Creating and Sustaining an Experiential Learning Component on Aging in a BSW Course

Abstract

Regardless of their particular field of practice, social workers increasingly serve the growing population of older adults in the United States. This article describes the process of integrating an experiential component into a Baccalaureate Social Work (BSW) course involving 75 BSW students. Reflections on the strengths and challenges during 3 years of the course and a successful sustainability strategy are discussed. Three methods of curriculum infusion were added to a required course: (a) guest speakers, (b) required volunteer hours, and (c) written reflections and class presentations. We discovered that students’ attitudes toward working with older adults were changed following their experience in this course. Cognizant of the difficulty introducing additional hours and content to a full course agenda, we advocate for curriculum change that includes an experiential component together with classroom discussion and activities. We provide details of our process of implementation and sustainability that might help guide similar course adaptations to increase BSW student exposure to working with older adults.

Introduction

The most recent U.S. census data reported more people above the age of 65 than in any previous census, and that between the years 2000 and 2010, this population increased at a faster rate than the total U.S. population (Werner, 2011). The opportunity and need for social workers to serve this population has been documented (Council on Social Work Education, 2001; Hash et al., 2007; Reed, Beall, & Baumhover, 1992; Scharlach, Damron-Rodriguez, Robinson, & Feldman, 2000; Tyler, 2008); however, social work students are reported to have mixed attitudes toward working with older adults (Kanenberg, Mapp, Dudley, & McFarland, 2014; Anderson & Wiscott, 2003; Cohen, Sandel, Thomas, & Barton, 2004; Lee & Waites, 2006). A large majority of students indicate an interest in working with children and families, addictions, cancer patients, the prison population, or in the area of mental health (all of which have relevance to older adults). Social work educators have the responsibility to help students understand the breadth of opportunities with older adults, to motivate them to consider this area of practice, and to equip them with the knowledge and skills necessary to successfully overcome any barriers they may face when working with the aging population (Singleton, 2009).

Several initiatives have been implemented to accomplish this task and are well documented in the literature (Scharlach & Robinson, 2005). The Council on Social Work Education’s Gero-Ed Center, funded in part by the John A. Hartford Foundation, invested greatly in preparing students, in particular targeting undergraduate students through the BSW Experiential Learning (BEL) program. The BEL program promoted innovative experiential learning activities with the aging population. This article provides a description of the implementation, process, and outcomes of one BEL funded program. The program targeted two of the Council on Social Work Education (CSWE) gerontological social work competencies: (a) assess and address values and biases regarding aging and (b) use empathy and sensitive interviewing skills to engage older clients in identifying their strengths and problems. Although there are nine identified gerontological social work competencies, this project focused strategically on these two because the students were either freshman or sophomores, and because they fit the mission of the agencies where the students were required to volunteer. The other seven competencies include more advanced knowledge and skills that include (among others) engaging in ethical decision making, providing interventions, and evaluating practices. Furthermore, it should be noted that the competencies will be evolving to more closely align with the 2015 Educational Policy and Accreditation Standards set forth by the Council on Social Work Education. An overview of the process for infusing a volunteer component into an existing BSW course, along with student feedback, and strategies for sustainability are presented below.

Review of the Literature

The incorporation of aging content into Baccalaureate Social Work (BSW) and Masters Social Work (MSW) curriculum has been a high priority in social work education for decades. The Council on Social Work Education initiative has supported social work programs through curriculum and leadership development through the GeroRich, BEL, and other programs. Many GeroRich projects have followed the infusion method by incorporating aging content into the core foundation courses, lectures, experiential methods, and other means (Cummings, McClure Cassie, Galambos, & Wilson, 2006; Green, Dezendorf, Lyman, & Lyman, 2005; Hash et al., 2007; Holody & Kolb, 2011; Snyder, Wesley, Bi Lin, & May, 2008). The advantage of the infusion approach is providing learning opportunities to all students and avoiding the suggestion of a concentration approach or elective that will only benefit a limited number of students (Cummings et al., 2006). This should not assume that the infusion approach is the ideal model as studies highlight potential barriers with implementation, inadequate coverage of the critical material, and challenges with sustainability of the infused content (Green et al., 2005; Haynes, 1999; Holody & Kolb, 2011). Despite possible limitations, the literature demonstrates that infusing gerontological content into the curriculum yields positive gains in student knowledge, interest, and skills for knowledge and specialization (Cummings et al., 2006; Dorfman, Ingram, Murty, & Li, 2008; Green et al., 2005; Holody & Kolb, 2011; Waites & Lee, 2006; Snyder et al., 2008; Tam, 2014).

