Teaching and learning communication skills in social work (PDF)

KNOWLEDGE REVIEW Teaching and learning communication skills in social work education KNOWLEDGE REVIEW 6 Teaching and learning communication skills in social work education The Social Care Institute for Excellence (SCIE) is an independent company and a charity, funded by government and other sources in England, Wales and Northern Ireland. SCIE’s mission is to develop and sustain the knowledge base for social care, and to make it available, free of charge, to the public and professionals alike through publications, resource packs and the electronic Library for Social Care (www.elsc.org.uk). Better knowledge for better practice Better knowledge for better practice 6 The better the education and training of social workers, the better the outcomes for users and carers. The Social Care Institute for Excellence (SCIE) is supporting the new degree in social work by providing a series of reviews on the best ways of educating and training social workers. Teaching and learning of communication skills is a core social work skill, and this review assists social work educators and students by examining the different approaches to this critical aspect of social work education. Other reviews in this series will focus on the teaching and learning of assessment, of law in social work, of partnership working, of interprofessional working and of human growth and behaviour. swapltsn Social Policy and Social Work Social Policy and Social Work Learning and Teaching Support Network Learning and Teaching Support Network  i KNOWLEDGE REVIEW Teaching and learning communication skills in social work education Pamela Trevithick, Sally Richards, Gillian Ruch and Bernard Moss With Linda Lines and Oded Manor 6 Better knowledge for better practice P P P R E S S POLICY  ii Knowledge Review 6: Teaching and learning communication skills First published in Great Britain in May 2004 by the Social Care Institute for Excellence (SCIE) Social Care Institute for Excellence 1st Floor Goldings House 2 Hay’s Lane London SE1 2HB UK www.scie.org.uk © University of Bristol, University of Reading, University of Southampton, Staffordshire University, 2004 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 1 904812 12 0 Pamela Trevithick is Senior Lecturer in the School for Policy Studies at the University of Bristol. Sally Richards is a Lecturer in the School of Health and Social Care at the University of Reading. Gillian Ruch is a Lecturer in the Division of Social Work Studies at the University of Southampton. Bernard Moss is a Principal Lecturer in Social Work and Applied Studies and a Learning and Teaching Fellow at Staffordshire University. Linda Lines is a Lecturer in Work-based Learning in the Department of Social Work at the Open University. Oded Manor is an Independent Groupwork Consultant, formerly Principal Lecturer in Social Work, Middlesex University. The right of Pamela Trevithick, Sally Richards, Gillian Ruch, Bernard Moss, Linda Lines and Oded Manor to be identified as authors of this work has been asserted by them in accordance with the 1988 Copyright, Designs and Patents Act. All rights reserved: no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of SCIE. Produced by The Policy Press University of Bristol Fourth Floor, Beacon House Queen’s Road Bristol BS8 1QU UK www.policypress.org.uk Front cover: photograph supplied by kind permission of third-avenue.co.uk Printed and bound in Great Britain by Hobbs the Printers Ltd, Southampton.  iii Contents Preface v Acknowledgements vi Executive summary vii 1. Introduction 1 1.1. The new social work degree 2 1.2. The Working Group and preparation of the review 4 2. Methodology 7 2.1. Electronic databases 7 2.2. Hand searching 7 2.3. Authors’ personal libraries/preliminary scoping 8 2.4. Inclusion criteria 8 2.5. Data recording and quality appraisal 8 2.6. Results 8 3. Theoretical frameworks underpinning the learning and 11 teaching of communication skills 3.1. Psychology and counselling theory 13 3.2. Communication and learning theory 14 3.3. Other theoretical perspectives 15 3.4. Texts covering communication skills 17 3.5. Summary of theoretical concerns 18 4. Teaching and learning communication skills: a review 19 of the evidence 4.1. Design and implementation 20 4.2. Impact of training 21 4.3. The contribution of IT and multi-media programs 23 4.4. Skills laboratories 26 4.5. Summary of narrative and evaluative concerns 27 5. Meeting particular communication needs 29 6. Summary of key findings 33 6.1. Theoretical underpinnings 33 6.2. The context and style of learning and teaching 33 6.3. The transferability and sustainability of learning and 34 teaching 6.4. Evaluation 34 6.5. User involvement 35 6.6. Transcultural communication and communication 35 with people with particular needs  iv Knowledge Review 6: Teaching and learning communication skills 7. Key messages 37 8. Conclusion and challenges for the future 39 References 41 Appendix A: Search strategy 59 Appendix B: Annotated bibliography of key references 103 Appendix C: Glossary of terms 113 Index 129  v Preface This review is one of a series supporting the introduction of a new degree in social work. Teaching and learning of communication skills is a core social work skill, and this review assists social work educators and students by examining the different approaches underpinning this critical aspect of social work education. The review will contribute to a resource guide for social