DECEMBER 2008 kR24 ADULTS’ SERVICES 3 Teaching and learning human … · 2011. 3. 28. · DECEMBER 2008 ADULTS’ SERVICES knowLEDgE REVIEw 23 Teaching and learning human growth

ADULTS’ SERVICES knowLEDgE REVIEw 23DECEMBER 2008

Teaching and learning human growth and development in social work

education: older people

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Teaching and learning human growth and development in social work education: older people

This knowledge review examines the nature of qualifying social work education about human growth and development with regard to older people (HGDOP), looking particularly at what promotes or hinders successful outcomes.

HGDOP is a central requirement of qualifying social work education, but has not previously been the focus of any knowledge review. Policies relating to older people are receiving increasing attention, which has important implications for the training and education of HGDOP.

All SCIE publications and resources are free.

This publication is available in an alternative format upon request.

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Teach�ng and learn�ng human growth and development �n soc�al work educat�on:

older people

Pat Le R�che, Margaret Boushel and Ela�ne Sharland

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ADULTS’ SERVICES

F�rst publ�shed �n Great Br�ta�n �n December 2008 by the Soc�al Care Inst�tute for Excellence

© Un�vers�ty of Sussex All r�ghts reserved

Wr�tten by Pat Le R�che, Margaret Boushel and Ela�ne Sharland

This report is available online www.scie.org.uk

Soc�al Care Inst�tute for Excellence Gold�ngs House 2 Hay’s Lane London SE1 2HB tel 020 7089 6840 fax 020 7089 6841 textphone 020 7089 6893 www.sc�e.org.uk

Front cover photograph k�ndly suppl�ed by www.photofus�onp�ctures.org

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Contents

Execut�ve summary v��

1 Introduct�on 1 1.1 Rat�onale for the knowledge rev�ew 1 1.2 Rev�ew quest�ons and object�ves 1 1.3 Pol�cy and pract�ce background to HGDOP 2 1.4 Regulatory context of HGDOP �n qual�fy�ng soc�al work 2 1.5 Def�n�t�ons 2 1.5.1 Human growth and development 2 1.5.2 ‘Old age’ as a concept 3 1.5.3 Cr�t�cal gerontology 3 1.6 The rev�ew team 4 1.7 Eth�cs 4 1.8 Stakeholder group 4

2 Research rev�ew methodology 5 2.1 Approach to the rev�ew and rev�ew quest�ons 5 2.2 Search�ng the l�terature 5 2.3 Inclus�on and exclus�on cr�ter�a 5 2.4 Keyword�ng 7 2.5 Data extract�on and �n-depth rev�ew 7 2.6 Stakeholder part�c�pat�on 7

3 Mapp�ng HGDOP: an overv�ew of the research 10 3.1 Introduct�on 10 3.2 HGDOP stud�es: type and qual�ty 10 3.2.1 Study locat�on and publ�cat�on 10 3.2.2 Type of study 10 3.3 A�ms and theor�es of HGDOP 11 3.3.1 A�ms of HGDOP teach�ng and learn�ng 11 3.3.2 Theor�es and concepts �n use 12 3.4 Character�st�cs of HGDOP 13 3.4.1 HGDOP process focus 13 3.4.2 T�m�ng and organ�sat�on of HGDOP �n�t�at�ve 14 3.4.3 Part�c�pants �n HGDOP 14 3.4.4 Sett�ng of HGDOP teach�ng and learn�ng 15 3.4.5 Pedagog�cal methods 16 3.4.6 Curr�culum organ�sat�on 17 3.4.7 Curr�culum content 19 3.4.8 Ma�n outcomes cons�dered 20 3.5 Ma�n cla�ms to ‘f�nd�ngs’ reported about HGDOP 22

4 In-depth rev�ew of stud�es of HGDOP outcomes 24 4.1 Nature and date of study 24 4.2 Study des�gn 24 4.2.1 HGDOP focus 24 4.2.2 Qual�tat�ve and quant�tat�ve approaches 24 4.2.3 Research sample 24 4.3 We�ght of ev�dence 25

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4.3.1 We�ght of ev�dence judgement 25 4.3.2 Factors contr�but�ng to the we�ght of ev�dence 26 4.4 A�ms of HGDOP 27 4.5 Theor�es and concepts �n use 28 4.5.1 Psycho-soc�al, l�fespan and developmental theory 28 4.5.2 Ecolog�cal theory and r�ghts-based approaches 28 4.5.3 Pedagog�cal theory 29 4.6 Nature of educat�onal �ntervent�on 29 4.6.1 Course or module type 29 4.6.2 Level of the teach�ng and learn�ng 30 4.6.3 HGDOP sett�ng 30 4.6.4 Part�c�pants �n HGDOP 31 4.6.5 HGDOP content and process 31 4.7 HGDOP outcomes exam�ned 33 4.7.1 Range of outcomes cons�dered 33 4.7.2 Measurement and mon�tor�ng of outcomes 33 4.8 Synthes�s�ng outcome f�nd�ngs 34 4.8.1 Pos�t�ve and negat�ve outcomes 34 4.9 Part�c�pant react�ons 35 4.10 Analys�s of outcomes 36 4.10.1 Knowledge �mprovement 36 4.10.2 Att�tude change 37 4.10.3 Sk�ll development 37 4.10.4 Outcomes for serv�ce users, carers and agenc�es 38 4.11 Fac�l�tators and barr�ers to HGDOP 38 4.11.1 Fund�ng and resources 39 4.11.2 Plann�ng and organ�sat�on 39 4.11.3 Agency support 40 4.11.4 Pedagog�cal approaches 41 4.11.5 Integrat�on of pract�ce learn�ng �n�t�at�ves 41 4.12 Conclus�on 42

5 HGDOP pract�ce survey 44 5.1 Introduct�on 44 5.2 A�ms and scope of the pract�ce survey 44 5.3 Summary of methodology 44 5.3.1 Sources of �nformat�on 44 5.3.2 Data collect�on methods 45 5.3.3 Conf�dent�al�ty, b�as and eth�cs 45 5.3.4 Data cod�ng and analys�s 45 5.4 Themes emerg�ng from the pract�ce survey 45 5.4.1 Pract�ce survey: a�ms of HGDOP teach�ng and learn�ng 46 5.4.2 Organ�s�ng frameworks and theoret�cal approaches to HGDOP 48 5.4.3 Pract�ce survey: HGDOP teach�ng and learn�ng structures and 49

sequence 5.4.4 Part�c�pants �n the organ�sat�on and del�very of HGDOP teach�ng 50

and learn�ng 5.4.5 Sett�ng of HGDOP teach�ng and learn�ng 51

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5.4.6 Practicesur�ey:HGDOPcurriculumcontentandprocess 53 5.4.7 OutcomesofHGDOPteachingandlearning 58 5.5 Practicesur�eyconcludingcomments 58

6 Findingsanddiscussion 60 6.1 Summaryoffindingsfromtheresearchre�iew 60 6.2 Summaryoffindingsfromthepracticesur�ey 61 6.4 Recommendationsforfutureresearchandpractice 63

References 65 Studiesincludedinin-depthre�iew 65 Reportslinkedtostudiesinin-depthre�iew 65 Studiesincludedinthematicanalysisonly 65 Reportslinkedtostudiesincludedinthematicanalysisonly 66 Additionalreferences 66

Index 69

Contents

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Executive summary

Background

Aims

The knowledge rev�ew a�ms to:

�) exam�ne the research ev�dence about human growth and development and older people (HGDOP), and �n part�cular what promotes or h�nders successful outcomes

��) map the progress of qual�fy�ng educat�on pract�ce �n HGDOP �n England, Wales and Northern Ireland.

The rev�ew a�ms to explore the follow�ng quest�ons:

• What �s the nature of qual�fy�ng soc�al work educat�on about HGDOP? • How effect�ve �s qual�fy�ng soc�al work educat�on about HGDOP, and what

promotes or h�nders successful outcomes? • How far are cr�t�cal perspect�ves, part�cularly soc�al gerontology, ev�dent �n

qual�fy�ng soc�al work educat�on about HGDOP, and how effect�ve are they?

Research review

Methodology

The rev�ew of the l�terature exam�nes the ev�dence about HGDOP �n qual�fy�ng soc�al work educat�on and synthes�ses f�nd�ngs �n order to address the rev�ew quest�ons. The rev�ew was conducted �n accordance w�th the Soc�al Care Inst�tute for Excellence (SCIE) gu�del�nes for complet�ng systemat�c rev�ews and was supported by EPPI-rev�ewer software.

The process of the knowledge rev�ew was �nformed by a stakeholder group that adv�sed on the des�gn and development of the rev�ew and work �n progress and commented on draft mater�als.

From a search of the l�terature 24 relevant stud�es were �dent�f�ed and key themes analysed. F�ve of these stud�es met the �nclus�on cr�ter�a for �n-depth rev�ew.

Key findings

• F�ve qual�ty-assessed stud�es met the �nclus�on cr�ter�a, all of wh�ch were publ�shed �n the US between 2002 and 2006. The fact that only f�ve stud�es met the �nclus�on cr�ter�a reflects the l�m�ted l�terature on the relat�onsh�p between human growth and development (HGD) and older people and on the outcomes of qual�fy�ng soc�al work educat�on.

• Apart from the�r focus on curr�culum development, the stud�es were d�verse �n terms of the�r a�ms and scope. They prov�ded cons�derable descr�pt�ve deta�l about

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Executive summary

the content and process of the changes made to the curr�culum. Most of these changes were des�gned to �ncrease knowledge about older people, change (mostly negat�ve) att�tudes and, to a lesser extent, develop sk�lls and �mprove the qual�ty of outcomes for serv�ce users and carers.

• The stud�es prov�ded l�m�ted ev�dence about wh�ch character�st�cs of HGDOP teach�ng and learn�ng were effect�ve �n del�ver�ng spec�f�c outcomes. In those stud�es that evaluated the v�ews of student part�c�pants there was some ev�dence of �ncreased knowledge and more pos�t�ve att�tudes towards older people. However, these changes were evaluated �n the short term and by student percept�ons rather than by the measurement of knowledge and behav�our.

• The stud�es prov�ded l�m�ted �nformat�on about the v�ews of other part�c�pants, although where the v�ews of older people and agency partners were reported, they were pos�t�ve about the�r �nvolvement.

• In relat�on to the theoret�cal frameworks underp�nn�ng HGDOP, there was ev�dence of more thorough explorat�on of pedagog�cal theory than of developmental or gerontolog�cal approaches.

• All f�ve stud�es reported on the �ntegrat�on of pract�ce or serv�ce learn�ng �n�t�at�ves �nto the un�vers�ty-based curr�culum. The rat�onale for th�s approach was to �ntroduce one-to-one contact between students and older people at an early stage of the soc�al work programme as one means of �ncreas�ng knowledge about the exper�ence of later l�fe and counteract�ng stereotyp�ng.

• Students found these exper�ences fac�l�tated the�r learn�ng, w�th reservat�ons about the amount of t�me necessary to complete the add�t�onal work. The older part�c�pants were un�versally pos�t�ve about the�r part�c�pat�on.

• The l�m�tat�ons of the rev�ew �n terms of the numbers and scope of the stud�es makes �t �mposs�ble to general�se about the contr�but�on of these developments to any evaluat�on of effect�veness. However, the stud�es suggest that greater �ntegrat�on of pract�ce learn�ng �n�t�at�ves, even on a l�m�ted scale, would be worth further �nvest�gat�on.

Practice survey

Background

The pract�ce survey reports the perspect�ves of n�ne h�gher educat�on �nst�tute (HEI) soc�al work educators recru�ted from s�x centres of soc�al work educat�on (four �n England, and one each �n Wales and Northern Ireland). The s�x centres �dent�f�ed ensured a range of prov�s�on and focus at undergraduate and postgraduate level, �nclud�ng full-t�me, part-t�me and work-based routes. The largest centre enrolled 100 students per year, the smallest, 20 students.

The pract�ce survey also reports the v�ews of members of the stakeholder group, wh�ch �ncluded students, serv�ce users and carers, pract�t�oners and staff/volunteers �n voluntary organ�sat�ons work�ng w�th older people, �nclud�ng older people from Black and m�nor�ty ethn�c backgrounds.

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Key findings

• The survey �nd�cated that effect�vely �ntegrat�ng HGDOP teach�ng and learn�ng w�th�n the curr�culum was challeng�ng and complex. T�me pressures were a constant constra�nt and other challenges �ncluded:

– �ntegrat�ng HGDOP w�th�n a curr�culum trad�t�onally focused on ch�ld development, and chang�ng student att�tudes to older people and later l�fe

– encourag�ng reflect�on on a t�me of l�fe many found troubl�ng and pa�nful to contemplate

– cont�nu�ng to address HGDOP �n modules focused on ‘do�ng’ soc�al work w�th older people �n an organ�sat�onal and regulatory context that was perce�ved as undervalu�ng the place of theory and reflect�ve pract�ce.

• The pract�ce survey �dent�f�ed many examples of �nnovat�ve attempts to �nclude attent�on to later l�fe, change att�tudes and encourage self-reflect�on, �nclud�ng the expl�c�t use of cross-cutt�ng theor�es and approaches and spec�f�c format�ve tasks, �nclud�ng the l�m�ted use of commun�ty-based learn�ng opportun�t�es.

• Attent�on to theory was more var�able. Wh�le there were examples of the use of cr�t�cal approaches to the use of theory, only one respondent spec�f�cally ment�oned the use of cr�t�cal soc�al gerontology.

• Most programmes lacked robust evaluat�on of HGDOP teach�ng and learn�ng outcomes.

• None of the pract�ce survey part�c�pants reported an expl�c�t pract�ce curr�culum for HGDOP. Educators expressed concerns about the lack of theory �n pract�ce placements, and the pr�or�ty somet�mes g�ven to learn�ng about formula�c approaches to ‘do�ng care management’. In only one programme was HGD an expl�c�t requ�rement �n pract�ce learn�ng assessment.

• Soc�al work educators and stakeholder respondents emphas�sed the �mportance of understand�ng and ‘att�tude’ �n underp�nn�ng soc�al work �ntervent�ons w�th older people. Educators pr�or�t�sed cr�t�cal understand�ng and apprec�at�on of theor�es of age�ng and self-reflect�on on the �mpact of th�s emot�ve area. Stakeholders, and espec�ally serv�ce users, emphas�sed the �mportance of be�ng able to l�sten to and hear older people’s d�verse knowledge and exper�ence.

Recommendations for future research and practice

• To develop a research base �n HGDOP �n the UK. The pract�ce survey �dent�f�ed some �nnovat�ve educat�onal pract�ce that would benef�t from evaluat�ve research and d�ssem�nat�on.

• To �nvolve all part�c�pants �n HGDOP �n the research process. The v�ews of students are central as the users of soc�al work educat�on but attent�on should also be pa�d to the v�ews of other stakeholders �nclud�ng serv�ce users, pract�t�oners and other agency partners.

• To develop research des�gns that evaluate and measure outcomes not only �mmed�ately after the teach�ng has taken place but �n relat�on to longer-term learn�ng ga�ns.

• To clar�fy the parameters of HGD �n relat�on to older people: what do soc�al workers need to know about ‘development’ �n later l�fe and how can a balance be struck between ‘normal’ development and the developmental problems and cr�ses soc�al workers encounter �n pract�ce?

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Executive summary

• To cons�der methods of �ntegrat�ng flex�ble models of serv�ce or pract�ce learn�ng �nto HGDOP, enabl�ng students to learn from older people �n the�r own env�ronments.

• To develop teach�ng and learn�ng methods that challenge age�st and other oppress�ve att�tudes towards older people and encourage all students to engage w�th learn�ng about later l�fe.

• To recogn�se that these developments are resource �ntens�ve and to f�nd ways of resourc�ng such developments.

• To rev�ew the pract�ce curr�culum and pract�ce learn�ng requ�rements to ensure that HGD �s �ntegrated w�th�n pract�ce learn�ng and �ts assessment.

• To develop approaches to curr�culum organ�sat�on that support and mon�tor the �ntegrat�on of HGD across the curr�culum.

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1 Introduction

1.1 Rationale for the knowledge review

The knowledge rev�ew of human growth and development and older people (HGDOP) �n qual�fy�ng soc�al work educat�on was comm�ss�oned by the Soc�al Care Inst�tute for Excellence (SCIE) and bu�lds on a broader scop�ng study on human growth and development (HGD), mental health and d�sab�l�ty, comm�ss�oned by SCIE from the same reg�stered prov�der.50 The knowledge rev�ew was comm�ss�oned �n the context of the requ�rement for teach�ng and learn�ng about HGD to be a key component of qual�fy�ng soc�al work educat�on �n England, Wales and Northern Ireland.32, 36, 39, 56

The rev�ew �dent�f�es and evaluates a w�de range of research mater�al relevant to the teach�ng, learn�ng, assessment and outcomes of HGDOP at qual�fy�ng soc�al work level. It �ncludes both a pract�ce survey and a research rev�ew:

• The research rev�ew exam�nes the ev�dence about HGDOP, and �n part�cular what promotes or h�nders successful outcomes.

• The pract�ce survey maps the progress of educat�on pract�ce �n HGDOP. The ma�n methods of data collect�on were telephone �nterv�ews w�th soc�al work educators and other stakeholders and the targeted use of quest�onna�res to access student v�ews.

1.2 Review questions and objectives

The research rev�ew and pract�ce survey explore the same central quest�ons:

• What �s the nature of qual�fy�ng soc�al work educat�on about HGDOP? • How effect�ve �s qual�fy�ng soc�al work educat�on about HGDOP, and what

promotes or h�nders successful outcomes? • How far are cr�t�cal perspect�ves, part�cularly soc�al gerontology, ev�dent �n

qual�fy�ng soc�al work educat�on about HGDOP, and how effect�ve are they?

The rev�ew �dent�f�es the range of emp�r�cal research relevant to these quest�ons, sett�ng them �n the context of pol�cy and research. The f�rst quest�on maps the nature and d�vers�ty of HGDOP �nclud�ng sett�ngs, pedagog�cal approaches, content, goals and a�ms. The second quest�on explores the nature of HGDOP outcomes and �dent�f�es the fac�l�tators and barr�ers affect�ng these outcomes. The th�rd research quest�on explores whether and to what extent cr�t�cal perspect�ves �nfluence the outcomes �dent�f�ed.

The rat�onale for the rev�ew �s that:

• HGD �s a central requ�rement of qual�fy�ng soc�al work educat�on • HGDOP has not been the focus of any prev�ous knowledge rev�ews • pol�c�es related to older people are rece�v�ng �ncreased attent�on and have

�mpl�cat�ons for tra�n�ng and educat�on.

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The rev�ew object�ves, as �dent�f�ed �n the a�ms and central research quest�ons, are set out �n Append�x 1.

1.3 Policy and practice background to HGDOP

The soc�al care agenda for older people �s led by central government, character�sed by pol�c�es wh�ch seek to promote soc�al �nclus�on, control, respect and cho�ce.38 The Nat�onal Serv�ce Framework (NSF) for older people35 �dent�f�ed root�ng out age d�scr�m�nat�on and the del�very of person-centred care as the f�rst two standards requ�red for good qual�ty health and soc�al serv�ces. Subsequent programmes for �mplement�ng the NSF have �dent�f�ed the �mprovement of health �n later l�fe, and d�gn�ty and �ntegrat�on �n care as pr�or�t�es for ra�s�ng the qual�ty of health and soc�al care.

Wh�le older people and the�r carers are h�gh on the pol�cy agenda, �n soc�al work educat�on the Requirements for social work training,36 wh�ch shaped the curr�culum for the soc�al work degree, make no spec�f�c reference to work w�th older people and the�r carers. However, they do requ�re educat�on prov�ders to �nclude HGD as a core component of the soc�al work curr�culum, although �t �s l�nked to d�sab�l�ty and mental health, w�th no reference to older people. S�m�larly, knowledge about HGD (from ch�ldhood to old age) �s a spec�f�c requ�rement of the Nat�onal Occupat�onal Standards (NOS) for soc�al work62 and soc�al workers are requ�red to be assessed on HGD dur�ng tra�n�ng.

1.4 Regulatory context of HGDOP in qualifying social work

The soc�al work degree was �ntroduced �n England �n October 2003 and �n Wales and Northern Ireland �n October 2004. The requ�rements relevant to the teach�ng, learn�ng and assessment of HGDOP are �ncluded �n Append�x 2. In each country HGD �s a key requ�rement of qual�fy�ng educat�on, although the requ�rements are sl�ghtly d�fferent.

1.5 Definitions

1.5.1 Human growth and development

The conclus�ons of the earl�er scop�ng study suggest the def�n�t�on of HGD and �ts relat�onsh�p to older people and soc�al work educat�on �s problemat�c. The pol�cy documents currently sett�ng out the requ�rements for HGD �n qual�fy�ng soc�al work educat�on make no attempt to def�ne �t, leav�ng open quest�ons about what a ‘developmental perspect�ve’ means. Th�s po�nt was conf�rmed by the �n�t�al scrut�ny of abstracts for the scop�ng study. Th�s �dent�f�ed a range of l�terature cla�m�ng to have a developmental focus but �n fact explor�ng the exper�ence of older people at a part�cular po�nt �n t�me rather than w�th�n the l�fespan context.

Educators �nterv�ewed for the scop�ng study �dent�f�ed another d�lemma �n the def�n�t�on of ‘human growth and development’. They reflected on the tens�on between teach�ng ‘normal’ development and/or concentrat�ng on barr�ers to and problems �n development, wh�ch soc�al workers encounter �n pract�ce.

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Introduction

In add�t�on, concepts of ‘growth’ and ‘development’ have been cr�t�c�sed from a number of perspect�ves as be�ng normat�ve, �nd�v�dual�st�c and unhelpful �n flu�d and rap�dly chang�ng contexts.44, 56, 58

1.5.2 ‘Old age’ as a concept

W�th�n the framework of human development, the usefulness of ‘old age’ as a concept �s also contested. Debates w�th�n gerontology ra�se quest�ons about whether the category ‘old’ should be the major determ�nant of our understand�ng of later l�fe, or whether �t �s only one, soc�ally determ�ned, d�mens�on of �dent�ty and exper�ence.28, 31

In response to these debates, the rev�ew team dec�ded to adopt Sugarman’s w�de-rang�ng def�n�t�on of HGDOP as:

… mater�al foreground�ng age�ng and acknowledg�ng the context of human development adopt�ng l�fecourse or l�fespan perspect�ves.59

1.5.3 Critical gerontology

Although the scop�ng study �dent�f�ed 104 papers d�scuss�ng human development and older people, many of these explored the problems older people exper�ence rather than emphas�s�ng pos�t�ve age�ng and the contr�but�ons older people make to soc�ety. The papers also reflected concern about soc�al work students’ reluctance to work w�th older people after qual�f�cat�on and the �mpact of th�s on the qual�ty of soc�al work pract�ce.

The th�rd research quest�on �n th�s rev�ew exam�nes whether there �s ev�dence that cr�t�cal gerontology plays a role �n counteract�ng these l�m�ted v�ews about HGDOP. Although cr�t�cal gerontology �ncludes a range of d�fferent theoret�cal approaches, �t seeks to explore �ssues and quest�ons that have not always been pr�or�t�sed by ma�nstream soc�al gerontology. These �nclude understand�ng what const�tutes ‘successful age�ng’, explor�ng the structural factors that �mpact on age�ng as well as valu�ng the exper�ence and mean�ng of age�ng to �nd�v�duals.45 Chambers8 has argued that w�th ‘a mult�-faceted approach to age�ng and a comm�tment to challenge d�scr�m�nat�on, cr�t�cal soc�al gerontology already parallels soc�al work educat�on and older people’ (p 745). She suggests �t has the potent�al to make a pos�t�ve contr�but�on to the soc�al work curr�culum �n three ma�n areas:

• challeng�ng age�sm • counteract�ng the ‘blam�ng’ culture, part�cularly �n relat�on to older people as a

‘welfare burden’ • character�s�ng old age as an �ntegral part of human development and the

‘accumulat�on of a l�fet�me’s exper�ence’ (8, p 757).

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1.6 The review team

The rev�ew team for th�s HGDOP knowledge rev�ew cons�sted of two members w�th prev�ous exper�ence of systemat�c rev�ews. The th�rd team member has prev�ously undertaken a rev�ew of ev�dence-based pract�ce.

1.7 Ethics

The research rev�ew �s a systemat�c rev�ew of ex�st�ng ev�dence already �n the publ�c doma�n. It d�d not ra�se �ssues of eth�cal research governance.

The pract�ce survey �ncluded �nterv�ews and quest�onna�res w�th educators, serv�ce users and students and requ�red �nformed consent. The anonym�ty of respondents was ensured as and where appropr�ate. In part�cular, steps were taken to ensure that students respond�ng to quest�onna�res d�d so anonymously �f they w�shed. The pract�ce survey was conducted �n accordance w�th the sponsor Sussex Inst�tute’s Research governance and ethics standards and guidelines.60 These are des�gned to meet the requ�rements of research funders, �nclud�ng those of the Department of Health Research Governance Framework.

1.8 Stakeholder group

The stakeholder group was appo�nted at the beg�nn�ng of the project and was consulted at key stages. Its purpose was to act �n an adv�sory capac�ty to the rev�ew. Its membersh�p reflects the nature of the rev�ew and the range of stakeholders to whom �t �s relevant. Stakeholder group membersh�p cons�sted of the follow�ng groups.

Users and carers: three users/carers from the Un�vers�ty of Sussex/Br�ghton Serv�ce User Network, one of whom was also an educator, and four members of a group for m�nor�ty ethn�c elders �n Br�ghton and Hove, �nterv�ewed for the pract�ce survey by a former group coord�nator.

Users’ and carers’ organisations: one coord�nator of an Age Concern local organ�sat�on and one former coord�nator of the group for ethn�c m�nor�ty elders ment�oned above.

Students: two undergraduate students from the Un�vers�ty of Sussex/Br�ghton BA programme and two postgraduate students from the Un�vers�ty of Sussex MA programme.

Practitioner/manager: one soc�al work pract�t�oner work�ng w�th older people �n a hosp�tal sett�ng, one soc�al work manager respons�ble for qual�ty assurance �ssues for older people’s serv�ces.

Social work educator: one academ�c, from Keele Un�vers�ty for whom HGDOP �s an area of spec�al�st �nterest.

Stakeholder �nvolvement at d�fferent stages of the rev�ew �s d�scussed further �n Sect�on 2.6 of th�s rev�ew.

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Research review

2 Research review methodology

2.1 Approach to the review and review questions

The rev�ew was conducted �n accordance w�th SCIE gu�del�nes for complet�ng systemat�c rev�ews34 and was supported by EPPI-rev�ewer software (Ev�dence for Pol�cy and Pract�ce Informat�on).63

The review structure: rev�ew f�nd�ngs are reported �n two ma�n sect�ons:

• A map of the research f�eld (Sect�on 3), prov�d�ng an overv�ew of all the research �ncluded �n the rev�ew. In th�s sect�on of the report stud�es were not qual�ty assessed for trustworth�ness, appropr�ateness or relevance. The map prov�des the context for the �n-depth rev�ew of the data-extracted stud�es.

• An �n-depth rev�ew (Sect�on 4) that prov�des a synthes�s of the evaluat�ve stud�es that exam�ned the outcomes of HGDOP �n qual�fy�ng soc�al work. The �ncluded stud�es were qual�ty assessed to determ�ne the we�ght of ev�dence attr�butable to them �n answer�ng the rev�ew quest�ons.

2.2 Searching the literature

The rev�ew search strategy covered the follow�ng types of sources, systemat�cally gathered from f�ve electron�c b�bl�ograph�c databases, relevant webs�tes, handsearch�ng and contact w�th experts:

• emp�r�cal stud�es from peer-rev�ewed sources • theoret�cal papers from peer-rev�ewed sources (to �nform the framework for

synthes�s) • profess�onal and pol�cy documents for background only • research reports and other relevant publ�shed l�terature.

Deta�ls of the search strategy are g�ven �n Append�x 3. A total of 727 c�tat�ons were retr�eved; w�th 187 dupl�cates extracted, there were 540 un�que c�tat�ons.

2.3 Inclusion and exclusion criteria

All �dent�f�ed stud�es were screened on the bas�s of t�tle and abstract accord�ng to agreed �nclus�on and exclus�on cr�ter�a. The exclus�on cr�ter�a are g�ven �n Table 1. Deta�ls of the numbers of reports excluded on each cr�ter�on are g�ven �n F�gure 1 and Append�x 3. Twenty per cent of all t�tles and abstracts were double screened �ndependently by two rev�ewers to ensure rel�ab�l�ty.

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Table 1: Exclusion criteria

Criterion label* Criterion details

F�rst stage

1 Not soc�al work educat�on2 Not qual�fy�ng level soc�al work educat�on3 Not focused on soc�al work educat�on and older people4 Not focused on soc�al work educat�on about HGD5 Not focused on soc�al work educat�on about HGDOP6 Tra�n�ng mater�al/textbook7 Book rev�ew8 B�bl�ography9 Journal�sm/bullet�n

10 Language other than Engl�shSecond stage

F�rst stage cr�ter�a re-appl�ed to full document

At the f�rst stage the major�ty of the 410 exclus�ons were made on the bases that reports were not focused on soc�al work educat�on about HGDOP, not focused on soc�al work educat�on about HGD or not about soc�al work educat�on and older people. From the t�tle and abstract alone, �t was d�ff�cult to �nterpret whether HGDOP was the focus of many papers. The rev�ewers erred on the s�de of �nclus�on at th�s stage, �dent�fy�ng 130 reports for further screen�ng. Seven papers could not be retr�eved, leav�ng 123 papers retr�eved.

At the second stage the same �nclus�on and exclus�on cr�ter�a were appl�ed to the full paper. The major�ty of second-stage exclus�ons were made on the bases that papers d�d not focus on soc�al work educat�on about HGDOP, or d�d not focus on soc�al work educat�on about HGD.

Twenty-s�x papers met the cr�ter�a for �nclus�on �n the rev�ew. Four of these reported on the same two stud�es; two reports were therefore treated as l�nked.20, 26 Thus 24 separate stud�es were �ncluded �n the rev�ew.

F�fteen of these papers reported on one or more of the 67 ‘Gero-r�ch’ �n�t�at�ves,47, 53 �nst�gated w�th the support of the Counc�l of Soc�al Work Educat�on (CSWE) �n the US and funded, or part-funded, by a US char�table foundat�on, the Hartford Foundat�on. As�de from two of the four stud�es �dent�f�ed as l�nked above, the emp�r�cal and theoret�cal reports relat�ng to th�s �n�t�at�ve took place on d�fferent s�tes and w�th d�fferent research teams and authors. They were therefore treated as separate reports.

At th�s stage, both emp�r�cal and non-emp�r�cal papers were �ncluded. Ach�ev�ng a rel�able def�n�t�on of what const�tuted emp�r�cal and non-emp�r�cal research �n th�s f�eld was not easy, s�nce many papers reported educat�on pract�ce/rout�ne course evaluat�on and descr�pt�ve or evaluat�ve research.

Note: *Not mutually exclus�ve.

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Research review

2.4 Keywording

The 24 papers were coded us�ng a rev�ew-spec�f�c keyword�ng strategy (see Append�x 4). The strategy �ncluded type of study, character�st�cs and contexts of HGDOP, the study f�nd�ngs and conclus�ons. It was des�gned �n the l�ght of the exper�ence of prev�ous rev�ews and the scop�ng study.

Twenty per cent of all papers �n the rev�ew were double keyworded �ndependently by two rev�ewers to establ�sh �nter-rater rel�ab�l�ty.

More d�scuss�on of the keyworded papers �s �ncluded �n Sect�on 3 of th�s rev�ew. They prov�de background �nformat�on on the nature and extent of the research ‘f�eld’ �n HGDOP.

A flowchart of the rev�ew process from search�ng to mapp�ng �s �ncluded below as F�gure 1.

2.5 Data extraction and in-depth review

An �n-depth rev�ew was undertaken of f�ve papers,1–5 and one l�nked paper6 to exam�ne emp�r�cal research, and, �n part�cular, work from wh�ch �nferences about effect�veness m�ght be drawn. Stud�es �ncluded were not only emp�r�cal, but prov�ded suff�c�ent methodolog�cal deta�l to allow qual�ty assessment.

Sect�on 4 descr�bes the nature and focus of the stud�es �nvolved, the character�st�cs of HGDOP d�scussed, and outcomes addressed, as well as key concepts �n use, f�nd�ngs and conclus�ons. A deta�led descr�pt�on of the stud�es �ncluded �n the �n-depth rev�ew �s prov�ded �n Append�x 5.

Stud�es �ncluded �n the �n-depth rev�ew were qual�ty assessed, �n accordance w�th SCIE and EPPI-Centre data extract�on gu�del�nes. The data extract�on strategy �ncluded r�gorous judgements of val�d�ty, rel�ab�l�ty, eth�cs, user engagement and qual�ty of research des�gn, execut�on and report�ng.

2.6 Stakeholder participation

The purpose of the stakeholder group was to engage users and carers, students, soc�al work pract�t�oners and managers �n the knowledge rev�ew both as critical friends at key stages �n the process and as �nformants �n the pract�ce survey.

The resources and t�me scale ava�lable meant �t was not poss�ble to �nvolve stakeholders �n all stages of the rev�ew. However, the�r v�ews were sought at key stages through telephone and ema�l contact. As critical friends, stakeholders were �nv�ted to comment on all key research dec�s�ons and consulted over spec�f�c �ssues. As �nformants, �nd�v�dual stakeholders contr�buted to the pract�ce survey themes by part�c�pat�ng �n telephone �nterv�ews. One stakeholder also �nterv�ewed older people from m�nor�ty ethn�c backgrounds to enable the�r v�ews to be �ncluded �n the pract�ce survey.

