Simulation in Social Work: Creativity of Students and Faculty during COVID-19

Abstract

Simulation learning plays an important role in social work education, allowing students to explore how theory and practice parameters can be integrated into actual situations they are likely to experience in the field. The arrival of COVID-19 and the sudden cessation of in-field practicum opportunities raised challenges for students to gain needed practice experience. Simulation offers an opportunity to enhance learning in place of some direct experience when that is not available. This paper reports on a simulation development practicum, where students, not able to be in an agency, sought out ways to achieve learning through the development and implementation of simulation learning. This was combined with a literature review. Results showed that student-generated simulation could be used to support direct practice learning. This project also illustrated that social work simulation can be used to help students safely explore areas of practice that they may not be exposed to in practicum through scenarios that cause them to examine how to work with clients where cross-cultural needs exist, and challenge ethical dilemmas in a ‘real-world’ situation while being required to face their biases.

1. Introduction

On 17 March 2020, field placement for students at Mount Royal University, Calgary, Canada abruptly changed as COVID-19 resulted in public health orders limiting options for field placements (World Health Organization 2020; Archer-Kuhn et al. 2020; Kourgiantakis and Lee 2020). The field placement model is a cornerstone of social work education which requires students to demonstrate how they incorporate theory and skill into practice in real situations.

Field placement for students enrolled during the spring semester required a markedly different approach in order to complete program requirements and accreditation and licensing requirements for graduation. The continuing public health orders resulted in development of creative solutions, grounded in social work practice that students would choose from. One of those options was the exploration of simulation in social work learning.

Students embraced this opportunity. The work undertaken was challenging, unique and bold. This field placement required students to review and incorporate educational content of previous courses into their assignments. At the conclusion of the field placement, student learning had significantly surpassed the knowledge and skill present at the outset, demonstrated by the completion of a review of simulation literature, development of simulation scenarios, background information for faculty, class discussions, assignment options, recordings of several scenarios and a list of future simulation topics to supplement current and future course delivery.

2. Challenges Related to COVID-19

We are immersed in a time where universities are experiencing reductions in funding, when students have a decrease in available financial resources exacerbated by COVID-19. Locally, nationally, and internationally, there are changes to the delivery of post-secondary education. With on-line delivery occurring at a significant rate due to public health restrictions, we anticipate that some of these changes will remain beyond the COVID-19 environment. Proposing increased simulation must consider the availability of funding to develop sufficient resources. The approach of rotating students through simulation where every student benefits even if they are not directly involved allows universities to do more with less. This approach is supported by Bethards (2014). “The reality of classroom constraints, such as time, budget, and scheduling issues, results in many students being relegated to the observer role. Students may feel they are missing out on critical learning experiences as an observer and may become inattentive during the scenario…evidence shows that observers may gain some of the same learning opportunities as the active participants” (p. 66). Bethards (2014) also cites two studies that are informative on this topic. The first study conducted in 2006, by Jeffries and Rizzolo, found that students in simulations, regardless of their roles, all experienced gains in self-confidence and knowledge, and were satisfied with the experience (p. 66). The second study, by Kaplan et al. (2012), found that there was no difference in retention between active and passive roles for students 3 weeks after their simulation experience (p. 66).

3. The Place of Simulation

The inclusion of simulation learning in social work is a growing area of interest (Bogo et al. 2014). Its usefulness as a learning mechanism is established in other professions at both the post-secondary level and through on-going professional development in the workplace. Post-secondary social work education is predicated on the development of theory and practice knowledge exhibited by the competency of graduates to enter the field with job ready skills. (Roberson 2020) notes the expansion of competencies over the past decade by the Council on Social Work Education in 2008, to a more holistic approach which includes professional judgement and critical thinking requires pedagogical adjustments best suited to engage and develop higher order skills in students. The onset of the pandemic and subsequent move to on-line learning provided the impetus to explore and develop new teaching modalities. As a result of COVID-19 restrictions to field placements (Government of Alberta 2020), four social work students nearing graduation and two faculty members took the opportunity to review literature related to simulation and adult learning theories. Following this, scenarios were developed and recorded. They will be trialed in courses in the fall semester of 2020 and winter semester 2021.