Specific strategies have been identified to assist programs with infusing gerontological content successfully into the curriculum (Green et al., 2005; Holody & Kolb, 2011; Tam, 2014). The first step for infusing new content into the curriculum is to engage with faculty to secure their participation and cooperation (Hash et al., 2007). A few ways to create faculty engagement include involving them in the planning process, pairing them with stakeholders in the aging field, and providing necessary resources to teach the material competently (Holody & Kolb, 2011). Along with faculty, stakeholders such as field instructors, alumni, and community partners in agencies where students complete field placements, are rich resources.

Providing opportunities for students to engage with many different organizations and agencies can also assist with infusion (Sanders, Dorfman, & Ingram, 2009). Creating rules and expectations helps to set the standard between the school and the partnering agencies. Reaching out to stakeholders can be just as important in the process of keeping and maintaining a program. McCaslin and Barnstable (2008) discuss various studies of GeroRich community-partnership programs in which one specific participant explained, “The involvement of students, faculty, community members, social workers, and consumers provided an opportunity for dialogue and involvement in the proposed changes in our curriculum. This increases buy-in and sustainability” (p. 13). This collaboration of all the involved parties can increase the likelihood for a sustainable infusion of aging content in BSW programs.

In educational pedagogy, student involvement in hands-on experiences is accepted as a central means of effective teaching, strongly associated with students’ political and social involvement (Kilgo, Ezell-Sheets, Pasquesi, & Pascarella, 2014). Learning through direct service provision has been the signature pedagogy of social work for decades. University student engagement in service-learning-type activities has been shown to have an impact on students’ beliefs, attitudes, and values, particularly related to working with older adults (Brown & Roodin, 2001; Yamashita, Kinney, & Lokon, 2011). In addition, Roodin, Brown, and Shedlock (2013) remind us of the many benefits of university-community engagement and collaboration to older adults as well. The journal Educational Gerontology published a special issue (Vol. 27, #1, 2001) focusing on the role of service-learning in educating future professionals. The articles ranged from reviews of the literature to methods of evaluating gerontology-related service-learning. In a summarizing article, Cavanaugh (2001) wrote, “It is one thing, of course, to extol the merits of connecting learning and doing. It is quite another to actually achieve it in a meaningful way within the constraints of an academic term” (p. 117). Cavanaugh (2001) continues in describing the tedium and importance of engaging and disseminating quality research results across fields of study. It is in this spirit that we share this case example with a multidisciplinary audience.

Method

The purpose of this study is to describe the process of integrating an experiential component into a BSW course. According to Creswell (2007), an intrinsic case study maintains, “ . . . the focus is on the case itself (e.g., evaluating a program) . . . the case study analytic procedures of a detailed description of the case, set within its context or surroundings . . . ” (p. 74). The goal of this “description of the case within its context” leads to what Creswell (2007) terms “assertions” followed by the researcher’s report on the “meaning of the case” (p. 75). Here, we define the “case” as the students’ experience with a hands-on component of a course infused with gerontological curriculum. We describe the setting, context, assertions, and meaning in the following sections.

Communication in the Helping Process, the first required course for BSW students was selected for our BEL project for the following reasons: (a) Students are required to take this course at the beginning of the social work major during their sophomore year; (b) this course had historically contained a volunteer component that was dropped due to complications, but was still valued by some key faculty; and (c) the course content meshed well with the aging competencies, a key to sustainability. The course included content related to the study of knowledge, skills, and values for effective communication and interpersonal relations in social work practice. The instructors for the course were doctoral students and worked closely with the principal investigator (PI) of this project to make adjustments to the course syllabi as needed across three semesters.

A total of 75 (three sections of 25) lower division BSW students completed 10 hours of volunteer work with older adults over one semester. Students were reflective of the racial composition of our BSW program, which is 53% White/non-Hispanic and 47% non-White (A. Newmark, personal communication, June 9, 2016). During the second class session, a panel of community-based social workers introduced students to potential volunteer sites and exposed them to five different settings with their respective social work roles. Some students arranged their own volunteer site with instructor approval; most utilized the volunteer sites that were provided by the instructor. Existing relationships with community social workers developed through our Community Consortium in concert with the Hartford Practicum Partnership Program (HPPP), a previous CSWE Gero-Ed initiative, were instrumental in the success of this project. Sample agencies and activities include the following: (a) Beth Sholom Life Care Community: Students learned about the continuum of care for physically and cognitively impaired older adults. (b) Better Housing Coalition (BHC) provides social services to help seniors “age in place” in community properties. Social workers employed by both Beth Sholom and BHC mentored student volunteers within their respective agencies. Students met individually with seniors to engage in life reviews and assisted with crafts, social, and intergenerational activities. (c) Circle Center Adult Day Services: Students assisted participants one-on-one with meals, exercise, and activities, and facilitated group activities. (d) Linwood Robinson Senior Center where students taught computer skills to individual seniors and assisted with group activities. Two agencies served predominantly African American older adults; the other two served a more heterogeneous population. This diversity of sites exposed students to a range of needs in the aging population, including the well elderly.