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Figure 1: Flowchart of research review process

Three-stage screeningPapers identified where there is

not immediate screening (eg electronic searching, secondary refs)

Potential includesn = 727

One-stage screeningPapers identified in ways

that allow immediate screening (eg handsearching)

Papers not obtained n = 7

First-stageexclusion criteria* 1 n = 2112 n = 2423 n = 2444 n = 3635 n = 3676 n = 437 n = 148 n = 19 n = 410 n = 0* Not mutuallyexclusive

Duplicate references excluded

Potential includesn = 540

Included in review for thematic analysis

n = 24 studies (26 reports)

Fulldocumentscreened

Title and abstract screening

71017

123 reports obtained

In-depth review n = 5

Potential includes n = 130

Second-stageexclusion criteria* 1 n = 132 n = 173 n = 374 n = 785 n = 966 n = 17 n = 18 n = 09 n = 010 n = 0

* Not mutuallyexclusive

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Research review

The stakeholder group was consulted at the follow�ng key stages:

• contr�but�ng to the def�n�t�on of the rev�ew quest�ons and the contents of the research proposal

• the des�gn of the keyword�ng strategy • comment�ng on drafts of the descr�pt�ve map • contr�but�ng to the content and process of the pract�ce survey.

Spec�f�cally:

• A br�ef pro forma was sent to all stakeholders at the start of the rev�ew. Th�s was to seek the�r v�ews on the def�n�t�ons of HGDOP and the �dent�f�cat�on of key �ssues. Th�s mater�al �nformed the �dent�f�cat�on of the research quest�ons and pr�or�t�es. A summary of th�s feedback �s �ncluded �n Append�x 9.

• The descr�pt�ve map was c�rculated to members of the stakeholder group and the result�ng feedback �nformed the ongo�ng progress of the rev�ew.

• F�ve group members – the three carers/serv�ce users and the Age Concern and m�nor�ty ethn�c elders group part�c�pants – made part�cular contr�but�ons to the pract�ce survey. They were �nterv�ewed us�ng a spec�f�cally des�gned quest�onna�re (�ncluded �n Append�x 8).

• One member �nvolved w�th a group of m�nor�ty ethn�c elders undertook �nterv�ews w�th four commun�ty members. She sought the�r v�ews about the�r exper�ences as older people �n relat�on to HGDOP. The quest�ons used and the�r analys�s �s �ncluded �n Append�x 8.

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3 Mapping HGDOP: an overview of the research

3.1 Introduction

Th�s sect�on �dent�f�es some of the character�st�cs of the 24 papers �dent�f�ed �n the keyword�ng process. It prov�des a map of HGDOP and follows the keyword�ng strategy. It �s structured under the follow�ng head�ngs:

• HGDOP stud�es: type and qual�ty • a�ms and theor�es of HGDOP • character�st�cs of HGDOP • ma�n cla�ms to ‘f�nd�ngs’ reported about HGDOP.

In th�s overv�ew of the research �ncluded �n the rev�ew, papers were not qual�ty assessed for trustworth�ness, appropr�ateness or relevance. What the overv�ew prov�des �s background �nformat�on on the nature and extent of the research ‘f�eld’ �n HGDOP. For reasons of space the f�nd�ngs are presented �n more deta�l �n Append�x 7.

3.2 HGDOP studies: type and quality

3.2.1 Study location and publication

All but one8 of the 24 papers �dent�f�ed by the keyword�ng process were from the US. Most were publ�shed s�nce 2000, w�th the oldest paper publ�shed �n 1988.

3.2.2 Type of study

The papers were placed �n four categor�es accord�ng to the type of study they represented:

• Emp�r�cal – evaluat�on • Emp�r�cal – descr�pt�ve • Non-emp�r�cal – descr�pt�ve • Non-emp�r�cal – other.

The def�n�t�on of emp�r�cal papers arr�ved at was:

• g�v�ng some �nd�cat�on of research methodology (for example, who was researched, how) and/or

• g�v�ng some data/f�nd�ngs that are clearly sourced from �nformants other than the author alone.

Papers des�gnated e�ther ‘non-emp�r�cal–descr�pt�ve’ or ‘other’ focused ma�nly on explorat�ons of curr�culum �n�t�at�ves, cons�der�ng spec�f�c modules or the �ntegrat�on of mater�al throughout the curr�culum. Twenty of the 24 papers reported

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Research review

�n th�s rev�ew descr�bed or evaluated pedagog�cal �nnovat�ons. The rema�n�ng four papers8, 22, 13, 18 prov�ded a cr�t�que of current HGDOP curr�cula w�th a more general d�scuss�on of the �mpl�cat�ons for the HGDOP curr�culum. Of these four papers, Chambers8 took a cr�t�cal gerontolog�cal and fem�n�st perspect�ve; Sherr and Blumhardt22 challenged the adequacy of current theoret�cal frameworks to encompass the pos�t�on of older rural women; and Crewe13 argued for the �nclus�on of an ethno-gerontolog�cal perspect�ve.

3.3 Aims and theories of HGDOP

3.3.1 Aims of HGDOP teaching and learning

Most stud�es �dent�f�ed a range of a�ms �n relat�on to the teach�ng, learn�ng and organ�sat�on of HGDOP and these are set out �n Table 2 below.

Table 2: Aims of HGDOP teaching and learning*

Aims of HGDOP teaching and learning Number of studies

Improv�ng understand�ng of human development and older people 22Improv�ng qual�ty of pract�ce 17Chang�ng att�tudes towards older people �n context of human development

16

Other 8Improv�ng outcomes for users and carers 6


The most frequently c�ted a�m was to �mprove understand�ng of HGDOP, although papers var�ed �n the level of deta�l prov�ded �n relat�on to th�s a�m. For example, one paper4 �dent�f�ed ‘learn�ng about’ older people as an a�m wh�le another3 a�med ‘to allow students to explore systemat�cally how the older narrators ... developed mean�ng �n the�r l�ves �n the context of h�stor�cal, soc�al, econom�c, pol�t�cal, and cultural real�t�es often much d�fferent from the students’ own’ (p 117).

In 11 of the 22 stud�es w�th the stated a�m of �mprov�ng understand�ng of HGDOP1–5,

9–11, 14, 15, 25 both classroom and pract�ce learn�ng sett�ngs were used. In n�ne, the classroom was the only sett�ng used.12, 13, 17–20, 22–24

Chang�ng att�tudes was a major object�ve of 16 papers1–5, 7–12, 14, 18, 20, 23, 25 and �n th�s group a comb�nat�on of classroom and pract�ce-based learn�ng was tw�ce as l�kely to be used as classroom learn�ng alone.

Seventeen stud�es also had as an a�m the �mprovement of the qual�ty of soc�al work pract�ce.1, 2, 5, 8, 9, 11, 13–16, 18–20, 22–25 Improved outcomes for users and carers was an expl�c�t teach�ng and learn�ng a�m for a smaller number of stud�es.2, 7, 8, 12, 17, 22

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ADULTS’ SERVICES

In the ‘other’ group the four stud�es4, 10, 15, 16 w�th the stated a�m of �ncreas�ng �nterest �n gerontolog�cal soc�al work as a career opt�on had between them a range of related a�ms, from �ncreased understand�ng,15 changes �n att�tude4, 10 and �mprovement �n pract�ce.16 Stud�es that �dent�f�ed a range of (usually) more spec�f�c a�ms (for example, �nclud�ng those such as �nvolv�ng students �n understand�ng rural sett�ngs,4 encourag�ng student self-reflect�on1 and �ncreas�ng access to tra�n�ng for res�dent�al staff7) were also �ncluded �n the ‘other’ category.

Where a�ms �ncluded �mprov�ng understand�ng, chang�ng att�tudes or �mprov�ng the qual�ty of pract�ce, part�c�pants �n learn�ng and teach�ng were more l�kely to �nclude users and carers. Half of the stud�es w�th each of these a�ms �ncluded users and carers �n teach�ng and learn�ng.3–5, 9–11, 14, 17, 20, 24, 25 Users, carers and commun�ty members were represented �n about the same proport�ons as soc�al work pract�t�oners/managers and other pract�t�oners/managers comb�ned.

3.3.2 Theories and concepts in use

The theor�es and concepts �dent�f�ed �n use are set out �n Table 3, w�th an �nd�cat�on of the number of papers that �dent�f�ed part�cular approaches. They refer both to HGDOP and to pedagog�cal theory. In most stud�es, the emphas�s was on one or other of these, but not both. Append�x 6 g�ves further �nformat�on about the def�n�t�ons of these theor�es and concepts adopted �n the rev�ew.

Table 3: Theories and concepts in use

Theories and concepts in use Number of studies

Psychosoc�al 15

Equal�t�es/r�ghts-based 14

Ecolog�cal/systems 10

Other 10

Soc�o-b�olog�cal 7

Cr�t�cal gerontology 6

Soc�olog�cal 6

Psycholog�cal 3

Not spec�f�ed 1

The overall �mpress�on ga�ned from the stud�es was that the conceptual and theoret�cal analys�s of HGD rece�ved l�ttle attent�on �n th�s l�terature. All stud�es made some statement �nd�cat�ng the range of areas drawn on as the theoret�cal context for HGDOP teach�ng and learn�ng (for example, phys�olog�cal, psycholog�cal, soc�olog�cal development, etc), and 10 papers1–3, 5, 8, 11, 13, 22–24 prov�ded a more susta�ned theoret�cal analys�s of the rat�onale for the�r approach. F�ve of these spec�f�cally ment�oned an ecolog�cal approach,2, 5, 13, 22, 23 one, 22 for example us�ng ‘a mult�d�mens�onal approach’ to cons�der the ‘goodness of f�t’ between �nd�v�duals and the�r env�ronment (p 49). Chambers8 drew on cr�t�cal gerontolog�cal concepts to challenge dom�nant d�scourses that ‘problemat�se’ female old age and w�dowhood.

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Research review

Soc�o-b�olog�cal aspects of age�ng rece�ved no susta�ned theoret�cal attent�on �n any of the papers rev�ewed, except �n relat�on to percept�ons of dement�a.18

There was much of �nterest �n the papers that focused on theor�s�ng teach�ng and learn�ng. Of the 10 papers �dent�f�ed as ‘other’, three concentrated on theor�s�ng the ‘�nfus�on’ model’, wh�ch a�med to make connect�ons between early and later l�fe exper�ences.12, 16, 21 ‘Infus�on’ was theor�sed as a ‘sp�ral’, a�m�ng to ‘art�culate the �nterconnect�ons among early and later l�fe exper�ences’ (16, p 16). The other seven3–5, 8–10, 14 explored spec�f�c pedagog�cal approaches �nclud�ng oral h�story/narrat�ve approaches3–5, 8, 9, 14 and ‘serv�ce learn�ng’.3, 4, 14 Serv�ce learn�ng �s def�ned as an approach wh�ch encompasses �nteract�ons between students and older people �n local commun�ty sett�ngs des�gned as a means of ‘acqu�r(�ng) exper�ences that w�ll enhance classroom learn�ng’ (52, p 175 c�ted �n 6, p 723).

3.4 Characteristics of HGDOP

3.4.1 HGDOP process focus

A major�ty of papers focused on quest�ons of teach�ng and learn�ng �n HGDOP. The ma�n po�nt of �nterest was that HGDOP mater�al was del�vered us�ng a range of overarch�ng frameworks �nclud�ng fem�n�st,8 ethno-gerontology,13 ecolog�cal theory7 and the stress/res�l�ency framework.24

The papers that d�scussed course organ�sat�on and management prov�ded some �nterest�ng and useful descr�pt�ons of the ways �n wh�ch curr�culum development was approached. Several descr�bed developmental work undertaken w�th pract�ce teachers and other commun�ty partners,1–4, 7, 9, 11 for example, the ‘benef�ts and barr�ers’ of �nter-generat�onal learn�ng;9 the development of ‘standard�sed learn�ng competenc�es’ �n pract�ce placements;2 and the �dent�f�cat�on of older volunteers for an oral h�story project.3 On a more general level, Hooyman and St Peter16 gave an overv�ew of four models of curr�culum change – spec�al�sat�on, �ntegrat�on, �nfus�on and transformat�on, the latter go�ng ‘beyond merely creat�ng a course or a module on ger�atr�c soc�al work, to develop�ng ways to fundamentally alter curr�culum structure, organ�sat�on, and pedagogy’ (p 15).

More l�m�ted attent�on was pa�d to assessment. The papers rev�ewed �ncluded almost no �nformat�on about how theoret�cal knowledge was assessed. Most of the s�x papers that �ncluded a focus on assessment descr�bed spec�f�c examples of HGDOP assessment tasks. The most frequently c�ted were tasks based on the use of oral h�stor�es and �nterv�ews w�th older people.3, 14, 20, 24 Three papers expl�c�tly �ncluded self-reflect�on �n the assessment process.14, 20, 24

There was no �nd�cat�on that users/carers/commun�ty members were �nvolved �n assessment processes – rather that work undertaken w�th them, such as oral h�story, was a focus of assessments such as ‘a wr�tten and/or v�sual p�ece celebrat�ng the�r partners’ l�ves and the events and c�rcumstances that shaped them’ (6, p 727) and was evaluated by �nstructors. Where assessment �nvolved a pract�ce element, examples �ncluded reports and wr�te-ups of oral h�story3, 14 and the requ�rement

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that a pract�ce placement exper�ence must �nclude at least one older serv�ce user or an �ntergenerat�onal case.15

3.4.2 Timing and organisation of HGDOP initiative

S�xteen papers3, 4, 7, 11, 12, 14–22, 24, 25 related to �n�t�at�ves that took place at an early stage of undergraduate or postgraduate qual�fy�ng educat�on, often as part of, or l�nked to, �ntroductory or foundat�on courses. A common concern was to engage students �n cons�der�ng �ssues related to age�ng and older people at an early stage of the�r profess�onal educat�on on the assumpt�on that th�s would have the most �mpact on chang�ng att�tudes and �ncreas�ng �nterest.

The rev�ew �dent�f�ed two approaches to curr�culum organ�sat�on: the d�screte and the embedded. Most papers (21 of 24) reported on the development of d�screte �n�t�at�ves or s�gn�f�cant module components w�th d�fferent emphas�s g�ven to the balance between HGD and HGDOP. In n�ne of the papers, one-to-one contact w�th an older person was central to the �n�t�at�ve descr�bed.2–5, 7, 9, 11, 14, 25

A further n�ne papers12, 13, 17–20, 22–24 �dent�f�ed HGD teach�ng and learn�ng as a d�screte �n�t�at�ve, usually as part of a human behav�our �n the soc�al env�ronment (HBSE) course. HBSE �s a core �ntroductory module �n US soc�al work programmes and �s one of the f�rst modules to be taught, usually dur�ng the f�rst semester.

Four of the US papers15, 16, 21, 25 were categor�sed as ‘embedded’ for the purposes of th�s rev�ew because they argued that the most effect�ve means of chang�ng att�tudes towards older people and encourag�ng students to work w�th them was to ‘embed’ gerontolog�cal teach�ng and learn�ng across the curr�culum. There were also examples of the d�screte and embedded approaches be�ng comb�ned w�th�n the curr�culum. N�ne ‘d�screte’ papers9, 12, 17–21, 23, 24 d�scussed HGD �n�t�at�ves that were part of a w�der �ntervent�on to embed gerontolog�cal content across the whole curr�culum.

Th�rteen papers3, 5, 9–12, 15–17, 21, 22, 24, 25 descr�bed �n�t�at�ves that were supported by some fund�ng from the Hartford Foundat�on Gero-r�ch project.54 Where papers were l�nked to that �n�t�at�ve, the emphas�s on HGD teach�ng and learn�ng var�ed greatly. They �ncluded examples of serv�ce learn�ng �n�t�at�ves wh�ch �nvolved s�gn�f�cant per�ods of commun�ty-based learn�ng,3 group and commun�ty work projects w�th a part�cular focus (for example, 9) or, the shortest d�screte �n�t�at�ve, a 60-m�nute observed focus group w�th a post-group d�scuss�on and class work.10

3.4.3 Participants in HGDOP

In all papers where spec�f�ed (22 – all but 8, 13) teach�ng and learn�ng was organ�sed and del�vered by soc�al work educators. The �nvolvement of other part�c�pants �n the organ�sat�on and del�very of HGDOP was l�m�ted �n sp�te of Hooyman and St Peter’s comment that �n �nfus�on models:

… all key stakeholders … need to be �nvolved �n the process of plann�ng, �mplement�ng, and susta�n�ng the curr�cular changes. (16, p 14)

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Research review

Participants in course organisation

Bes�des soc�al work educators, the next group most often reported as �nvolved �n the organ�sat�on of teach�ng and learn�ng were soc�al work pract�t�oners,2, 7, 14, 16, 21 followed by other pract�t�oners.2, 4, 11, 21 Only one paper16 reported educators other than soc�al workers be�ng �nvolved �n course management and organ�sat�on. None of the stud�es w�th the stated a�m of chang�ng student att�tudes towards older people reported �nvolv�ng users, carers or commun�ty members �n course organ�sat�on and management. Four stud�es10, 12, 16, 21 �dent�f�ed students as part�c�pants �n course organ�sat�on.

Participants in teaching and learning

Pred�ctably, soc�al work educators were �dent�f�ed as part�c�pat�ng �n teach�ng and learn�ng �n most of the papers, wh�le users, carers and/or commun�ty members were the second most frequently ment�oned part�c�pants.3–5, 9–11, 14, 17, 20, 24, 25 Examples of the�r �nvolvement �ncluded guest speak�ng �n college-based teach�ng sess�ons, prov�d�ng �nput on oral h�story methods,4 focus group part�c�pat�on10 and part�c�pat�ng �n one-to-one �nteract�ons w�th students.2, 4, 11, 14 Two stud�es ment�oned the potent�al for older people to be �nvolved w�th assessment.17, 20

Seven papers �dent�f�ed a role, or range of roles, �n teach�ng and learn�ng for soc�al work pract�t�oners/managers.1, 2, 7, 9, 12, 14, 15 The papers �nd�cated very l�ttle use of soc�al work pract�t�oners/managers �n the classroom-based elements of the programmes d�scussed. Where the sett�ng �ncluded both pract�ce and classroom-based elements, the soc�al work pract�t�oners/managers seemed to be �nvolved �n the pract�ce element only �n all but two stud�es.9, 14 Somet�mes pract�t�oners were reported as work�ng w�th mater�als prov�ded by soc�al work educators (for example, 1, 2), but more often they prov�ded consultat�ons, support and guest lectures. In one example ‘agency soc�al workers prov�de educat�onal opportun�t�es and consultat�on … and serve as profess�onal role models’ (4, p 99).

3.4.4 Setting of HGDOP teaching and learning

There were sl�ghtly more papers d�scuss�ng �n�t�at�ves that �ntegrated classroom and pract�ce learn�ng12 than those report�ng classroom-only modules.10 ‘Pract�ce learn�ng’ �n th�s rev�ew �ncluded assessed pract�ce placements (commonly referred to ‘as the pract�cum’ �n the US), but were more l�kely to refer to var�able t�me-l�m�ted exper�ences �n agency and/or commun�ty sett�ngs, such as ‘pa�red’ contact w�th older people, observat�onal v�s�ts or serv�ce learn�ng �n the US l�terature. These serv�ce learn�ng exper�ences were usually assessed by soc�al work educators as an element of a classroom-h�gher educat�on �nst�tute (HEI)-based module.

F�ve papers referred to �n�t�at�ves w�th�n formal pract�ce placements,1, 2, 15, 16, 25 of wh�ch three1, 2, 15 prov�ded deta�led content. The paper by Browne et al2 was the only one to focus on a HGDOP teach�ng and learn�ng curr�culum w�th�n a requ�red pract�ce placement. B�rkenma�er et al1 descr�bed an �n�t�at�ve a�med at explor�ng and �ntegrat�ng sp�r�tual bel�efs �n serv�ce prov�s�on for older people. The �n�t�at�ve was

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organ�sed and prov�ded by soc�al work educators wh�le students were on an elect�ve pract�ce placement. Further deta�ls of these �n�t�at�ves are �ncluded �n Append�x 7.

The other seven papers d�scuss�ng �ntegrated classroom/pract�ce �n�t�at�ves �ncluded oral h�story projects where the sett�ngs were �dent�f�ed and selected by soc�al work educators �n consultat�on w�th agency staff,3–5, 14 or �nterv�ews or focus groups w�th older people on spec�f�c top�cs,10, 11 and observat�ons and v�s�ts.5, 25 The result�ng mater�al was used to complement learn�ng and assessment �n the classroom.

Ten of the papers referred to classroom-based learn�ng only.12, 13, 17–24 Most of these13, 17, 18, 20, 23, 24 descr�bed general approaches to or models of HGDOP. Only one paper7 reported on a purely pract�ce-based sett�ng. Th�s paper descr�bed programmes prov�d�ng pract�ce placements w�th chron�cally mentally �ll older people �n res�dent�al sett�ngs. The placements were superv�sed by pract�ce teachers who also prov�ded the formal educat�onal �nput. Students undertak�ng these placements were pa�d a st�pend and g�ven a reduct�on �n tu�t�on fees.

3.4.5 Pedagogical methods

Some papers were very expl�c�t about the�r teach�ng methods5, 11, 12, 20 and on occas�on th�s was the focus of the paper (for example, 3, 10, 25). F�gure 2 �dent�f�es the range of methods �dent�f�ed by the papers, although these categor�es are not mutually exclus�ve, and 10 papers prov�ded no deta�l about the methods used.

Figure 2: Pedagogical methods

Note: Categor�es not mutually exclus�ve.

Classroom-based

experientialFormal

didactical/receivedlearning

Groupwork

Notspecified

Other

Classroom-based

practicelearning

12

10

8

6

4

2

0

Pedagogical methods

17

Research review

Formal d�dact�c approaches such as lectures were referred to �n 12 of the 14 papers prov�d�ng �nformat�on on the pedagog�cal approaches used.2–5, 9–12, 14, 19, 24, 25 However, formal teach�ng was �nvar�ably used alongs�de a range of other methods, �nclud�ng case stud�es, classroom exerc�ses and the use of v�deo. F�ve stud�es had a part�cular focus on learn�ng through group work, to support self-reflect�ve d�scuss�on of pract�ce exper�ences1, 9, 11, 14 or through observat�on of focus groups of serv�ce prov�ders and users.10

A w�de var�ety of approaches to classroom-based exper�ent�al learn�ng were descr�bed �n 11 papers.1–3, 5, 9–11, 14, 20, 24, 25 W�th�n th�s were two ma�n emphases: self-reflect�on,1, 5, 9, 10, 11, 14, 20, 24, 25 and d�scuss�on of pract�ce/serv�ce-learn�ng exper�ences.2, 3, 14 Examples were prov�ded of a range of approaches used to encourage self-reflect�on, such as use of t�me l�nes,5, 20, 24 med�tat�ons,1 s�mulat�ons,25 and other reflect�ons on age�ng.1, 10, 20, 24 In some papers these approaches were descr�bed �n deta�l. Wa�tes and Lee25 cons�dered the response of students to a range of s�mulat�ons, such as wear�ng th�ck gloves to s�mulate the �mpact of arthr�t�s, wh�le B�rkenma�er et al1 descr�bed the deta�l of a med�tat�on exerc�se to help reflect on later l�fe and dy�ng. The use of reflect�ve journals was ment�oned by two stud�es.3, 4 Ames and D�epstra6 saw these journals as a way of �ntegrat�ng classroom mater�al w�th oral h�story learn�ng and ‘prov�d(�ng) a mechan�sm for focuss�ng class d�scuss�ons’ (6, p 725). E�ght other stud�es1, 10, 14, 20,

24, 25 reported pedagog�cal approaches that encouraged wr�tten self-reflect�ve tasks of var�ous k�nds.

There were no references made to the use of e-learn�ng support�ng any of the pedagog�cal methods �dent�f�ed �n classroom or pract�ce learn�ng.

Pract�ce-based learn�ng was ment�oned as a pedagog�cal method �n 10 papers and �ncluded var�ed and �mag�nat�ve approaches. Four of these 10 papers1, 2,

7, 25 related to formal placement exper�ences. Others �ncluded the use �n the classroom of mater�al prov�ded by students from the�r placements;9 a module on sp�r�tual�ty undertaken together by pract�ce teacher and l�nked student;1 and pract�ce placements alongs�de other serv�ce learn�ng opportun�t�es such as v�s�ts and volunteer�ng.25 S�x papers descr�bed between them a var�ety of ‘serv�ce learn�ng’ �n�t�at�ves �n agency or commun�ty sett�ngs, such as scheduled rem�n�scence and oral h�story; v�s�ts to matched3, 4, 14 – or perhaps unmatched5 – older people �n nurs�ng home or �ndependent l�v�ng sett�ngs; observat�ons and ‘report back’ of day centre fac�l�t�es.5 In these examples serv�ce learn�ng was seen as an �mportant method of �ntegrat�ng theory and pract�ce, complement�ng learn�ng and assessment �n the classroom.3, 4, 25 These �n�t�at�ves were usually assessed by soc�al work educators as an element of a classroom-HEI-based module.

3.4.6 Curriculum organisation

The papers reflected some of the d�lemmas related to organ�s�ng a d�verse and substant�al range of mater�al �nto an appropr�ate curr�culum at an �ntroductory po�nt �n the course. Overall, there was no obv�ous relat�onsh�p between the perspect�ves chosen and the papers’ declared a�ms, pedagog�cal approaches or part�c�pants �n teach�ng and learn�ng.

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Ten papers were �dent�f�ed as approach�ng curr�culum organ�sat�on from more than one perspect�ve,5, 8, 11, 14, 17–22 argu�ng that an eclect�c approach was requ�red to do just�ce to the complex�ty of the subject (see Table 4).

Table 4: Curriculum organisation*

Curriculum organisation Number of studies

Theory-based 15

Top�c-based 7

R�ghts-based 6

L�near/sequent�al 4

Other 2

Not spec�f�ed 1

Note: *Categor�es not mutually exclus�ve.

Theory-based

As Table 4 shows, 15 papers2–5, 7–9, 11, 13, 14, 16, 19–22 suggested that part�cular theor�es or approaches prov�ded an appropr�ate framework for del�ver�ng the HGDOP curr�culum, although no preva�l�ng theoret�cal approach emerged. S�x stud�es �dent�f�ed ecolog�cal models as the overarch�ng framework.2, 5, 7, 9, 19, 22 For some th�s framework was comb�ned w�th other approaches such as l�fespan theor�es (for example, 5), and phenomenology, confl�ct and empowerment theory.22 Other relevant HGD theor�es �dent�f�ed as prov�d�ng the organ�sat�onal framework for the curr�culum �ncluded cr�t�cal theor�es,8, 20 psychosoc�al/l�fespan theory,3, 5, 11, 14, 16,

21 ethno-gerontology13 and soc�olog�cal theor�es of age�ng such as d�sengagement or act�v�ty theory.23

Topic-based

Seven papers were categor�sed as top�c-based.1, 10, 12, 17–19, 23 Three of these argued for greater attent�on to be pa�d to a spec�f�c �ssue (such as mental health12, 18) and three focused on the needs of a part�cular serv�ce user group – grandparents �n k�nsh�p care,17 older people w�th learn�ng d�ff�cult�es,19 and older people w�th dement�a.18 Kropf19 �s �ncluded �n th�s group because, although the ma�n organ�s�ng framework was theory-based, the focus was on a part�cular top�c. Others1, 10, 23 focused on top�cs that related more spec�f�cally to development �n later l�fe, �nclud�ng the psycholog�cal d�mens�ons of successful age�ng and the management of stress.23

Rights-based

S�x stud�es5, 8, 11, 17, 18, 22 �ncluded a r�ghts-based approach as an �mportant, but not the only, approach to curr�culum organ�sat�on. All of these stud�es �ncorporated an ant�-oppress�ve focus, w�th spec�f�c groups of d�scr�m�nated-aga�nst older people the focus of attent�on �n some papers, for example, women;8, 22 rac�al and cultural oppress�on;17 and older people w�th dement�a.18

19

Research review

Linear (‘cradle to grave’)

The four l�near and sequent�al (‘cradle to grave’) models18, 20, 21, 25 were l�nked to the promot�on of �deas about pos�t�ve age�ng20, 21, 25 and attent�on to �ssues for the very old.18 The paper by Eun-Kyoung et al15 d�d not �dent�fy how teach�ng and learn�ng m�ght be organ�sed. Vandsburger et al,24 on the other hand, expl�c�tly stated that the stress and res�l�ency framework d�scussed was flex�ble enough to be adapted to any form of curr�culum organ�sat�on. Downey and M�les14 �ncluded �n the�r approach to curr�culum organ�sat�on a focus on the programme’s older part�c�pants and prov�d�ng ‘�solated �nd�v�duals w�th support and compan�onsh�p and the opportun�ty to contr�bute to the growth and development of the next generat�on of soc�al workers’ (p 95).

3.4.7 Curriculum content

Developmental processes, pos�t�ve age�ng and values/att�tudes/ant�-oppress�ve pract�ce (AOP) prov�ded the core curr�culum content. It was d�ff�cult to d�st�ngu�sh between these three attr�butes, as def�n�t�ons were unclear �n some papers where examples of content were not always deta�led or spec�f�c.

Developmental processes

Many papers prov�ded relat�vely unexplored descr�pt�ons of HGD content on ‘developmental processes’. Th�s �s not surpr�s�ng, perhaps, g�ven that most of the papers �ncluded �n the rev�ew d�d not focus the�r d�scuss�on on an overarch�ng theoret�cal perspect�ve on HGD for older people w�th�n the curr�culum. So, for example, Dorfman et al4 referred rather generally to a ‘bas�c aspects of ag�ng’ curr�culum that �ncluded ‘the b�olog�cal, soc�al, and psycholog�cal aspects of ag�ng, and �ncludes a broad var�ety of top�cs �nclud�ng health, econom�c status, soc�al supports’ (p 223). Others �nd�cated a more spec�f�c approach to developmental processes. For Crewe,13 for example, the focus was on ethno-gerontology w�th�n a l�fecourse perspect�ve. Many papers that reported on curr�culum developments (part�cularly �n relat�on to the HBSE modules) assumed that content on b�o-psychosoc�al development was automat�cally �ncluded and therefore deta�led explorat�on of mater�al relevant to these areas was l�m�ted (for example, 4). Other papers referred to mater�al draw�ng on the work of ‘standard’ developmental theor�sts such as Lev�nson51 and Er�kson40, 41 and to soc�al gerontolog�sts such as Neugarten54 and Hav�ghurst43 (for example, 5, 23).

Values and attitudes

In n�ne papers developmental processes and a l�fespan perspect�ve also �ncluded content on values and att�tudes and on pos�t�ve age�ng.4, 5, 8, 11, 14, 17, 20, 21, 23 Content on values, att�tudes and AOP was a strong theme, w�th all of the 17 papers �n th�s group g�v�ng at least some attent�on to stereotypes of age�ng.1–5, 7–11, 13, 14,

17, 18, 20–23 Some papers h�ghl�ghted spec�f�c areas of ant�-oppress�ve understand�ng and pract�ce such as rac�al and cultural d�vers�ty,2, 13, 17, 18 �nclud�ng m�grants’ exper�ences.21 One focused more part�cularly on older women’s exper�ences8 and one �ncluded some attent�on to gay and lesb�an older people.21

20

ADULTS’ SERVICES

Positive ageing

Pos�t�ve age�ng was d�scussed from a number of perspect�ves. Some4, 8, 20 cons�dered �t ma�nly �n relat�on to pedagog�cal methods and suggested that narrat�ve and b�ograph�cal approaches were useful. Gray and Kabadak�5 also focused on methods and the mer�ts of v�deos and v�gnettes. Others1, 14, 17, 22–24 emphas�sed a ‘strengths and res�l�ence’ framework, and/or the abol�t�on of stereotypes and �ncreased ‘apprec�at�on for the�r (older adults) role and contr�but�ons to soc�ety’ (14, p 96).

All of the n�ne papers that �ncluded sk�lls work �n curr�culum content were among the 16 papers that �dent�f�ed chang�ng att�tudes as a programme a�m. The sk�lls content �ncluded �n these n�ne papers1–4, 7, 9, 11, 14, 25 �ncluded: commun�cat�on, �nterv�ew�ng and l�sten�ng sk�lls;3, 9, 11, 14 tra�n�ng �n oral h�story methods;4 and sk�lls �n assessment,1, 2, 25 w�th Wa�tes and Lee25 spec�f�cally ment�on�ng the ab�l�ty to make b�o-psychosoc�al assessments. Other sk�lls ment�oned �ncluded conference organ�sat�on,9 soc�al act�on,9 network bu�ld�ng,7 research and computer sk�lls.5, 7

Biological ageing

A gap �n the l�terature was the l�m�ted range of papers that s�tuated or cons�dered the �mpact of b�olog�cal age�ng and common chron�c cond�t�ons w�th�n the HGDOP focus. There was l�ttle d�scuss�on about what to �nclude �n relat�on to age-related health/�llness (w�th the except�on of Kane and Houston-Vega’s 2004 paper on dement�a18) and end-of-l�fe stud�es.

3.4.8 Main outcomes considered

The outcomes �dent�f�ed �n th�s rev�ew reflect the ma�n cla�ms �dent�f�ed �n the papers rather than the outcomes that the papers evaluated (see Table 5).

Table 5: Main outcomes considered*

Main outcomes considered Number of studies

Acqu�s�t�on of knowledge/understand�ng 19

Changed att�tudes/percept�ons to HGDOP 17

Part�c�pant react�ons 8

Acqu�s�t�on of sk�lls 7

Improved profess�onal behav�our/qual�ty of pract�ce 5

Other 5

Improved outcomes for users/carers 3

Not spec�f�ed/ not appl�cable 1

Note: *Categor�es not mutually exclus�ve.