In 2020, Kourgiantakis and colleagues published Simulation in Social Work Education: A Scoping Review. This created an opportunity for students to carefully examine what has been occurring in the field and contemplate how that knowledge could enhance program delivery using simulation. Students used their own proximity to the classroom learning experience. This platform provided the opportunity for students to focus on how simulation could expand learning opportunities better preparing students for practicum and understanding the clinical challenges they may encounter. It also offered an opportunity to consider issues which students could benefit from—bridging theory and practice pre-practicum.

Simulation is an experiential learning strategy used in many educational settings such as nurse and physician training often utilizing paid actors in the role of the client. Bland et al. (2011) define simulation as,

a dynamic process involving the creation of a hypothetical opportunity that incorporates an authentic representation of reality, facilitates active student engagement, and integrates the complexities of practical and theoretical learning with opportunity for repetition, feedback, evaluation, and reflection.

(p. 668)

Gaba (2007) adds perspective, “simulation is a technique—not a technology—to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner” (p. 12).

Craig et al. (2017), discussed their perspective on role play and simulation in the health social work context. Role play, they note, is most often utilized by faculty in the form of activities that occur in a classroom/lab environment where students take on the roles of client and social worker to practice and develop critical social work skills. Role play in courses with laboratory components and using trained actors in simulations have been the most used, but widely used techniques in health care such as computer-generated models, computerized mannequins, simulated environments, and standardized patients are relatively new tools in the social work field (Regehr 2013). Role play is the most common classroom approach used to transfer theory into skill development. As role play is a cornerstone of social work education, the difference between the two is an important distinction for the field.

Much of the simulation literature is based on medical models that are incorporated in the pedagogical approach of post-secondary institutions for the training of nurses, physicians, and other health profession students. Rosen (2008) provides a detailed overview of the history of medical simulation and only a brief summary of that history will be recaptured in this article for the purposes of context.

Rosen (2008) notes that simulations which were already in use by aviation and military training were a necessary way to supplement formal education. Simulation in the medical sector began without the research in place to determine its value. While the benefits of simulations were unproven, the need for a different approach to training new physicians and nurses was too great. The inventor of the modern patient simulator, Dr. David Gaba (as cited in Rosen 2008, p. 159) states, “No industry in which human lives depend on the skilled performance of responsible operators has waited for the unequivocal proof of the benefit of simulation before embracing it.” The famous task trainer, Rescue Annie was utilized beginning in the 1960s, for skill development of mouth-to-mouth breathing (Rosen 2008, p. 160). Patient actors were in use as early as 1963, and by the late 1980s, medical conferences began presenting on simulations and their uses (Rosen 2008, p. 158). Simulation is seen as a way to build highly skilled graduates who are more job ready than students who do not have such experiences built into their program of study. This is true of all sectors that incorporate simulation into curriculum expectations.

Historically, social work students have been assessed through their academic performance and performance in the field, with the understanding that the classroom teaches theoretical knowledge and skills, and the field education gives the students hands-on experience (Bogo 2015; Kourgiantakis et al. 2020). A disconnect between the “hard high ground” of academia and the “swampy lowlands” of field education is identified in Schön’s seminal work (Schon 1983, p. 42). Students who struggle the most are those that are challenged by the requirement to integrate theory into practice. Simulation offers an alternative to assist students in their development of practice and to assist faculty in assessing competencies required of social work graduates. It also prepares students for practicums where they will need to integrate theory and practice.

Social work education is well positioned to adopt the meaningful components of simulation and to further develop the rich learning models that social workers need to provide excellent service to the community. This paper explores literature regarding simulation in post-secondary education and literature specifically related to simulation in social work education. Further, important theoretical frameworks are reviewed to assist with the development of scenarios that are based on the best available research combined with the graduating students’ experiences as social work students. Students as partners in the development of simulation does not track in the literature. The students involved in this field placement research are ideally positioned to provide guidance to faculty as to how their learning needs are best met (Cook-Sather et al. 2014).