In addition to the volunteer experience, students completed two brief reflection papers and prepared an in-class presentation. These assignments allowed the students to discuss their volunteer experiences, linking this to core communication concepts covered in the course. This was the first contact for most students with social work professionals and clients one year prior to their first field placement. Many students noted this experience enhanced their learning about communication, older adults, and the social work profession.

The student reflection papers provided some of the data for thematic analysis in this study. Following an intrinsic case study approach (Stake, 1995), the researchers used categorical aggregation or pattern identification, to identify topics that led to outcomes. We highlight some specific student quotes to further illustrate those outcomes and how they compare with the literature. Triangulation was used between the PI and the instructors of the course to develop consensus and increase the trustworthiness of the findings. In-class presentations also served as a form of data triangulation (Denzin, 1978) as the PI was invited to the end of the semester to observe the students’ learning. Utilizing student outcomes further demonstrates the usefulness of incorporating experiential learning opportunities in the BSW curriculum and reaffirms the work and processes needed to make these opportunities sustainable.

Description and Implementation of Assignments

Students were introduced to the course structure and the gerontological curriculum infusion on the first day of class. The course syllabus outlined three relevant assignments:

1. volunteer for no less than 10 hours at an approved agency serving older adults,

2. written journal reflections (two) relating to the volunteer experience with older adults, and

3. in-class presentation where students report on their volunteer experience with older adults, and tie their learning to the competencies of the communications course.

On the first day of class, prior to any exposure to the volunteer component or aging content, the instructor engaged with the students in a discussion about myths of aging using the What Is Your Aging IQ? scale (www.nia.nih.gov), and about the breadth of aging service opportunities using the Older Adult Service Matrix from the Social Work Leadership Institute (www.socialworkleadership.org). During the second class session, social workers/agency representatives were invited to class to introduce students to the volunteer opportunities, as well as to share their passion about their work with older adults. Students were able to choose one of these agencies at which to complete their volunteer hours (though a few students volunteered at other approved aging-related agencies). Following the initial two class sessions that focused primarily on aging, instructors continued to use older adults as a sample population when illustrating key course concepts.

The Older Adult Service Matrix is an especially important tool. Developed by the Harford Partnership Program for Aging Education (HPPAE, see www.hartfordpartnership.org for more details), this matrix depicts the range of social services across the top axis including wellness/prevention, social/community/spiritual engagement, housing, mental health care, health care, legal system, and planning/advocacy. Along the vertical axis, well elderly, functionally impaired, and end of life categories subdivide and identify specific roles and settings for each of the practice areas listed. Students are consistently surprised to see the variety of care settings and services compared across level of need. The matrix begins to challenge their values and biases regarding aging and to see that working with older adults is more than working in a nursing home.

Hearing from four or five passionate social workers who have dedicated their careers to working with older adults in a wide variety of settings was also motivational, regardless of which agency the students chose for their volunteer work. After hearing about the agencies, they were able to choose which agencies most interested them. This element of choice was appreciated by students.

The agencies that were selected have long-standing relationships with the school of social work as field placements and more recently as key partners in our Hartford Practicum, Partnership Program. The PI and the instructor of the course visited each agency prior to approval as a volunteer site for this project. The agencies were selected on the basis of the variety of clients they serve, the proximity to campus and accessibility to students, and on the historic relationships between the agency representative and the school of social work. These criteria were used to make the project as sustainable as possible from the beginning.

The students were required to make contact with the agency and schedule their volunteer times. Meeting an agency representative in class helped the students feel more at ease in reaching out to an agency to begin their volunteer experience. Students were asked to spend at least two consecutive hours at their volunteer agency, but were allowed to split their total time between two different agencies if desired. No major issues related to students’ completion of the required volunteer hours were encountered over the three semesters.