work educators and students, to be made available early summer 2004. We are grateful to the authors for undertaking this review, and also to the Social Policy and Social Work Learning and Teaching Support Network (SWAPltsn) for their support and assistance as co- commissioners of this work. Other reviews in this series will focus on the teaching and learning of assessment, of law in social work, of partnership working, of interprofessional working and of human growth and behaviour. The review focuses specifically on the teaching and learning of communications skills for those working in the field of social care. Further work is also planned to examine the literature on teaching and learning of communication skills in other sectors such as medicine, nursing and allied health professionals, improving the communications skills of users and also on communication with children. Wendy Hardyman Research Analyst  vi Knowledge Review 6: Teaching and learning communication skills Acknowledgements The authors would like to extend their appreciation to Julia Phillips (SWAPltsn) for her efficient and sensitive management of the project, and her keen sense of humour, Jackie Rafferty (SWAPltsn) for her incisive comments on the final draft and SCIE staff for the support and guidance provided throughout the review. We would also like to acknowledge the skilful work undertaken by Gill Ritchie, Mark Rodgers and Lisa Jones at the Centre for Reviews and Dissemination, University of York.  vii Executive summary • This review of the literature on the learning and teaching of communication skills in social work education was commissioned by the Social Care Institute for Excellence (SCIE), in collaboration with the Social Work and Social Policy Learning and Teaching Support Network (SWAPltsn). • The context for the review is the introduction of the new social work degree. Underpinning this new award are the National Occupational Standards and Key Skills for Social Work, the Quality Assurance Agency Subject Benchmarks for Social Work, the Department of Health Requirements for social work training issued in 2002 and the National Assembly for Wales (NAW) Requirements for an award of a degree in social work, issued in 2003. Throughout, there is an emphasis on the importance of communication skills for social work. • The purpose of the review was: ◗ to identify the key messages concerning the learning and teaching of communication skills on social work qualifying courses/training programmes, in order to facilitate effective practice with a range of client groups; and ◗ to enable social work educators to reflect these messages in the design and delivery of social work programmes. • A search of electronic databases was conducted by the Centre for Reviews and Dissemination (CRD) at the University of York using search terms agreed by the Working Group. This generated a vast literature of 8,023 records, mostly relating to communication skills for health professionals. Only records relating to the learning and teaching of communication skills for social care professionals were included in the review, with additional material identified by hand searching key journals and from group members’ personal libraries. • The review focused on two main areas: ◗ the theoretical underpinnings for the learning and teaching of communication skills; ◗ how communication skills are being taught and to what effect.  viii Knowledge Review 6: Teaching and learning communication skills Findings • Much of the literature was from North America and may not be relevant to the UK. Relatively little has been published in the UK on the learning and teaching of communication skills in social work education. • The review revealed the absence of a common language in the area of communication skills. Terms such as ‘interpersonal skills’, ‘listening skills’, ‘interviewing skills’, ‘helping skills’, ‘counselling skills’ and ‘micro- skills’ were used, but often without careful definition. • The papers tended to draw on either humanistic psychology and counselling theory, or on communication and learning theory. The link between theory and practice is often tenuous and there is a lack of evidence of any coherent theoretical framework that informs the learning and teaching of communication skills. Theoretical coverage tends to be implicit or, if explicit, lacks depth and critical analysis. • Most of the training programmes described focused on developing empathy, although micro-skills training, which is concerned with the process of communication, was also in evidence. Recent examples were found of innovative approaches to the learning and teaching of communication skills in social work education in the UK. These attempt to link theory and practice more effectively and to create a suitable learning environment for skill development. • IT and multi-media based resources are increasingly used in communication skills training. The limited evidence available suggests that they are best used to support, enhance and consolidate – not replace – face-to-face teaching. • There is little evidence that communication skills training includes either written communication skills or specialist skills for work with children or adults with particular communication needs. • The findings from evaluative studies suggest that communication skills training generally increases skilfulness and is well received by students. However, improvements do not necessarily transfer to practice settings with service users, which indicates the importance of integrating communication skills training with practice learning. • The systematic evaluation of communication skills training presents substantial methodological difficulties. A particular challenge is the definition and measurement of outcomes, which typically are measured in terms of changes in the student rather than in service users.  