4. Methodology Literature Review

The primary questions for this work centered around three specific foci which build or ladder upon each other to provide a robust method for the gathering of relevant information. The questions are:

• What does the literature tell us about simulation in the context of social work education?
• What does the literature tell us about simulation in the context of education in related fields such as nursing and medicine? and
• How does social work meaningfully incorporate simulation into the learning environment to enhance student success?

A preliminary review of the literature was conducted to ascertain the general state of the research for the purpose of determining how simulation is being used in social work education. The search used the following keywords: simulation, social work, nursing, physician, health, role play, education, and COVID-19, with a focus on undergraduate studies. Students were supported by the social work librarian to develop the process, identify key words, and complete a search for articles. SocINDEX, MedLine, Education Research Complete, SCOPUS and Science Direct and Web of Science were searched for relevant articles. Using the keywords simulation, social work, and education a first database search was completed (see

Table 1. Social Work Abstract Search Results.

Database	Total Abstracts (Social Work, Health and Other)	Social Work Education Focus
SOCIndex	59	24
Medline	43	6 (accounting for duplicates)
Education Research Complete	47	4 (accounting for duplicates)
Science Direct	1	0 (accounting for duplicates)
SCOPUS	8	1 (accounting for duplicates)
Web of Science	5	0 (accounting for duplicates

) Upon the full-text review of the social work focused articles, 21 were selected as in scope for this review. The search was then expanded to the health sector (nursing, physician, health simulation). A further 27 articles were included on the basis that significant knowledge of simulation rests in the health sector some of which could be transferable to the social work context.

The scope of the review was limited by year of publication between 2010 and 2020. English was a requirement. One article has a publication date of 2008 and was added for contextual purposes, as it provides an important historical overview of simulation.

Articles were then sorted based on the goodness of fit with social work education. For example, article topics related to specific medical and nursing procedures, policies and practice were eliminated. Our team was most interested in articles whose focus was on simulation for the purpose of clinical skill building, interpersonal skill development and critical thinking in the context of social work education. Publications that closely aligned with social work or could be easily transferred to social work simulation development were included. In addition, the team reviewed articles that provided information about the components of simulation education that would best support students and faculty in successful implementation.

As a result of the literature review students realized that they needed to integrate the literature on simulation with adult learning theory specific to the simulation learning process. Therefore, the team reviewed the alignment between several theories which helped explain the ways in which adults learn. The purpose was to understand the connection between the use of simulation, skill acquisition and the retention of the skills as students moved from understanding theory to demonstrating skill in social work practice. The main theories included Adult Learning Theory (Knowles 2016), Experiential Learning Theory (Kolb, as cited by Sims 1983), Transformational Learning Theory (Mezirow 2016), and Social Learning Theory (Bandura 1977). A total of six articles were reviewed for this purpose.

5. Using the Literature Review as a Mechanism to Build Standard Simulations

Students utilized their learning from the review along with their academic and community experiences to translate the information into simulation scenarios to be used by program faculty. In the creation of scenarios, students further scanned the literature for case/topic specific information. They developed a comprehensive list of potential simulation scenarios (see Appendix A) for our university’s social work program. Students then recorded simulations that could be immediately piloted by faculty over the 2020–2021 academic year (also noted in Appendix A). In the development of materials for faculty, students were careful to review specific literature on the pre- and post-simulation roles of instructors. This was to ensure that simulation activities would occur within a safe space to reinforce the message (Kolb, as cited in Sims 1983) that simulation learning includes learning from the making of mistakes.

6. Definition Confusion

In the literature, the terms simulation and role play are often interchanged or used to refer to the same activities. They are not well differentiated one from the other. The following example in a recent article “Using simulation-based education to help social work students prepare for practice”, Dodds et al. (2018) offers a window into how the terminology can easily become confusing. Dodds et al. (2018) discuss “four forms of simulation” (p. 598). Role play is identified and discussed as one of the four. It is critical for researchers to clearly define terms as they are used interchangeably throughout the literature and by instructors in fields of study that use simulation as part of their pedagogy.

