1 ©2009 national association of social workers. all rights reserved. strengthening the cancer...

1©2009 National Association of Social Workers. All Rights Reserved.

Strengthening the Cancer Knowledge and Skills of the Social Work Labor Force

Maureen Y. Lichtveld, MD, MPHAlison P. Smith, BA, BSN, RN


• 501 (3) c (not for profit) organization

• Organization of leaders

– Private – pharma, biotech, insurance

– Public – federal, state, local health agencies

– Not-for-Profit – professional, advocacy, care-giving organizations

• Collaborate to address issues that can not be solved in isolation

• Work spans the continuum of research and care


Learning Objectives

At the end of this session, participants will be able to:

• Articulate the significance of the health workforce shortages effecting people at risk for and living with cancer

• Identify priority areas for cancer competency among LCSW students and practicing clinicians

• Describe the practical utility and flexibility of the competency tools for strengthening social worker’s cancer knowledge and skills

• Apply competency-based methods and tools to develop cancer programs for social workers


The Cancer Workforce Shortage

Challenge


Supply of Social Workers

Health of the Profession - From NASW• The social work labor force is older than most professions with nearly

30% of licensed social workers over 55 years of age • Social workers employed in hospices are most likely to report

vacancies as common(19%), followed by those in hospitals (14%) and health clinics (8%)

• They are more likely to serve clients of color than social workers overall (52% versus 43%)

• Significantly less satisfied with client access to mental health services than licensed social workers overall (43% versus 59%)

• Those practicing in rural areas are least satisfied with access to resources

• There are approximately 1500 oncology social workers


Supply of Cancer Team Members

Shortage of cancer specialists:

• Social Workers

• Physicians / Oncologists

• Nurses

• Pharmacists

• Technologists

• Researchers

• Cancer Registrars


Demand for Cancer Services

• Cancer is the second most common cause of death by disease claiming the lives of more than half a million people per year (ACS, 2007)

• Cancer rates are expected to increase as baby boomers age (CDC, 2000)

• The lifetime probability of developing cancer is 1 in every 2 men and 1 in every 3 women (NCI, 2005)

• Five-year cancer survival rates have risen to 64% for adults (CDC, 2005)


Overview of Challenge

Supply, Demand, & Action

• Widespread shortages across the cancer workforce

• Demand for cancer services exceeds current and projected needs

• Many organizations addressing discipline- or specialty-specific cancer workforce issues


Strengthening the Non-Oncology Health Workforce

Solutions


Untapped Opportunity

Oncology Specialists All Professionals

Social Workers1,200 AOSW Members

380 APOSW Members

320, 000 Licensed Clinical Social Workers

Nurses21,000

Oncology certified 2,000,000

Registered Nurses

Illustrative


Cancer Core Competency Initiative

Goal:

Strengthen the basic cancer competency

(knowledge, skills, and attitudes)

of non-oncology health workforce


Competency StandardsIn order to reduce the nation’s burden of cancer, any health professional must be able, within the scope of his/her professional practice, to:

Domain I – Continuum of Cancer Care• Describe the components comprehensive cancer care, including team

communication , diagnosis and treatment, palliative care, survivorship• Describe cancer prevention guidelines (e.g., USPSTF, ACS)• Direct an individual to resources for cancer prevention

Domain II – Basic Cancer Science• Define the purpose and requirements of cancer registries.• Describe the clinical trial process beginning with informed consent

Domain III – Communication & Collaboration• Incorporate cross-cultural communication strategies in conveying cancer

information• Describe the contribution of each professional perspective in the development of a

cancer care plan

examples


Breadth & Depth of Competency Standards

AdministrationAmbulatory Clinics Academics

Acute Care Clinics Cancer Centers

Home Health Agencies Professional Societies

Advocacy Organizations

Domain IContinuum of Care

Prevention / Early DetectionTreatment / Survivorship

Palliative Care

Domain IIBasic Cancer Science Etiology / Epidemiology

Clinical Trials Cancer Surveillance

Domain IIICommunication & Collaboration

Interdisciplinary CarePsychosocial CommunicationCross-Cultural Communication

Grieving

Work Setting

Dis

cip

lin

e

Competency Standards

Allied Health MedicineNursingPharmacyPublic HealthResearchSocial Work

StudentsResidents/FellowsField FacultyPracticing Professionals


Cancer Core Competency Initiative:Program Elements

• Planning– Competency Standards– Program design tools

• Implementation– Educational encounter

• Evaluation– Knowledge– Skills– Attitudes

15

Pilot Site Findings:Marshall University - Huntington, WV

• Medical Students• Breast cancer screening & patient communication• Standardized patient examination & communication

• Improvement in Knowledge: 119% from pre-post test

• Measureable clinical & interpersonal skill increases

©2009 National Association of Social Workers. All Rights Reserved.