In addition to the 10 volunteer hours, students were required to turn in written reflections of their experience on two separate occasions. The first reflection guideline was broad and open ended, asking students to reflect on their biases and prejudices related to older adults. The assignment had a strategically assigned due date to encourage students to start their volunteer hours early in the semester. All students completed the assignment, giving the instructor helpful and early feedback on the process. The second written reflection was due toward the middle of the semester, requiring the student to begin to incorporate what they were learning from their volunteer experience with the course content aimed at teaching communication skills. These two reflection assignments helped students step out of both the volunteer assignment and the course content requirements, and encourage them to see how this experience was impacting their view of gerontological social work. These two written assignments also provided an avenue for the instructor to monitor the process.

At the conclusion of the volunteer experience, students were required to complete and present a group project. The goal of this final assignment addressed the second gerontological social work competency selected for this project: “Use empathy and sensitive interviewing skills to engage older clients in identifying their strengths and problems.” Students were required to creatively demonstrate how their volunteer experience meshed with the course competencies. Students were given significant latitude regarding format and structure of the presentation, and many took advantage of the opportunity for creativity. Presentations ranged from PowerPoint, to sophisticated videos, to organizing class activities, posters, dramatic portrayal, and others. Many students identified this final “creative presentation” as their favorite part on course evaluations. The PI and the BSW program director were invited to observe the presentations. With the students’ permission, one video that was created for this assignment was shown at the BSW program committee to help foster faculty engagement. For most students, this final project encouraged them to demonstrate their learning about both the aging population and the non-aging course competencies.

At the conclusion of each semester, additional student feedback was solicited by the PI via class discussion, or the students’ written responses to questions about their experiences including what they would change. Helpful insight was gained and applied to future course syllabi and planning based on these evaluation activities.

Preliminary Findings

Student Evaluations

The quotations we provide here were identified through a thematic analysis and were selected to demonstrate the variety of experiences rather than a reduction or congruity of student experiences. Students were asked about the experience in an ungraded discussion/qualitative questionnaire. When asked, “What did you learn about yourself?” they responded: “ . . . I didn’t know working with older adults was a ‘social work’ job” and “I realized what a variety of options there are in social work.” Others responded with “I thought I knew what I wanted to do, and even though I may not be working with older adults directly, I now know there are lots of options.” The theme continued, “I realized that, although I consider myself to have good communication skills, I have never had to practice and develop skills with older adults.” When prompted to continue, this student stated, “In social work, I know that even working with families, I will likely end up needing to communicate effectively with older adults.” Another student shared that “ . . . with my personality I would be great for working with [older adults].” Another student similarly writes, “I learned that I have a lot of patience and that I do want to pursue a career working with older adults.” One student shared her experience adapting to her environment in this way: “When I started I thought I had more patience than I did, but I found more.” Another student found that working with older adults is not a one-way street: “ . . . help and communication can go both ways.”

When asked what lessons they learned about older adults, some of the responses included “ . . . to value the experience of older adults and be more self-aware when it comes to my communications with seniors.” Another student reported, “I learned that older adults could be lively or unmotivated just like younger adults.” Also, “ . . . it is impossible to stereotype because of the vast differences in this population.” For some students, the experience does not translate into a career path, but still holds some benefits: “The two most important lessons I learned are that working with the elderly is not for me and in many ways, the elderly still act young.” One student shared this insight: “ . . . the aging population needs/wants validation just like the rest of us, and each elderly individual is extremely unique. Their personality has not deteriorated through the years.” Some students learned more specific lessons: “there are varying degrees of ability and challenges. Economic inequality and community access needs to be more adequately addressed among those in subsidized housing.”

Students also commented on the volunteer requirement: “You can learn skills in a classroom, but the volunteer experience helped connect the learning with the practicing of communication skills.” Another student noted, “It was insightful and thought provoking and somewhat of a challenge. Overall, it was rewarding and although I may not want to work with this population, I may still volunteer.” One student commented on their reluctance to volunteer at first: “I learned to always go into a new situation with an open mind, and be willing to go outside your comfort zone.”

When asked whether any of their stereotypes were challenged, one student responded, “I was afraid I would be ‘too much’ and too energetic and over stimulating, but they enjoyed it and would engage with you.” Another student shared, “I found that [older adults] appreciate sharing about their lives and connecting with people.” And “they don’t like to be coddled. They want to feel useful for the most part and I had to understand that.” And “ . . . older adults aren’t all that different from young people and I need to not put so much space between us.” One student summed it up this way: “Don’t stereotype and they are more similar to you than you may think.”

Students seem to have grasped the lessons they were intended to learn. They grew in self-reflection and self-awareness, they stepped outside of their comfort zone, they had their own stereotypes and biases challenged, and by in large, they got a glimpse of the need for well-trained social workers in gerontological settings. The following quote represents the overall experience:

I have learned how rewarding working with older adults can be. They seemed to really appreciate the work we did. I also learned that older adults are fun and intelligent people just like us who could use more attention and respect.