A critical question to ask ourselves as the inclusion of simulation into social work curriculum is considered is, if role play and simulation are the same thing, then why the interest in simulation specific to social work education? Role play has been a part of social work education and ongoing professional development for decades. We argue that role play, and simulation are notably different.

Dennison (2011) defines role play as “following a more traditional method, such that social work students were paired with one another so each student would have an opportunity to act out the role of social worker and client” (p. 416). Role play has limitations. Kinney and Aspinwall-Roberts (2010) add, “resistance to the approach is frequently encountered. Students are often uncomfortable with what they perceive as an artificial or theatrical activity. Some find it hard to pretend; others embrace their inner thespian a little too much, playing for laughs, rather than thinking critically and behaving authentically” (as cited in Dodd et al. 2018, p. 598). Students are practicing skills they are just learning and feel uncomfortable and unsure about what their practice is supposed to look like. Student ability to act in the role of the client causes significant distress as well, with the role plays reverting to unfocused discussion, laughter, or avoidance altogether.

Simulation has been defined along a continuum from a narrow focus (a single medical procedure) to a broad definition that lacks clarity regarding what simulation is, and its role in the learning process. At its best, simulation has concrete steps that when applied appropriately result in significant learning and transformative change in the student. These components include pre-briefing, de-briefing, psychological safety, and assessment activities aligned closely with “real world” practice. These components will be discussed in more detail later in this section.

Researchers and educators have a responsibility to clearly define these two terms. Simulation in realistic environments has long been established in health care and provides social work with examples that can be adjusted for social work education. There is a clear differentiation between role play and simulation. “In contrast to role-play and case studies, simulation through immersive technologies, incorporating feedback and debriefing, encourages learners to experience authenticity, think critically and, particularly through deliberate practice, acquire skills and competence” (McGaghie et al. 2011 as cited in Dodds et al. 2018).

Without clear definition, students hear role play, invoking emotional response and negative assumptions. As social work adapts and incorporates more simulation into its curriculum it is the responsibility of social work to define simulation clearly for the benefit of students, faculty, other professionals, community and research using a social work context. Social work needs to firmly establish simulation as a key pedagogical approach.

7. Interprofessional Practice

Interprofessional education occurs, ‘‘when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes’’ (World Health Organization 2010, p. 7). The collaboration between social work and other professions is increasing and welcomed. Much of the literature on interdisciplinary practice is reflective of the strong role that simulation plays in the education of physicians and nurses. A study by Nimmagadda and Murphy (2014) reviews a model of simulation within the health system specific to nursing and social work. Their findings are strong and speak to the depth and breadth of learning that occurs within these opportunities:

SW students identified cultural competence, ability to work in a high stress environment and compassion. On post-test both nursing and SW students identified new strengths such as reflective listening and open-mindedness for the SW role. The most frequently reported challenge by both groups on pre-test was inter-professional role uncertainty, while at post-test this challenge was reduced by over two-thirds. In as much as student’s reported increased understanding of roles (by 2/3rds over entry knowledge).

(p. 259)

The above study demonstrates that as much as student learning and collaboration increased, so did collaboration across faculties.

A simulation called, The Social Work Big Day In (Agllias et al. 2020) highlights the importance of interprofessional practice, the requirement to engage in difficult conversations and to coordinate and plan with others. Simulation offers the opportunity to provide a rich experience for students across disciplines to: engage with one another, increase their understanding of other professions, critically think as part of a team, share decision making and responsibility for the provision of the most appropriate, informed and ethical services in the context of their social work role (Boet et al. 2014).

8. Adult Learning Theories

What we know about how humans learn has demonstrated that simulations have a meaningful role to play in coursework. Learning theories such as adult learning, experiential learning, transformational learning and social learning support the use of simulations in the classroom when done properly. These theories show us how simulations help us learn, what best practices are when using them, and what to consider when designing or facilitating such components.