21

Research review

Acquisition of knowledge

Regardless of the underp�nn�ng theor�es and concepts used, the most s�gn�f�cant outcome cons�dered was the acqu�s�t�on of knowledge and understand�ng (19 papers 1–5, 8–10, 13, 15, 17–25). The focus was more often on �ncreased ‘understand�ng’ through serv�ce learn�ng and classroom-based exper�ent�al approaches rather than on knowledge of spec�f�c gerontolog�cal concepts or theoret�cal models, although at least 10 papers focused on knowledge as well as understand�ng.2, 3, 5, 8, 9, 13, 20, 22–24

Changing attitudes

Seventeen papers focused on chang�ng att�tudes as an outcome of teach�ng and learn�ng.1, 3–5, 7–10, 13–16, 18, 20, 21, 24, 25 Th�s was very much �n keep�ng w�th the central concern of the Gero-r�ch �n�t�at�ve �n �ncreas�ng understand�ng of the exper�ence of older people w�th a v�ew to �ncreas�ng �nterest �n gerontolog�cal soc�al work. Indeed all f�ve of the stud�es13, 15, 16, 21, 25 where HGDOP was descr�bed as ‘embedded’ �n other modules, wh�ch �s such a feature of the approach of the Gero-r�ch project, had as an outcome changed att�tudes and percept�ons. Of these f�ve papers all but Crewe declared some fund�ng through the Gero-r�ch project. None of th�s group cons�dered part�c�pant react�ons or acqu�s�t�on of sk�lls as ma�n outcomes.

Acquisition of skills

Conf�dence and sk�ll bu�ld�ng �n areas such as l�sten�ng and work�ng w�th cultural d�vers�ty were outcomes cons�dered �n seven papers.1–3, 9, 14, 17, 24 Improved profess�onal pract�ce was a stated outcome of �nterest �n f�ve papers.8, 13, 18, 23,

24 Improved outcomes for uses and carers underp�ns all developments �n th�s as �n other areas of soc�al work educat�on. However, three papers explored th�s aspect spec�f�cally – two at a theoret�cal level8, 20 and one7 as an element of the evaluat�on of a pract�ce �ntervent�on.

Other outcomes of �nterest �ncluded �ncreas�ng �nterest �n gerontology as a career10,

12, 15 and the development of an embedded model of teach�ng and learn�ng as a way of �ncreas�ng understand�ng of older people and gerontolog�cal soc�al work among all soc�al work students.16

A relat�vely small number of papers (e�ght1–5, 9, 10, 20) cons�dered students’ exper�ence of teach�ng and learn�ng as an outcome. Those that d�d were �nterested �n the perce�ved usefulness of the course (for example, 5), reflect�ons on course structure and content, and suggest�ons for �mprovement.1, 3, 10 Student react�ons �n relat�on to assessment were a focus ment�oned �n only two stud�es.3, 20 S�nce half the papers �dent�f�ed both classroom and pract�ce as teach�ng and learn�ng sett�ngs and most also �ncluded more than one pedagog�cal method, �t �s not surpr�s�ng that no s�gn�f�cant relat�onsh�p emerged between these factors and the outcomes cons�dered.

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ADULTS’ SERVICES

3.5 Main claims to ‘findings’ reported about HGDOP

Th�s sect�on a�ms to present an overv�ew of the cla�ms made about HGDOP teach�ng and learn�ng �n the 24 papers. The papers were var�ed �n terms of methodology and �n the amount of deta�l they prov�ded, and unl�ke the papers d�scussed �n Sect�on 4 of th�s rev�ew they have not been qual�ty assessed. Therefore, no appra�sal can be made of the trustworth�ness of the cla�ms made about ‘f�nd�ngs’. Instead, presented here �s a broad �nd�cat�on of the range of cla�ms be�ng made.

What stands out most �s that all of the 14 papers that evaluated or descr�bed ‘f�nd�ngs’ �n relat�on to the HGD curr�culum have predom�nantly pos�t�ve cla�ms to make about the �ntervent�ons descr�bed and/or the�r effect�veness, and none was predom�nantly negat�ve, or even m�xed. The h�ghest proport�on of pos�t�ve f�nd�ngs was assoc�ated w�th chang�ng att�tudes (75%), followed by �mproved understand�ng (59%) and �mproved qual�ty of pract�ce (53%), but not all of these cla�ms were backed up by clear emp�r�cal data.

A second key po�nt �s that most of the papers report�ng ‘f�nd�ngs’ focus on the v�ews of student part�c�pants rather than other part�c�pants �nclud�ng serv�ce users and carers, pract�t�oners and managers. The v�ews of serv�ce users and carers, �n part�cular, rece�ved l�m�ted attent�on.

The seven emp�r�cal papers1–5, 9, 10 that �ncluded part�c�pant react�ons all reported pos�t�ve f�nd�ngs. For example, one paper5 reported that students found the curr�culum approach a ‘change of pace from lecture, encouraged part�c�pat�on, and helped them to remember and understand concepts’ (p 62). Students undertak�ng a sp�r�tual�ty and age�ng module1 were reported to have valued the knowledge �nput and felt that the gu�ded med�tat�ons could be used �n other sett�ngs. The one paper4 that evaluated outcomes for older people �nvolved �n an oral h�story project reported that the �nteract�on was enjoyed by all. Older part�c�pants commented, for example, that �t gave them a greater understand�ng of young people and an opportun�ty to make a contr�but�on.

Ten of the 14 papers prov�ded or referred to ev�dence to support predom�nantly pos�t�ve changes for students. E�ght of these cla�med an �ncrease �n students’ knowledge, understand�ng and sk�lls.1–5, 9, 10, 15 Pos�t�ve changes �n student att�tudes were reported �n s�x papers,1, 4, 7, 9, 10, 14 w�th, for example, Cohen et al descr�b�ng the �mpact of the approach adopted as ‘a transformat�ve exper�ence’ (p 341) �n wh�ch ‘students began to deconstruct the�r �mages of older adults and those pract�t�oners who serve older adults’ (10, pp 341–2). D�epstra and Ames,3 on the other hand, reported pos�t�ve f�nd�ngs but no stat�st�cally s�gn�f�cant pos�t�ve change �n students’ att�tudes towards older people. Two of the emp�r�cal evaluat�ons reported f�nd�ngs of �mproved qual�ty of pract�ce sk�lls,2, 3 as d�d Downey and M�les,14 one of the emp�r�cal descr�pt�ve papers. Vandsburger et al24 also cla�med �mproved qual�ty of soc�al work pract�ce, but th�s was not explored �n deta�l. Two papers1, 9 reported a d�m�n�shed but cont�nued student ‘d�scomfort’, one �n �ntegrat�ng learn�ng �nto pract�ce1 and the other ra�s�ng �ssues such as sexual�ty.9 A reduct�on �n student fears of gett�ng old was reported by Dorfman et al,4 wh�le Downey and M�les14 cla�med

23

Research review

that the oral h�story project prov�ded ‘lessons �n how to l�ve one’s l�fe more fully, deal�ng w�th pa�n and suffer�ng’ (p 100).

S�x papers reported on changes �n student �nterest �n a career �n gerontolog�cal soc�al work. Of these, four reported �ncreased �nterest4, 7, 10, 14 but the other two found no s�gn�f�cant change �n th�s area.3, 15

Some papers reported on students’ suggest�ons for programme �mprovements. Students �dent�f�ed greater use of exper�ent�al mater�al and emphas�s on ‘normal’ or healthy age�ng rather than on pathology and soc�al problems. In one paper1 students suggested that more examples and modell�ng of d�rect work w�th older people be �ncluded. In another paper3 students had some recommendat�ons to make about the t�m�ngs of v�s�ts and the select�on of older people to ensure that they had suff�c�ent memory to part�c�pate.

L�m�ted attent�on was pa�d to outcomes for pract�t�oners, and soc�al work staff. There were three except�ons: Abramson et al,7 who reported that student f�eld placements �n res�dent�al sett�ngs for chron�cally mentally �ll older people brought benef�ts to the staff as well as the students �nvolved. Ranney et al21 cla�med that the approach taken to the preparat�on of faculty staff to �ncrease the gerontolog�cal content of the HGD and other aspects of the soc�al work curr�culum had ensured that the faculty were ‘less threatened’ (p 93). Browne et al reported ‘a h�gh level of sat�sfact�on w�th all project act�v�t�es’ (p 703) among the programme consort�um members.

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4 In-depth review of studies of HGDOP outcomes

F�ve stud�es w�th one further l�nked study were �dent�f�ed as be�ng su�table for �n-depth rev�ew. A summary of each study �s g�ven �n Append�x 5.

The stud�es were analysed �n depth us�ng the EPPI-Centre’s data extract�on gu�del�nes (EPPI-Centre, 2007) and EPPI-Rev�ewer software.64 Rev�ewers allocated d�fferent we�ghts of ev�dence to the f�ve stud�es on the grounds of trustworth�ness, appropr�ateness and relevance to the rev�ew quest�ons, and overall we�ght of ev�dence for th�s rev�ew. Each study was �ndependently data extracted by two team members and consensus reached by subsequent consultat�on.

4.1 Nature and date of study

All of the �ncluded stud�es were publ�shed �n the US after 2000. Two stud�es were publ�shed �n 2002, two �n 2005 and the rema�n�ng study was publ�shed �n 2006.

4.2 Study design

4.2.1 HGDOP focus

In sp�te of some d�fferences of emphas�s there were s�m�lar�t�es �n the focus of the stud�es. All f�ve stud�es reported on curr�culum �n�t�at�ves and outcomes for part�c�pants. The ma�n outcomes reported were changes �n student att�tudes and self-percept�on3, 4 and the development of knowledge and sk�lls.3, 5 Three stud�es reported the responses of part�c�pants other than students, for example older people,4 consort�um members2 and pract�ce assessors.1

4.2.2 Qualitative and quantitative approaches

Four stud�es1–3, 5 d�d not �nvolve researcher man�pulat�on but collected pre- and post-test data. They comb�ned student quest�onna�res1–3, 5 w�th other �nstruments such as �nterv�ews,2 or qual�tat�ve comments/evaluat�on.5 One paper used the standard�sed Hertford Gero-r�ch quest�onna�re as the ma�n means of data collect�on.3 In the rema�n�ng study4 an exper�mental serv�ce learn�ng group and control group were set up us�ng quest�onna�res to collect mater�al from students. Th�s paper also used �nterv�ews to collect qual�tat�ve data from older people.

4.2.3 Research sample

Where stud�es reported on the s�ze of the�r research samples, these were small. They ranged from 12 students,2 e�ght students and e�ght f�eld �nstructors,1 through to a sample of 13 students �n an ‘exper�mental’ group sample matched to 13 serv�ce users w�th a control group of 36 students.4 In one study, the sample was 63 students3 and one study5 gave no deta�ls about the s�ze of the sample.

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Only one study4 �ncluded an �nter-profess�onal student sample.

All stud�es �ncluded students. Most of these were undergraduates although one study1 �ncluded both undergraduates and postgraduates. Most of the students attended one un�vers�ty although one paper reported a sample from two un�vers�t�es.3 Other part�c�pants �ncluded f�eld �nstructors,1 project team members2 and serv�ce users �n soc�al or res�dent�al care sett�ngs.

4.3 Weight of evidence

4.3.1 Weight of evidence judgement

To exam�ne the level or character�st�cs of the HGDOP outcomes cla�med �n the rev�ew we have borrowed the model adapted by Barr29 from K�rkpatr�ck49 and used �n earl�er rev�ews.61 Th�s model has been mod�f�ed to su�t the spec�f�c requ�rements of th�s rev�ew. Follow�ng the EPPI-Centre categor�es for qual�ty assessment, the we�ght of ev�dence attr�butable to each study was judged by the rev�ew team, shown �n Table 6. Wh�le rat�ngs of trustworth�ness refer to the �nherent qual�ty of each study, rat�ngs of appropr�ateness and relevance refer spec�f�cally to the rev�ew quest�ons; they are not judgements of the qual�ty of the study �tself. W�th�n th�s small sample of stud�es, the d�str�but�on of overall we�ght of ev�dence was one h�gh, two med�um and two low.

Table 6: Judgements on trustworthiness, appropriateness, relevance and overall weight of evidence

Study A: Trustworthy B: Appropriate for review

C: Relevance for review

D: Overall weight of evidence

Birkenmaier et al1

Med�um Med�um Low Low

Browne et al2 Low Med�um H�gh Med�um

Diepstra and Ames3*

Med�um Med�um H�gh Med�um

Dorfman et al4

H�gh H�gh Med�um H�gh

Gray and Kabadaki5

Med�um Low H�gh Low

Note: *A l�nked report to th�s study �s �dent�f�ed �n Append�x 5.

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Key to Table 6: Definitions of judgements adapted from the EPPI-Centre categories

Weight of evidence A: Tak�ng account of all qual�ty assessment �ssues, can the study f�nd�ngs be trusted �n answer�ng the study quest�on(s)?

Weight of evidence B: Appropr�ateness of research des�gn and analys�s for address�ng the quest�on, or sub-quest�ons, of th�s spec�f�c systemat�c rev�ew

Weight of evidence C: Relevance of part�cular focus of the study (�nclud�ng conceptual focus, context, sample and measures) for address�ng the quest�on, or sub-quest�ons, of th�s spec�f�c systemat�c rev�ew

Weight of evidence D: Tak�ng �nto account trustworth�ness, appropr�ateness of des�gn and relevance of focus, what �s the overall we�ght of ev�dence th�s study prov�des to answer the quest�ons of th�s systemat�c rev�ew?

4.3.2 Factors contributing to the weight of evidence

The study rated low �n terms of trustworth�ness2 was l�m�ted by the m�n�mal qual�ty of report�ng of deta�ls about the methods used, process of data analys�s or other factors w�th wh�ch to judge rel�ab�l�ty and val�d�ty. The three stud�es where the we�ght of ev�dence (WOE) was judged as med�um1, 3, 5 prov�ded more methodolog�cal or process deta�l but were l�m�ted by other factors such as small or unrepresentat�ve samples,1, 3 lack of researcher �ndependence3 and lack of compar�son or control cond�t�ons.1, 3 The one study rated h�gh �n terms of trustworth�ness4 prov�ded a mult�-sourced analys�s of both qual�tat�ve and quant�tat�ve data across groups (�nclud�ng older people) and over t�me.

The same study4 was the only one rated h�gh �n terms of appropr�ateness. Although there were some l�m�tat�ons ev�denced �n terms of sample s�ze, the study took a creat�ve and r�gorous approach to explor�ng the exper�ence and outcomes of an HGDOP �ntervent�on from several d�fferent perspect�ves, pre- and post-test. All three stud�es1–3 judged med�um for appropr�ateness of research des�gn and analys�s employed pre- and post-test des�gns to address aspects of curr�culum �nnovat�on �n relat�on to HGDOP.

The three papers w�th h�gh rat�ngs for relevance2, 3, 5 prov�ded cons�derable deta�l about the curr�culum developments explored �n relat�on to HGDOP. These �ncluded the rat�onale, content and processes �nvolved, as well as focus on the outcomes of the �ntervent�ons d�scussed. The l�m�tat�ons of the study assessed as med�um relevance4 related not to �ts overall relevance but to the fact that the sample �ncluded a range of profess�onal d�sc�pl�nes. It was not clear what proport�on of students were soc�al work students and, �n add�t�on, the outcomes were ma�nly at the level of att�tudes and reflect�ons on exper�ence, rather than behav�our.

The factor �nfluenc�ng the low relevance rat�ng �n the study by B�rkenma�er et al1 related to the narrow focus on just one aspect of HGDOP, sp�r�tual�ty �n assessment and �ntervent�on.

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4.4 Aims of HGDOP

In common w�th the a�ms of the papers �ncluded �n the overv�ew �n Sect�on 3, the a�ms �dent�f�ed by the stud�es were most l�kely to emphas�se the development of knowledge/understand�ng comb�ned w�th chang�ng att�tudes/self-reflect�on. Of lesser s�gn�f�cance was �mprov�ng the qual�ty of pract�ce and outcomes for users and carers (see Table 7).

Table 7: Aims of HGDOP

Aims of HGDOP Number of studies*Knowledge development 4 Chang�ng att�tudes/self-reflect�on 3 Improv�ng qual�ty of pract�ce 1 Improv�ng outcomes for serv�ce users/carers 1


S�nce all the data-extracted stud�es explored curr�culum �nnovat�on as the major theme, �t was not surpr�s�ng that four stud�es �dent�f�ed the development of students’ knowledge about spec�f�c frameworks as an a�m. Gray and Kabadak�, argued that a strengths-based approach would enable students to: ‘understand the complex relat�onsh�ps ... wh�ch �nfluence human development and funct�on�ng’ (p 56). Browne et al2 also argued for �ncreased knowledge about the strengths-based approach but felt �t should be comb�ned w�th an understand�ng of ecolog�cal models of development.

For Dorfman et al4 oral h�story and rem�n�scence enabled ‘elders [to] help students learn about rural commun�t�es …’ (p 221). In th�s study oral h�story was a s�gn�f�cant veh�cle for �ncreas�ng knowledge. For Ames and D�epstra6 the a�ms of the study were to explore:

… how engagement �n an oral h�story project w�th older adult partners �nfluenced students’ personal awareness, understand�ng of l�fe span development, and knowledge about older adults. (p 725)

One study4 suggested that serv�ce learn�ng prov�ded a means of promot�ng process knowledge about HGDOP by encourag�ng the �ntegrat�on of theory and pract�ce. Serv�ce learn�ng gave students opportun�t�es to ‘ga�n valuable hands-on appl�cat�on of �n-class learn�ng’ (p 223).

Att�tude change, personal development and �ncreased self-awareness were the second set of espoused a�ms. All f�ve papers �dent�f�ed these a�ms, somet�mes relat�ng to spec�f�c �ssues such as sp�r�tual awareness1 and, �n other stud�es, relat�ng to w�der structural factors such as age�sm.2 For Browne et al,2 one a�m was to explore a curr�culum where students learned to develop greater understand�ng about ‘age�sm and �ts �mpl�cat�ons for evaluat�on of one’s own pract�ce’ (p 701). Gray and Kabadak�’s study5 sought to understand whether �t was poss�ble to ‘apply human behav�or

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knowledge to �ncrease self-awareness and fac�l�tate personal and profess�onal development’ (p 56). They reflected on the s�gn�f�cance of explor�ng quest�ons about develop�ng a HGD curr�culum as a means of chang�ng att�tudes towards older people. Only one study4 spec�f�cally related chang�ng att�tudes to career development and career cho�ce. However, the concern to ra�se the prof�le of gerontolog�cal soc�al work �n the US suggests that chang�ng att�tudes was a key a�m of curr�culum �nnovat�on even when th�s was not expl�c�tly stated �n the stud�es.

Only two papers spec�f�cally ment�oned sk�ll development as an a�m, although one study4 argued that serv�ce learn�ng prov�ded opportun�t�es for develop�ng commun�cat�on sk�lls. In Gray and Kabadak�’s study,5 the focus was on �mprov�ng assessment sk�lls w�th older people, wh�le B�rkenma�er et al1 descr�bed the �mportance of sp�r�tual�ty �n the development of pract�ce sk�lls. The fact that most d�screte HBSE modules take place at an early stage �n soc�al work programmes may be one explanat�on for the l�m�ted emphas�s on sk�ll development �n the expl�c�t a�ms of these f�ve stud�es.

4.5 Theories and concepts in use

The stud�es drew on a w�de range of theor�es, concepts and frameworks but, �n the ma�n, these were not explored or cr�t�qued �n deta�l. Th�s l�m�ted attent�on to HGDOP theor�es reflected the character�st�cs of the w�der group of stud�es �ncluded �n the mapp�ng process. In many of these stud�es a range of theor�es was alluded to but not always explored as a means of develop�ng an �ntegrated theoret�cal approach to HGDOP.

4.5.1 Psychosocial, lifespan and developmental theory

In the f�ve stud�es references to l�fespan and developmental stud�es lack spec�f�c�ty, poss�bly because the context of HBSE modules assumed that th�s mater�al was a ‘taken for granted’ aspect of the curr�culum. An example of th�s approach was Dorfman et al’s4 paper d�scuss�ng a ‘bas�c aspects of ag�ng’ course wh�ch:

… covers the b�olog�cal, soc�al, and psycholog�cal aspects of ag�ng, and �ncludes a broad var�ety of top�cs �nclud�ng health, econom�c status, soc�al supports, and health and soc�al serv�ces for elders. (p 223)

No further deta�l was g�ven about how th�s mater�al was used. One paper5 referred to the work of Er�kson40, 41 and Peck65 as preparat�on for l�fe story �nterv�ews where the a�m was to ‘understand �nd�v�dual’s needs and development over the l�fe span’ (p 60). Selected students would then ‘observe and assess an older person’s current funct�on�ng and compare that w�th the standard textbook �nformat�on’ (p 61).

4.5.2 Ecological theory and rights-based approaches

Ecolog�cal theory was spec�f�cally referred to �n two stud�es2, 5 where �t prov�ded an overarch�ng framework and was usually comb�ned w�th other theoret�cal models. Gray and Kabadak� emphas�sed the strengths perspect�ve but made spec�f�c reference

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to ecolog�cal theory l�nked to a l�fespan approach. By the end of the course, students should be able to:

… cr�t�cally appra�se research and theor�es related to humans and the�r env�ronment for use �n general�st soc�al work pract�ce. (p 56)

Ames and D�epstra6 drew on Ashford et al’s work27 on ecomaps �n order: ‘to exam�ne “the po�nts of connect�on between systems �nfluenc�ng a person’s l�fe” as well as “po�nts of confl�ct and po�nts of support”’ (6, p 726). Browne et al2 made spec�f�c reference to research such as that by Hooyman and Kyak,46 wh�ch focused on the exper�ence of older people us�ng an ecolog�cal framework.

Browne et al’s work2 also made connect�ons between ecolog�cal approaches and the development of students’ cultural competence, although the ma�n a�m of the paper was to exam�ne d�sadvantage and �nequal�ty. The course:

… art�culates the structural barr�ers and d�sadvantages and advantages across the l�fe course that result �n d�fferent�al access-to-serv�ce patterns and documented health d�spar�t�es among ethn�c groups. (p 702)

Every class sess�on ... �s taught from a d�vers�ty perspect�ve. (p 702)

Gray and Kabadak�’s paper5 ment�oned draw�ng on a range of theor�sts to explore negat�ve soc�al att�tudes w�th�n a course where object�ves �ncluded enabl�ng students to analyse the ‘�mpact of oppress�on and d�scr�m�nat�on’ (p 56).

4.5.3 Pedagogical theory

However, two stud�es explored pedagog�cal theory �n cons�derable deta�l.3, 4 Both argued that models of serv�ce learn�ng were underp�nned by a research base that supported �ts use as a means to ‘acqu�re exper�ences that w�ll enhance classroom learn�ng’ (51, p 175, c�ted �n 6, p 722). Th�s �ncluded cr�t�cal th�nk�ng sk�lls and the �ntegrat�on of theory and research w�th pract�ce.

The study by D�epstra and Ames3 drew on research on oral h�story as method of prov�d�ng ‘context, perspect�ve, �nterpretat�on, d�alogue, and mean�ng’ (48, p 206, c�ted �n 3, p 117). The study suggested there was ev�dence that oral h�story also promoted empathy and understand�ng, �nterv�ew�ng sk�lls and conf�dence, espec�ally �n cross-cultural s�tuat�ons and w�th marg�nal�sed groups.

4.6 Nature of educational intervention

4.6.1 Course or module type

The f�ve stud�es descr�bed a var�ety of approaches to the structur�ng of teach�ng and learn�ng about HGDOP. Three stud�es d�scussed semester-long modules,3–5 one focused on a d�screte �n�t�at�ve wh�ch took the form of b�monthly sess�ons taught dur�ng a 13-week pract�ce placement,1 wh�le the rema�n�ng paper explored three developments tak�ng place w�th�n an elect�ve on age�ng.2 The overall length of the

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pract�ce learn�ng exper�ence was not spec�f�ed �n the �ntervent�on descr�bed by Browne et al.2

There was some recogn�t�on that content about HGDOP should be a requ�rement for all students at an �ntroductory level. Th�s was �llustrated by the fact that the HBSE modules were compulsory (d�scussed �n 3, 5). In the rema�n�ng three stud�es there was some voluntary element to the teach�ng and learn�ng about HGDOP. In the study by B�rkenma�er et al1 a d�screte module on sp�r�tual�ty was a voluntary opt�on w�th�n the pract�ce learn�ng exper�ence. Another study descr�bed two compulsory college-based modules and a 13-week pract�ce curr�culum w�th�n the framework of an elect�ve programme on age�ng.2 In a th�rd paper students from a number of d�sc�pl�nes took part �n a voluntary, �ntroductory course on gerontology.4

Whether the modules were requ�red or elect�ve, all f�ve �n�t�at�ves were assessed, suggest�ng that they had a formal status w�th�n the qual�fy�ng programme.

4.6.2 Level of the teaching and learning

As the prev�ous sect�on has suggested, HGDOP was del�vered to students at d�fferent levels of learn�ng. Dorfman et al’s study4 was the only one to d�scuss �nter-profess�onal learn�ng, �nclud�ng students from a range of d�sc�pl�nes such as nurs�ng, soc�al work, age�ng stud�es and health. As the t�tle ‘Bas�c aspect of ag�ng’ suggests, th�s course was des�gned to present a w�de range of mater�al at an �ntroductory level. Of the f�ve stud�es, three (�nclud�ng 4) descr�bed undergraduate programmes, one a Master’s programme,2 and one1 a programme for both undergraduate and postgraduate students.

4.6.3 HGDOP setting

The f�ve qual�ty-assessed stud�es represented comb�ned elements of learn�ng �n both classroom and pract�ce sett�ngs.

The study by B�rkenma�er et al1 descr�bed a formal class-based �n�t�at�ve that took place �n pract�ce sett�ngs. Browne et al’s2 study �ncluded both a 13-week f�eld-based curr�culum for students and f�eld �nstructors and a classroom-based curr�culum for students, �nvolv�ng two modules related to age�ng and d�vers�ty. The semester-long serv�ce learn�ng �n�t�at�ve descr�bed by Dorfman et al4 was an opt�onal part of an �ntroductory classroom-based gerontology course. Th�s �nvolved students learn�ng from ongo�ng contact w�th older people l�v�ng �n soc�al care fac�l�t�es �n a small rural commun�ty. D�epstra and Ames3, 6 reported on an oral h�story project wh�ch requ�red at least seven �nteract�ons w�th selected older person partners from d�verse backgrounds, along w�th a reflect�ve journal wh�ch was used to �ntegrate classroom mater�al w�th oral h�story learn�ng and ‘prov�de a mechan�sm for focuss�ng class d�scuss�ons’ (6, p 725). The study descr�bed by Gray and Kabadak�5 seemed to be the most classroom-or�ented, but �ncluded a requ�rement that ‘students complete an �ntens�ve �nterv�ew w�th an older adult’ (p 60).

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4.6.4 Participants in HGDOP

Three stud�es explored the �nvolvement of serv�ce users �n teach�ng and learn�ng.3, 4 In two of these, older volunteers were �nvolved �n oral h�story projects where they were ‘pa�red’ w�th a student. A th�rd study5 d�scussed the �nvolvement of older people as ‘experts’ ‘who are adapt�ng and cop�ng successfully w�th the age�ng process (and who) ‘are �nv�ted to class to speak about the�r exper�ences’ (5, p 61). The same study ment�oned the �nvolvement of older people �n an ‘�ntens�ve �nterv�ew’ w�th students, although no further deta�l was prov�ded of the process and outcomes of th�s �n�t�at�ve.

In the Dorfman et al study4 the older part�c�pants �n the oral h�story project were asked for the�r v�ews. In �nterv�ews w�th the project staff: ‘The older part�c�pants were asked to g�ve both the�r general and spec�f�c thoughts about the project, what they perce�ved as the�r own and students’ contr�but�ons to the project, and �f they had suggest�ons or recommendat�ons regard�ng future act�v�t�es or �mprovements’ (4, p 228). The other two stud�es descr�b�ng the �nvolvement of older people �n teach�ng and learn�ng3, 5 d�d not d�scuss the older people’s v�ews of the exper�ence.

One study2 explored the �nvolvement of a range of part�c�pants �n course management. A pr�mary focus of the �n�t�at�ve was to work �n partnersh�p to �dent�fy an agreed set of competences �n �nterd�sc�pl�nary pract�ce w�th older people. The ma�n a�m was to educate culturally competent soc�al workers. Th�s curr�culum was targeted at both students and pract�t�oners. In order to fac�l�tate th�s a�m the authors of the study set up two adv�sory counc�ls, �nvolv�ng commun�ty leaders and members of partner agenc�es �nclud�ng sen�or managers, pract�ce teachers and serv�ce managers. The role of these groups was to oversee the development and del�very of the curr�culum and to ensure ‘that pract�t�oners’ concerns were addressed’ (2, p 699).

The �mpress�on from the f�ve stud�es was that the major part�c�pants �n HGDOP rema�ned the un�vers�ty-based soc�al care staff and students. There were no examples of the �nvolvement of other profess�onals �n the learn�ng process. There were also no examples of serv�ce users and carers be�ng �nvolved �n management or assessment, although one paper2 focused on the �nvolvement of the w�der local and soc�al work commun�ty �n curr�culum development. Students’ v�ews were sought �n all f�ve stud�es, although one study5 prov�ded l�ttle deta�l about th�s consultat�on. There were no examples of students be�ng �nvolved �n management groups and no deta�l about the�r v�ews on the future development of the teach�ng and learn�ng about HGDOP.

4.6.5 HGDOP content and process

The content and process of teach�ng and learn�ng reflected the pr�mary a�ms of the f�ve stud�es: chang�ng students’ att�tudes towards age�ng and soc�al work w�th older people and �ncreased knowledge of human development. The stud�es e�ther approached these a�ms through a spec�f�c content focus such as awareness of the �mportance of sp�r�tual�ty1 or cultural competence,2 or pedagog�cal approaches such as serv�ce learn�ng and oral h�story.3, 4 In terms of chang�ng att�tudes and percept�ons Dorfman et al4 argued that �n �ntergenerat�onal serv�ce learn�ng ‘The most prevalent

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theme �s development of more pos�t�ve att�tudes toward and understand�ng of older people’ (p 221). Mak�ng s�m�lar po�nts �n relat�on to oral h�story, D�epstra and Ames3 commented that the �ntent of the �n�t�at�ve descr�bed �n th�s study ‘was to change soc�al work students’ att�tudes toward and �nterest �n work�ng w�th older adults wh�le expand�ng the�r awareness and understand�ng of human behav�our �n the soc�al env�ronment’ (p 116).

To d�fferent degrees all f�ve stud�es reflected a strong emphas�s on:

• content der�ved from pract�ce sett�ngs • the transfer of learn�ng from the classroom to pract�ce and v�ce versa • learn�ng by do�ng and exper�enc�ng.

The two papers wh�ch exam�ned more focused �n�t�at�ves1, 2 also �ncluded elements of ‘pract�ce learn�ng’. B�rkenma�er et al1 descr�bed a module w�th�n the f�eldwork pract�cum wh�ch �nvolved three group meet�ngs of students and the�r f�eld �nstructors. The content of the groups was des�gned to prov�de ‘an overv�ew of sp�r�tual aspects of human development and �nformat�on regard�ng ag�ng and sp�r�tual�ty’ (p 750). Two stud�es outl�ned pract�ce-based �n�t�at�ves that prov�ded opportun�t�es for sk�ll development such as �nterv�ew�ng, commun�cat�ng and assessment.2, 3 In add�t�on, one study argued that ev�dence from research on oral h�story suggested that �t prov�ded a veh�cle for the development of conf�dence �n �nterv�ew�ng, part�cularly �n relat�on to marg�nal�sed or excluded groups.3

G�ven the small number of qual�ty-assessed stud�es, th�s emphas�s on learn�ng from and about pract�ce �s all the more noteworthy and h�ghl�ghts the d�fferent ways �n wh�ch ‘pract�ce learn�ng’ can be �ntegrated �nto HGDOP. Th�s ranged from the formally assessed pract�cum,1 to �nd�v�dual �nterv�ews between students and older serv�ce users des�gned to develop commun�cat�on sk�lls and/or �ncreased knowledge of later l�fe.5

Another major theme �n relat�on to the content and process of HGDOP was the use of reflect�on to develop personal awareness and profess�onal �dent�ty. B�rkenma�er et al’s study of sp�r�tual�ty and HGDOP1 d�scussed med�tat�on and self-reflect�on �nclud�ng the use of metaphors around age�ng and dy�ng as techn�ques for �ncreas�ng self-awareness. Three stud�es3–5 report on the use of reflect�ve journals to enable students to �dent�fy the�r learn�ng and �ntegrate classroom and pract�ce-based learn�ng. All f�ve stud�es favour exper�ent�al and �nteract�ve models of learn�ng �nclud�ng the use of case stud�es and v�gnettes, presentat�ons, observat�on, v�deo cl�ps and classroom exerc�ses.

Only two stud�es3, 5 prov�ded �nformat�on about how HGDOP was assessed. In both examples, m�xed methods of assessment were used �nclud�ng ecomaps and genograms, reflect�ve commentar�es and analyses. One study5 descr�bed how students were requ�red to undertake a l�fe story �nterv�ew w�th an older person and complete an analys�s �dent�fy�ng s�gn�f�cant developmental m�lestones, and l�fecourse events, �dent�f�ed �n the l�fe story. Although serv�ce users were not formally �nvolved �n the assessment process, one study6 made the po�nt that the assessment ‘products’

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Research review

were ‘des�gned to be subm�tted to the�r [oral h�story] partners at the conclus�on of the course’ (p 727).

4.7 HGDOP outcomes examined

4.7.1 Range of outcomes considered

Table 8 sets out the range of outcomes that stud�es exam�ned. All but one of the stud�es was concerned w�th part�c�pant react�ons to HGDOP. Where stud�es explored the outcomes that suggested HGDOP effect�veness, th�s was at the level of �nd�v�dual learn�ng. Only one study1 focused on the �nvolvement of agenc�es as an outcome and two stud�es1, 3 commented on benef�ts to part�c�pants other than students: serv�ce users and carers3 and f�eld �nstructors.1

Table 8: Outcomes examined

Outcomes Number of studies*

Part�c�pant react�ons 4

Changed att�tudes 4

Sk�ll development 2

Knowledge acqu�s�t�on 5

Agency �nvolvement 1

User/carer benef�t 2


The most common outcomes addressed on an �nd�v�dual level were knowledge acqu�s�t�on (f�ve stud�es) and changes �n att�tude (four stud�es). These outcomes were �nferred by part�c�pants’ reports of �mprovement rather than by measur�ng change �n knowledge and att�tude. However, g�ven the emphas�s on pract�ce-based �n�t�at�ves �t may be that these outcomes and others such as the development of sk�lls were more comprehens�vely tested �n pract�ce placements and other parts of the course.