1 1 Introduction Good communication is at the heart of best practice in social work. Indeed, social work was one of the first professions to recognise the importance of communications skills and how these skills link to effective practice1-4. It is through our capacity to communicate that we relate and convey our respect and concern for others5. Communication skills are also essential to the task of assessment and later decision making, not only for social workers but also for other professionals, particularly those working in the field of health and social care. The importance of communication skills can also be seen in government policy, and the emphasis being placed on the role of service users and carers in relation to the new social work degree, and patients (consumers) in relation to health research, policy and practice. For all professions, the failure to communicate effectively can lead to serious – and sometimes tragic – consequences. In relation to social work, these failures have been been brought to light in the public inquiries into the death of children known to social services6-8, the most recent tragedy being the death of Victoria Climbié9. Poor communication among professionals – and in relation to service users – is one failure that has been highlighted in many of these reports. These events form part of the background to this knowledge review. Another important influence has been the development of the new degree in social work, implemented by the Department of Health (DH) and the National Assembly for Wales (NAW). With funding made available from the DH and NAW, the Social Care Institute for Excellence (SCIE), in collaboration with the Social Work and Social Policy Learning and Teaching Support Network (SWAPltsn), agreed to commission a Working Group to undertake a research review. The task of the Working Group was to undertake a review of the literature on the learning and teaching of communication skills in social work education, in order to: • identify the key messages concerning the learning and teaching of communication skills on social work qualifying course/training  2 Knowledge Review 6: Teaching and learning communication skills programmes, in order to facilitate effective practice with a range of client groups; and • enable social work educators to reflect these messages in the design and delivery of social work programmes. Although the work most closely relates to the DH identification of communication as one of the core skills, this knowledge review is also relevant to Wales, in that communication skills form part of the requirements laid down by the Care Council for Wales (CCW). 1.1. The new social work degree The new degree provides an important context and a strong impetus for this knowledge review because of the emphasis placed on communication skills in the new curriculum. For example, communication skills are a prominent theme in each of the strands that contributes to curriculum development: • The national occupational standards10 and Key Skills for Social Work defines the competences required for the social work role. • The Quality Assurance Agency benchmark statement11 places the education and training of social workers firmly in the context of the learning outcomes and academic standards expected at degree level. • The Requirements for social work training12 lays down entry requirements for candidates applying for social work courses, and clear teaching, learning and assessment standards. The document also identifies five key areas, one of which is “communication skills with children, adults and those with particular communication needs”13. The requirements for Wales also place great emphasis on effective communication. • The Care Councils (General Social Care Council [GSCC], Care Council for Wales [CCW]), whose roles are to monitor the quality of social work education, have a strong emphasis on students’ ‘fitness for practice’. This inevitably includes the quality of students’ communication skills and how these are used in all aspects of their social work practice. • Additional funding has been made available to social work programmes to establish skills laboratories to help students develop their communication skills in ways that are effective and transferable.  3 As part of the Requirements for social work training put forward by the Care Councils, the emphasis in the new degree is not only on improving interprofessional communication but improving communication skills with service users. Pierson and Thomas14 highlight the importance of communication in social work in relation to service users, and also with regard to others involved in practice effectiveness and ‘high quality results’: In social work and social welfare agencies, good, clear, accurate communication is essential in several contexts. First, all organisations should provide quality information about services that they offer, which should be widely accessible. This will involve not only a range of languages relevant to their local community, but also in electronic, Braille and perhaps taped formats. Secondly, all workers need to develop appropriate