As post-secondary students are most likely to be adult learners, they will have different learning needs than young children or adolescents. Knowles’ theory, which he called andragogy, or the art and science to tailor learning for adults, will sound familiar to social work educators and students. The art and science of social work are foundational constructs in social work education (Knowles 2016). Zigmont et al. (2011) note the unique aspects of adult learners:

as self-regulated learners, adults learn what they want to learn, when they want and need to learn. Readiness to learn is triggered by a need to know how to perform more effectively in some aspect of one’s life. Self-regulated learners require a student-centered approach which puts the learning objectives most important and relevant to the learner at the fore-front.

(p. 48)

It is important that educators reflect on adult approaches to learning and design curriculum that aligns with adult student expectations. Bringing their own lived experience to the classroom, adult learners expect to be challenged, apply previous knowledge and lived experience and immerse themselves in learning experiences they find valuable. Clapper (2010) notes that “there appear to be two types of educators, teachers and facilitators of learning. The latter may be more conducive to learning” (p. e8). Further support for simulation comes from Zigmont et al’s work in 2011. They note, “simulation provides a perfect opportunity for active experimentation by allowing the learner to try out new ideas immediately. Such active experimentation promotes “cementing” of new knowledge and long-term changes in practice” (p. 50).

As a simulation is intended to provide students with new experiences, Kolb’s Experiential Learning Theory is helpful to understanding its value. According to Fry and Kolb (1979) learning occurs in four interconnected phases: concrete experience, reflective observation, abstract conceptualization, and active experimentation. In essence, learners engage in a concrete experience, they reflect on the experience and make personal observations. From these observations the student forms new ideas or concepts, which are then put into practice as the learner experiments with what they have learned (pp. 79–91). As demonstrated by this theory, true learning occurs after the experience happens. Kolb (as cited by Washburn and Zhou 2018) contends that, “experiential learning is a cyclical process involving thinking, planning, and decision making along with action, refection, and evaluation. Experience, including mistakes, provides essential opportunities for self-refection so students will develop the skills necessary for professional practice” (p. 555). The tenants of social work practice are a good fit with Experiential Learning Theory both in the teaching of concepts and skills to students and in the interaction between social worker and client.

We should also consider Mezirow’s Transformative Learning Theory. Mezirow (2016) states, “transformative learning involves critical reflection of assumptions that may occur either in group interaction or independently. Testing the validity of a transformed frame of reference in communicative learning requires critical-dialectical discourse” (p. 61). Adult learners are capable of taking prior understandings and transforming them into new interpretations of an experience that will guide their future interactions—making meaning of all that they know and experience through the learning process and integrating that learning into their social work practice. Clapper (2010) provides a clear example of how this unfolds—the process is started by a trigger event, such as a simulation experience, and is followed by self-examination, where the person explores the emotions and feelings, and ways of thinking around the event. From this process, the individual can create new ways of thinking regarding the event (simulation), and then bravely act in new ways. The instructor becomes a facilitator of the process and of the learning.

Albert Bandura’s (1977) social learning theory makes a case for the usefulness of observing simulations. Bandura proposed that humans can learn just from watching the actions of others, and this learning process has four components: attention, retention, motor reproduction, and motivation (as cited in Bethards 2014, p. 65). Further, Bethards (2014) sets out the social learning process as envisioned by Bandura in this way:

To learn anything, students must first pay attention to what others around them are doing. To retain the information, humans use both imaginative and verbal strategies, such as when they picture themselves performing the behaviour, or when they talk about what they witnessed with others. Once the learners have mentally processed what they visualized, they can mimic the behaviour. Lastly, the behaviour is most likely to become adopted by the observer if they perceive intrinsic or extrinsic factors, such as making students more confident in their skills, or the promises of a better paying job respectively.

(p. 66)

9. Simulation—The Fundamental Components

9.1. Pre-Briefing

The purpose of pre-briefing in all the literature examined generally aligns with Fanning and Gaba’s (2007) description of this phase as an opportunity for the instructor to clarify the process of the upcoming simulated scenario for the students—to prepare them for what they are about to engage in. Primarily, pre-briefing should involve reviewing objectives, an orientation to the simulation manikin or environment, and general functional guidelines for the simulation activity, such as communication, roles, conduct, and confidentiality (Page-Cutrara 2014, p. 137).