4.7.2 Measurement and monitoring of outcomes

All f�ve stud�es exam�ned the outcomes of a spec�f�c curr�culum �nnovat�on, mon�tored and measured w�th�n short t�me scales rather than longer-term cons�derat�ons such as the ma�ntenance of change or �ts appl�cat�on to post-qual�fy�ng pract�ce. Four stud�es1–4 measured outcomes pre- and post-del�very of the HGDOP module/�n�t�at�ve. The rema�n�ng study5 mon�tored outcomes post-test only (see Table 9).

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ADULTS’ SERVICES

Table 9: Outcomes measured and monitored*

Outcomes Number of studies measured

Number of studies monitored only

Part�c�pant react�ons 3 1

Changed att�tudes 3 1

Sk�ll development 3 0

Knowledge acqu�s�t�on 4 1

Agency �nvolvement 0 1

User/carer benef�t 1 1

Knowledge acqu�s�t�on rece�ved the most attent�on, followed by part�c�pant react�ons, changed att�tudes and sk�ll development. Only one study4 measured outcomes for serv�ce user part�c�pants, wh�le another br�efly mon�tored outcomes.3

Most attent�on was pa�d to �nd�v�dual change. Only one paper2 commented on organ�sat�onal change and suggested that th�s was mon�tored through �nvolvement �n course management and the complet�on of a survey of consort�um members’ v�ews. No further deta�ls were prov�ded about the outcomes of th�s survey.

4.8 Synthesising outcome findings

4.8.1 Positive and negative outcomes

Four of the f�ve stud�es presented predom�nantly pos�t�ve outcomes, although only two cla�med un�versally pos�t�ve outcomes. One study cla�med that ‘We met or exceeded all project object�ves’ (p 703). The second study that cla�med cons�stently pos�t�ve outcomes5 prov�ded l�m�ted deta�l w�th wh�ch to substant�ate these cla�ms. In the other two stud�es report�ng overall pos�t�ve outcomes,1, 4 the p�cture appeared to be more ‘m�xed’ than un�versally pos�t�ve. One study4 reported marg�nal d�fferences between study and control groups �n terms of general att�tude measures, although on other spec�f�c att�tude measures (such as fear of age�ng and more pos�t�ve att�tudes towards older people) there was greater d�fferent�at�on between the two groups pre- and post-test, w�th more pos�t�ve change �dent�f�ed �n the study group. In the other study1 quant�tat�ve data suggested more pos�t�ve outcomes than qual�tat�ve data.

The rema�n�ng study3 reported m�xed HGDOP outcomes. In common w�th the study by B�rkenma�er et al1 there were some reported d�fferences between qual�tat�ve and quant�tat�ve outcomes. There was no s�gn�f�cant change pre-test to post-test �n three of the four quant�tat�ve measures of student att�tude and �nterest: students’ att�tudes towards older people, �nterest �n learn�ng about them or �nterest �n work�ng w�th them. However, there was a s�gn�f�cant �mprovement �n students’ self-percept�on of the�r ab�l�ty to work w�th older adults.


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Research review

4.9 Participant reactions

All f�ve stud�es reported on students’ responses to HGDOP draw�ng on feedback gathered formally or �nformally. One study also reported on feedback from f�eldwork educators,1 one from serv�ce user part�c�pants4 and one from agency pract�t�oners and managers.2

In one of the two stud�es cla�m�ng un�versally pos�t�ve outcomes,2 students reported feel�ng more conf�dent about work�ng w�th older adults from m�nor�ty ethn�c groups, and about the�r own role �n �nterd�sc�pl�nary teams. They also felt more knowledgeable about normal age�ng and about the eth�cal d�lemmas �nvolved �n soc�al care. The students �n the second study �n th�s group5 rated curr�culum change as ‘cons�stently pos�t�ve’, part�cularly the �ntroduct�on of more �nteract�ve models of learn�ng.

One of the pos�t�ve stud�es descr�bed the development of a curr�culum that focused on sp�r�tual�ty.1 Student self-reports �n the qual�tat�ve data reported greater awareness of the s�gn�f�cance of the �ssue as well as greater competence �n relat�on to pract�ce. However, �n qual�tat�ve focus groups, students �nd�cated some cont�nu�ng level of d�scomfort �n �ntegrat�ng the�r learn�ng �nto d�rect pract�ce. The study by Dorfman and colleagues4 reported a greater overall change �n outcomes for those students who took part �n the serv�ce learn�ng �n�t�at�ve compared w�th those who d�d not. However, as Sect�on 4.7.1 reported, some measures of att�tude change demonstrated only marg�nal post-test d�fferences between the two groups.

In Dorfman et al’s study4 the serv�ce learn�ng students were all pos�t�ve about the exper�ence both �n relat�on to �ncreased knowledge:

It showed me that the theor�es of ag�ng about d�vers�ty and elders ag�ng d�fferently was very much true. (p 233)

and awareness:

I feel more �nformed about the myths versus the real�t�es of ag�ng. (p 234)

In the study report�ng m�xed outcomes,3 the qual�tat�ve data �nd�cated that students were more pos�t�ve �n the�r percept�ons of course usefulness, wh�le the quant�tat�ve measures showed less change �n student att�tudes or �nterest. The qual�tat�ve f�nd�ngs were descr�bed by the authors as ‘more def�n�t�ve’; however, these f�nd�ngs were at the level of students’ perce�ved sk�lls and understand�ng, rather than measured outcomes. In the short term students expressed pos�t�ve v�ews, part�cularly �n relat�on to serv�ce learn�ng and the use of oral h�story. The more amb�t�ous goals of chang�ng att�tudes and mot�vat�ng students to work w�th older people seemed to be more elus�ve.

The l�m�ted �nformat�on about the �nvolvement of other part�c�pants suggested that they were generally pos�t�ve. Older adults part�c�pat�ng �n serv�ce learn�ng felt the process had been reward�ng for them s�nce they l�ked the �nteract�on w�th young people.4 One study2 that surveyed consort�um partners (�nclud�ng agency managers

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and pract�t�oners) prov�ded no deta�ls of the survey but �nd�cated part�c�pants’ ‘h�gh level of sat�sfact�on w�th all project act�v�t�es’ (p 703). Th�s related part�cularly to the �n�t�at�ve’s �mpact on recru�tment strateg�es and educat�onal outcomes.

A self-selected group of e�ght f�eld �nstructors part�c�pated �n the development of the sp�r�tual�ty �n�t�at�ve,1 complet�ng pre- and post-test quest�onna�res and tak�ng part �n focus groups. The quant�tat�ve data reported wholly pos�t�ve outcomes, part�cularly �n �ncreas�ng conf�dence �n �n�t�at�ng and ma�nta�n�ng �ntervent�ons relat�ng to sp�r�tual�ty. The qual�tat�ve data noted �mprovements �n assessment sk�lls, knowledge and sens�t�v�ty. In common w�th the student part�c�pants, the f�eld �nstructors ‘reported an �ncreased knowledge and comfort w�th the top�c of sp�r�tual�ty and ag�ng’ (p 756).

4.10 Analysis of outcomes

4.10.1 Knowledge improvement

Change �n the level of students’ �nd�v�dual knowledge was the most frequently evaluated outcome of HGDOP. Improvement was reported �n all f�ve stud�es w�th three emphas�s�ng change �n knowledge about l�fespan development as a key outcome.2–4 These three stud�es also reported on �ncreased knowledge of theoret�cal approaches, for example, the strengths perspect�ve,2, 3 the ecolog�cal model and empowerment theory2 and about d�vers�ty and �nequal�ty. In the study by Browne and colleagues 2 all 12 students �n the sample reported feel�ng greater competence and conf�dence when ‘�nterven�ng w�th As�an and Pac�f�c Islander elders and older women’ (p 703).

The strength and deta�l of the cla�ms to knowledge change var�ed �n the f�ve stud�es. One study1 made general cla�ms to �ncreased awareness of the �mportance of sp�r�tual�ty and greater w�ll�ngness to ra�se the �ssue �n pract�ce. In the other study that reported generally on knowledge change,5 students made cons�stently pos�t�ve comments about teach�ng and learn�ng processes that enabled them to develop a greater understand�ng of concepts.

The three stud�es that prov�ded greater deta�l about knowledge change also showed var�at�ons �n the strengths of the cla�ms to change. The study by Browne et al2 was pos�t�ve �n relat�on to knowledge development, report�ng that all 12 students �n the sample felt they understood more about normal age�ng and about �nterd�sc�pl�nary teamwork. Eleven felt they were knowledgeable about common eth�cal d�lemmas faced �n elder care and understood the�r roles �n pol�cy analys�s, programme evaluat�on and resource development.

However, �n the study by D�epstra and Ames,3 the outcomes were more m�xed. For example, wh�le the major�ty (97%) of students found the course very useful �n one or other of the four measures used, 43% found �t useful �n develop�ng greater understand�ng of the effects of age, race, ethn�c�ty, rel�g�on, culture and soc�al class on development across the l�fespan, wh�le s�gn�f�cant m�nor�t�es found the course somewhat useful, and sl�ghtly useful (31% and 22% respect�vely) on th�s measure.

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Research review

Outcomes �n relat�on to theoret�cal knowledge were more m�xed, w�th 29% f�nd�ng the course very useful, 49% somewhat and 19% sl�ghtly useful.

4.10.2 Attitude change

Att�tude change �n relat�on to HGDOP was the second most s�gn�f�cant outcome evaluated �n the stud�es. It was �dent�f�ed �n four stud�es, three of wh�ch measured and one of wh�ch mon�tored changes �n att�tudes.

The two papers3,4 that focused more generally on HGDOP suggested the �ntroduct�on of serv�ce learn�ng and oral h�story �n�t�at�ves prov�d�ng students w�th susta�ned, one-to-one contact w�th older people, led to s�gn�f�cant change �n att�tudes �n some areas. The study by D�epstra and Ames3 found that after the�r �nvolvement �n an oral h�story project students felt more conf�dent about the�r ab�l�ty to work w�th older people. They also reported greater self-awareness about the�r �nterpersonal sk�lls, values and preferences. Dorfman et al’s study4 reported that those students who part�c�pated �n a serv�ce learn�ng project were s�gn�f�cantly more l�kely to have pos�t�ve att�tudes towards older people and towards work�ng w�th them than those who d�d not take part �n the project.

Of the other two projects �dent�fy�ng att�tude change as an outcome one1 was concerned w�th one aspect of HGDOP, the s�gn�f�cance of sp�r�tual�ty �n soc�al work pract�ce w�th older people. Th�s study reported on students’ �ncreased awareness of the value and appropr�ateness of focus�ng on sp�r�tual�ty �n assessment and work w�th older people. The study by Gray and Kabadak�5 referred to f�nd�ngs of a separate study, part of larger Gero-r�ch pre-test/post-test evaluat�on, wh�ch showed a ‘more pos�t�ve percept�on of older adults’ follow�ng the course (p 62). However, no further deta�ls were prov�ded about the evaluat�on.

4.10.3 Skill development

Two of the three stud�es2, 3 wh�ch reported outcomes �n sk�ll development rel�ed on students self-report�ng rather than the measurement of change. The th�rd study,1 wh�ch took place �n pract�ce sett�ngs, may have measured change through the formal assessment process but th�s was not reported by the study.

Changes �n sk�lls were typ�cally reported �n relat�on to greater conf�dence �n work�ng w�th older people, although the study by Browne et al2 also reported the development of sk�lls �n cultural competence.

The stud�es by Browne and colleagues2 and D�epstra and Ames3 reported �mproved commun�cat�on and �nterv�ew�ng sk�lls as s�gn�f�cant aspects of change. All 12 students �n Browne et al’s sample reported greater conf�dence �n the�r �nterv�ew�ng sk�lls. In the study by D�epstra and Ames,3 where the reported changes were m�xed �n terms of knowledge and att�tude, change �n sk�ll development was less equ�vocal. Of the sample of 59 students post-test, 75% found the course very useful �n develop�ng the�r ab�l�ty to engage and commun�cate w�th older people. Both stud�es reported �n�t�at�ves that �ncluded substant�al contact w�th older people as key elements �n the curr�culum.

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ADULTS’ SERVICES

The study by Dorfman et al4 d�d not comment on sk�ll development even though deta�led attent�on was pa�d to other aspects of change. Th�s may have been because the students �n th�s sample were from var�ed academ�c and profess�onal backgrounds and the �ntervent�on was des�gned to change knowledge and att�tudes rather than focus on the development of profess�onal sk�lls.

4.10.4 Outcomes for service users, carers and agencies

In the f�ve qual�ty-assessed papers outcomes for serv�ce users and carers and agency partners rece�ve far less attent�on than outcomes for students.

Two stud�es explored change for serv�ce users and carers. Only one of these4 measured outcomes by complet�ng �nd�v�dual �nterv�ews w�th older part�c�pants. They were asked for the�r v�ews about the serv�ce learn�ng project and about the�r own and the students’ contr�but�ons. They were also asked to suggest future �mprovements. No d�sl�kes were ment�oned by the older people, who commented favourably on the plann�ng and organ�sat�on of the project. All l�ked the personal �nteract�on, shar�ng the�r l�fe exper�ences and the rec�procal nature of contact w�th the students. All felt the project should cont�nue and the�r ma�n recommendat�on was that �t should be extended to �nclude greater numbers of older people l�v�ng �n soc�al care fac�l�t�es. Outcomes for older people �ncluded ‘opportun�t�es to �nteract w�th students, to contr�bute to the�r learn�ng, and to rece�ve recogn�t�on for the�r worth and l�fe exper�ence’ (p 239).

In terms of outcomes for agenc�es, the l�m�ted �nformat�on relat�ng to outcomes for agency partners has already been d�scussed �n Sect�on 4.9. However, the managers and pract�t�oners who were part of the consort�um tak�ng part �n one study2 �nd�cated h�gh levels of sat�sfact�on that led to the�r cont�nu�ng comm�tment after the end of the project.

4.11 Facilitators and barriers to HGDOP

G�ven the small number of stud�es �ncluded for qual�ty assessment and the d�vers�ty of the�r scope and focus, there �s l�m�ted �nformat�on about what �s effect�ve �n terms of the del�very of a HGDOP curr�culum. As the prev�ous sect�on has outl�ned, the reported outcomes of HGDOP suggested some ev�dence of change �n knowledge and att�tude on an �nd�v�dual level. However, these outcomes were only evaluated �n the short term and were ev�denced largely by student percept�ons rather than measurement. In add�t�on, as some of the stud�es suggested, the strength of the reported f�nd�ngs was also l�m�ted by small samples and lack of outs�de evaluat�on.3,4

In sp�te of these l�m�tat�ons, an analys�s of the f�ve stud�es �dent�f�ed some factors that �nfluenced the outcomes of HGDOP. These fac�l�tators and barr�ers were �dent�f�ed by part�c�pants and by the educators respons�ble for develop�ng the HGDOP curr�culum (see Table 10).

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Research review

Table 10: Facilitators and barriers to HGDOP

Facilitator and barrier Number of studies*

Fund�ng/resources 2

Plann�ng/organ�sat�on 4

Agency support 1

Pedagog�cal approach 5

Integrat�on of pract�ce learn�ng �n�t�at�ves 5


4.11.1 Funding and resources

All f�ve stud�es reported �n�t�at�ves that were supported by external fund�ng; two by the nat�onal Gero-r�ch �n�t�at�ve,3, 5 one as part of the Gero-r�ch �n�t�at�ve and w�th add�t�onal nat�onal fund�ng1 and the rema�n�ng two by local or nat�onal funders.2, 4

Two stud�es emphas�sed the role add�t�onal fund�ng played �n support�ng curr�culum development and fac�l�tat�ng outcomes:

Important to the success of th�s model was the presence of seed money. Funds allowed the use of faculty t�me and other resources to develop and p�lot the project. (1, p 759)

Browne and colleagues also used add�t�onal fund�ng to release staff from some respons�b�l�t�es and recru�t a project manager. Th�s study also reported the use of outs�de fund�ng to offer bursar�es to students as part of a w�der recru�tment strategy. However, the authors �dent�f�ed concerns about ma�nta�n�ng change over the longer term w�thout cont�nued fund�ng:

… susta�n�ng a project such as th�s one requ�res an �nfus�on of mon�es that �n turn can support the work of commun�ty soc�al workers, busy and often understaffed profess�onals �n the�r own work sett�ngs. (p 703)

Th�s underl�nes the resource �mpl�cat�ons for all part�c�pants, recogn�s�ng that �nnovat�on requ�res comm�tment from agenc�es as well as un�vers�t�es �f outcomes are to be ma�nta�ned and development cont�nued.

4.11.2 Planning and organisation

The plann�ng and organ�sat�on of HGDOP was commented on by student part�c�pants �n two stud�es.3, 4 The�r most frequent comments related to the add�t�onal workload �nvolved, somet�mes because �t was unexpected and somet�mes because students felt d�sadvantaged by add�t�onal assessment tasks. Th�s was most ev�dent �n serv�ce learn�ng projects where negat�ve comments related to �ncreased workload:

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ADULTS’ SERVICES

The only negat�ve comments that several students made about the exper�ence centred on workload �ssues, because the serv�ce-learn�ng exper�ence was very t�me consum�ng and was probably more work than many students had ant�c�pated. (4, p 235)

In response to th�s feedback future groups w�ll rece�ve add�t�onal cred�ts �f they are �nvolved �n serv�ce learn�ng projects.

Although students ma�nly recogn�sed serv�ce learn�ng as a pos�t�ve exper�ence, they suggested �mprovements to a range of log�st�cal �ssues other than workload. In one study3 recommendat�ons �ncluded changes �n the t�m�ng of assessments, the locat�on of the serv�ce learn�ng and the requ�red number of v�s�ts. Outcomes were affected by the fact that these were new developments that �nvolved the management of complex arrangements between the un�vers�ty and a range of collaborators. Staff were requ�red to oversee these arrangements and to ensure that all went accord�ng to plan:

… we made sure that commun�ty f�eld staff part�c�pants had the�r park�ng pre-arranged, the�r lunch served, the�r books and other work well-organ�zed…. (2, p 703)

Such attent�on to deta�l was requ�red to ensure that part�c�pants cont�nued to support the work and offer students learn�ng opportun�t�es �n pract�ce sett�ngs.

One of the serv�ce learn�ng stud�es3 also �dent�f�ed �ssues �n the match�ng of part�c�pants. In the l�nked study by Ames and D�epstra6 28% of the students felt that un�vers�ty staff should take a more act�ve role �n select�ng the older people �nvolved �n the project:

… they expressed frustrat�on over the d�ff�culty some oral h�story partners had remember�ng deta�ls of the�r l�ves…. (p 732)

4.11.3 Agency support

One study2 spec�f�cally �dent�f�ed the �nvolvement of agency partners as a fac�l�tator to ach�ev�ng outcomes: ‘The project was successful because of strong comm�tment w�th our agency partners’ (p 730). Th�s was the only study that was concerned w�th outcomes on an organ�sat�onal level s�nce �ts a�ms �ncluded develop�ng a set of competenc�es wh�ch were ‘owned’ by employers, pract�t�oners and students.

However, g�ven the collaborat�ve nature of the �n�t�at�ves reported �n the f�ve stud�es, all were dependent on support from agency partners for success. Th�s �ncluded the �dent�f�cat�on of oral h�story partners,3, 4 the �nvolvement �n f�eld �nstructors �n the sp�r�tual�ty groups1 and the use of commun�ty-based fac�l�t�es such as day centres and nurs�ng homes.3

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Research review

4.11.4 Pedagogical approaches

Exper�ent�al and act�ve learn�ng approaches were �dent�f�ed as key fac�l�tators �n the f�ve qual�ty-assessed stud�es. In relat�on to exper�ent�al learn�ng �n the classroom, the stud�es d�d not �dent�fy one preva�l�ng pedagog�cal approach. Instead, a range of d�fferent techn�ques was adopted to fac�l�tate learn�ng a�ms. In the study by B�rkenma�er and colleagues1 students �dent�f�ed med�tat�on as a helpful means of explor�ng sp�r�tual�ty. They also found modell�ng assessment and d�rect pract�ce sk�lls a useful preparat�on for ra�s�ng �ssues about sp�r�tual�ty w�th older people. In two stud�es3, 4 students were asked to keep reflect�ve journals, as a record of both the�r learn�ng exper�ence and personal/profess�onal development. These documents were resources for classroom presentat�ons and ass�gnments.

Gray and Kabadak�’s study5 suggested a range of methods to �ntegrate a strengths-based model of HGDOP �nto the HBSE curr�culum. These �ncluded the use of dramat�c v�gnettes to sens�t�se students to the concerns of older people and the�r fam�l�es, and the use of presentat�ons:

Selected students observe and assess an older person’s current funct�on�ng and compare that w�th the standard text book �nformat�on perta�n�ng to the b�olog�cal, psycholog�cal and soc�al aspects of ag�ng. The students present the�r f�nd�ngs to the class us�ng v�sual a�ds such as posters, photo albums and PowerPo�nt presentat�ons. (p 61)

Students �n th�s study5 rated the usefulness of curr�culum act�v�t�es and ass�gnments at 4.1 on the L�kert 5-po�nt scale and the�r comments also reported as ‘cons�stently pos�t�ve’ act�v�t�es and ass�gnments that fostered act�ve learn�ng.

4.11.5 Integration of practice learning initiatives

The �ntegrat�on of pract�ce learn�ng �n�t�at�ves was �dent�f�ed as a fac�l�tator �n all f�ve stud�es. The nature and scope of these �n�t�at�ves was var�ed (see Table 11).

Table 11: Characteristics of practice learning initiatives

Nature of the practice learning initiative Number of studies

Substant�al serv�ce learn�ng/oral h�story project throughout a classroom-based module

2

Pract�ce learn�ng exper�ence as a s�gn�f�cant part of a classroom-based module

1

HGDOP �n�t�at�ve as part of assessed pract�ce learn�ng exper�ence (f�eld pract�cum)

1

One-off pract�ce/commun�ty learn�ng exper�ence contr�but�ng to classroom module

1

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One study1 reported on the �ntegrat�on of a spec�f�c aspect of HGDOP �nto formally assessed pract�ce learn�ng. In th�s example students had chosen to work w�th older people and to take part �n the sp�r�tual�ty module. Three other stud�es2–4 reported on the �ntegrat�on of serv�ce learn�ng or other substant�ve pract�ce-based �n�t�at�ves �nto classroom modules. One study5 d�scussed the �ntegrat�on of a one-off �nterv�ew w�th an older person �nto an HBSE module.

One of the stud�es that reported on the use of oral h�story3 �n a HBSE course argued that �t had ‘the potent�al to prov�de students w�th earl�er opportun�t�es for �ntegrat�ng emp�r�cal and pract�ce-based knowledge’ (p 115). Wh�le the f�nd�ngs suggested students ga�ned more knowledge about older people and had greater opportun�ty to �nteract w�th them, there was no ev�dence of �ncreased mot�vat�on to work w�th older people. The authors comment that although students may perce�ve themselves to be more competent, ‘they s�mply may choose not to work w�th th�s populat�on’ (p 122).

The substant�ve serv�ce learn�ng �n�t�at�ve reported by Dorfman and colleagues4 was less equ�vocal �n �dent�fy�ng the learn�ng outcomes ach�eved. The authors argued that the�r project supported f�nd�ngs from other research that demonstrated the value of �ntegrat�ng serv�ce learn�ng �n�t�at�ves �nto ex�st�ng programmes. The authors cla�med that the advantages of serv�ce learn�ng are also relevant to develop�ng a HGDOP curr�culum. Unl�ke the study by D�epstra and Ames,3 Dorfman et al4 argued that students �n the�r sample showed greater �nterest �n work�ng w�th older people as a result of �ncorporat�ng serv�ce learn�ng �nto HGDOP.

One other study5 suggested that the �ntegrat�on of pract�ce learn�ng, even when �t was on a l�m�ted scale, acted as a fac�l�tator to ach�ev�ng a range of d�fferent outcomes. Th�s study reported on an ass�gnment requ�r�ng students to complete a l�fe story �nterv�ew w�th an older person and analyse th�s exper�ence by answer�ng a number of quest�ons. The authors argued that even th�s l�m�ted use of d�rect work w�th older people contr�buted to the ‘cons�stently pos�t�ve’ p�cture of learn�ng already d�scussed.

4.12 Conclusion

The research rev�ew explored ev�dence of the nature of HGDOP and what promoted or h�ndered successful outcomes. The rev�ew revealed a l�m�ted l�terature explor�ng human growth and development and older people �n the context of qualifying social work education. The f�ve qual�ty-assessed stud�es �dent�f�ed for �nclus�on were all publ�shed �n the US and reported on curr�culum developments. Otherw�se they were d�verse �n relat�on to the�r scope and focus.

The stud�es prov�ded cons�derable deta�l about the process and content of the curr�culum developments w�th wh�ch they were concerned. However, they prov�ded l�m�ted ev�dence of effect�veness �n relat�on to the curr�culum changes they reported. In the short term, those stud�es that evaluated the v�ews of student part�c�pants �dent�f�ed ma�nly pos�t�ve changes �n relat�on to �ncreased knowledge about HGDOP and att�tudes towards older people. However, these changes were evaluated �n the short term and by student percept�ons rather than measurement. The stud�es

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prov�ded l�m�ted ev�dence of the v�ews of other part�c�pants �n the educat�onal process, but those older people and agency partners who were �nvolved descr�bed the exper�ence as pos�t�ve.

The rev�ew suggests one area that would benef�t from further �nvest�gat�on. The f�ve stud�es reflected the preva�l�ng concern �n the US w�th the lack of students want�ng to work w�th older people post-qual�f�cat�on and the need to develop a curr�culum that would help to m�t�gate th�s s�tuat�on. The f�nd�ngs of the rev�ew were �nconclus�ve �n terms of �dent�fy�ng factors that could make an �mpact on th�s �ssue. However, the f�ve stud�es suggested some of the fac�l�tators (and barr�ers) to �ncreas�ng knowledge and chang�ng att�tudes to later l�fe. One of the key fac�l�tators appeared to be the �ntegrat�on of pract�ce/commun�ty learn�ng �nto the college curr�culum. Stud�es that reported on these developments suggested HGD/HBSE prov�ded a s�gn�f�cant learn�ng opportun�ty by �nvolv�ng students �n one-to-one contact w�th older people at an early stage �n qual�fy�ng educat�on.

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5 HGDOP practice survey

5.1 Introduction

Th�s sect�on reports on the pract�ce survey. The pract�ce survey complements the research rev�ew and reports on the perspect�ves and pract�ces of soc�al work educators �nvolved �n HGDOP pre-qual�fy�ng educat�on �n England, Wales and Northern Ireland. It covers the same top�c areas and �ssues as �n the l�terature rev�ew, w�th a spec�f�c focus on current pract�ce, contexts, exper�ence, developments and challenges. It also �ncludes stakeholder comments on some of the rev�ew’s central themes. It �s structured under the follow�ng head�ngs:

• a�ms and scope of the pract�ce survey • summary of methodology • themes emerg�ng from the pract�ce survey.

Where stakeholders have prov�ded v�ews, �llustrat�ve examples are �ncluded at the end of the relevant sub-sect�on.

For reasons of resource and log�st�cs, the pract�ce survey d�d not seek to map current educat�on pract�ce across the reg�ons; nor does �t make cla�ms to represent w�der consensus or trends.

5.2 Aims and scope of the practice survey

The purpose of the pract�ce survey, �n l�ne w�th gu�dance from SCIE, was to complement the research rev�ew, and to exam�ne the same rev�ew quest�ons about the nature and effect�veness of HGDOP teach�ng and learn�ng, and ev�dence of cr�t�cal gerontolog�cal perspect�ves, explor�ng these �n the contexts of current qual�fy�ng soc�al work educat�on �n England, Wales and Northern Ireland.

5.3 Summary of methodology

The methodology used �n the pract�ce survey �s summar�sed below. Full deta�ls are set out �n Append�x 10.

5.3.1 Sources of information

The pract�ce survey reports d�rectly the perspect�ves of n�ne HEI soc�al work educators, recru�ted from s�x centres of soc�al work educat�on (four �n England, and one each �n Wales and Northern Ireland), �dent�f�ed on both pragmat�c and purpos�ve bases through the follow�ng means:

• part�c�pants �ncluded �n the scop�ng study • research reports retr�eved �n the research rev�ew • stakeholder and contact �nformat�on

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• �nv�tat�on to self-�dent�fy, v�a SWAP (Soc�al Pol�cy and Soc�al Work) newsletter and Jo�nt Un�vers�ty Counc�l Soc�al Work Educat�on Comm�ttee, JUCSWEC, ma�l�ng l�st (see Append�x 11).

The s�x centres �dent�f�ed ensured a range of prov�s�on and focus at undergraduate and postgraduate level, �nclud�ng full-t�me, part-t�me and work-based routes. The largest centre enrolled 100 students per year, the smallest, 20 students. Part�c�pants �ncluded f�ve soc�al work educators w�th lead respons�b�l�ty for teach�ng and learn�ng about older people, and four who coord�nated HGD modules. Programme documentat�on was sought as a complement to other data gathered from part�c�pant HEIs, but not from other prov�ders.

The pract�ce survey also reports on the v�ews of members of the stakeholder groups wh�ch �ncluded students, serv�ce users and carers, pract�t�oners and staff/volunteers �n voluntary organ�sat�ons work�ng w�th older people, �nclud�ng older people from Black and m�nor�ty ethn�c backgrounds.

5.3.2 Data collection methods

All data collect�on tools were developed �n consultat�on w�th stakeholders. Telephone �nterv�ews us�ng a sem�-structured quest�onna�re (see Append�x 11) were conducted w�th the n�ne soc�al work educator part�c�pants. Course and programme documentat�on was prov�ded by four programmes and �ncluded �n the data analys�s. Sem�-structured quest�onna�res (see Append�x 11) were forwarded v�a educators to relevant cohorts of students. The only response rece�ved has been �ncluded w�th�n the stakeholder feedback.

Stakeholders were �nv�ted to complete a quest�onna�re or telephone �nterv�ew focus�ng on the a�ms, content, del�very and d�rect�on of HGDOP educat�on. Serv�ce users/carers were �nv�ted to comment, from the�r exper�ence, on the strengths and weaknesses of soc�al work pract�ce w�th older people. Illustrat�ve examples of the v�ews of stakeholders are �ncluded �n Sect�on 5.4 below (see Append�x 9 for fuller deta�ls of stakeholder responses).

5.3.3 Confidentiality, bias and ethics

Issues of �nformed consent, conf�dent�al�ty, anonym�ty and researcher b�as were addressed �n accordance w�th sponsor gu�del�nes, as �nd�cated �n Append�x 10.

5.3.4 Data coding and analysis

Pract�ce survey data were coded us�ng themat�c manual analys�s based on schema compat�ble w�th the keyword�ng and data extract�on strateg�es of the l�terature rev�ew, and �nformed by prel�m�nary f�nd�ngs from the mapp�ng stage of that rev�ew.

5.4 Themes emerging from the practice survey

In th�s sub-sect�on the themes emerg�ng from the pract�ce survey are grouped to reflect the format outl�ned at the beg�nn�ng of th�s sect�on, start�ng w�th the a�ms

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of HGDOP teach�ng and learn�ng. Under each head�ng the f�nd�ngs of the survey are organ�sed under sub-themes and �llustrated by quotes from soc�al work educator respondents. At the end of sub-sect�ons where stakeholders have prov�ded a v�ew, br�ef �llustrat�ons of the�r perspect�ves are �ncluded.

5.4.1 Practice survey: aims of HGDOP teaching and learning

All n�ne soc�al work educator part�c�pants reported on a number of a�ms for HGDOP teach�ng and learn�ng. These m�rrored the range found �n the l�terature rev�ew, and reflected d�fferent emphases between programmes and between modules w�th�n programmes. They may be grouped as follows.

Improving theoretical understanding

All but one part�c�pant gave as an a�m the development of understand�ng and knowledge about HGDOP �n order to:

‘… bu�ld up the students’ knowledge base for appl�cat�on to soc�al work pract�ce.’

Some educators (espec�ally but not only the postgraduate programmes) emphas�sed the need to pay part�cular attent�on to cr�t�cal analys�s:

‘We have throughout the teach�ng a challeng�ng att�tude towards all the normat�ve theor�es about development and ensure that all the taught sess�ons �nclude a cr�t�que of theoret�cal perspect�ves.’

Another commented on the need to �ntegrate theor�es from gerontology �nto modules explor�ng age�ng:

‘I strongly bel�eve that there �s a need for soc�al workers to have a better gerontolog�cal knowledge base,… I am pass�onate about the case for cr�t�cal soc�al work w�th older people.’

Changing attitudes

S�x of the n�ne part�c�pants �dent�f�ed chang�ng att�tudes to older people as an a�m. In HGD th�s could be to challenge ex�st�ng stereotypes or �ntroduce students to mater�al they were reluctant to engage w�th:

‘I use a strengths model, try to challenge �deas of “decl�ne”, deal w�th the stereotypes about chron�c s�ckness, “normal�s�ng” the l�fecourse.’

Educators work�ng w�th students later �n the course a�med to change a ‘manager�al�st’ approach to work�ng w�th older people. One educator a�med:

‘… to counter “check l�st” v�ews of how you work w�th older people and see the r�ch and d�verse l�ves that they have already led.’

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Developing skills

Two of the part�c�pants lead�ng modules w�th a focus on older people spec�f�cally �ncluded sk�lls development as an a�m:

‘… part�cularly commun�cat�on sk�lls … hear�ng older people’s l�fe stor�es, be�ng able to talk to older and d�sabled people about th�ngs that may be d�ff�cult and challeng�ng and where there may be r�sks, or confl�cts of values.’