Pilot Site Findings:California University of Pennsylvania - California, PA

• Social Work Students & Field Instructors• Cancer-related Anxiety and Depression• Classroom, on-line, and standardized patients

• Improvement in Knowledge: 136% from pre-post test• Measurable increases in ability to recognize and manage anxiety

and depression


Pilot Site Findings:Audrain Medical Center - Mexico, MO

• Public health nurses working in rural counties• Skin cancer screening & early detection • Course and clinical rotation


• Measureable increases in differentiating between benign and malignant lesions


Pilot Site Findings:University of Pittsburgh Medical Center - Pittsburgh, PA

• Primary care practitioners working in rural areas

• Survivorship

• Workshop, enduring Webcast, and toolkit


• Measurable increases in ability to assess and manage survivorship issues


Pilot Site Findings: Qualitative Outcomes

Institution Enhanced

visibility/ credibility

Provided foundation for future trainings

Community Enhanced

relationship with institution

Addressed needs Benefits of better

prepared/ increased workforce

Professional Professional

developmentLearner

Increased knowledge

Increased confidence

Received tangible reference materials

Enhanced academic experience

Enhanced professional self-reflection


Cancer Core Competency Initiative:Pilot Site Findings

UTILITY

• Pilot sites found the cancer core competencies to be highly useful

FLEXIBILITY

• Implementation of the competencies was feasible across cancer core continuum, professional settings, and disciplines


Investing in a Competency-Driven Approach to Improve Cancer Care

Getting the Results


Anatomy of a Competency Standard

Competency statements define what a professional should know or do:

Define palliative and end-of-life care

Targeted cancer contentLevel of complexity and/or independence

Within context:Scope of PracticeLevel of Expertise

Role and Responsibilities

23

Bloom’s Taxonomy

Increasing

level of

independence

KNOWLEDGE

COMPREHENSION

APPLICATION

ANALYSIS

SYNTHESIS

EVALUATION


Adult Learning Practices

• Adult learning environments are designed to minimize dependence and maximize independence.

• Adult instructional strategies adapt to the learners’ previous experiences including skills and content.

• Faculty in adult learning settings function as both instructors and facilitators.

25

Competency to Curriculum

Verb

Describe

Instructional Design

LearnerAssessment

Dialogue Short Answer

Apply Case Study Role Play

Synthesize Table Top Essay Question

Evaluate Peer Review Standardized

Patients


Planning, Implementation & Evaluation Tools: Logic Model

INPUTS OUTPUTS OUTCOMES

Program resources

Activities Participation Short Medium Long-term

Efforts on the part of the program or intervention staff

Changes in the participants

Changes in the learner’s knowledge, attitudes, beliefs

The logic model assures that all of the program resources directly support the achievement of the desired competency outcome.


Planning, Implementation & Evaluation Tools: Validation Template

28

Steps for Program Development

Sustain Efforts

Through Sharing

Implement & Manage

with Attention to Details

Evaluate and Interpret

Data

Define Audience & Topic Area

Refine Competency

Focus

Build a Balanced

Leadership Team

Develop Logic Model & Validation Template

IMPLEMENT

EVALUATE PLAN

PLAN

Complete Needs Assessment & Interpret Findings



Define Audience & Topic Area

Build a Balanced

Leadership Team

Needs Assessment & Interpret Findings

Are there colleagues who would benefit from a competency program?What cancer topic would help professionals meet the needs of clients/patients?

Who are the topic experts?Who can foster support for the program?

What will motivate participants?What will translate learning into practice?



What do I want the professionals to know or do?Refine Competency

Focus

Implement & Manage with

Attention to Details

Does IRB approval need to be obtained? Can CME/CEU credit be provided?

Logic Model& ValidationTemplate

What resources will support my program? What programmatic activities will occur?What are the desired changes in participants?



How can participants be evaluated through pre-post tests, skills tests, and/or participant perceptions?

Evaluate and Interpret

Data

Sustain Efforts

Through Sharing

How can project activities be shared within and outside of the professional community?


Resources and Next Steps

Summary

33

Program ResourcesPilot Site Report

Universtiy of Pittsburgh Medical Center

Pilot Site ReportMarshall University School of Medicine

Pilot Site ReportCalifornia University of Pennsylvania

School of Social Work

Pilot Site ReportAudrain Medical Center

Addressing the Cancer Workforce CrisisUsing a Competency-Based Approach

with Non-Oncology Professionals

Pilot Project Evaluation Report

July 2008

Summary Publications

Overview & “How to” Guidance

Examples & Templates

34©2009 National Association of Social Workers. All Rights Reserved. 1

Cancer Core Competency Initiative

Summary

• Effective method to address the cancer workforce shortage

• Applicable in a variety of professional disciplines and settings

• Bolsters professional development and retention efforts

• Provides numerous resources for competency-based program development

• www.cancercorecompetency.org

• [email protected]

http://www.cancercorecompetency.org/

1 ©2009 national association of social workers. all rights reserved. strengthening the cancer...

Documents

licensed social workers

oncology social workers

years of age social

supply of social workershealth

cancer competency

cancer rates

cancer programs

cancer servicescancer