9.2. Debriefing

Debriefing is defined by the International Nursing Association for Clinical Simulation and Learning as the activity that follows a simulation experience led by a facilitator wherein feedback is provided on simulation participants’ performance while positive aspects of the completed simulation are discussed, and reflective thinking encouraged (Murphy and Nimmagadda 2014, p. 543). Zigmont et al. (2011) note that debriefing is central to the learning process and should not be discounted by instructors (Zigmont et al. 2011, p. 49). Everyone who has undergone a simulation should be given the opportunity to debrief which should be facilitated by the instructor who is also an observer to the process and will have insights and feedback that will further assist in the learning. The instructor must clearly understand the simulation scenario and be prepared for the impact that it may have on student participants (Rojas et al. 2017).

9.3. Psychological Safety

Fundamental in social work education and indeed in social work practice is the establishment of a safe space. To do this requires trust built on establishing boundaries, clarifying expectations, open communication, reflective listening, and respectful interactions between all involved. Simulation, which may be new to students and faculty requires an intentional creation of safe space. DeCaporale-Ryan et al. (2016) and colleagues tell usthat establishing a safe learning environment is essential before simulation begins as the goals of learning and rules for participation are outlined. Facilitators should also explain how debriefings will be used after the session is over. Without these components, trainees may not openly share their emotions and perspectives. (p. 161).

DeCaporale-Ryan et al. (2016) go further noting that, “learners may feel especially vulnerable in a group setting when individuals with supervisory roles participate as a facilitator or as part of the reflecting team” (p. 161). Their advice goes further noting that no matter how well we try to address the hierarchy that exists between instructor and student, the power differential will still have a presence in the simulation space. “The instructor’s facilitation skills play a major role in engendering trust”.

(p. 161)

The establishment of a learning environment that embraces vulnerability and supports learning in positive ways with honest and respectful feedback also assists social workers in understanding the need to create the same environment when working in the field. Students learn the qualities of a good facilitator from their instructor. They experience the benefits of a good orientation to process and the impact of making mistakes without judgement (Kang and Min 2019; Turner and Harder 2018).

9.4. Structure

We purport that in part the structure is what separates simulation from other forms of learning. Kourgiantakis et al. (2019) and colleagues propose a structure to assist delivering simulation that is meaningful and results in practice improvement (see Figure 1).

9.5. Assessment

Just as important as the other components is assessment. The integration of theory into practice is needed in simulation. Ensuring the graduation of skilled professionals into our field is our role as post-secondary educators. Kourgiantakis et al. (2019) raise the notion of holistic competence and tells us that it encompasses two dimensions: procedural and meta-competence.

To have procedural competence, students need to demonstrate correctly performed procedures, behaviours, and responses that are required in a situation. To have meta-competence, students need to demonstrate they are capable of introspection of their own actions, thought processes, and emotional states.

(Kourgiantakis et al. 2019, p. 551)

9.6. Scenario Development

Social work is in its infancy in developing simulation and researching all aspects of it. Given academia’s history as developers of social work education that teaches clinical skills for the workplace, the academy is in a strong position to undertake this next stage of development. Scenario development requires significant, intentional reflection on the content of courses taught in the social work program combined with the knowledge about the most recommended components of a simulation exercise. There must be a defined purpose that will make sense for students and faculty. Background information to support the topic is best practice as many of the situations encountered by social workers are emotional and dynamic. There should be a laddering of simulation scenarios so that the experience and applied learning are matched accurately with student knowledge. For example, a beginning social work student should not be expected to participate in a complex multisystem simulation focused on the traumatic suicide of a young person. Beginning social workers need skill building first and then they will be ready to explore complex situations without experiencing triggers that they are not prepared to manage.

Students in this field placement took this responsibility seriously as they moved from the literature review to development. A fulsome brainstorm activity resulted in many great ideas that were then sorted in terms of priorities, level of comfort with the topic and fit with coursework. The students had completed all social work courses prior to this field placement. They reviewed course content and made informed decisions. Students paid particular attention to ethical practice and diversity. Students consulted with experts in each topic and identified what was outside their area of skill and comfort level to ensure a high-quality product (see Appendix A for the list of scenarios).