The a�ms reported by educators lead�ng HGD teach�ng and learn�ng were less l�kely to �nclude sk�lls development, although, as w�ll be seen below, some of the pedagog�cal approaches used �n these modules often had the potent�al to �ncrease sk�lls �n observat�on, l�sten�ng and commun�cat�on.

Increasing interest in this area of practice

Only one part�c�pant reported th�s as a spec�f�c a�m and l�nked �t to chang�ng att�tudes. She suggested that the content of the older people module enabled tutors to challenge students who d�d not want to work w�th older people �n pract�ce placements. The teach�ng and learn�ng framework prov�ded:

‘... a language to talk to students about what are really age�st assumpt�ons.’

Improving quality of practice

Two part�c�pants ment�oned �mprov�ng the qual�ty of pract�ce as an a�m. One gave as her rat�onale a:

‘… deep concern about the eros�on of soc�al work sk�lls w�th older people and soc�al work w�th older people….’

Other aims

Three part�c�pants �dent�f�ed the development of reflective practice as an a�m, pr�nc�pally to help prepare students to manage and not avo�d the strong emot�onal responses l�kely to be �nvoked by work w�th older people. For example:

‘… somet�mes people want to know what really happens �n the real world �n a very concrete way rather than us�ng the mater�al to engage w�th what �t’s l�ke to talk about these k�nds of subjects and to talk w�th people who are older, who are d�sabled, who are fac�ng the end of the�r l�fe �n pa�n or fac�ng part�cular k�nds of challenges.… People avo�d that by go�ng �nto … what are the pol�c�es and procedures, laws. Perhaps �t feels more secure, or �t’s actually very pa�nful to th�nk about, really to talk about some of the th�ngs the case mater�al br�ngs up or the l�fe stor�es.’

One h�ghl�ghted the contr�but�on of an understand�ng of HGD theor�es to preparation for interprofessional practice:

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‘… we are also very consc�ous that people operate �n mult�-profess�onal contexts and �t’s �mportant that … they [students] have the opportun�ty to be exposed to broad th�nk�ng about the subject.’

Stakeholder responses

There were very clear messages from stakeholders about what should be the a�ms of HGDOP (see Append�x 9). These m�ght be summar�sed as:

• knowledge • sk�lls • understand�ng • respect.

The serv�ce users �n part�cular �dent�f�ed good l�sten�ng sk�lls as essent�al �n develop�ng understand�ng and show�ng respect. Th�s was h�ghl�ghted by two older stakeholders:

‘Older people ... feel they are not l�stened to, they also feel they are second class c�t�zens.’

‘Commun�cat�on �s top pr�or�ty.’

A soc�al work manager argued that HGDOP teach�ng and learn�ng should:

‘… enable students to beg�n to understand �nd�v�dual responses to the un�versal exper�ence of age�ng w�th�n spec�f�c soc�al and cultural contexts.’

5.4.2 Organising frameworks and theoretical approaches to HGDOP

As was the case w�th the research rev�ew, most soc�al work educator respondents reported us�ng an eclect�c theoret�cal approach w�th�n a top�c-based organ�s�ng framework. L�fespan/psychosoc�al theor�es dom�nated – the four HGD coord�nators �nterv�ewed all referred to approaches based on these theor�es, but three also drew on soc�olog�cal, b�olog�cal and equal�t�es-based theor�es.

Some sought to �nclude overarch�ng top�cs such as attachment w�th�n a b�rth-to-death l�fecourse approach:

‘It’s top�c-based and goes from pre-b�rth to post-death ... but at the start of the programme we have underp�nn�ng sess�ons on, for example, nature/nurture, stress/vulnerab�l�ty … gender and race.’

Eclect�c approaches were most ev�dent �n �nterv�ews w�th the educators teach�ng about older people. The follow�ng comments relate to the�r organ�s�ng frameworks:

‘To be honest, b�o-soc�al-psycholog�cal – sounds a b�t all encompass�ng but �f you th�nk of those three parts of the Venn d�agram, I do try to cover all of them and show how they f�t together.’

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‘Integrat�on, rooted �n psychology because �t’s �n HGD. Also �ntroduce soc�olog�cal �deas to cr�t�que them, cr�t�cal evaluat�on of �nd�v�dual�st�c psycholog�cal approaches. Ant�-age�st, ant�-d�sabl�st perspect�ves, the soc�al model of d�sab�l�ty. Can we th�nk about a soc�al model of older age?’

One respondent clearly �dent�f�ed cr�t�cal gerontology as the ma�n perspect�ve:

‘The organ�s�ng framework �s a cr�t�cal perspect�ve ... gerontolog�cal �s the overarch�ng �dea, w�th�n that soc�olog�cal, soc�al pol�cy, r�ghts-based and cr�t�cal perspect�ves.’

The �mportance g�ven to theory var�ed greatly between respondents. Some prov�ded l�ttle ev�dence of a strong theoret�cal framework, wh�le others saw �t as very �mportant that students developed a cr�t�cal theoret�cal base to underp�n the�r work w�th older people. For example:

‘I strongly bel�eve ... there �s a need for soc�al workers to have a better gerontolog�cal knowledge base,… mak�ng the case that soc�al work w�th older people �s complex, that older people have needs other than just hav�ng care shoved �n the�r d�rect�on.’

One educator h�ghl�ghted the d�ff�cult�es some students had �n �dent�f�y�ng theoret�cal approaches to apply to pract�ce s�tuat�ons:

‘Students say �n placement “I haven’t got any theory to do w�th older people”. Publ�cat�ons are rather pragmat�c as opposed to theoret�cal. People th�nk there are no theor�es around older people.’

In general, there seemed to be some symmetry between the theoret�cal approach of the HGD and older people elements w�th�n a programme. It �s clear that ach�ev�ng effect�ve �ntegrat�on of HGDOP requ�res a whole-programme strategy, a po�nt made by one educator emphas�s�ng the d�fferent approaches taken �n the two modules:

‘The organ�s�ng framework [of the older people module] �s a cr�t�cal perspect�ve ... [on] an �nterd�sc�pl�nary subject … [w�th�n the HGD module] teach�ng �s psycholog�cal, currently.’

As w�ll be seen �n sub-sect�on 5.4.5 below, there was l�m�ted ev�dence of theoret�cal cont�nu�ty �n relat�on to HGDOP between class-based and pract�ce learn�ng elements.

5.4.3 Practice survey: HGDOP teaching and learning structures and sequence

The pract�ce survey conf�rmed that HGDOP teach�ng and learn�ng does not f�t neatly �nto a d�screte module w�th�n UK qual�fy�ng soc�al work educat�on. In all programmes �t was covered to some extent w�th�n HGD modules – or early stage modules that �ncluded HGD. To a much more var�ed degree �t appeared �n later modules focused on areas of pract�ce, and the t�m�ng of pract�ce learn�ng also affected the way �n wh�ch HGDOP teach�ng and learn�ng was structured w�th�n the curr�culum. All soc�al work

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educator respondents spoke of the need to ensure that HGDOP rece�ved suff�c�ent attent�on �n all aspects of the programme. The challenge of manag�ng th�s effect�vely w�th�n a crowded curr�culum was a ser�ous concern for many. The organ�sat�on and t�metabl�ng of pract�ce learn�ng modules also affected course des�gn and structure.

To deal w�th th�s complex�ty, some programmes developed ‘cross-teach�ng’ and other ‘cross-referenc�ng’ strateg�es:

‘F�rst year, �n part�cular, �s structured for modules to be taught/coord�nated by more than one person, so cross-referr�ng woven �nto [the] structure.… Students have “reflect�ve journals” wh�ch run underneath the whole three years, we try to consc�ously weave them all together.’

Another approach was to:

‘… try and g�ve a “scaffold�ng approach”; very sw�ft overv�ew at Level 5 but some �ssues p�cked up on �n f�nal year.’

5.4.4 Participants in the organisation and delivery of HGDOP teaching and learning

Programme organisation and management

It was d�ff�cult to get a clear �mpress�on of the extent to wh�ch older people were �nvolved �n curr�culum organ�sat�on and management. Carers and older people were somet�mes seen as �nterchangeable, desp�te the�r d�ffer�ng perspect�ves. Two respondents reported s�gn�f�cant �nvolvement of older people �n programme organ�sat�on, �nclud�ng tak�ng part �n the development and management of the curr�culum. In the other example:

‘Four older people from th�s carers’ group … are very act�ve �n select�on and access; also �nvolved w�th the programme management comm�ttee, pract�ce assessment and Exam Board.’

Teaching and learning

There was l�m�ted �nvolvement of older people or of other pract�t�oners �n teach�ng and learn�ng �n HGD-focused modules. Only one part�c�pant descr�bed the �nvolvement of other pract�t�oners:

‘People come �n from hosp�ces to do a sess�on on death and dy�ng ... and then another one on gr�ef and mourn�ng. Although not focused just on older people, �ts a�m �s to extend the �dea of what HGD �s about.’

The older people modules were more l�kely to draw on the expert�se of others �n teach�ng and learn�ng, although the focus of the�r �nvolvement was not always clear. The follow�ng example �llustrates pract�t�oner �nvolvement �n the classroom and �n the commun�ty:

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‘Yes, I �nvolve some pract�t�oners – take students on [a] couple of v�s�ts, for example, to the local �ntermed�ate care centre – they are shown around and get a talk on how centre works and what serv�ces are there; I also �nvolve a nurse lecturer on health �ssues relat�ng to late age and also a safeguard�ng adults coord�nator comes �n….’

One programme reported the �nvolvement of a range of people who ‘happened to be old’ �n teach�ng and learn�ng across the curr�culum:

‘… ret�red pract�t�oners who are “older people” are also �nvolved �n teach�ng, eg a ret�red lay mental health tr�bunal member talks about h�s exper�ence �n the past and what he does around mental health now.’

The t�me ava�lable and the focus on HGDOP w�th�n the curr�culum had an �mpact on the �nvolvement of non-HEI part�c�pants �n teach�ng and learn�ng. It may also be that an �ncreased use of commun�ty-based sett�ngs could prov�de more appropr�ate opportun�t�es for the part�c�pat�on of older people.


All stakeholders felt that older people who used serv�ces, carers and other pract�t�oners, along w�th college tutors, should be �nvolved �n teach�ng and learn�ng. Several made the po�nt that older people who do not currently use serv�ces should be �nvolved:

‘Th�s must �nclude users of serv�ces and non-users to present a balanced p�cture of older people to prevent a patholog�sed approach. Older people talk�ng about the�r exper�ences, v�ews and �nterpretat�on of older age must be a part of the learn�ng exper�ence.’ (student)

‘People who use serv�ces should be �nvolved to talk about good and bad exper�ences and what they want to see and don’t want to see happen.’ (serv�ce user)

5.4.5 Setting of HGDOP teaching and learning

Most, but not all respondents drew on pract�ce learn�ng exper�ences to enhance HGDOP knowledge and understand�ng. However, unl�ke much of the l�terature reported �n th�s rev�ew, the pract�ce survey found that the sett�ng for HGDOP teach�ng and learn�ng was predom�nantly classroom-based. Structured, pract�ce-based or ‘serv�ce learn�ng’ opportun�t�es were very rare, and only one programme �ncluded HGDOP theory and knowledge as an expl�c�t pract�ce learn�ng requ�rement.

Practice learning in the classroom

Typ�cally, respondents reported draw�ng on student’s pract�ce-based case stud�es �n classroom and small group d�scuss�on:

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‘… part�cularly �n the second year [we] ask them to br�ng mater�al about work w�th an older person to look at cr�t�cally, apply theory, apply knowledge, apply sk�lls.’

Some respondents draw on case study examples developed w�th pract�t�oners or, �n one case, on the�r own pract�ce exper�ence:

‘… because I go �nto pract�ce �n the summer … so I br�ng changed and anonym�sed exper�ence and so do students.’

But, as one respondent made clear, the pract�ce examples drawn on do not necessar�ly �nvolve a HGD element:

‘I �nv�te them to contr�bute to d�scuss�ons us�ng �llustrat�ons – [they are] eager to do that. [The ma�n pract�ce �ssues ra�sed are] �ssues about do�ng assessments, people refus�ng serv�ces or not accept�ng serv�ces they th�nk are most needed….’

HGD-focused modules seemed far less l�kely to draw on pract�ce exper�ence, perhaps because of t�m�ng w�th�n the programme or the amount of focus on older people w�th�n the modules. One HGD convenor responded that she “can’t g�ve examples” of pract�ce-based learn�ng be�ng drawn on. Another, who was not a soc�al work academ�c, was reported as hav�ng “developed case stud�es l�nked to soc�al work l�terature for use �n her teach�ng”.

Practice learning requirements

One programme expl�c�tly requ�red a HGD element �n the pract�ce learn�ng portfol�o, although th�s was not necessar�ly �n relat�on to older people:

‘[Students are] requ�red to ev�dence a human growth perspect�ve �n the portfol�o [as part of an] analys�s of pract�ce, �f they are wr�t�ng about an older person they would be expected to have a developmental understand�ng.’

Several other respondents reported (more or less) �mpl�c�t requ�rements. The follow�ng two examples are representat�ve:

‘When on placement we would usually requ�re a case analys�s. We are not say�ng to them you must br�ng �n your HGD knowledge, [we] don’t make that expectat�on expl�c�t, but [we] do rem�nd them of module ... what knowledge do you have already to draw on? There �s an expectat�on that they would automat�cally do that.’

‘HGD �s not overtly �ncluded �n pract�ce assessment requ�rements, but students need to reflect on the�r exper�ence and l�nk to theory, �f appropr�ate.’

Service learning

Serv�ce learn�ng �n�t�at�ves were far less frequent than �n the (ma�nly US) l�terature rev�ewed. However, two programmes �ncluded a short mandatory serv�ce learn�ng

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element and two �ncluded v�s�ts, one to ‘B�g P�t’, where older ex-m�ners work, and another to an assessment centre.

Good practice examples of service learning

University of Northumbria

‘We ask students to �nterv�ew an older person to get the�r v�ews of the age�ng process. One of the most upl�ft�ng moments of read�ng I have �n the year �s when I read these because so many older people say such pos�t�ve th�ngs. Th�s �s a format�ve learn�ng task but �t has proved to suff�c�ently effect�ve to be proposed as a summat�ve task for the future.’

University of Teesside

‘One of the f�rst th�ngs I ask them to do �n connect�on w�th percept�ons of age�ng �s to go to the local shopp�ng centre and s�t and stand around for half an hour and see who they recogn�se as an older person, what they are do�ng, who they are w�th and what they are us�ng when they are judg�ng them to be “older”. That gets some qu�te useful d�scuss�on go�ng.’


The stakeholders were unan�mous �n �dent�fy�ng the need for both HEI and pract�ce-based/serv�ce learn�ng. The Black and m�nor�ty ethn�c elders group members were not asked th�s quest�on, but �t �s �nterest�ng that two of them also recommended �nvolvement �n commun�ty-based sett�ngs:

‘Learn�ng �n the f�eld �s very �mportant �n ga�n�ng a pract�cal understand�ng of real�t�es l�ke poverty … older people �n general, rather than those gett�ng serv�ces, should be the focus, need to see at f�rst hand how older people l�ve – “most learn�ng takes place through our eyes”.’ (older serv�ce user)

‘Pract�ce-based learn�ng �s essent�al and th�s should be coupled w�th the reflect�ve explorat�on of the personal �mpact of �ssues of age�ng.’ (NGO coord�nator)

‘[I do] not th�nk �t would be a good �dea for … elders to go to the un�vers�ty as they m�ght not be comfortable there, because they [m�nor�ty ethn�c groups �n general] are not educated…. Soc�al work [students] should go to m�nor�ty ethn�c groups and spend t�me w�th them.’

5.4.6 Practice survey: HGDOP curriculum content and process

Part�c�pants prov�ded examples of an �nnovat�ve range of pedagog�cal approaches, wh�ch many descr�bed as constra�ned by the t�me ava�lable and by class s�ze. The approaches used were ma�nly classroom-based, and �ncluded a m�xture of d�dact�c and exper�ent�al learn�ng processes. The examples g�ven focused on exper�ent�al

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understand�ng rather than theoret�cal knowledge and analys�s, m�rror�ng the focus of much of the l�terature reported �n th�s rev�ew. The barr�ers �dent�f�ed are descr�bed f�rst, before mov�ng on to pedagog�cal approaches and assessment. Th�s �s followed by stakeholders’ v�ews on module content.

Barriers

Constra�nts of time were descr�bed by most respondents:

‘T�me affects pedagogy. In the new degree you are f�ght�ng for t�me, negot�at�ng compet�ng demands.’

Other barr�ers ment�oned by several respondents �ncluded the perce�ved lack of attent�on g�ven to HGDOP �n soc�al work NOS:

‘… the NOS do not encourage th�s [HGD �n pract�ce learn�ng.’

the dominance of policy and performance-dr�ven approaches �n the pract�ce learn�ng curr�culum:

‘Theoret�cal �ssues were subord�nated by procedure,... because a lot was hang�ng on �t [to be competent]. Pract�ce teachers are under pressure to “do the job r�ght” [so you get] rule follow�ng’

and, to a lesser degree, the dom�nance of ch�ld development w�th�n the HGD curr�culum and HGD staff teaching specialisms.

Class size was a challenge �n some HGD modules, generally taught to whole year cohorts and, at �ts most extreme, to 100 students �n a two-hour class:

‘HGD �s del�vered �n large lectures then d�rected learn�ng tasks �n small groups.… It’s really tough to cover everyth�ng we need to �n the t�me we’ve got.’

Pedagogical approaches

Desp�te constra�nts of t�me and programme des�gn, respondents descr�bed a range of creat�ve exper�ent�al teach�ng and learn�ng �ntervent�ons. These tended to be ordered �n a loosely s�m�lar and overlapp�ng sequence, beg�nn�ng w�th act�v�t�es a�med at engag�ng �nterest, then challeng�ng stereotypes, then focus�ng on �ncreas�ng self-reflect�on and mov�ng on to focus on the development of empathy. Explor�ng each element �n turn, the follow�ng are some of the exper�ent�al tasks reported (see Append�x 12 for a full l�st of �n�t�at�ves).

Engaging interest

‘I do a lot of th�ngs, v�deos, DVDs, v�deos from the Alzhe�mer’s Soc�ety, dement�a centre, mental health, BBC plays, novels. I’ll use whatever to engage people, get the�r �nterest.’

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‘Before the case mater�al I always ask them to share the�r exper�ences of work�ng w�th older people, be�ng part of a commun�ty �nclud�ng older people, be�ng older. Also of older people w�th�n the�r fam�ly, assum�ng that people are com�ng w�th pre-ex�st�ng knowledge and are not just blank slates.…’

Changing attitudes and challenging stereotypes

One respondent po�nted to the sk�lls needed to change att�tudes and challenge stereotypes:

‘It’s more about awareness ra�s�ng, because many people don’t know anyth�ng. It’s about �nform�ng them “�n a nurtur�ng way”. It’s a del�cate balance.’

Several approaches to meet�ng th�s challenge were reported:

‘We get them to �nterv�ew an older person to get the�r v�ews of the age�ng process.’

‘It’s a d�dact�c lecture, encourag�ng examples from pract�ce, and I often use my mother, recently gone �nto nurs�ng home. [It’s] helpful to use a pract�cal model that has changed my att�tude. My mother has become a case study.’

Encouraging self-reflection

Th�s was thought essent�al by many �n order for students to understand the �mpact of HGDOP on themselves and on the�r approach to work w�th older people:

‘[We use] self-selected groups … because we feel very strongly that �t’s an opportun�ty to th�nk about how some of the theoret�cal models apply to us/them as people and as learners because we want them to be very aware of how powerful and emot�ve some of th�s mater�al �s – �t’s very easy to read mater�al from a book ... but actually when you are apply�ng �t to people or th�nk�ng through some of the concepts they have a really emot�onal resonance for people, so that’s why we get them to choose the�r own groups, because shar�ng some of that mater�al may be tr�cky �n a group where you are d�rected to jo�n �t.’

Developing understanding and empathy

A range of approaches was used to develop understand�ng and empathy, often �nclud�ng an element of self-reflect�on.

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Good practice examples: exercises for developing empathy

Goldsmith’s, University of London

‘[We do an] exerc�se at the beg�nn�ng for people to �mag�nat�vely th�nk about themselves as an older person. Th�nk about themselves now and what they want to say to themselves as an older person, what are the�r asp�rat�ons and dreams as an older person, what serv�ces they would l�ke, what serv�ces they would l�ke �n the�r commun�ty, how would they want to be treated. Start�ng w�th the self, to use empathy, to bu�ld empathy to work w�th older people.’

Queen’s University, Belfast

‘In … groups of 12 ... I’ve used B�gg’s work, Confronting ageing30 to develop a gu�ded fantasy. Go�ng forward �n t�me, what w�ll old age be l�ke, who w�ll you be w�th, etc. I put th�s �n the context of empathy. So although the development of empathy �s the goal, �nequal�ty �ssues also emerge.

Anti-oppressive practice

Part�c�pants were asked how they �ntegrated �ssues of equal�ty and d�vers�ty �nto teach�ng and learn�ng about older people. They responded to th�s �n a number of ways. Some reflected on approaches used to challenge age�sm w�th�n the programme structure as a whole; others focused on pedagog�cal approaches:

‘We don’t spec�f�cally talk about �t, as “soc�al and cultural d�vers�ty and equal�ty” �s a spec�f�c foundat�on model so we w�ll refer across.… We expect them to start p�ck�ng up as the teach�ng goes on that th�s �s the way you should be able to th�nk about �t….’

‘We do a sess�on wh�ch sets out pr�nc�ples of th�ngs to be aware of �n any of the psycholog�cal research or theoret�cal perspect�ves, then we make a po�nt of teas�ng out �ssues �n each of the taught sess�ons.’

‘ … [students] develop the br�ef scenar�o �nto a more extended l�fe h�story and people are encouraged to th�nk about a range of �ssues related to power and d�vers�ty to construct those stor�es … [th�s] helps people to th�nk about how other aspects of d�fference �ntersect w�th age.’

Three part�c�pants (two from the same programme) felt that the approaches taken needed further development:

‘There are some examples �n the case mater�al but �t’s a po�nt of development because �t’s not embedded �nto the lecture.’

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Assessment

There was cons�derable var�ab�l�ty �n approaches to the assessment of HGDOP w�th�n and between HGD and older people modules.

In several there was no automat�c format�ve or summat�ve assessment of HGDOP. For example, �n one HGD module both HGD assessment opt�ons were related to ch�ldren and fam�l�es. In another, the only assessed task was a ch�ld observat�on, although there �s “an assessment for those who chose to work w�th adults w�th�n the case study �n year two”. In others, assessment of HGDOP was one of several HGD assessment opt�ons.

In one HGD module, a summat�ve assessment was comb�ned w�th a workbook of format�ve assessments, �nclud�ng some related to HGDOP, and subm�tted for tutor feedback. The summat�ve assessment emphas�sed self-reflect�on:

‘A 3,000 word ass�gnment ask�ng them to wr�te about the�r understand�ng of attachment and how �t appl�es to them �n the�r l�fe – a meta learn�ng opportun�ty….’

�n wh�ch HGDOP may feature �f the attachments descr�bed �nclude older people.


The perspect�ves of stakeholders on the content of HGDOP teach�ng and learn�ng had �n common an emphas�s on the need to understand age�sm and that people exper�ence old age d�fferently. W�th�n that, students and pract�t�oners were sl�ghtly more l�kely to emphas�se theoret�cal knowledge:

‘Academ�c learn�ng leg�t�mates thoughts and feel�ngs, prov�d�ng context, we�ght and understand�ng. Students should know everyth�ng about l�fespan development and dement�a.’ (pract�t�oner)

Serv�ce users and carers pr�or�t�sed l�sten�ng and commun�cat�on sk�lls, soc�al h�story, age�sm and knowledge of resources:

‘Students need to learn that old age can be very good – not t�ed to work, lots of advantages as well as d�sadvantages. Soc�al workers need to po�nt out the qual�ty of l�fe that �s poss�ble, help a sense of self-worth … soc�al workers need to be able to help older people talk about [the past]. Soc�al h�story helps soc�al workers empath�se and allows older people and soc�al worker to have an �ntell�gent conversat�on.’ (older stakeholder)

‘It would be a good �dea for students to do [a] “day �n the l�fe of” exerc�se and spend t�me w�th an older person who was funct�on�ng well desp�te some problems.’ (serv�ce user/carer)

‘The most �mportant �ssue was why older people are not treated well. That should be pr�or�t�sed although other �mportant �ssues are l�sten�ng to the v�ews of

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d�fferent people and the soc�al worker be�ng pos�t�ve.’ (Black and m�nor�ty ethn�c elder)

‘You have to get students �nvolved �n know�ng about how you ach�eve equal�ty accord�ng to the�r culture.’ (NGO Coord�nator)

‘[Those students who d�d] less well were those who were less able to �ntegrate theory to personal exper�ence and reflect�on…. It �s �mportant to g�ve some careful attent�on to �ssues of mortal�ty because these underp�n a fundamental aspect of all human exper�ence around age�ng and l�e at the centre of quest�ons about qual�ty of l�fe. How well we are able to v�s�t and l�ve w�th these quest�ons actually �mpacts on the qual�ty of presence and support we prov�de.’ (NGO Coord�nator)

5.4.7 Outcomes of HGDOP teaching and learning

As the pract�ce survey f�nd�ngs on assessment �nd�cate, many programmes struggled to evaluate students’ theory, knowledge and understand�ng of HGDOP on the bas�s of assessed work alone, and �ndeed there was l�ttle ev�dence that th�s approach was used. Th�s �s at least partly because of the complex processes of HGDOP teach�ng and learn�ng �n most programmes. Few respondents focused attent�on on outcomes dur�ng the telephone �nterv�ews, and the pract�ce survey d�d not f�nd ev�dence of a comprehens�ve, structured approach to evaluat�ng outcomes �n the programmes d�scussed.

Two respondents reported the success of certa�n approaches on the bas�s of student feedback:

‘[Hav�ng done the study un�t] students often report that they have changed the�r m�nd and that they are more open to th�nk�ng about work�ng w�th older people.’

‘Study un�t comes out well. Really enjoy �t, get engaged w�th �t, often say they weren’t look�ng forward to �t, but �t’s been a br�ll�ant learn�ng exper�ence.’

However, �t �s clear from these f�nd�ngs that there �s room for development �n the assessment of outcomes of HGDOP.

5.5 Practice survey: concluding comments

The pract�ce survey �dent�f�ed a number of examples of good and �nnovat�ve pract�ce �n HGDOP (add�t�onal examples are g�ven �n Append�x 12), �nclud�ng the expl�c�t use of cross-cutt�ng theor�es and approaches and of spec�f�c format�ve tasks, and some l�m�ted use of commun�ty-based learn�ng opportun�t�es. Educators reflected concerns �dent�f�ed by the l�terature, espec�ally the �mportance of HGDOP �n�t�at�ves that a�m to develop student understand�ng, change att�tudes and encourage self-reflect�on. There were the �nev�table tens�ons created by a congested curr�culum, where soc�al work educat�on about older people �s not an �dent�f�ed ‘requ�rement’ and has to compete w�th a range of other top�cs. T�me pressures were a constant constra�nt, as were the challenges of chang�ng att�tudes to older people and later

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l�fe, and encourag�ng reflect�on on a t�me of l�fe many found troubl�ng and pa�nful to contemplate.

Soc�al work educators and stakeholder respondents emphas�sed the �mportance of understand�ng and ‘att�tude’ �n underp�nn�ng soc�al work �ntervent�ons w�th older people and had clear �deas about how th�s m�ght be ach�eved. Educators pr�or�t�sed cr�t�cal understand�ng and apprec�at�on of theor�es of age�ng, an understand�ng of the d�verse l�ves and exper�ences of older people, and self-reflect�on on the �mpact of th�s emot�ve area. Stakeholders, and espec�ally serv�ce users, emphas�sed the �mportance of soc�al workers be�ng able to l�sten to and hear older people’s d�verse knowledge and exper�ence. The �nd�cat�on was that th�s was best ach�eved by spend�ng t�me w�th older people w�th�n the�r own commun�t�es.

Attent�on to theory was var�able, and the assessment of HGDOP and the evaluat�on of HGDOP teach�ng and learn�ng outcomes were less than robust �n most programmes. None of the pract�ce survey part�c�pants reported an expl�c�t pract�ce curr�culum for HGDOP. Educators found th�s could h�nder the effect�ve use of pract�ce learn�ng exper�ence �n explor�ng HGDOP both �n pract�ce and �n the classroom. In only one programme was HGD an expl�c�t requ�rement �n pract�ce learn�ng assessment.

The pract�ce survey responses suggest that these are complex �ssues that requ�re further attent�on at pol�cy and programme levels. It also �nd�cates that the potent�al of short, �nformal serv�ce and commun�ty-based learn�ng exper�ences to meet HGDOP teach�ng and learn�ng pr�or�t�es may be under-explored and could be an area for development.

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6 Findings and discussion

6.1 Summary of findings from the research review

The research rev�ew explored the ev�dence of the nature of HGDOP �n qual�fy�ng soc�al work educat�on and the factors that encouraged or h�ndered successful outcomes. In add�t�on, the rev�ew a�med to explore the extent to wh�ch cr�t�cal perspect�ves, part�cularly cr�t�cal gerontology, were ev�dent �n the teach�ng of HGDOP.

F�ve qual�ty-assessed stud�es met the �nclus�on cr�ter�a, all of wh�ch were publ�shed �n the US between 2002 and 2006. A larger number of stud�es (24) were �dent�f�ed at the keyword�ng stage of the rev�ew. The fact that only f�ve of these met the �nclus�on cr�ter�a reflected the l�m�ted l�terature that explored the relat�onsh�p between HGD and older people and evaluated the outcomes of �ntervent�ons �n the context of qual�fy�ng soc�al work educat�on.

The f�ve stud�es all reported on curr�culum developments �n HGDOP des�gned to �ncrease the qual�ty and quant�ty of teach�ng about older people. These developments reflected w�despread concern �n the US about the l�m�ted numbers of qual�fy�ng soc�al workers choos�ng to work w�th older people �n the context of an �ncreas�ngly age�ng populat�on.54

Apart from the�r focus on curr�culum development, the stud�es were d�verse �n terms of the�r a�ms and scope. They prov�ded cons�derable descr�pt�ve deta�l about the content and process of the changes made to the curr�culum. Most of these changes were des�gned to �ncrease knowledge about older people, change (mostly negat�ve) att�tudes and, to a lesser extent, develop sk�lls and �mprove the qual�ty of outcomes for serv�ce users and carers.

The stud�es prov�ded l�m�ted ev�dence about wh�ch character�st�cs of HGDOP teach�ng and learn�ng were effect�ve �n del�ver�ng spec�f�c outcomes. In those stud�es that evaluated the v�ews of student part�c�pants there was some ev�dence of �ncreased knowledge and more pos�t�ve att�tudes towards older people. However, these changes were evaluated �n the short term and by student percept�ons rather than the measurement of knowledge and behav�our. The stud�es prov�ded l�m�ted �nformat�on about the v�ews of other part�c�pants, although where the v�ews of older people and agency partners were reported, they were pos�t�ve about the�r �nvolvement.

In relat�on to the theoret�cal frameworks underp�nn�ng HGDOP, there was ev�dence of more thorough explorat�on of pedagog�cal theory than of developmental or gerontolog�cal approaches. For example, research �nto the use of oral h�story and serv�ce learn�ng supported the �ntroduct�on of these methods of teach�ng and learn�ng. Students and older part�c�pants evaluated these pedagog�cal approaches pos�t�vely although the l�m�tat�ons already d�scussed also apply to evaluat�ng the�r effect�veness. Students asserted they had learned about HGDOP by tak�ng part

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�n oral h�story projects or serv�ce learn�ng and �n one study4 these v�ews were supported by compar�son w�th a control group. These f�nd�ngs rema�n to be tested by long-term follow-up stud�es.

There was no ev�dence of the systemat�c use of cr�t�cal gerontology �n the rev�ew. Wh�le a number of theoret�cal models and approaches to HGDOP were c�ted, there was no deta�led report�ng of the rat�onale for the�r use or of the�r �mpact on part�cular outcomes.

All f�ve stud�es reported on the �ntegrat�on of pract�ce or serv�ce learn�ng �n�t�at�ves �nto the un�vers�ty-based curr�culum. The rat�onale for th�s approach was to �ntroduce one-to-one contact between students and older people at an early stage of the soc�al work programme as one means of �ncreas�ng knowledge about the exper�ence of later l�fe and counteract�ng stereotyp�ng. These developments ranged from one-off l�fe story �nterv�ews between �nd�v�dual students and an older person, to semester-long oral h�story projects. Student learn�ng was assessed on the bas�s of related ass�gnments or classroom presentat�ons.

Students found these exper�ences fac�l�tated the�r learn�ng, w�th qual�f�cat�ons about the amount of t�me necessary to complete the add�t�onal work. The older part�c�pants were un�versally pos�t�ve about the�r part�c�pat�on.

The l�m�tat�ons of the rev�ew �n terms of the numbers and scope of the stud�es makes �t �mposs�ble to general�se about the contr�but�on of these developments to any evaluat�on of effect�veness. However, the stud�es suggest that greater �ntegrat�on of pract�ce learn�ng �n�t�at�ves, even on a l�m�ted scale, would be worth further �nvest�gat�on.

6.2 Summary of findings from the practice survey

The pract�ce survey explored the perspect�ves on HGDOP of n�ne soc�al work educators w�th respons�b�l�t�es for HGD and/or older people teach�ng and learn�ng �n s�x HEIs �n England, Wales and Northern Ireland. It also �ncluded the v�ews of 11 stakeholders and four elders from a m�nor�ty ethn�c organ�sat�on.