Students did express some concerns regarding challenges with transportation, scheduling their hours, and generally balancing their work and school commitments with this volunteer experience.

Discussion

The results of this BEL project substantiate much of what the literature shows in regard to the other GeroRich initiatives. Generally, exposing students to knowledge of the aging population and providing opportunities for interaction with older adults can enhance attitudes toward older adults and improve gerontological knowledge (Cummings et al., 2006; Dorfman et al., 2008; Green et al., 2005; Holody & Kolb, 2011; Lee & Waites, 2006; Singleton, 2009; Snyder et al., 2008). The value of this article is twofold: first, a demonstration of the established pedagogical theory related to experiential learning and, second, a practical, sustainable example sharing how we infused a brimming BSW program with aging curriculum and qualitatively showed an increased interest on the part of students in working with older adults. This program introduced 75 BSW (sophomore level) students to older adults and affected their own values and biases about aging. Requests for field placements with a gerontological focus have increased, students continue to volunteer with the partnering agencies, and this BEL-initiated GeroInfusion project is now a permanent aspect of the course through service-learning, which has also increased the number of volunteer hours from 10 to 30.

Additional positive outcomes were seen with the partnering agencies and the instructors of the course. Five different agencies benefited from student volunteers who helped seniors with a variety of skills such as learning how to use the computer to email or sign up on social networking sites to connect with family and friends. Two doctoral students who served as adjunct faculty for this course are now teaching in social work programs elsewhere (one in Idaho, one in California), and have taken this experience with them to their new positions. Although this attrition of involved faculty is one of the challenges (see below), these two doctoral students helped to highlight the unintended benefits. One student, whose practice and research interests/experience are adolescent related, said this BEL project was pivotal in helping him learn more about older adults and ways to integrate content and experiential components into his teaching.

The greatest challenge we experienced is the turnover in adjunct faculty who teach this course. This is a course that is often taught by doctoral candidates; they bring good experience, tremendous interest, and receptivity because this in one of their first teaching experiences, but they finish their dissertations and leave. Both doctoral students (and co-authors) taught the course twice, which was very helpful, but the reality is that this course has not been “owned” by a full-time faculty member who will consistently integrate this project. The management of this activity in terms of introducing it to the faculty member and getting them “on board” has been difficult but doable. We have been able to infuse this project deeper into the curriculum because of several “lessons learned” from the literature that indicates ways to make this project sustainable.

One of these lessons is to assure that your BSW program director and program faculty are involved and supportive. This is critical and we were fortunate that a new program director who started during the first year was incredibly interested and supportive. He invited the PI to speak twice to the program faculty, first as more of an introduction, and later to provide an update and solicit feedback they might have received. The faculty were willing to try new approaches and shared the vision for the future of this project. Achieving this “buy-in” proved to be extremely beneficial. Finally, we discovered that it was important to record the panel presentations of agency representatives during the first week. This way if students were absent, they were able to view the presentation at a later date; also, the panel is time intensive and may not always be feasible for the agency representatives each semester.

Implications and Conclusions

We are quick to identify several limitations with this study. We used three different interventions, each aimed at encouraging students to explore their interest in working with older adults: (a) guest speakers, (b) volunteer experience requirement, and (c) reflection and process assignment. Although we observed an increase in interest on the part of the students to work with older adults, we were unable to determine the influence of the interventions individually; rather, we were only able observe their impact cumulatively. Furthermore, we used a thematic analysis to identify themes in the qualitative data, but we did not use a more rigorous method such as constant comparison or include a process to evaluate inter-rater reliability. Although it is important to note these limitations for the benefit of future research, we are confident that our preliminary findings contribute to this important and growing body of literature.

We provide detail about the development and implementation of our program, knowing that it is unique to our program, but hoping for relevance to others interested in such initiatives. It is promising that our findings are similar to many in the literature and we recognize that additional research is needed in this area including the long-term impact of such initiatives and the outcomes of students entering into practice with older adults. We also recognize that, although we focused on preparing social work students to assess and engage with older adults, other fields that also work with aging populations can make use of these findings such as human services, psychology, sociology, gerontology, and geriatrics. Additional research may examine the applicability of the infusion method across the curriculum in social work. In other words, can this model be applied in other courses? Given the growth of the aging population and the need for prepared, competent, and compassionate social workers, it is important to provide opportunities for students to gain more knowledge and skill in this area. Infusing the social work curriculum with gerontological content and opportunities to experience older adults is one strategy to help address this need.