communication skills both for face-to-face and for written communications. The ability to avoid jargon and to communicate in good, clear English or Welsh is of paramount importance. When using other languages, it is equally important that the clear meaning is fully communicated. Workers also need to consider the context in which they are required to speak and to write, and to ensure that they develop a style that is appropriate and relevant for their audience. Thirdly, some people have specific communication needs. People who take pride in belonging to the deaf community, for example, need to be offered trained competent British Sign Language (BSL) interpreters so that they can communicate clearly in their first language. Some people who have serious communication problems as a result of disability may require specialist support for communication (see Braille, low-vision aids, Moon). Fourthly, agencies that are closely collaborating on projects, working in partnership or negotiating service level agreements, need to develop effective channels for communication in order to enhance collaboration. Fifthly, with the developing emphasis upon a research culture in social welfare, workers need to be able to communicate clearly with funders, research colleagues and research participants in order to produce high Introduction  4 Knowledge Review 6: Teaching and learning communication skills quality results and be able to disseminate their findings clearly and imaginatively in order to improve practice. Finally, communication has a non-verbal dimension. Workers need to be aware of body language, and the importance of listening skills, as part of their effective communication repertoire.14 1.2. The Working Group and preparation of the review An invitation to apply to join a Working Group to write a review of the literature on the learning and teaching of communication skills in social work education was issued by SCIE/SWAPltsn in March 2003. From a wide range of people who expressed an interest in undertaking this task, six social work educators were selected to join the Working Group. All had experience of teaching communication skills, together with research knowledge in this field. In addition, the Working Group included a member of SWAPltsn who acted as a resource to the group. Representatives from SCIE were also involved with the Working Group in their role as commissioners, and also in relation to circulating papers and articles identified as relevant to the literature search and review. The process of identifying the literature for inclusion in the research review proved challenging. There exists a vast literature on communication skills, most of which related to the health professions. Some preliminary searching conducted by a research analyst at SCIE identified key literature and the utility of various search terms. These details, together with examples of relevant records, identified from preliminary searching, were passed on to the Centre for Reviews and Dissemination (CRD) at the University of York, who were commissioned to undertake an electronic database search. (See Appendix A for a more detailed account of the search strategy adopted.) Hand searching of selected journals produced further material, and the Working Group also drew on books and articles from their own personal libraries. Given the extensive literature on communication skills, determining the scope of the search presented some difficulties. It was anticipated that the literature in this area relating specifically to social work might be quite limited. At the same time, it was felt that the literature from professions outside of social work and social care, such as nursing, medicine  5 and allied professions, was likely to be relevant to social work. In time it became clear that the limited time and resources available for this task meant that it was only possible for the knowledge review to focus on those areas most relevant to the new degree. For this reason, it was agreed to focus on those records relating to the learning and teaching of communication skills for social care professionals. As part of the selection process, two group members read and coded all abstracts considered to be relevant under four headings: theoretical, narrative, evaluative, and specialist communication skills. These categories enabled the Working Group to explore the extent to which theoretical knowledge underpins the learning and teaching of communication skills. They also allowed a focus to be placed on how communication skills are being taught on social work courses, and to what effect. Working collaboratively in pairs, group members prepared a draft report. This was submitted to two independent reviewers, and the DH and NAW, for their comments. The completed report has benefited from the reviewers’ observations and recommendations. The next chapter outlines the methodology used. This is followed by the findings from the literature review which address four main questions: • What theoretical frameworks inform the learning and teaching of communication skills? • How have social work teachers designed and implemented programmes for learning communication skills? • What has been the impact, if any, of learning communication skills? • What is known about the learning and teaching of specialist communication skills? The knowledge review concludes with key messages and suggestions for further work. Introduction  6 Knowledge Review 6: Teaching and learning communication skills