The survey �nd�cated that effect�vely �ntegrat�ng HGDOP teach�ng and learn�ng w�th�n the curr�culum was challeng�ng and complex. T�me pressures were a constant constra�nt. In the early stages of the course, where most HGD teach�ng and learn�ng took place, the challenges �ncluded �ntegrat�ng HGDOP w�th�n a curr�culum trad�t�onally focused on ch�ld development, chang�ng student att�tudes to older people and later l�fe and encourag�ng reflect�on on a t�me of l�fe many found troubl�ng and pa�nful to contemplate. Later �n the programme the challenge was to cont�nue to address HGDOP �n modules focused on ‘do�ng’ soc�al work w�th older people �n an organ�sat�onal and regulatory context that was perce�ved as undervalu�ng the place of theory and reflect�ve pract�ce.

W�th�n HGD and older people modules educators reported many examples of �nnovat�ve attempts to �nclude attent�on to later l�fe, change att�tudes and encourage self-reflect�on (see Append�x 12), �nclud�ng the expl�c�t use of cross-cutt�ng theor�es

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and approaches and of spec�f�c format�ve tasks, �nclud�ng the l�m�ted use of commun�ty-based learn�ng opportun�t�es. Attent�on to theory was more var�able. Wh�le there were examples of the use of cr�t�cal approaches to the use of theory, only one respondent spec�f�cally ment�oned the use of cr�t�cal soc�al gerontology.

The assessment of HGDOP and the evaluat�on of HGDOP teach�ng and learn�ng outcomes were less than robust �n most programmes. In two of the s�x programmes the only requ�red assessment of HGD focused on ch�ld development. HGDOP was rarely an assessment requ�rement for all students.

None of the pract�ce survey part�c�pants reported an expl�c�t pract�ce curr�culum for HGDOP. Educators found th�s could h�nder the effect�ve use of pract�ce learn�ng exper�ence �n explor�ng HGDOP both �n pract�ce and �n the classroom. They expressed concerns about the lack of theory �n pract�ce placements and the pr�or�ty somet�mes g�ven to learn�ng about formula�c approaches to ‘do�ng care management’. In only one programme was HGD an expl�c�t requ�rement �n pract�ce learn�ng assessment.

Soc�al work educators and stakeholder respondents emphas�sed the �mportance of understand�ng and ‘att�tude’ �n underp�nn�ng soc�al work �ntervent�ons w�th older people and had clear �deas about how th�s m�ght be ach�eved. Educators pr�or�t�sed cr�t�cal understand�ng and apprec�at�on of theor�es of age�ng, an understand�ng of the d�verse l�ves and exper�ences of older people, and self-reflect�on on the �mpact of th�s emot�ve area. Stakeholders, and espec�ally serv�ce users, emphas�sed the �mportance of be�ng able to l�sten to and hear older people’s d�verse knowledge and exper�ence. The �nd�cat�on was that th�s was best ach�eved by spend�ng t�me w�th older people w�th�n the�r own commun�t�es.

6.3 Discussion

The rev�ew of HGDOP has �dent�f�ed the l�m�tat�ons of the research �n terms of �ts quant�ty and qual�ty. One of the ma�n l�m�tat�ons has been the lack of ava�lable research address�ng both human growth and development and later l�fe. Add�ng an educat�onal perspect�ve �nto the m�x further l�m�ts the ava�lable research ‘f�eld’.

In the US concern about the l�m�ted ava�lab�l�ty of soc�al workers want�ng to work w�th older people has led to a nat�onal �n�t�at�ve des�gned to �ncrease the amount and qual�ty of gerontolog�cal content �n qual�fy�ng programmes. Wh�le the Hartford Gero-r�ch project47, 53 has �ncreased the number of publ�cat�ons d�scuss�ng these developments, s�m�lar concerns have not yet been reflected �n publ�cat�ons outs�de the US.

Improv�ng the qual�ty of gerontolog�cal educat�on rema�ns h�gh on the US agenda but HGD has rece�ved more l�m�ted attent�on.47 The major�ty of stud�es �n the research rev�ew explore HBSE modules as an example of �ntegrat�ng teach�ng and learn�ng about older people �nto the curr�culum. Where there �s a w�der explorat�on of HGD, th�s typ�cally focuses on one aspect, such as B�rkenma�er and colleagues’ work on sp�r�tual�ty.1

63

Findings and discussion

The pract�ce survey �dent�f�ed a number of examples of good and �nnovat�ve pract�ce �n HGDOP but for a var�ety of reasons, �nclud�ng the l�m�tat�ons of personal and organ�sat�onal resources, these are not w�dely d�ssem�nated. Educators reflected other concerns �dent�f�ed by the l�terature, espec�ally the �mportance of HGDOP �n�t�at�ves that a�m to develop student understand�ng, change att�tudes and encourage self-reflect�on. There were the �nev�table tens�ons created by a congested curr�culum, where soc�al work educat�on about older people �s not an �dent�f�ed ‘requ�rement’ and has to compete w�th a range of other top�cs.

The pract�ce survey responses suggest that these are complex �ssues that requ�re further attent�on at programme level and w�th�n nat�onal standards and requ�rements. It suggests that the assessment and evaluat�on of HGDOP teach�ng and learn�ng outcomes may be less than robust �n many programmes.

The pract�ce survey also �nd�cates that the potent�al of short, �nformal serv�ce and commun�ty-based learn�ng exper�ences to meet HGDOP teach�ng and learn�ng pr�or�t�es may be under-explored and could be an area for development. It suggests that th�s approach to �nvolv�ng older people �n HGDOP would more fully engage w�th the real�ty of the�r l�ves and be more comfortable for many than �nclus�on �n classroom-based ‘teach�ng’.

The lack of attent�on to HGDOP �n the w�der l�terature and the f�nd�ngs of the pract�ce survey prov�de an opportun�ty to �ncrease the scope and qual�ty of UK research �n some of the areas below.

6.4 Recommendations for future research and practice

• To develop further a research base �n HGDOP �n the UK. • To develop a research base �n soc�al work educat�on �n relat�on to HGDOP �n the

UK. The pract�ce survey �dent�f�ed some �nnovat�ve educat�onal pract�ce that would benef�t from evaluat�ve research and d�ssem�nat�on.

• To �nvolve all part�c�pants �n HGDOP �n the research process. The v�ews of students are central as the users of soc�al work educat�on but attent�on should also be pa�d to the v�ews of other stakeholders �nclud�ng serv�ce users, pract�t�oners and other agency partners.

• To develop research des�gns that evaluate and measure outcomes not only �mmed�ately after the teach�ng has taken place but �n relat�on to longer-term learn�ng ga�ns.

• To clar�fy the parameters of HGD �n relat�on to older people: what do soc�al workers need to know about ‘development’ �n later l�fe and how �s a balance struck between ‘normal’ development and the developmental problems and cr�ses soc�al workers encounter �n pract�ce?

• To cons�der methods of �ntegrat�ng flex�ble models of serv�ce or pract�ce learn�ng �nto HGDOP, enabl�ng students to learn from older people �n the�r own env�ronments.

• To develop teach�ng and learn�ng methods that challenge age�st and other oppress�ve att�tudes towards older people and encourage all students to engage w�th learn�ng about later l�fe.

64

ADULTS’ SERVICES

• To recogn�se that these developments are resource �ntens�ve and to f�nd ways of resourc�ng such developments.

• To rev�ew the pract�ce curr�culum and pract�ce learn�ng requ�rements to ensure that HGD �s �ntegrated w�th�n pract�ce learn�ng and �ts assessment.

• To develop approaches to curr�culum organ�sat�on that support and mon�tor the �ntegrat�on of HGD across the curr�culum.

65

References

References

Studies included in in-depth review1 B�rkenma�er, J., Behrman, G. and Berg-Weger, M. (2005) ‘Integrat�ng curr�culum and

pract�ce w�th students and the�r f�eld superv�sors: reflect�ons on sp�r�tual�ty and the ag�ng (ROSA) model’, Educational Gerontology, vol 31, no 10, pp 745–63.

2 Browne, C.V., Bruan, K.L., Mokuau, N. and McLaughl�n, L. (2002) ‘Develop�ng a mult�s�te project �n ger�atr�c and/or gerontolog�cal educat�on w�th emphases �n �nterd�sc�pl�nary pract�ce and cultural competence’, Gerontologist, vol 42, no 5, pp 698–704.

3 D�epstra, S.A. and Ames, N. (2006) ‘Intergenerat�onal and d�verse oral h�story: pedagog�cal connect�ons and outcomes for BSW HBSE courses’, The Journal of Baccalaureate Social Work, vol 11, no 2, pp 115–25.

4 Dorfman, L.T., Murty, S., Ingram, J.G. and Evans, R.J. (2002) ‘Incorporat�ng �ntergenerat�onal serv�ce-learn�ng �nto an �ntroductory gerontology course’, Journal of Gerontological Social Work, vol 39, nos 1/2, pp 219–40.

5 Gray, J.I. and Kabadak�, K. (2005) ‘A strengths perspect�ve for assess�ng older adults: curr�culum enr�chment �n a human behav�or course’, The Journal of Baccalaureate Social Work, vol 11, pp 55–66.

Reports linked to studies in in-depth review6 Ames, N. and D�epstra, S.A. (2006) ‘Us�ng �ntergenerat�onal oral h�story serv�ce-

learn�ng projects to teach human behav�or concepts: a qual�tat�ve analys�s’, Educational Gerontology, vol 32, no 9, pp 721–35.

Studies included in thematic analysis only7 Abramson, N.S., Johnston, N. and Quam, J.K. (1988) ‘Res�dent�al care for the

chron�cally mentally �ll elderly: creat�ng educat�onal opportun�t�es for students’, Arete, vol 13, no 1, pp 23–8.

8 Chambers, P. (2004) ‘The case for cr�t�cal soc�al gerontology �n soc�al work educat�on and older women’, Social Work Education, vol 23, no 6, pp 745–58.

9 Cohen, H., Hatchett, B. and Eastr�dge, D. (2006) ‘Intergenerat�onal serv�ce-learn�ng: an �nnovat�ve teach�ng strategy to �nfuse gerontology content �nto foundat�on courses’, Journal of Gerontological Social Work, vol 48, nos 1/2, pp 161–78.

10 Cohen, H.L., Sandel, M.H., Thomas, C.L. and Barton, T.R. (2004) ‘Us�ng focus groups as an educat�onal methodology: deconstruct�ng stereotypes and soc�al work pract�ce m�sconcept�ons concern�ng ag�ng and older adults’, Educational Gerontology, vol 30, no 4, pp 329–46.

11 Coll�ns, K.S., Furman, R., Hackman, R., Bender, K. and Bruce, E.A. (2007) ‘Tend�ng the soul: a teach�ng module for �ncreas�ng student sens�t�v�ty to the sp�r�tual needs of older adults’, Educational Gerontology, vol 33, no 9, pp 707–72.

12 Corley, C.S., Dav�s, P., Jackson, L. and Stuart Bach, M. (2007) ‘Sp�r�t of ag�ng r�s�ng: cross-cutt�ng themat�c modules to enr�ch foundat�on graduate soc�al work courses’, Journal of Gerontological Social Work, vol 48, nos 3/4, pp 299–309.

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13 Crewe, S.E. (2004) ‘Ethnogerontology: prepar�ng culturally competent soc�al workers for the d�verse fac�ng of ag�ng’, Journal of Gerontological Social Work, vol 43, no 4, pp 45–57.

14 Downey, E.P. and M�les, B.K. (2005) ‘“Betty �s someone I w�ll never forget”: an exper�ent�al learn�ng model w�th older adults’, The Journal of Baccalaureate Social Work, vol 11, pp 95–104.

15 Eun-Kyoung, O.L., Coll�ns, P., Mahoney, K., McInn�s-D�ttr�ch, K. and Boucher, E. (2006) ‘Enhanc�ng soc�al work pract�ce w�th older adults: the role of �nfus�ng gerontology content �nto the master of soc�al work foundat�on curr�culum’, Educational Gerontology, vol 32, no 9, pp 737–56.

16 Hooyman, N. and St Peter, S. (2006) ‘Creat�ng ag�ng-enr�ched soc�al work educat�on: a process of curr�cular and organ�zat�onal change’, Journal of Gerontological Social Work, vol 48, nos 1/2, pp 9–29.

17 Johnson-Dalz�ne, P. (2007) ‘Prepar�ng soc�al work students to work w�th grandparents �n k�nsh�p care: an approach to �nfus�on of content mater�als �nto selected core soc�al work courses’, Journal of Gerontological Social Work, vol 48, nos 3/4, pp 405–20.

18 Kane, M. and Houston-Vega, M.K. (2004) ‘Max�m�z�ng content on elders w�th dement�a wh�le teach�ng mult�cultural d�vers�ty’, Journal of Social Work Education, vol 40, no 2, pp 285–303.

19 Kropf, N.P. (1996) ‘Infus�ng content on older people w�th developmental d�sab�l�t�es �nto the curr�culum’, Journal of Social Work Education, vol 32, no 2, pp 215–26.

20 Patterson, F.M. (2005) ‘Explor�ng ag�ng through �ntergenerat�onal and cross-cultural narrat�ves’, The Journal of Baccalaureate Social Work, vol 11, pp 105–19.

21 Ranney, M., Goodman, C.C., Tan, P. and Glezakos, A. (2006) ‘Bu�ld�ng on the l�fe-span perspect�ve: a model for �nfus�ng ger�atr�c soc�al work’, Journal of Gerontological Social Work, vol 48,nos 1/2, pp 83–96.

22 Sherr, M.E. and Blumhardt, F.C. (2002) ‘Rural elderly women: appl�cat�on of human behav�or theory and �ssues for soc�al work educat�on’, Journal of Human Behavior in the Social Environment, vol 6, no 4, pp 47–64.

23 Solomon, R. (1992) ‘Curr�culum for cl�n�cal pract�ce’, Journal of Gerontological Social Work, vol 18, nos 3/4, pp 101–17.

24 Vandsburger, E., Crawley-Woods, G., Gottl�eb, J. and Shelek-Furbee, K. (2005) ‘Apply�ng a stress and res�l�ency framework for teach�ng adult development and ag�ng throughout the soc�al work undergraduate-level curr�culum’, The Journal of Baccalaureate Social Work, vol 11, pp 67–81.

25 Wa�tes, C.E. and Lee, E.O. (2006) ‘Strengthen�ng ag�ng content �n the baccalaureate soc�al work curr�cula: what students have to say’, Journal of Gerontological Social Work, vol 48, nos 1/2, pp 47–62.

Reports linked to studies included in thematic analysis only26 Patterson, F.M. (2004) ‘Mot�vat�ng students to work w�th elders: a strengths, soc�al

construct�on, and human r�ghts and soc�al just�ce approach’, Journal of Teaching in Social Work, vol 24, nos 3/4, pp 165–81.

Additional references27 Ashford, J.B., Lecroy, C. and Lort�e, K.I. (2001) Human behaviour in the social

environment: A multidimensional perspective (2nd edn), Belmont, CA: Wadsworth/Thompson Learn�ng.

67

References

28 Andrews, M. (2000) ‘Ageful and proud’, Ageing and Society, vol 20, no 6, pp 791–5.29 Barr, H (1996) ‘Ends and means �n �nter profess�onal educat�on: towards a typology’,

Education for Health, no 3, pp 341–52.30 B�ggs, S. (1989) Confronting ageing, London: CCETSW.31 Bytheway, B. (2000) ‘Youthfulness and agelessness: a comment’, Ageing and Society,

vol 20, no 6, pp 781–9.32 CCW (Care Counc�l for Wales) (2004) All Wales framework for assessment of social

work, Card�ff: CCW, Welsh Off�ce (www.ccwales.org.uk/).33 Chambers, P. (2004) ‘The case for soc�al gerontology �n soc�al work educat�on and

older women’, Soc�al Work Educat�on, vol 23, no 6, pp 745–58.34 Coren, E. and F�sher, M. (2006) The conduct of systematic research reviews for SCIE

knowledge reviews, London: Soc�al Care Inst�tute for Excellence.35 DH (Department of Health) (2001) National Service Framework for older

people (www.dh.gov.uk/en/Soc�alCare/Del�ver�ngadultsoc�alcare/Olderpeople/OlderpeoplesNSFstandards/�ndex.htm, accessed 12/06/08).

36 DH (2002) Requirements for social work training, London: DH.37 DH (2006) A new ambition for old age: Next steps in implementing the National

Service Framework for Older People: A resource document (www.dh.gov.uk/en/Soc�alCare/Del�ver�ngadultsoc�alcare/Olderpeople/�ndex.htm, accessed 12/06/08).

38 DH (2008) Delivering adult social care policy (www.dh.gov.uk/en/Soc�alCare/Del�ver�ngadultsoc�alcare/Olderpeople/�ndex.htm, accessed 12/06/08).

39 DHSSPS (Department for Health, Soc�al Serv�ces and Publ�c Safety) (Northern Ireland) (2003) Framework specification for the degree in social work, Belfast: DHSSPS.

40 Er�kson, E. (1959) ‘Ident�ty and the l�fe cycle’, Selected Papers, New York: Internat�onal Un�vers�t�es Press.

41 Er�kson, E., Er�kson, J. and K�vrl�ck, H. (1986) Vital involvement in old age, New York: W.W. Norton.

42 Germa�n, C.B. and G�tterman, A. (1980) A life model of social work practice, New York: Columb�a Un�vers�ty Press.

43 Hav�ghurst, R. (1968) ‘A soc�al psycholog�cal perspect�ve on ag�ng’, Gerontologist, vol 8, no 20.

44 Hockey, J. and James, A. (2003) Social identities across the lifecourse, Bas�ngstoke: Palgrave Macm�llan.

45 Holste�n, M.B. and M�nkler, M. (2007) ‘Cr�t�cal gerontology: reflect�ons for the 21st century’, �n M. Bernard and T. Scharf (eds) Critical perspectives on ageing societies, Br�stol: The Pol�cy Press.

46 Hooyman, N. and K�yak, A. (1999) Social gerontology: A multidisciplinary perspective (5th edn), Needham He�ghts, MA: Allyn and Bacon.

47 Hooyman, N. (2006) Achieving curricular and organizational change: Impact of the CSWE Geriatric Enrichment in Social Work Education Project, Gero-r�ch Monograph, Alexandr�a, VA: CSWE Gero-Ed Center.

48 Hudson, L.E. and Santora, E.D. (2003) ‘Oral h�story: an �nclus�ve h�ghway to the past’, The History Teacher, vol 36, no 2, pp 206–20.

49 K�rkpatr�ck, D.L. (1967) ‘Evaluat�on of tra�n�ng’, �n R. Cra�g and L. B�ttel (eds) Training and development handbook, New York: McGraw H�ll, pp 87–112.

50 Le R�che, P., Orr, D. and Sharland, E. (2007) Scoping report of qualifying social work education about human growth and development, mental health and disability, London: SCIE.

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51 Lev�nson, D. (1978) The seasons of a man’s life, New York: Alfred A. Knopf.52 Lucas, E.T. (2000) ‘L�nk�ng soc�al work and serv�ce learn�ng’, Journal of Baccaulaureate

Social Work, vol 5, no 2, pp 167–78.53 Nat�onal Center for Gerontolog�cal Soc�al Work Educat�on, Gero-rich initiative (http://

depts.wash�ngton.edu/geroctr/).54 Neugarten, B.L. (1968) Middle age and aging: A reader in social psychology, Ch�cago, IL:

Un�vers�ty of Ch�cago Press.55 Pr�estley, M. (2003) Disability: A lifecourse approach, London: Pol�ty Press.56 QAA (Qual�ty Assurance Agency) for H�gher Educat�on (2000) Social policy and

administration and social work: Subject benchmarking statements, Br�stol: QAA, February.

57 Roer-Str�er, D. (2005) Human development education for social workers in multicultural societies, London: Routledge.

58 Sharland, E. and Taylor, I. (2007) Interprofessional education in qualifying social work, Knowledge Rev�ew 10, London: SCIE (www.sc�e.org.uk/publ�cat�ons/m�sc/�pe.asp).

59 Sugarman, L. (2000) Life-span development: Frameworks, accounts and strategies, Hove: Routledge.

60 Sussex Inst�tute (2007) Research governance and ethics standards and guidelines (www.sussex.ac.uk/s�/1-7-6.html).

61 Taylor, I., Sharland, E., Sebba, J. and Le R�che, P. (2006) Learning, teaching and assessment of partnership work in social work education, Knowledge Rev�ew 10, London: SCIE.

62 TOPSS (Tra�n�ng Organ�sat�on for the Personal Soc�al Serv�ces) (2003) National Occupational Standards for social work, Leeds: TOPSS.

63 Thomas, J. and Brunton, J. (2006) EPPI-Reviewer 3.0: Analysis and management of data for research synthesis, EPPI-Centre software, London: Soc�al Sc�ence Research Un�t, Inst�tute of Educat�on.

64 Zastrow, C. and K�rst-Ashman, K. (2004) Understanding human behaviour and the social environment, Belmont, CA: Brooks/Cole.

69

Index

AAbramson, N.S. et al 23age�ng b�olog�cal stud�es 20 developmental processes 19 pos�t�ve perspect�ves 20 values and att�tudes 19age�sm, challenges 3agency partner support 40a�ms of HGDOP 1-2, 11-13, 27-8, 47-8Ames, N. and D�epstra, S.A. 17, 27, 25-6ant�-oppress�ve pract�ces 56Ashford, J.B. et al 29assessment of HGDOP knowledge 13-14,

32-3, 48-9, 57assessment sk�lls 28att�tudes towards age�ng 28, 31-2 changes to 37, 46, 55 mot�vat�ons to work w�th older people

42-3

BBarr, H. 25barr�ers to HGDOP learn�ng 38-42, 54b�olog�cal age�ng stud�es 20B�rkenma�er, J. et al 15-16, 17, 25-6, 28, 30,

32, 34, 41, 62, 65Browne, C.V. et al 15, 23, 25-6, 27-8, 29-30,

36-7, 39, 65

CChambers, P. 3, 11, 12class s�zes 54Cohen, H.L. et al 22commun�cat�on sk�lls 20, 28, 32, 37, 47-8,

57Crewe, S.E. 11, 19, 21cr�t�cal gerontology 3, 12-13curr�culum (HGDOP) content 2, 19-20, 31-3, 50-1 �nvolvement of older people 50-1

Index

Note: HGDOP refers to ‘Human Growth and Development and Older People’

survey f�nd�ngs 53-8 des�gn and organ�sat�on 17-19, 48-9 learn�ng structures and sequences 49-50 theor�es and frameworks 12-14, 28-9,

48-9, 54 see also tra�n�ng and educat�on (HGDOP)

Ddata collect�on methods (knowledge

rev�ew) 45data extract�on (knowledge rev�ew) 7des�gn of study, research rev�ew 24-5developmental theor�es 19, 28development of sk�lls see sk�lls

developmentD�epstra, S.A. and Ames, N. 17, 22, 25-6, 27,

29-30, 32, 36-7, 40, 42, 65d�vers�ty perspect�ves 29Dorfmann, L.T. et al 19, 22-3, 25-6, 27, 28,

30-2, 35, 37-8, 42, 65Downey, E.P. and M�les, B.K. 19, 22-3

Ee-learn�ng 17ecolog�cal theor�es 28-9ecomaps 29empathy and understand�ng 55-6EPPI-Centre gu�del�nes 24Er�kson, E. 19, 28Eun-Kyoung, O.L. et al 19evaluat�on of learn�ng (HGDOP outcomes)

36-8, 58exclus�on cr�ter�a (knowledge rev�ew) 5-6exper�ent�al learn�ng see pedagog�cal theory

and approaches

Ff�eld placements see pract�ce placementsfund�ng �ssues 39

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Ggay and lesb�an couples 19gerontology, cr�t�ques 3, 12-13Gero-r�ch project (US) 6, 14, 21, 24, 37, 39,

62Goldsm�th’s College (Un�vers�ty of London)

56Gray, J.I. and Kabadak�, K. 20, 25-6, 27-30,

37, 41, 65

HHartford Gero-r�ch project (US) 6, 14, 21,

24, 37, 39, 62Hav�ghurst, R. 19HGD see human growth and development

(HGD)HGDOP knowledge rev�ew see knowledge

rev�ew (HGDOP)Hooyman, N. and K�yak, A. 29Hooyman, N. and St. Peter, S. 13, 14human growth and development (HGD) concepts and def�n�t�ons 2-3 cr�t�cal gerontology 3, 12-13 see also tra�n�ng and educat�on (HGDOP)

I�nclus�on cr�ter�a (knowledge rev�ew) 5-6‘�nfus�on’ models 13�nteract�ve models of learn�ng 35�ntergenerat�onal serv�ce learn�ng 31-2

KKane, M. and Houston-Vega, M.K. 20keyword searches (knowledge rev�ew) 7K�rkpatr�ck, D.L. 25knowledge �mprovement 27, 36knowledge rev�ew (HGDOP) - overv�ewbackground v� a�ms and rat�onale 1-2, 11-13 def�n�t�ons and contexts 2-3 eth�cs 4 key quest�on and object�ves 1-2 pol�cy agendas 2 stakeholder groups 4 research rev�ew v�-v��, 10-23, 24-43 background and overv�ew of key stud�es

10-23 �n-depth rev�ews of key stud�es 24-43 methodology 5-9

process flowchart 8 pract�ce survey v��-�x, 44-59 key f�nd�ngs v�� recommendat�ons v��-�x summary of f�nd�ngs 60-4 from pract�ce survey 61-2 from research rev�ew 60-1 d�scuss�on and recommendat�ons 63-4Kropf, N.P. 18

LLev�nson, D. 19l�fespan perspect�ves 18, 19-20, 28l�near/chronolog�cal-based curr�culum

organ�sat�on 19l�sten�ng sk�lls 20, 21, 47, 48, 57-8, 62l�terature searches see research rev�ew

(HGDOP)

Mmed�tat�on 17, 41methodolog�es (HGDOP) v� pract�ce survey 44-5 research rev�ew 5-9, 25-6modell�ng ass�gnments 41mot�vat�on to work w�th older people 42-3

NNeugarten, B.L. 19

O‘old age’, concepts 3older people as ‘expert’ 31 see also age�ngoral h�story projects 22, 31-2, 42, 60-1organ�sat�on and plann�ng �ssues 39-40outcomes for serv�ce users a�ms 27-8 changes 38

Ppartnersh�p agency support 40pedagog�cal theory and approaches 16-17,

29, 41, 54placements see pract�ce placementsplann�ng and organ�sat�on �ssues 39-40pos�t�ve age�ng att�tudes 20 see also strength-based models of HGDOP

71

Index

post-qual�f�cat�on jobs, work�ng w�th older people 42-3

pract�ce placements 15-16, 23, 32, 41-2, 52 ev�dence of HGD knowledge 52 use of case analys�s 52 see also serv�ce learn�ng �n�t�at�vespract�ce survey (HGDOP) v��-�x, 44-59 a�ms and scope 44 emergent themes 45-58 key f�nd�ngs v�� methodology 44-5 recommendat�ons and comments v��-�x,

58-9pract�ce-based learn�ng 15-16, 17, 23, 32, 52 character�st�cs 41 �ntegrat�on 41-2, 61 see also serv�ce learn�ng �n�t�at�vespsychosoc�al theor�es 28

Qqual�tat�ve approaches 24, 34, 35quant�tat�ve approaches 24, 34, 35Queen’s un�vers�ty (Belfast) 56

RRanney, M. et al 23recommendat�ons for future pract�ce

(knowledge rev�ew) 63-4reflect�ve journals 17, 41relevancy of stud�es 25-6research rev�ew (HGDOP) v�-v��, 10-23, 24-

43 a�ms 11-12 categor�es of study 10-11 des�gn 24-5 frameworks and theor�es 12-14, 28-9 methodolog�es 5-9 we�ght of ev�dence judgements 25-6 organ�sat�on and t�m�ng cons�derat�ons 14 part�c�pants 14-15 process flowchart 8 study f�nd�ngs ma�n cla�ms 22-3 nature of educat�onal �ntervent�on 29-33 outcomes analys�s 36-8 overv�ew 10-23 part�c�pant feedback 23, 35-6 scope and evaluat�on (outcomes) 20-1,

33-8

resource �mpl�cat�ons 39rev�ew team 4r�ght-based curr�culum approaches 18role modell�ng 41

Sself-reflect�ve learn�ng 17, 55, 63serv�ce learn�ng �n�t�at�ves 13, 17, 52-3, 61 see also pract�ce-based learn�ngsett�ngs for HGDOP learn�ng 15-16, 30Sherr, M.E. and Blumhardt, F.C. 11s�mulat�on work 17sk�lls development a�ms 28, 32, 33-4, 47 changes to behav�our 37-8, 47sp�r�tual�ty and age�ng 15-16, 17, 22, 35, 42,

62 med�tat�on and modell�ng techn�ques 41stakeholders 4 part�c�pat�on 7-9 survey responses 48, 51, 53, 57-8stereotypes 55strength-based models of HGDOP 27, 28-9,

36, 41, 46Sugarman, L. 3survey methods see pract�ce survey

(HGDOP)Sussex Inst�tute 4

Ttheory and concepts �n HGDOP teach�ng

12-13, 18, 28-9, 61 organ�sat�on of approaches 48-9 student comprehens�on 46, 61, 62t�me constra�nts 54, 61t�me-l�nes 17top�c-based curr�culum approaches 18tra�n�ng and educat�on (HGDOP) course types and management 13, 15,

29-33 evaluat�on of learn�ng (outcomes) 36-8,

58 levels of teach�ng 30 processes 31-3 scope and outcomes 20-1, 22-3, 33-8 sett�ngs 15-16, 30 teach�ng methods 16-17 curr�culum content 2, 19-20, 31-3, 53-8

72

ADULTS’ SERVICES

des�gn and organ�sat�on 17-19 learn�ng structures and sequences 49-50 theor�es and frameworks 12-14, 28-9,

48-9, 54 fac�l�tators and barr�ers to HGDOP

learn�ng 38-42, 54 �nvolvement of older people 14-15, 31,

50-1 part�c�pant feedback 23, 35-6 see also research rev�ew (HGDOP)

UUn�vers�ty of Northumbr�a 53Un�vers�ty of Sussex 4Un�vers�ty of Tees�de 53

Vvalues and att�tudes (age�ng) 19Vandsburger, E. et al 19, 22

WWa�tes, C.E. and Lee, E.O. 17, 20we�ght of ev�dence judgements 25-6work�ng w�th older people, post-

qual�f�cat�on jobs 42-3

Appendix 1: Review objectives • To examine what is meant by ‘human growth and development and older people’

(HGDOP) as it relates to qualifying social work education. • To examine the range of approaches, participants, contexts and methods of

qualifying social work education about HGDOP. • To examine the theoretical frameworks underpinning HGDOP, and its

effectiveness in qualifying social work education. • To identify the range of process and effectiveness outcomes identified for

HGDOP, including student learning and transfer of learning into practice. • To examine the effectiveness of different approaches to HGDOP in achieving

identified outcomes. • To identify the facilitators and barriers to effective teaching and learning about

HGDOP in qualifying social work. • To highlight in particular the prevalence, nature and effectiveness of critical

perspectives in teaching and learning of HGDOP at qualifying level. • To highlight where possible examples of good practice in England, Wales and

Northern Ireland.

Appendix 2: Requirements for teaching, learning and assessment of

human growth and development in qualifying social work education Guidance Requirement

UK Code of Practice for social care workers

(2004)

‘Respecting diversity and different cultures and

values.’

United Kingdom

Quality Assurance Authority benchmark

statement for social work (2008)

‘The relevance of sociological perspectives to

understanding societal and structural influences

on human behaviour at individual, group and

community levels.’

‘The relevance of psychological, physical and

physiological perspectives to understanding

personal and social development and

functioning.’

National Occupational Standards (NOS) for

social work (2003)

‘Psychological and sociological explanations of:

human growth and development and the factors

that impact on it

human behaviour.’

‘Assist people to identify and address

developmental needs and associated risks.’

‘Work with risk, that is associated with human growth and development, promoting independence, learning, social inclusion or “alternative” lifestyles.’ ‘‘ Assist

England

Department of Health requirements for social

work training (2002)

‘Providers will have to demonstrate that all

students undertake specific learning and

assessment in the following key areas:

• human growth, development, mental health

and disability.’

Wales Raising standards: The Qualification

Framework for the social care sector in Wales

(Welsh Assembly Government, 2004)

(incorporates the All Wales Assessment

Framework, including NOS, the social work

benchmarking statement and skill requirement of

Quality Assurance Agency statement for social

work and Code of Practice for social care workers)

‘Psychological and physiological perspectives

on individual and social development and

functioning from infancy to old age. The nature

and characteristics of developmental delay,

disruption and trauma.’

‘The relevance of sociological perspectives to

understanding societal and structural influences

on human behaviour at individual, group and

community levels.’