Bethards (2014) advises that “facilitators should do their best to ensure the application of attention, retention, motor reproduction, and motivation, are encouraged by simulations” (p. 67). We cannot emphasize enough that attaching assignments to simulation experiences is an important engagement and retention strategy. Once students enter the workplace, this type of attention to detail, reflection and growth is required. This approach begins with their social work education and high expectations of instructors for students to meet or exceed practice expectations. The following case studies (see Appendix B) provide a good example of what the students produced. A new mom is just home from the hospital with her baby. The Public Health Nurse visited the home and became concerned that mom is co-sleeping with the baby. Mom is from India and this is common, traditional practice. Mom wishes to ensure a close bond between infant and parents.

Two assignments follow the completion of these cross-cultural scenarios. Students are asked to reflect on the differences between the two scenarios and identify how they would approach this situation. Students are then asked to consider both culture and safety and discuss the intersections between the two identifying what that means for social work practice.

The intent of these assignments is to have students think deeply about what they observed, their assumptions and biases that could impede their practice. Consideration of the impact on the client and their future trust of social workers is an important component for debriefing. Zigmont et al. (2011) reinforce this approach stating the importance of simulations providing the experiential learning, time for student reflection as well as a process through which the mental model the student holds is revised based on the experience. Therefore, simulation is unique and upholds the tenets of experiential learning through the provision of hands-on experience and intentional reflection.

In a second example, a social worker meets with a parent to gather a history and complete a genogram. While the social worker guides the conversation and involves the parent in the drawing of a genogram (a collaborative approach), the students are inserting themselves in real time into the role of the social worker and drawing the genogram as they watch and listen. This exercise requires students to listen deeply, observe and create all at the same time emulating what this activity looks and feels like in practice. Students are also immersed in practice that is about “doing with the client, not to the client”.

As these scenarios are piloted in our program, there will be an intentional gathering of feedback regarding the experience from pre-briefing to the conclusion of the process including the effectiveness of the activities and assignments attached to the simulation. The results of this work will be seen in three pathways. Students created simulations that are being introduced into social work classes for trial and evaluation. Secondly, they have developed a list of scenarios that act as the basis for further development. The value of this list is that it acts as a way forward for other students and faculty to add to the possible ways to think about scenarios that can be integrated into course. Thirdly, it shows that students can be empowered to develop materials that fit their own learning needs while honouring the objectives of social work education. In summary, “the role of the instructor becomes one of helping the student engage with their prior knowledge and place it in context to the new situation presented. Simply, instructors need to be less focused on presenting information, and focus on the facilitation process, which helps students transform their experience into new learning concepts” (Zigmont et al. 2011, p. 50).

10. Discussion

The experience of COVID-19 has certainly been challenging. Early research indicates that the pandemic has changed how education is occurring (Day et al. 2021; Archer-Kuhn et al. 2020). For social work, it has emphasized that simulation learning is vital to being able to enhance theory to practice learning pathways. The pandemic has also created an urgency to ensure practice-ready graduates who can enter the field ready to take on challenging situations in health care, child protection, community development and other complex settings. This project has offered early insights into how simulation can be further developed. More research is needed.

COVID-19 has, however, offered some opportunities to engage with students differently. Exploring alternate field placement options has resulted in the development of resources to support future social work education. Critical thinking, reflection, ethical practice, compassion, attention to diversity and clinical skills practice are just some of the benefits of the work that was completed.

Faculty involvement as the students’ field placement supervisor was also a unique experience as student’s usual involvement with faculty at the under-graduate level is as the instructors in their social work courses. Mentorship of students had positive bi-directional outcomes. Student enthusiasm to excel in their assigned work engages faculty at a different level of intensity over a 350 h field placement. This sees students and faculty as partners in learning (Cook-Sather et al. 2014).

Students noted that they were completely unsure of what this field placement would entail. They took a leap of faith as did faculty. Upon completion, students reflected that this was one of the most enriching and growth experiences they have had while in the program. In many ways, it had the elements of a capstone project and represented a level of work most often seen in a post-graduate program.

