to learn from several
 different instructors
 in my field practicum
 enhanced my learning.

6. As a result of my 159 1-5 4.30 0.90
 participation in the
 Hartford program, I am
 more confident in working
 as part of an
 interdisciplinary team.

7. I would recommend 159 1-5 4.60 0.90
 the Hartford program
 to other students
 in aging.

Note. Scale ranged from strongly
disagree (1) to strongly agree (5).
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Author:Ivry, Joann; Lawrance, Frances P.; Damron-Rodriguez, JoAnn; Robbins, Virginia Cooke
Publication:Journal of Social Work Education
Geographic Code:1USA
Date:Sep 22, 2005
Words:7614
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