Appendix 3: Search strategy and study selection The research review team developed the search strategy based on the experience gained in the scoping review,48 which supported the identification of relevant terms and appropriate databases. The strategy was modified further during searching on each individual database, to take account of the varying descriptor terms used to classify citations and to allow adaptations to be made. The choice of databases to search was determined by the Social Care Institute for Excellence’s (SCIE’s) guidance on systematic reviewing and the resources available. Search terms and databases Five bibliographic databases were included in the search:

AgeInfo ASSIA (Applied Social Sciences Index and Abstracts) PsychInfo Social Services Abstracts Social Care Online

The search strategy used with the bibliographic databases was based on a combination of the following elements:

• human growth and development (HGD) • relevance to older people • relevance to social work education

The search terms and results for each database were as follows: AgeInfo Search 6/8/07 Text = (social work or social care or human service prof*) and Text = (educat* or student or curriculu* or train*) and Keyword = “ageing process@”/“mental health (elderly)@”/”attitudes to the old of general public@”/”rights (elderly)@” ASSIA (Applied Social Sciences Index and Abstracts) Searched 8/10/07 Human growth and development dimension (((DE=(personality)) or (DE=(person-environment fit)) or (DE=(human ecology)) or (DE=(human development)) or (DE=(mental health))) or ((AB=(resilienc*) or TI=(resilienc*)) or (AB=(capacit*) or TI=(capacit*)) or (AB=(aging) or TI=(aging)) or (AB=(ageing) or TI=(ageing)) or (AB=(adult develop*) or TI=(adult develop*)) or (AB=(crosscultur*) or TI=(crosscultur*)) or (AB=(cross cultur*) or TI=(cross cultur*)) or (AB=(divers*) or TI=(divers*)) or (AB=(identit*) or TI=(identit*)) or (AB=(transition*) or TI=(transition*)) or (AB=(lifecourse) or TI=(lifecourse)) or (AB=(life course) or TI=(life course)) or (AB=(lifecycle) or TI=(lifecycle)) or (AB=(life cycle) or TI=(life cycle)) or (AB=(life span) or TI=(life span)) or (AB=(lifespan) or TI=(lifespan)) or (AB=(stage) or TI=(stage)) or (AB=(develop*) or TI=(develop*)) or (AB=(normative develop*) or TI=(normative develop*)) or (AB=(human develop*) or TI=(human develop*)) or (AB=(human growth) or TI=(human growth)))) Older people dimension ((DE=(elderly people)) or (DE=(older people)) or ((AB=(geront*) or TI=(geront*)) or (AB=(older adult*) or TI=(older adult*)) or (AB=(later life) or TI=(later life)) or (AB=(aging) or TI=(aging)) or (AB=(ageing) or TI=(ageing)) or (AB=(older people) or TI=(older people)))) Social work education dimension (((ab=(social care) or ti=(social care)) within 6 ((ab=(educat**) or ti=(educat**)) or (ab=(stud**) or ti=(stud**)) or (ab=(qualify**) or ti=(qualify**)) or (ab=(program**) or ti=(program**)) or (ab=(curricul**) or ti=(curricul**)) or (ab=(fieldwork**) or ti=(fieldwork**)) or (ab=(practice placement**) or ti=(practice placement**)))) or ((ab=(social work) or ti=(social work)) within 6 ((ab=(educat**) or ti=(educat**)) or (ab=(stud**) or ti=(stud**)) or (ab=(qualify**) or ti=(qualify**)) or (ab=(program**)

or ti=(program**)) or (ab=(curricul**) or ti=(curricul**)) or (ab=(fieldwork**) or ti=(fieldwork**)) or (ab=(practice placement**) or ti=(practice placement**)))) or (((ab=(practice placement**) or ti=(practice placement**)) or (ab=(fieldwork**) or ti=(fieldwork**)) or (ab=(curricul**) or ti=(curricul**)) or (ab=(program**) or ti=(program**)) or (ab=(qualify**) or ti=(qualify**)) or (ab=(stud**) or ti=(stud**)) or (ab=(educat**) or ti=(educat**))) and ((ab=(human service** profession**) or ti=(human service** profession**)) or (ab=(social care) or ti=(social care)) or (ab=(social work) or ti=(social work))))) Combined search (((DE=(personality)) or (DE=(person-environment fit)) or (DE=(human ecology)) or (DE=(human development)) or (DE=(mental health))) or ((AB=(resilienc*) or TI=(resilienc*)) or (AB=(capacit*) or TI=(capacit*)) or (AB=(aging) or TI=(aging)) or (AB=(ageing) or TI=(ageing)) or (AB=(adult develop*) or TI=(adult develop*)) or (AB=(crosscultur*) or TI=(crosscultur*)) or (AB=(cross cultur*) or TI=(cross cultur*)) or (AB=(divers*) or TI=(divers*)) or (AB=(identit*) or TI=(identit*)) or (AB=(transition*) or TI=(transition*)) or (AB=(lifecourse) or TI=(lifecourse)) or (AB=(life course) or TI=(life course)) or (AB=(lifecycle) or TI=(lifecycle)) or (AB=(life cycle) or TI=(life cycle)) or (AB=(life span) or TI=(life span)) or (AB=(lifespan) or TI=(lifespan)) or (AB=(stage) or TI=(stage)) or (AB=(develop*) or TI=(develop*)) or (AB=(normative develop*) or TI=(normative develop*)) or (AB=(human develop*) or TI=(human develop*)) or (AB=(human growth) or TI=(human growth)))) and ((DE=(elderly people)) or (DE=(older people)) or ((AB=(geront*) or TI=(geront*)) or (AB=(older adult*) or TI=(older adult*)) or (AB=(later life) or TI=(later life)) or (AB=(aging) or TI=(aging)) or (AB=(ageing) or TI=(ageing)) or (AB=(older people) or TI=(older people)))) and (((ab=(social care) or ti=(social care)) within 6 ((ab=(educat**) or ti=(educat**)) or (ab=(stud**) or ti=(stud**)) or (ab=(qualify**) or ti=(qualify**)) or (ab=(program**) or ti=(program**)) or (ab=(curricul**) or ti=(curricul**)) or (ab=(fieldwork**) or ti=(fieldwork**)) or (ab=(practice placement**) or ti=(practice placement**)))) or ((ab=(social work) or ti=(social work)) within 6 ((ab=(educat**) or ti=(educat**)) or (ab=(stud**) or ti=(stud**)) or (ab=(qualify**) or ti=(qualify**)) or (ab=(program**) or ti=(program**)) or (ab=(curricul**) or ti=(curricul**)) or (ab=(fieldwork**) or ti=(fieldwork**)) or (ab=(practice placement**) or ti=(practice placement**)))) or (((ab=(practice placement**) or ti=(practice placement**)) or (ab=(fieldwork**) or ti=(fieldwork**)) or (ab=(curricul**) or ti=(curricul**)) or (ab=(program**) or ti=(program**)) or (ab=(qualify**) or ti=(qualify**)) or (ab=(stud**) or ti=(stud**)) or (ab=(educat**) or ti=(educat**))) and ((ab=(human service** profession**) or ti=(human service** profession**)) or (ab=(social care) or ti=(social care)) or (ab=(social work) or ti=(social work))))) PsychInfo Searched 26/7/07 #1 (older adj people) in AB) #2 (ageing) in AB) #3 (aging) in AB) #4 (later adj life) in AB) #5 (elder*) in AB) #6 (older adj adult) in AB) #7 (geront*) in AB #8 #1 or #2 or #3 or #4 or #5 or #6 or #7 #9 (human adj growth) in AB #10 (human adj develop*) in AB #11 (normative adj develop*) in AB #12 (develop* adj stage) in AB #13 (lifespan) in AB #14 (life adj cycle) in AB

#15 (life adj course) in AB) #16 (transition*) in AB #17 (identity) in AB #18 (divers*) in AB #19 (cross-cultur*) in AB #20 (cross adj cultur*) in AB #21 (life adj stage) in AB #22 (resilienc*) in AB #23 (develop) in AB #24 (stage) in AB #25 #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or

#20 or #21 or #22 or #23 or #24 #26 #8 and #25 #27 (social adj work) in AB #28 (social adj care) in AB #29 ((human adj service*) in AB) and ((profession*) in AB) #30 #27 or #28 or #29 #31 (educat*) in AB #32 (stud*) in AB #33 (qualify*) in AB #34 (program*) in AB #35 (curricul*) in AB #36 (fieldwork) in AB #37 (practic*) in AB #38 (service adj learn*) in AB #39 #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 #40 #30 and #39 #41 #8 and #25 and #40 Social Care Online Because of the limitations of the Social Care Online database, and on advice from technical staff at SCIE, this search was completed in two parts and then duplicates removed, giving 131 unique results in total. Part 1 search 10/7/07 Human growth and development dimension ((@p=(“normative”)or @p=(“develop*”)or @p=(“stage”)or @p=(“lifespan”)or @p=(“life course”)or @p=(“life cycle”)or @p=(“human growth”) or @p=(“identit*”)or @p=(“transition”)or @p=(“diversity”)or @p=(“cross-cultural”)) or (@k= (“living and life events”) or @k=(“life style”) or @k=(“personality development”) or @k=(“child development”) or @k=(“ecological approach”)))

Older people dimension and (@p=(“later life”) or @p=(“ageing”) or @p=(“aging”) or @p=(“elder*”) or @p=(“older people”) or @p=(“older adults”) or @p=(“ageism”) or @p=(“agism”) or @p=(“geriatric”)or @p=(“geront*”)or @p=(“senior*”)or @p=(“third age”))

Social work education dimension and (@k= (“social work education”) or @k= (“student social workers”) or (@k= (“social care professionals”) and @k=(“education”)))

Or

Part 2 search 6/10/07

Human growth and development dimension (@k=(“life style” or “personality” or “ecological approach” or “ageing” or “resilience” or “mental health” or “cultural identity” or “age discrimination” or “develop*”) Older people dimension and @k=(“older people” or “ageing”) Social work education dimension and @k=(“social work education” or “student social workers”)) Part 1 and Part 2 with duplicates removed: 131 results Social Services Abstracts Search 8/10/07 Query: ((DE=(life stage transitions)) or (DE=(geront*)) or (DE=(life cycle)) or (DE=(mental health)) or (((AB=(normative) or TI=(normative)) or (AB=(life span) or TI=(life span)) or (AB=(lifecycle) or TI=(lifecycle)) or (AB=(life-cycle) or TI=(life-cycle)) or (AB=(life course) or TI=(life course)) or (AB=(transition) or TI=(transition)) or (AB=(ident*) or TI=(ident*)) or (AB=(crosscultur*) or TI=(crosscultur*)) or (AB=(corsscultur*) or TI=(crosscultur*)) or (AB=(stage) or TI=(stage)) or (AB=(mental health) or TI=(mental health)) or (AB=(adult develop*) or TI=(adult develop*)) or (AB=(parent*) or TI=(parent*)) or (AB=(aging) or TI=(aging)) or (AB=(ageing) or TI=(ageing))) or ((AB=(attach*) or TI=(attach*)) or (AB=(child*) or TI=(child*)) or (AB=(loss*) or TI=(loss*)) or (AB=(parenthood) or TI=(parenthood)) or (AB=(capacit*) or TI=(capacit*)) or (AB=(normative) or TI=(normative)) or (AB=(resilien*) or TI=(resilien*)) or (AB=(human within 4 develop*) or TI=(human within 4 develop*)) or (AB=(human within 4 growth) or TI=(human within 4 growth)) or (AB=(adult within 4 develop*) or TI=(adult within 4 develop*)) or (AB=(mental within 1 health*) or TI=(mental within 1 health*)) or (AB=(stage*) or TI=(stage*)) or (AB=(cross-cultur*) or TI=(cross-cultur*)) or (AB=(cross cultur*) or TI=(cross cultur*)) or (AB=(divers*) or TI=(divers*)) or (AB=(identit*) or TI=(identit*)) or (AB=(transition*) or TI=(transition*)) or (AB=(life course) or TI=(life course)) or (AB=(life cycle) or TI=(life cycle)) or (AB=(lifespan) or TI=(lifespan)) or (AB=(stage) or TI=(stage)) or (AB=(develop*) or TI=(develop*)) or (AB=(normative develop*) or TI=(normative develop*)) or (AB=(human develop*) or TI=(human develop*)) or (AB=(human growth) or TI=(human growth))))) and ((DE=(elder*)) or (((DE=(older people)) or (AB=(elder) or TI=(elder)) or (AB=(older adult) or TI=(older adult))) or ((AB=(geront*) or TI=(geront*)) or (AB=(older adult*) or TI=(older adult*)) or (AB=(elder*) or TI=(elder*)) or (AB=(later life) or TI=(later life)) or (AB=(aging) or TI=(aging)) or (AB=(ageing) or TI=(ageing)) or (AB=(older people) or TI=(older people))))) and (DE=(social work education)) Handsearches The following journals were handsearched: Ageing & Society (title search for period 2000–08) British Journal of Social Work (title search for period 2000–07) Educational Gerontology (title search for period 2000–07) Social Work Education (title search for period 2000–07) Through handsearching and through references from database citations 17 relevant references were found that had not already emerged from the database searches and were included in the review. An author search was undertaken (on 8/2/08) using Google Scholar, to identify any relevant publications for the following authors whose names had emerged from the

database and policy website searches as authors of textbooks and/or relevant policy documents (period covered 1996 to 8/2/08):

Coleman, P. Crawford, K. Gearing, B. Langley, J. Milne, A. Phillips, J. Tanner, D. Walker, A. Walker, J. Wilson, G.

No relevant references were found that had not already emerged from the database and handsearches. Website searches The following policy websites were searched in the course of the review: Government sites Department of Health www.dh.gov.uk/en/Policyandguidance/SocialCare/Deliveringadultsocialcare/Olderpeople/OlderpeoplesNSFstandards/index.htm (National Service Framework [NSF] for older people standards) searched 8/2/08. www.olderpeoplesmentalhealth.csip.org.uk/silo/files/integrating-opmh-services.pdf (mental health) searched 8/2/08. Northern Ireland www.dhsspsni.gov.uk Scotland www.scotland.gov.uk/Publications/Recent (care and social work) www.scotland.gov.uk/Resource/Doc/124015/0029863.pdf Wales http://new.wales.gov.uk/topics/health/?lang=en http://new.wales.gov.uk/about/departments/dhss/?lang=en Social care workforce www.dh.gov.uk/en/Policyandguidance/SocialCare/workforce/index.htm www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsLibrary/index.htm, searched 8/2/08. Other UK sites General Social Care Council www.gscc.org.uk/News+and+events/Consultations/Roles+and+Tasks+of+social+work/ HEA/SWAP www.swap.ac.uk/ (searched 7/2/08) Joint Social Work Education Council (JSWEC) (searched 7/2/08, from 2005 to present) www.jswec.co.uk Social Care Institute for Excellence (SCIE) (searched 7/2/08) www.scie.org.uk/ Age Concern (searched 8/2/08) www.ageconcern.org.uk Help the Aged Research (searched 8/2/08) www.helptheaged.org.uk/ US sites CSWE National Centre for Gerontological Social Work Education http://depts.washington.edu/geroctr/ Gero-rich/Hartford Foundation www.jhartfound.org/v1i3.htm

http://new.wales.gov.uk/topics/health/?lang=en

http://www.dh.gov.uk/en/Policyandguidance/SocialCare/workforce/index.htm

Where relevant policy documents have been found they are included in the review text. No other specific human growth and development and older people (HGDOP) documentation in addition to that which had been obtained by the other methods was discovered through this approach. Search strategy results: sources of reports A total of 727 citations were retrieved; with duplicates extracted, there were 540 unique citations. The table below shows the number of citations yielded from each source, both including and excluding duplicates. Citations retrieved by source Database Total citations

retrieved by search strategy (including duplicates)

Unique citations retrieved by search strategy

Social Care Online 131 131 Social Services Abstracts

182 136

ASSIA 171 98 PsycInfo (118) 118 76 AgeInfo 98 82 Handsearch 17 17 Total 727 540 Screening: inclusion and exclusion for thematic analysis The following figure provides a flow chart of the research review process to date, indicating inclusions, exclusions and number of remaining reports/studies at all stages. Titles and abstracts of all unique citations retrieved were screened to determine whether the full reports should be acquired.

Flowchart of research review process

Three-stage screening Papers identified where there is not immediate screening (eg electronic

searching, secondary refs)


One-stage screening Papers identified in ways that allow

immediate screening (eg handsearching)

Papers not obtained n = 7

First stage exclusion criteria* 1 n = 211 2 n = 242 3 n = 244 4 n = 363 5 n = 367 6 n = 43 7 n = 14 8 n = 1 9 n = 4 10 n = 0 * Not mutually exclusive

Duplicate references excluded


Included in review for thematic analysis

n = 24 studies (26 reports)

Full document screened

Title and abstract screening

710 17

123 reports obtained

In-depth review n = studies (5)


Second stage exclusion criteria* 1 n = 13 2 n = 17 3 n = 37 4 n = 78 5 n = 96 6 n = 1 7 n = 0 8 n = 0 9 n = 0 10 n = 0 * not mutually exclusive

Screening and filtering of reports The figure above illustrates the process of filtering reports, from searching to mapping. At the first exclusion stage, titles and abstracts were screened using the exclusion criteria set out in the review protocol. These were not mutually exclusive, and not coded sequentially or hierarchically; papers were excluded on all relevant counts. The first stage exclusion criteria are as shown in the table below. Exclusion criteria Criterion

label* Criterion details

1 Not social work education

2 Not qualifying level social work education

3 Not focused on social work education and older people

4 Not focused on social work education about HGD

5 Not focused on social work education about HGDOP

6 Training material/textbook

7 Book review

8 Bibliography

9 Journalism/bulletin

First stage

10 Language other than English

Second stage

First stage criteria re-applied to full document

As indicated in the figure above, the majority of exclusions at this stage (410) were made on the bases that reports were not focused on social work education about HGDOP (367), not focused on social work education about HGD (363) or not about social work education and older people (244). As a result, 130 reports remained to be screened, on the basis of the full paper. First stage screening indicated that, from the title and abstract alone, it was difficult to interpret whether HGD in relation to older people was the focus of many papers. The reviewers erred on the side of inclusion at this stage, identifying 130 reports for further screening, using the same inclusion and exclusion criteria, on the basis of the full paper at the second stage. Seven papers could not be retrieved, leaving 123 papers retrieved. As expected, the majority of second stage exclusions were made on the bases that papers did not focus on social work education about HGDOP (n = 97), or did not focus on social work education about HGD at all (n = 78). Twenty-six papers met the criteria for inclusion in the review. Four of these reported on the same two studies; two reports were therefore treated as linked, and integrated in keywording of one ‘lead’ report per study. At this stage, both empirical and non-empirical studies were included. It should also be noted that at least 15 of these studies reported on one or more of the 67 ‘Gero-rich’ initiatives52 instigated with the support of the Council of Social Work Education (CSWE) in the US and funded, or part-funded by a US charitable foundation, the Hartford Foundation. Aside from two of the four studies identified as linked above, the empirical and theoretical reports relating to this initiative have taken place on different sites and by different research teams and authors. They were therefore treated as separate reports. Five empirical studies were identified for consideration.1–5

Achieving a reliable definition of what constitutes empirical and non-empirical research in this field was not easy, since many papers border between accounts of education practice /routine course evaluation and descriptive or evaluative research. Quality assurance The review team endeavoured to achieve consistency and reliability at all stages as follows: • Screening of titles and abstracts (first stage): 20% of all first stage screening was

undertaken independently by two members of the review team, achieving 93% reliability. Where there was uncertainty or discrepancy in reviewer judgements these were addressed in team discussion and agreement reached.

• Screening of full reports: 100% of the full reports were double-screened separately by two reviewers, achieving 90% reliability. Any disagreements or difficulties in application of inclusion/exclusion criteria were resolved in discussion.

• Keywording studies: Two research team members piloted the keywording strategy to establish consistency by independently coding five full reports (20%), then conferring to establish reliability. Uncertainty or discrepancy between reviewers’ judgements was addressed in team discussion, to achieve clarification and consensus.

Appendix 4: Keywording and data extraction strategies Keywording strategy IItem Code Text Linked reports • Not linked

• Linked Give details

Status • Published • In press

Location • UK • Europe • USA • Australia • Other (please

specify) • Not specified

Give details

Type of study • Empirical – evaluation

• Empirical – descriptive

• Non-empirical – descriptive

• Non-empirical – other

Give details

Summary (brief outline of topic, findings, arguconclusions – no more than 100 wo

Give details

HGDOP programme/course name, location and type (eg undergraduate/postgraduate)

• Programme details

• N/A • Improving

• Give details

Aims of HGDOP teaching and learning (explicit or implicit) (tick all that apply)

understanding of human development and older people

• Changing attitudes towards older people in context of human development

• Improving quality of practice

• Improving outcomes for users and carers

• Other • Not specified

Professional focus (tick all that apply)

• Uni-professional learning

• Inter-professional learning

• Not specified

Give details

HGDOP process focus (tick all that apply)

• Teaching and learning

• Assessment • Course

management/ organisation


Give details

Participants in HGDOP organisation/management (tick all that apply)

• Social work educators

• Other educators • Social work

practitioners – managers (including practice assessors)

• Other practitioners – managers • Users/carers/

community members

• Other • Not specified/n/a

Give details

Participants in HGDOP

teaching/learning/assessment (tick all that apply)

• Social work educators

• Other educators • Social work

practitioners – managers (including practice assessors)

• Other practitioners – managers • Users/carers/

community members

• Other • Not specified/n/a

Give details

Pedagogical methods (tick all that apply)

• Formal didactic/ received learning

• Group work • Enquiry/problem-

based learning • Classroom-based

experiential learning • Practice learning • Other • Not specified

Give details

HGDOP setting (tick all that apply)

• Classroom/higher education institute (HEI)

• Practice learning • Both • Other • Not specified

Give details

Curriculum organisation (tick all that apply)

• Topic-based • Theory-based • Linear/sequential • Rights-based • Other • Not specified

Give details

HGDOP curriculum

content (academic or practice earning) (tick all that apply)

• Developmental processes

• Positive ageing • Values/attitudes/

anti-oppressive practice (AOP)

• Skills work • Professional

practice/teamwork • Reflective or

evidence-based practice


Give details

Status of HGDOP initiative(s) (tick all that apply)

• Brief discrete initiative eg one visit/session

• Substantial discrete initiative eg significant module component

• Embedded in other modules • Not specified/n/a

Stage of student education (tick all that apply)

• Early (eg first year • Undergraduate/Ma

ster’s • Middle (eg second

year undergraduate)

• Late (final year) • Throughout • Not specified/n/a

Theory/concepts in

use (state if explicit or mplicit) (tick all that apply)

• Psychological • Sociological • Psychosocial • Socio/biological • Ecological/systems • Equalities/rights-based • Critical gerontology • Other • None specified

Key informants of study (tick all that apply)

• Students • Educators • Practitioners/managers • Users/carers • Author only • Other • Unclear

Give details

Main HGDOP outcomes considered in study (tick all that apply)

• Participant reactions • Changed attitudes/perceptions • Acquisition of knowledge/

understanding • Acquisition of skills • Improved professional

behaviour/quality of practice • Improved outcomes for

users/carers • Other • Not specified/n/a

Give details

Main findings/claims about HGDOP

• Predominantly positive • Predominantly negative • Inconclusive /mixed • Other • N/A

Give details

Suitable for data extraction

• Yes • Possible (why?) • No (why?)

Give details

Data extraction strategy

Section A: Administration details A.1. Name of reviewer A.1.1. Please specify A.2. Date of review A.2.1. Please specify A.3. Title of main paper and date of publication A.3.1. Please specify A.4. Author(s) A.4.1. Please specify A.5. Linked reports A.5.1. Details A.5.2. Not applicable (no linked reports) Section B: Study aim(s), rationale and research questions B.1. Please describe the study’s aims and research questions B.1.1. Details Section C: Nature of education intervention C.1. Please outline the type of education intervention with which the study is concerned (eg course/module type, level, participants, mode of delivery, primary focus) C.1.1. Details C.1.2. Not applicable (not focused on specific education intervention) C.2. Does the education intervention draw on any theoretical/conceptual frameworks? Please give details C.2.1. Details C.2.2. Not applicable (no theoretical/conceptual frameworks identified)

Section D: Nature of study D.1. Which study type and design does this report describe? (eg descriptive; pre and/or post test evaluation; comparison/controls) D.1.1. Details D.2. Which variables does the study seek to measure or examine? (please specify whether measured or not) D.2.1. Baseline characteristics (of sample) D.2.2. Intervention characteristics D.2.3. Outcomes D.2.4. Facilitators/barriers D.2.5. Other D.2.6. Not stated/unclear D.3. Are comparisons made between two or more groups? (please give details eg number of groups, basis for allocation and/or comparison of groups) D.3.1. Details D.3.2. Not applicable (not more than one group) D.4. What is the sampling strategy? (eg how is the sample selected, is it intended to be representative) D.4.1. Details D.4.2. Not stated/unclear D.5. How were participants recruited? (comment on incentives, consent etc) D.5.1. Details D.5.2. Not stated/unclear D.6. What was the sample size/number of study participants? D.6.1. Details D.6.2. Not stated/unclear D.7. What were the participant characteristics? (eg age, gender, ethnicity, academic

level) D.7.1. Details D.7.2. Not stated/unclear D.8. Who collected the data? (eg independent researcher, educator) D.8.1. Details D.8.2. Not stated/unclear D.9. Which methods were used to collect the data? (eg routine formal/informal course evaluation, research interview/questionnaire/focus group; research tools used, etc) D.9.1. Details D.9.2. Not stated/unclear D.10. Please comment on reliability and validity of data collection methods D.10.1. Details D.11. What are the main methods of analysis used in the study? D.11.1. Details D.11.2. Not stated/unclear D.12. Please comment on reliability and validity of data analysis methods D.12.1. Details Section E: Findings and conclusions E.1. Please summarise the findings of the study (indicating if possible where positive/negative mixed/other, where statistically significant) E.1.1. Outcomes of education intervention E.1.2. Facilitators/barriers to HGDOP E.1.3. Other E.2. Please summarise the conclusions/recommendations of the study

E.2.1. Details E.2.2. Not stated/unclear Section F: Quality and relevance of the study F.1. Please comment on strengths and limitations of the study in addressing its own questions F.1.1. Quality of reporting (including bias, gaps) F.1.2. Choice of research design F.1.3. Sampling F.1.4. Data collection methods (including reliability, validity) F.1.5. Data analysis methods (including reliability, validity) F.1.6. Ethics F.2. Weight of evidence A: taking account of all quality assessment issues, can the study findings be trusted in answering the study’s own question or sub-question(s)? F.2.1. High trustworthiness F.2.2. Medium trustworthiness F.2.3. Low trustworthiness F.3. Weight of evidence B: how appropriate is the design of this study for addressing the question(s) of this particular review? F.3.1. High appropriateness F.3.2. Medium appropriateness F.3.3. Low appropriateness F.4 Weight of evidence C: how relevant is the particular focus of this study for addressing the question(s) of this particular review? (conceptual, type and context of intervention and respondents, type of outcomes considered etc) F.4.1. High relevance F.4.2. Medium relevance F.4.3. Low relevance

F.5. Weight of evidence D: taking into account weights of evidence A, B and C, what is the overall weight of evidence this study provides to answer the question(s) of this particular review? F.5.1. High weight of evidence (please specify) F.5.2. Medium weight of evidence (please specify) F.5.3. Low weight of evidence (please specify)

App

endi

x 5:

Dat

a ex

trac

ted

stud

ies

Stud

y A

ims

of th

e st

udy

HG

DO

P in

terv

entio

n St

udy

desi

gn

Find

ings

and

con

clus

ions

B

irken

mai

er,

J., B

ehrm

an,

G. a

nd B

erg-

Weg

er, M

. (2

005)

1 Lo

w w

eigh

t of

evi

denc

e

• To

pro

vide

a

fram

ewor

k fo

r exp

lorin

g an

d in

tegr

atin

g sp

iritu

al

belie

fs in

ser

vice

pr

ovis

ion

for o

lder

pe

ople

. •

To p

rovi

de a

n ov

ervi

ew

of s

pirit

ual a

spec

ts o

f hu

man

dev

elop

men

t an

d in

form

atio

n ab

out

the

inte

grat

ion

of

agei

ng a

nd s

pirit

ualit

y.

• To

enc

oura

ge s

tude

nt

self-

refle

ctio

n ab

out

spiri

tual

ity a

nd it

s im

pact

on

thei

r pr

ofes

sion

al p

ract

ice.

•

Mor

e ge

nera

lly to

im

prov

e un

ders

tand

ing

of h

uman

dev

elop

men

t an

d ol

der p

eopl

e.

• U

S-b

ased

stu

dy. A

dis

cret

e an

d vo

lunt

ary

mod

ule

linke

d to

the

prac

ticum

of a

soc

ial

wor

k pr

ogra

mm

e, in

clud

ing

both

und

ergr

adua

tes

and

post

grad

uate

s.

• P

rovi

ded

by a

cade

mic

sta

ff,

parti

cipa

nts

are

stud

ents

and

fie

ld in

stru

ctor

s, fr

om a

rang

e of

pla

cem

ent s

ettin

gs fo

r ol

der p

eopl

e.

• E

xplo

res

spiri

tual

bel

iefs

in

serv

ice

prov

isio

n fo

r old

er

peop

le, t

he s

pirit

ual a

spec

ts

of h

uman

dev

elop

men

t and

is

sues

of i

nteg

ratio

n of

ag

eing

and

spi

ritua

lity

to

prom

ote

posi

tive

agei

ng.

• In

clud

es s

tude

nt s

elf-

refle

ctio

n on

spi

ritua

lity

and

its im

pact

on

thei

r pr

ofes

sion

al p

ract

ice.

•

Invo

lves

thre

e fo

ur-h

our

grou

p se

ssio

ns in

join

t st

uden

t/pra

ctic

e te

ache

r gr

oups

. •

Incl

udes

: pre

-rea

ding

, m

edita

tions

, sel

f-ref

lect

ion

and

ques

tions

cha

lleng

ing

‘bin

ary

thin

king

’ abo

ut

spiri

tual

ity a

nd a

gein

g.

• N

on-e

xper

imen

tal

desi

gn, p

re-te

st,

post

-test

usi

ng

ques

tionn

aire

, plu

s po

st-te

st fo

cus

grou

ps (o

ne fo

r st

uden

ts, o

ne fo

r fie

ld in

stru

ctor

s).

• C

onve

nien

ce s

ampl

e of

eig

ht s

tude

nts

and

thei

r eig

ht fi

eld

inst

ruct

ors.

•

Qua

ntita

tive

and

qual

itativ

e an

alys

is

of th

e im

pact

of t

he

mod

ule

on s

tude

nts’

an

d fie

ld in

stru

ctor

s’

attit

udes

and

ski

lls.

• Th

e qu

estio

nnai

re

was

not

test

ed fo

r re

liabi

lity

or v

alid

ity.

How

ever

, the

au

thor

s tri

angu

late

d th

is w

ith fo

cus

grou

p da

ta to

hel

p fle

sh o

ut

inte

rnal

val

idity

. •

The

auth

ors

who

fa

cilit

ated

the

focu

s gr

oups

wer

e no

t the

ed

ucat

ors

invo

lved

in

the

clas

sroo

m

The

findi

ngs

wer

e pr

edom

inan

tly p

ositi

ve.

Stu

dent

s an

d fie

ld in

stru

ctor

s re

porte

d:

• in

crea

sed

awar

enes

s of

the

valu

e of

fo

cusi

ng o

n sp

iritu

ality

in a

sses

smen

t and

w

ork

with

old

er p

eopl

e •

an in

crea

sed

feel

ing

of c

ompe

tenc

e to

pe

rform

a s

pirit

ual i

nter

vent

ion

• gr

eate

r willi

ngne

ss to

rais

e is

sues

of

spiri

tual

ity in

pra

ctic

e.

Fiel

d in

stru

ctor

s re

com

men

ded

the

intro

duct

ion

of a

spi

ritua

lity

mod

ule

rele

vant

to a

ll cl

ient

gr

oups

. How

ever

: •

in q

ualit

ativ

e fo

cus

grou

ps, s

tude

nts

still

in

dica

ted

som

e le

vel o

f dis

com

fort

in

inte

grat

ing

lear

ning

into

dire

ct p

ract

ice

• st

uden

ts g

ave

very

littl

e re

port

of a

ctua

lly

havi

ng u

sed

any

spiri

tual

as

sess

men

t/int

erve

ntio

n in

thei

r pra

ctic

e.

Faci

litat

ors:

stu

dent

s fo

und

the

use

of g

uide

d m

edita

tions

, dire

ct w

ork

with

old

er p

eopl

e an

d m

odel

ling

asse

ssm

ent s

kills

ver

y he

lpfu

l. B

arrie

rs: t

hey

iden

tifie

d in

stitu

tiona

l bar

riers

to

inco

rpor

atin

g sp

iritu

ality

into

ass

essm

ent a

nd

prac

tice

incl

udin

g:

• bu

reau

crat

ic o

bsta

cles

and

lack

of t

ime

• th

e ne

ed fo

r coo

rdin

atio

n an

d co

nsen

sus

betw

een

prof

essi

onal

s in

mul

ti-pr

ofes

sion

al

setti

ngs.

sses

smen

t for

mat

. se

ssio

ns.

Stud

y A

ims

of th

e st

udy

HG

DO

P in

terv

entio

n St

udy

desi

gn

Find

ings

and

con

clus

ions

B

row

ne,

C.,

Bra

un,

K.,

Mok

uau,

N.

and

McL

augh

lin, L

. (20

02)2

Med

ium

w

eigh

t of

evid

ence

To d

escr

ibe

the

deve

lopm

ent o

f a

curr

icul

um a

nd

cour

se, w

hich

aim

s to

: •

impr

ove

stud

ent

unde

rsta

ndin

g of

hu

man

de

velo

pmen

t an

d ol

der

peop

le, i

nclu

ding

no

rmal

age

ing,

an

d m

ajor

ps

ycho

soci

al

issu

es

• im

prov

e un

ders

tand

ing

of

the

ecol

ogic

al

mod

el, s

treng

ths

pers

pect

ive

and

empo

wer

men

t th

eory

•

incr

ease

kn

owle

dge

abou

t di

vers

e cu

lture

s •

deve

lop

skills

in

cultu

ral

com

pete

nce

and

the

awar

enes

s of

th

e im

pact

of

agei

sm o

n st

uden

ts’

prac

tice.

US

-bas

ed in

itiat

ive

to d

evel

op a

se

t of c

ompe

tenc

ies

in a

nd

curri

culu

m fo

r cul

tura

lly

com

pete

nt in

terd

isci

plin

ary

prac

tice

with

old

er p

eopl

e.

Focu

s is

on

lear

ning

and

de

velo

pmen

t bot

h of

stu

dent

s (M

SW

) and

pra

ctiti

oner

s. T

he

cour

se w

as a

n el

ectiv

e fo

r soc

ial

wor

k st

uden

ts, w

orki

ng w

ith

olde

r peo

ple.

In

itiat

ive

deve

lope

d an

d m

anag

ed in

par

tner

ship

with

ag

enci

es.