The simulation literature is limited in social work practice. Growing interest has seen an increase in publications that are social work specific. This literature is important. Sharing of inspirational work in the field and moving our educational approach forward to enhance learning, skill attainment. Lee et al. (2019) challenges us to embrace new opportunities.

Simulation-based learning thus changes the way social work practice is taught in the classroom and permits educators to bridge theory and practice and teach not only about practice but how to do practice. With a strong foundation of knowledge and competence, students are better equipped to engage in field learning.

(p. 330)

In 2014, the Council on Social Work Education (CSWE) “called for social work educators to shoulder more of the responsibility of teaching and assessing students’ skills and competency” (Council on Social Work Education 2015; Kourgiantakis et al. 2020, p. 433). The position of the CSWE recognizes that field placement options vary for students. Further, in 2015, the CSWE recognized simulation as a valid teaching method giving legitimacy to educators to incorporate a higher order of experiential learning in their pedagogical approach. Ensuring that students graduate with the core skills and a level of practice required to enter the field is best accomplished through educational structure that both sets out and assesses to those expectations prior to graduation. Simulation offers a structure to support this needed change. Field placement is also critically important. Simulation and field placement support one another as students can actively apply the learning across both environments giving rise to important insight.

Social work education has the advantage of learning from others who have gone before and developing a menu of options that can include paid actors and special equipment but can also include the type of scenarios that we are proposing. Our scenarios are filmed in a realistic setting and utilize experienced faculty and students as actors. Complex scenarios were written and intended for collaboration with colleagues and students in other professions once the public health restrictions are lifted (see Appendix A for a list of scenarios).

11. Conclusions

In disseminating our findings, our goal is to build on the body of currently available literature in order to assist the field of social work in the development of relevant social work simulations. The provision of high-fidelity learning approaches supplementing and building on current course requirements is educators’ responsibility. Through the work of the students in their field placement, we have highlighted the role that students can take in moving the social work field forward. In fact, when given the opportunity, students embrace it to demonstrate their commitment as a new generation of social workers. This project adds to the discussion on students as partners in research, curriculum development and ways to explore translating theory to practice. The student editors of the International Journal for Students as Partners (Ntem et al. 2020) note the following result from student/faculty experiences related to COVID-19, “The successful and generative virtual partnerships that have recently emerged have led to more recent attention to the specifics of virtual experiences. As a result, future practice may include more virtual and blended approaches, (p. 5).” This has certainly been our experience—students play a valued and valuable role in the evolution of social work pedagogy.

As we noted, adult learning theories are a critical component of this work. Simulation has a structure that does not exist in traditional role play. The structure is what knits all of the components of learning together ensuring internalization of social work practice. As well, it teaches critical thinking which serves students well throughout their career.

Our review of the literature aligns with the conclusions in the 2020 Scoping Review completed by Kourgiantakis and colleagues who noted that they could find “little available research on the use of effectiveness of simulation within social work education …the quality was variable and that few studies built on the contributions of previous studies” (p. 435). Further, Roberson (2020) emphasizes that social work education requires the legitimacy of a pedagogical framework that intertwines simulation with current teaching methods. We agree. There is a tangible opportunity for social work to lead the development of simulation that meets the unique needs of our profession.

Collaborative practice is a fundamental component of social work. While other systems look inside their organizations for collaboration across various roles such as nursing, physicians, allied health, social work facilitates the gathering of diverse individuals and communities. Coordinating the various professionals, community supports and family members to gather for a common goal is what social workers excel at. There has never been a better time for social work to take hold of our profession and initiate positive change.

12. Limitations

This work was only limited by the length of the field placement. This article was written post the completion of the 350 h requirement.

13. Directions for Future Research

We recommend that research focus on the development and implementation of social work-led simulation. Further reviews of the literature are not prudent at this time as the most recent review was completed in 2020.

A focus on social work practice and skill building and a focus on leading collaborative simulation are promising.

Building the literature from within the field is the next significant step for instructors and researchers as we enter a new decade.