The

initi

ativ

e in

clud

es:

• 13

-wee

k fie

ld-b

ased

cu

rric

ulum

for s

tude

nts

durin

g th

eir p

ract

ice

plac

emen

t, to

pro

vide

co

ntin

uing

edu

catio

n to

all

proj

ect p

artn

ers

incl

udin

g fie

ld in

stru

ctor

s. T

he

curr

icul

um in

clud

ed

prac

tice-

base

d se

min

ars

prov

idin

g op

portu

nitie

s to

pr

actic

e as

sess

men

t ski

lls

usin

g ca

se s

tudi

es

• tw

o un

iver

sity

-bas

ed

requ

ired

mod

ules

for t

he

agei

ng e

lect

ive

incl

udin

g:

norm

al a

gein

g, a

sses

smen

t an

d in

terv

entio

n pl

us a

new

el

ectiv

e ‘D

iver

sity

and

the

This

stu

dy is

pr

edom

inan

tly d

escr

iptiv

e of

a m

ulti-

stra

nded

ap

proa

ch to

ge

ront

olog

ical

edu

catio

n.

How

ever

, it a

lso

incl

udes

an

ele

men

t of

inde

pend

ent e

valu

atio

n.

• P

re a

nd p

ost-t

est

ques

tionn

aire

s w

ith

smal

l stu

dent

sam

ple

(n =

12)

from

one

20

00–0

1 co

hort.

•

Eva

luat

ion

focu

ses

on

the

deve

lopm

ent o

f kn

owle

dge

and

skill

s re

late

d to

cul

tura

l co

mpe

tenc

y, a

nd

inte

r-dis

cipl

inar

y w

ork.

•

The

eval

uatio

n al

so

draw

s on

a s

urve

y of

an

d in

terv

iew

s w

ith

the

proj

ect t

eam

and

pr

ojec

t par

ticip

ants

al

thou

gh n

o de

tails

ab

out t

he s

urve

y ar

e pr

ovid

ed.

• Li

ttle

info

rmat

ion

prov

ided

abo

ut d

ata

colle

ctio

n m

etho

ds o

n w

hich

to ju

dge

relia

bilit

y or

val

idity

.

Pre

dom

inan

tly p

ositi

ve fi

ndin

gs

All

12 s

tude

nts

in th

e sa

mpl

e re

port:

•

feel

ing

com

pete

nce

and

conf

iden

ce

abou

t ‘in

terv

enin

g w

ith A

sian

and

P

acifi

c Is

land

er e

lder

s an

d ol

der

wom

en’

• co

nfid

ence

abo

ut th

eir r

ole

in in

ter-

disc

iplin

ary

team

s, a

nd in

inte

rvie

win

g sk

ills

• th

ey u

nder

stoo

d no

rmal

age

ing,

and

th

e ap

plic

atio

n of

the

ecol

ogic

al m

odel

, em

pow

erm

ent t

heor

y an

d th

e st

reng

ths

pers

pect

ive

• 11

/12

felt

they

wer

e kn

owle

dgea

ble

abou

t com

mon

eth

ical

dile

mm

as fa

ced

in e

lder

car

e •

11/1

2 al

so c

laim

ed to

und

erst

and

thei

r ro

les

in p

olic

y an

alys

is, p

rogr

amm

e ev

alua

tion

and

reso

urce

dev

elop

men

t •

7/12

felt

com

pete

nt to

ass

ess

elde

r ab

use;

or f

elt k

now

ledg

eabl

e ab

out t

he

full

rang

e of

soc

ial w

ork

inte

rven

tions

w

ith o

lder

peo

ple.

C

onso

rtium

mem

bers

are

repo

rted

to h

ave

felt

a ‘h

igh

leve

l of s

atis

fact

ion

with

all

proj

ect a

ctiv

ities

’. Fa

cilit

ator

s: th

e st

rong

com

mitm

ent o

f all

com

mun

ity p

artn

ers.

B

arrie

rs: s

usta

inab

ility

and

reso

urce

im

plic

atio

ns –

initi

ativ

es li

ke th

is re

quire

the

infu

sion

of m

onie

s to

sup

port

the

wor

k of

th

e pr

actit

ione

rs in

volv

ed, a

nd a

llow

som

e bu

y-ou

t of f

acul

ty to

sup

port

the

proj

ect.

* A

gein

g E

xper

ienc

e’.

• N

o di

scus

sion

of p

re-

test

sco

res

or c

hang

e ov

er ti

me.

Stud

y A

ims

of th

e st

udy

HG

DO

P in

terv

entio

n St

udy

desi

gn

Find

ings

and

con

clus

ions

D

ieps

tra, S

.A.

and

Am

es, N

. (2

006)

3 M

ediu

m w

eigh

t of

evi

denc

e

• To

eva

luat

e ho

w

invo

lvem

ent i

n an

or

al h

isto

ry p

roje

ct

with

old

er a

dults

in

fluen

ced:

•

stud

ents

’ pe

rson

al

awar

enes

s •

unde

rsta

ndin

g of

lif

espa

n de

velo

pmen

t •

know

ledg

e ab

out

old

age.

•

To in

corp

orat

e ke

y te

achi

ng a

nd

lear

ning

con

cept

s in

to h

uman

be

havi

our i

n th

e so

cial

env

ironm

ent

(HB

SE

) mod

ules

. •

To s

truct

ure

an

assi

gnm

ent t

o en

sure

that

st

uden

ts

dem

onst

rate

d sy

stem

atic

kn

owle

dge

abou

t so

cial

and

pol

itica

l co

ntex

ts a

nd

awar

enes

s of

how

ol

der p

eopl

e de

velo

ped

mea

ning

in th

eir

• U

S-b

ased

pro

ject

w

hich

requ

ired

stud

ents

to b

e pa

ired

with

an

olde

r per

son

to ta

ke p

art i

n a

sem

este

r-lo

ng o

ral

hist

ory

proj

ect.

• Th

e st

uden

ts w

ere

enro

lled

on th

e fir

st

year

soc

ial w

ork

prog

ram

me

in tw

o un

iver

sitie

s. T

his

proj

ect w

as in

clud

ed

in th

e H

BS

E m

odul

e.

• Th

e ol

der p

eopl

e w

ere

volu

ntee

rs fr

om

adul

t day

car

e fa

cilit

ies

or li

ving

in

resi

dent

ial c

are

hom

es.

• B

efor

e th

e pr

ojec

t st

arte

d st

uden

ts w

ere

prep

ared

thro

ugh

ques

tion

and

answ

er

sess

ions

, inc

ludi

ng

info

rmat

ion

abou

t co

nfid

entia

lity

and

inte

rvie

win

g te

chni

ques

. •

Dis

cuss

ions

and

as

sign

men

ts in

clud

ed

refle

ctiv

e jo

urna

ls to

fa

cilit

ate

the

• Q

uant

itativ

e an

d qu

alita

tive

eval

uatio

n,

pre

and

post

-test

sel

f-re

port

usin

g co

nven

ienc

e sa

mpl

e of

63

stud

ents

. All

63

com

plet

ed p

re-te

st,

60 c

ompl

eted

pos

t-te

st.

• U

ses

adap

tatio

n of

st

anda

rdis

ed

ques

tionn

aire

use

d by

H

ertfo

rd G

eri

Enr

ichm

ent p

roje

ct.

• E

xam

ines

pro

cess

ou

tcom

es (s

tude

nt

feed

back

on

the

cour

se) a

nd c

hang

es

in s

tude

nt a

ttitu

des

and

know

ledg

e.

• N

o co

mpa

rison

or

cont

rol g

roup

. •

Sam

ple

appe

ars

to b

e m

ost o

f the

rele

vant

st

uden

t pop

ulat

ion.

Th

e sa

mpl

e is

mai

nly

fem

ale

and

alm

ost a

ll w

hite

. Aut

hors

say

th

is is

repr

esen

tativ

e of

the

stud

ent

popu

latio

n,

pres

umab

ly a

t the

two

univ

ersi

ties.

Find

ings

wer

e m

ixed

, and

qua

litat

ivel

y m

ore

posi

tive

abou

t stu

dent

per

cept

ions

of t

he

cour

se, t

han

quan

titat

ivel

y in

cha

ngin

g at

titud

es o

r int

eres

t. N

o si

gnifi

cant

cha

nge

pre

to p

ost-t

est i

n th

ree

of th

e fo

ur q

uant

itativ

e m

easu

res

of

stud

ent a

ttitu

de:

• to

war

ds o

lder

adu

lts

• in

tere

st in

lear

ning

mor

e ab

out o

lder

ad

ults

•

inte

rest

in w

orki

ng w

ith o

lder

adu

lts.

Qua

litat

ive

data

sug

gest

a s

igni

fican

t im

prov

emen

t in

stud

ent s

elf-p

erce

ptio

ns o

f th

eir a

bilit

y to

wor

k w

ith o

lder

adu

lts

(how

ever

, thi

s is

per

ceiv

ed a

bilit

y, o

r co

nfid

ence

, rat

her t

han

actu

al a

bilit

y).

Stu

dent

s w

ere

mos

t pos

itive

abo

ut:

• th

eir d

evel

opin

g ab

ility

to c

omm

unic

ate

with

old

er p

eopl

e •

thei

r lea

rnin

g ab

out t

hem

selv

es (t

heir

own

inte

rper

sona

l ski

lls, c

hara

cter

istic

s,

valu

es a

nd p

refe

renc

es)

• im

prov

ed u

nder

stan

ding

of t

he e

ffect

s of

age

, rac

e, e

thni

city

, rel

igio

n, c

ultu

re

and

soci

al c

lass

on

deve

lopm

ent a

cros

s th

e lif

espa

n.

Bar

riers

: the

logi

stic

s of

vis

its w

ere

diffi

cult

to m

anag

e an

d st

uden

t fee

dbac

k su

gges

ted

the

need

for i

mpr

oved

arr

ange

men

ts fo

r se

lect

ing

and

scre

enin

g pr

ospe

ctiv

e or

al

hist

ory

partn

ers.

lives

.

inte

grat

ion

of

clas

sroo

m m

ater

ial

with

ora

l his

tory

le

arni

ng.

• A

ssig

nmen

ts in

clud

ed

prod

ucin

g ge

nogr

ams,

eco

map

s an

d tim

e lin

es s

hare

d w

ith th

e st

uden

ts’ o

ral

hist

ory

partn

ers.

Stud

y A

ims

of th

e st

udy

HG

DO

P in

terv

entio

n St

udy

desi

gn

Find

ings

and

con

clus

ions

D

orfm

an, L

.T.,

Eva

ns, R

.J.,

Ingr

am, J

.G.

and

Mur

ty, S

. (2

002)

4 H

igh

wei

ght o

f ev

iden

ce

• U

S-b

ased

stu

dy

that

aim

s to

de

scrib

e an

d ev

alua

te a

se

rvic

e le

arni

ng

initi

ativ

e as

par

t of

an

intro

duct

ory,

in

terd

isci

plin

ary

cour

se o

n ge

ront

olog

ical

so

cial

wor

k.

• S

ervi

ce le

arni

ng

inte

rven

tion

aim

s to

impr

ove

unde

rsta

ndin

g,

and

chan

ge

stud

ent a

ttitu

des

to o

lder

peo

ple

in

the

cont

ext o

f hu

man

de

velo

pmen

t. •

Stu

dent

s ar

e en

gage

d in

one

-to

-one

con

tact

w

ith o

lder

peo

ple

in a

rura

l co

mm

unity

se

tting

.

• A

n op

tiona

l sem

este

r-lo

ng s

ervi

ce le

arni

ng

proj

ect e

mbe

dded

in

an in

trodu

ctor

y in

ter-

disc

iplin

ary

gero

ntol

ogy

cour

se.

• It

incl

udes

stu

dent

s fro

m s

ocia

l wor

k an

d ot

her d

isci

plin

es.

• Th

e co

urse

cov

ers

biol

ogic

al, s

ocia

l, an

d ps

ycho

logi

cal a

gein

g.

• Th

irtee

n se

rvic

e le

arni

ng s

tude

nts

wer

e re

crui

ted

and

train

ed. T

hey

wer

e pa

ired

with

old

er

peop

le in

nur

sing

ho

mes

or s

emi-

inde

pend

ent l

ivin

g in

a

smal

l rur

al to

wn.

•

The

focu

s is

on

prep

arat

ion

and

supp

ort o

f stu

dent

s en

gage

d in

ex

perie

ntia

l lea

rnin

g th

roug

h co

mpl

etin

g or

al h

isto

ry p

roje

cts.

•

Stu

dent

s m

ake

four

fo

ur-h

our v

isits

in

clud

ing

visi

ting

soci

al c

are

reso

urce

s fo

r old

er p

eopl

e.

A q

uasi

-exp

erim

enta

l, pr

ospe

ctiv

e st

udy,

whi

ch

desc

ribes

and

eva

luat

es

the

impa

ct o

f a s

ervi

ce

lear

ning

initi

ativ

e.

It in

volv

es c

ompa

rison

on

stan

dard

ised

atti

tude

test

s be

twee

n:

• th

e ‘e

xper

imen

tal’

serv

ice

lear

ning

st

uden

t gro

up (S

L) (n

=

13) a

nd th

e co

ntro

l no

n-se

rvic

e le

arni

ng

grou

p (N

SL)

(n =

36)

ot

herw

ise

unde

rtaki

ng th

e sa

me

cour

se

• pr

e an

d po

st-te

st

com

paris

on w

ithin

an

d be

twee

n gr

oups

. A

dditi

onal

qua

litat

ive

data

co

llect

ed:

• fro

m p

re a

nd p

ost-t

est

ques

tionn

aire

s to

se

rvic

e le

arni

ng

stud

ents

abo

ut th

eir

attit

udes

and

the

perc

eive

d va

lue

of th

e pr

ojec

t •

from

par

ticip

atin

g ol

der

peop

le in

terv

iew

ed

abou

t the

ir re

flect

ions

on

the

expe

rienc

e.

Pre

dom

inan

tly p

ositi

ve fi

ndin

gs:

• be

twee

n pr

e an

d po

st-te

st (i

mpr

ovem

ent

in a

ttitu

des

for a

ll st

uden

ts p

ost-t

est)

• be

twee

n S

Ls a

nd N

SLs

(SLs

had

a

slig

htly

gre

ater

impr

ovem

ent i

n at

titud

es)

• qu

alita

tive

feed

back

from

SL

stud

ents

w

as p

rimar

ily p

ositi

ve; f

rom

old

er

parti

cipa

nts

the

feed

back

was

who

lly

posi

tive.

Th

ere

wer

e fe

w d

iffer

ence

s at

pre

-test

be

twee

n th

e S

L gr

oup

and

mat

ched

gro

up. A

t po

st-te

st:

• th

e S

Ls w

ere

mar

gina

lly m

ore

posi

tive

on

the

‘Gen

eral

Atti

tude

s to

war

ds th

e E

lder

ly

Sca

le’

• th

e S

Ls h

ad m

argi

nally

mor

e po

sitiv

e at

titud

es to

war

ds w

orki

ng w

ith o

lder

pe

ople

than

the

NS

Ls.

SL

stud

ents

’ ref

lect

ions

on

the

lear

ning

ex

perie

nce:

•

the

maj

ority

of S

Ls re

porte

d en

hanc

emen

t of

cla

ss le

arni

ng, r

epor

ting

incr

ease

d kn

owle

dge

and

unde

rsta

ndin

g, p

artic

ular

ly

abou

t eld

ers

from

rura

l com

mun

ities

•

the

maj

ority

wer

e po

sitiv

e or

acc

eptin

g ab

out t

heir

own

agei

ng.

The

olde

r peo

ple

wer

e al

l pos

itive

abo

ut th

e ex

perie

nce,

par

ticul

arly

the

reci

proc

al

inte

ract

ion.

The

y di

d no

t mak

e an

y re

com

men

datio

ns a

bout

the

futu

re o

f the

co

urse

. Fa

cilit

ator

s an

d ba

rrie

rs: s

tude

nts

valu

ed th

e se

rvic

e le

arni

ng e

xper

ienc

e bu

t had

con

cern

s

• S

tude

nts

keep

wee

kly

refle

ctiv

e jo

urna

ls a

nd

mak

e pr

esen

tatio

ns to

th

e w

hole

cla

ss.

abou

t add

ition

al ti

me

and

wor

kloa

d re

quire

d.

Stud

y A

ims

of th

e st

udy

HG

DO

P in

terv

entio

n St

udy

desi

gn

Find

ings

and

con

clus

ions

G

ray,

J.I.

and

Kab

adak

i, K

. (2

005)

5 Lo

w w

eigh

t of e

vide

nce

• Th

e ai

ms

of th

is U

S-ba

sed

stud

y ar

e to

de

scrib

e in

det

ail a

st

reng

ths-

base

d H

SBE

curri

culu

m.

• Th

e cu

rric

ulum

is

desi

gned

to h

elp

stud

ents

to:

• und

erst

and

hum

an

deve

lopm

ent a

nd

func

tioni

ng

(par

ticul

arly

hu

man

re

latio

nshi

ps)

• app

ly h

uman

be

havi

our

know

ledg

e to

in

crea

se s

elf-

awar

enes

s an

d pe

rson

al a

nd

prof

essi

onal

de

velo

pmen

t • i

ncor

pora

te a

st

reng

ths

pers

pect

ive

to

help

them

im

prov

e th

eir

know

ledg

e ab

out

and

skills

in

asse

ssin

g ol

der

adul

ts.

A c

lass

room

-bas

ed H

BS

E

curri

culu

m fo

r sec

ond

year

un

derg

radu

ate

stud

ents

. Th

e ra

nge

of te

achi

ng a

nd

lear

ning

act

iviti

es in

clud

es:

• th

e us

e of

vid

eo c

lips

and

dram

atic

vig

nette

s to

ill

ustra

te p

ositi

ve a

gein

g •

time

line

exer

cise

s en

ablin

g st

uden

ts to

th

ink

abou

t the

ir fu

ture

an

d to

iden

tify

wis

hes

and

conc

erns

•

deve

lopm

enta

l mile

ston

e pr

esen

tatio

ns

• co

ntrib

utio

ns b

y ol

der

adul

ts (‘

elde

rs a

s ex

perts

’) •

stud

ents

und

erta

ke

obse

rvat

ions

at d

ay

cent

res

and

repo

rt ba

ck

to th

e cl

ass

• st

uden

ts c

ompl

ete

an

indi

vidu

al in

terv

iew

with

an

old

er p

erso

n to

ex

plor

e th

eir l

ife

expe

rienc

es a

nd

deve

lopm

ent

• an

ong

oing

focu

s on

the

deve

lopm

ent o

f com

pute

r sk

ills a

nd re

sear

ch

com

pete

nce.

• P

rimar

ily a

des

crip

tive

stud

y w

ith li

mite

d de

tail

of th

e m

etho

ds o

f the

ev

alua

tion.

•

This

just

qua

lifie

s as

an

em

piric

al s

tudy

be

caus

e a

smal

l am

ount

of e

valu

atio

n da

ta a

re s

ourc

ed fr

om

stud

ents

. •

The

stud

y dr

aws

on

post

-test

que

stio

nnai

re

data

col

lect

ed fr

om

stud

ents

, and

als

o qu

alita

tive

stud

ent

eval

uatio

n co

mm

ents

. •

Littl

e de

tail

is g

iven

ab

out h

ow th

is m

ater

ial

has

been

col

lect

ed a

nd

anal

ysed

. •

Ref

eren

ce is

als

o m

ade

to a

sep

arat

e st

udy

in w

hich

this

co

urse

was

eva

luat

ed.

This

was

par

t of l

arge

r G

ero-

rich

pre

and

post

-test

eva

luat

ion

proj

ect.

No

deta

il is

gi

ven

abou

t tha

t stu

dy,

nor i

s it

refe

renc

ed, b

ut

men

tion

is m

ade

to it

s po

sitiv

e fin

ding

s in

te

rms

of a

chie

ving

The

findi

ngs

are

pred

omin

antly

pos

itive

. S

tude

nts

rate

d th

e us

eful

ness

of

cur

ricul

um a

ctiv

ities

and

as

sign

men

ts a

t 4.1

on

the

Like

rt 5-

poin

t sca

le.

Stu

dent

com

men

ts w

ere

also

re

porte

d as

‘con

sist

ently

po

sitiv

e’ a

bout

the

new

cu

rric

ulum

, par

ticul

arly

the

enha

nced

leve

l of

parti

cipa

tion

that

they

felt

impr

oved

thei

r cap

acity

to

reta

in k

now

ledg

e.

The

auth

ors

conc

lude

with

the

expr

esse

d ho

pe th

at th

e in

tegr

atio

n of

the

mod

ule

they

de

scrib

e in

to p

rogr

amm

e cu

rric

ula

will

: •

broa

den

stud

ents

' pe

rspe

ctiv

es

• de

velo

p th

eir a

bilit

ies

to

asse

ss o

lder

adu

lts

• en

able

stu

dent

s to

en

gage

in s

ocia

l wor

k pr

actic

e th

at in

clud

es

dial

ogue

and

focu

ses

on

stre

ngth

s an

d re

silie

nce,

no

t pat

holo

gy.

stud

ent a

ttitu

de

chan

ge.

Appendix 6: Definitions of theories and concepts adopted in the review Many studies made passing reference to the theoretical and conceptual approach informing the paper, often by listing a range of perspectives that were expected to inform students’ learning. Because of this lack of detailed attention it was difficult to categorise this area of the review, since the range of theoretical and conceptual perspectives mentioned as relevant in any one paper were not necessarily accompanied by related discussion or analysis. The following definitions were identified in the scoping study and subsequently refined for this review. Psycho-social Students learn from an approach which

emphasises the dynamic relationship between the whole person and the social context throughout the lifespan

Rights and equalities A rights and equalities approach provides a theoretical framework for students to learn how to practice anti-oppressively. There is a particular emphasis on anti-ageist approaches with an acknowledgement of the impact of interacting disadvantage

Ecological/systems approach Students learn from an ecological perspective linked to a lifespan approach. This includes knowledge of biological, sociological, cultural, psychological and spiritual development across the lifespan, social systems and their impact on the individual. At the end of the course, students should be able to ‘Critically appraise research and theories related to humans and their environment for use in generalist social work practice’ (5, p 56)

Socio-biological In this approach students learn about the interaction between biology and old age and how biological ageing interacts with structural factors

Critical gerontology Students learn by exploring the experience of older people including the physiological, psychological, sociological and political dimensions of later life and challenging dominant discourses that problematise old age

Sociological Students learn by exploring the political, economic and historical location of old age, including social roles and stratification

Psychological In this approach students focus more on developmental processes from an individual perspective, learning from the work of theorists such Erikson40, 41 and Levinson49

Appendix 7: Additional data from the 24 papers in the HGDOP map* * In this appendix the section numbers follow those in Section 3 of the main review with additional sub-sections included. To avoid confusion with the main review, tables are not numbered.

3.2. HGDOP studies: type and quality

3.2.1. Study location and publication Location of study Location of study Number of studies US 23 UK 1 All but one8 of the 24 included studies were from the US. All have been published. Most were published since 2000, with three older studies. The oldest study included was published in 1988.7

Publication date

Date of study Number of studies

2000 to present 21

1990–99 2

1980–89 1

3.2.2. Type of study Type of study Type of study Number of studies Empirical – evaluation 8 Empirical – descriptive 6 Non-empirical – descriptive 7 Non-empirical – other 3 Ten studies were designated either ‘non-empirical – descriptive’11, 13, 17, 18, 20, 23, 24 or ‘other’.16, 19, 22 In both these categories the papers focused mainly on explorations of curriculum initiatives, considering specific modules or the ‘infusion’ of material throughout the curriculum. Twenty of the 24 papers reported in this review described or evaluated pedagogical innovations. The remaining four papers8, 13, 18, 22 provided a critique of current human growth and development and older people (HGDOP) curricula with a more general discussion of the implications for the HGDOP curriculum.

Of these four papers, Chambers8 took a critical gerontological and feminist perspective; Sherr and Blumhardt22 challenged the adequacy of current theoretical frameworks to encompass the position of older rural women; Crewe13 argued for the inclusion of ethno-gerontological theories and Kane and Houston-Vega18 focused on the need for inclusion of dementia when exploring diversity. The definition of empirical studies arrived at was:

• giving some indication of research methodology (for example, who was researched, how)

and/or

• giving some data/findings that are clearly sourced from informants other than the author alone.

Only a minority of all studies reported focused solely on HGDOP. There was greater preoccupation with human growth and development as part of a wider concern to evaluate or describe gerontological initiatives. Of the eight empirical evaluation papers three had a primary focus on HGDOP3–5 or aspects of HGDOP.1 In the remaining papers in this group2, 10, 12, 15 HGDOP was included as part of a wider evaluation. A minority of studies1, 2–4, 15 sought to evaluate the effectiveness of initiatives, pre and post-test. Two studies5, 10 reported on a post-test evaluation only, although one of these,5 and another empirical study,12 referred to pre and post-test evaluations but did not supply details of one or both elements. Seven of the eight empirical studies reported on a substantial discrete initiative. The eighth15 explored an embedded approach. Slightly less than half of the empirically evaluated studies reported feedback from students. Dorfman et al4 was the only study to report feedback from users and carers. In the six papers identified as empirical descriptive there was little or no evaluation of data, although some outlined varying degrees of qualitative feedback.14, 25

Within all categories where the sample sizes were reported, they were mostly under 50. The only exceptions were Eun-Kuong et al,15 with a sample of 164 students, and Downey and Miles,14 which referred to an analysis of 150 student reports over five years.

3.3. Aims and theories of HGDOP 3.3.1. Aims of HGDOP teaching and learning

All studies identified at least one aim in relation to HGDOP. All but one paper21 indicated more than one teaching and learning aim.

Aims of HGDOP teaching and learning* Aims of HGDOP teaching and learning Number of

studies Improving understanding of human development and older people 22 Improving quality of practice 17 Changing attitudes towards older people in context of human development

16

Other 8 Improving outcomes for users and carers 6 Note: * Not mutually exclusive.

As the table above demonstrates, the most frequently cited aim was to improve understanding of HGDOP, cited explicitly in all but two papers.16, 21 Papers varied greatly in the level of detail provided in relation to this aim. For example, Dorfman et al4 mentioned as an aim that students ‘learn about’ older people in rural communities while Diepstra and Ames (3, p 117) reported that, ‘The assignment was structured to allow students to explore systematically how the older narrators ... developed meaning in their lives in the context of historical, social, economic, political, and cultural realities often much different from the students’ own’. The only interprofessional programme reported in this review4 focused on improving understanding and attitudes and did not include improved practice or improved outcomes for users and carers as aims.

In 11 of the studies with the stated aim of improving understanding of HGDOP,1–5, 9–11,

14, 18, 20, 23, 25 both classroom and practice learning settings were used. In nine, the classroom was the only setting used.12, 13, 17–20, 22–24 Of the remaining two studies in this group, one, Abramson et al,7 specified a practice-based setting. In her theoretical paper Chambers8 did not specify the setting. Where the aim was changing attitudes, a combination of classroom and practice was twice as likely to be used as classroom alone. Changing attitudes was a major objective of 16 papers.1–5, 7–12, 14, 18, 20, 23, 25 Seventeen studies also had as an aim the improvement of the quality of social work practice.1, 2,

5, 8, 9, 11, 13–16, 18–20, 22–25 Improved outcomes for users and carers was an explicit teaching and learning aim for a smaller number of studies.2, 7, 8, 12, 17, 22 The four studies4, 10, 15, 16 with the stated aim of increasing interest in gerontological social work as a career option had between them a range of related aims, from increased understanding,15 changes in attitude4, 10 and improvement in practice.16 Studies that identified a range of (usually more specific) aims (for example, including those such as involving students in understanding rural settings,4 encouraging student self-reflection1 and increasing access to training for residential staff7 were also included in the ‘other’ category. Where aims included improving understanding, changing attitudes or improving the quality of practice, participants in learning and teaching were more likely to include users and carers. Half of the studies with each of these aims included users and carers in teaching and learning.3–5, 9–11, 14, 17, 20, 24, 25 Users, carers and community members were represented in about the same proportions as social work practitioners/managers and other practitioner/managers combined. All eight of the empirically evaluated studies had as an aim improved understanding of HGDOP, and all but one15 aimed to change student attitudes towards older people. Four aimed to evaluate the quality of practice,1, 2, 5, 15 but only Browne et al2 and Corley et al12 had as an aim the evaluation of improved outcomes for users and carers. The empirical evaluated studies were more likely than other studies to include an increased interest in gerontological social work as a career as an aim.4, 10, 15 Two also had more specific aims, for example, ‘to involve students in meaningful interactions in a rural community setting’4 or encourage student self-reflection.1

3.3.2. Theories and concepts in use The theories and concepts reported in the papers related both to HGDOP and to pedagogical theory. In most studies, the emphasis was on one or other of these, but not both. Theories and concepts in use Theories and concepts in use Number of studies Psychosocial 15 Equalities/rights-based 14 Ecological/systems 10 Other 10 Socio/biological 7 Critical gerontology 6 Sociological 6 Psychological 3 Not specified 1

The overall impression gained from the studies included was that the conceptual and theoretical analysis of human growth and development (HGD) received little attention

in this literature. Across all studies, Erikson40, 41 was the theoretician most cited (for example, in 11, 13, 23, 24), followed by Germain and Gitterman42 (for example, in 3, 7, 22). In relation to HGDOP theories, all studies made some statement indicating the range of areas drawn on as the theoretical context for HGDOP teaching and learning (for example, physiological, psychological, sociological etc), and 10 papers1–3, 5, 8, 11, 13, 22–

24 engaged in more sustained theoretical analysis of the rationale for their approach. Of these 10 studies, six gave some focus to rights and equalities approaches.2, 5, 8, 11,

13, 22 For example, Crewe13 drew on the concept of ethno-gerontology within an ecological perspective to explore the relationship between biographical diversity and cultural factors. Five of the 10 papers specifically mentioned an ecological approach.2, 5, 13, 22, 23 Sherr and Blumhardt,22, for example used ‘a multidimensional approach’ to consider the application of Germain and Glitterman’s42 theories about ‘goodness of fit’ between individuals and their environment in order ‘to holistically portray the heterogeneity of rural elderly women’ (22, p 49). Chambers8 drew on critical gerontological concepts to challenge dominant discourses that ‘problematise’ female old age and widowhood. Birkenmaier et al1 and Diepstra and Ames3 drew on psychosocial theories, with Birkenmaier et al1 focusing on research on spirituality, social support and coping to inform their approach to teaching and learning about spirituality in old age. Socio-biological aspects of aging received no sustained theoretical attention in any of the papers reviewed, except in relation to perceptions of dementia, which were explored by Kane and Houston-Vega.18 The theories and concepts identified in these papers are set out in the table above, with an indication of the number of papers that identified particular approaches. Many studies only made passing reference to the theoretical and conceptual approach informing the paper, often by listing a range of perspectives that were expected to inform students’ learning (for example, knowledge of the relationships ‘between bio-psycho-social-cultural-spiritual systems’,17, p 414). Because of this lack of detailed attention it was difficult to categorise this area of the review since the range of theoretical and conceptual perspectives mentioned as relevant in any one paper were not necessarily accompanied by related discussion or analysis. This was a particular issue in relation to the categories ‘psycho-social’ and ‘ecological’ since several studies (for example, 1, 3) expressly mentioned consideration of factors related to the wider environment but situated this within a psycho-social approach. There was much of interest in the papers that focused on theorising or conceptualising teaching and learning. Of the 10 papers identified as ‘other’, three concentrated on theorising the ‘infusion’ model’ and its application to curriculum development.12, 16, 21 ‘Infusion’ was theorised as a ‘spiral’, aiming to ‘articulate the interconnections among early and later life experiences’ (16, p 16). Eun-Kyoung et al,15 categorised in the table above as ‘non-specified’, also focused on infusion, with less attention to theoretical concepts. The other seven3–5, 8–10, 14 explored in some detail theoretical and conceptual development related to specific teaching and learning approaches. It was noteworthy that six studies focused attention on the theories underpinning oral history/narrative approaches.3–5, 8, 9, 14 Three studies3, 4, 14 outlined theoretical approaches to ‘service learning’, defined as an approach which encompasses interactions between students and older people in local community settings designed as a means of ‘acquir(ing) experiences that will enhance classroom learning’ (51, p 175 in 6, p 723). Cohen et al9 explored the use of focus groups as an approach to learning. The main pedagogical theories in use in these papers are set out in the table below. Theories and concepts in relation to pedagogy of HGDOP Infusion (4 studies) This approach argues that students learn about

HGDOP through the development of an ‘infused’ curriculum. Learning about older people is located

within the perspective of the total lifespan rather than the separation of later life suggested by a specific module.

Oral history/narrative approaches (6 studies)

A means of accessing the life stories/biographies of older people in order to develop understanding of their life experience and its diversity.

Service learning (3 studies)

A vehicle for encouraging integrative learning across a number of dimensions: linking practice and classroom based learning, encouraging reflective practice and skill development. Students learn by directly engaging with older people.

3.4. Characteristics of HGDOP 3.4.1. HGDOP process focus HGDOP process focus HGDOP process focus Number of studies

Teaching and learning 23

Course management/organisation 13

Assessment 6

Other 1 A majority of studies (all but 21) focused on questions of teaching and learning in HGDOP. Thirteen, including Ranney et al,1–5, 7, 9–12, 15, 16, 21 focused on course management and organisation and six3, 14, 15, 17, 20, 24 included a focus on assessment. In those papers discussing teaching and learning, the main point of interest was that HGDOP material was delivered using a range of overarching frameworks. These included feminist,8 ethno-gerontology,13 ecological theory,7 and the stress/resiliency framework24. Nine papers reported initiatives to infuse content about specific topics or service user groups into an existing curriculum, including cross-cultural understanding,2, 20 spirituality,1, 11 dementia,18 older chronically mentally ill people,7 the growing significance of grandparents as providers of kinship care,17 older people with learning disabilities19 and rural older women.22 The 13 papers that discussed course organisation and management provided some interesting and useful descriptions of the ways in which curriculum development was approached. Several described the developmental work undertaken with practice teachers and other community partners.1–4, 7, 9, 11 For example, Cohen et al9 analysed the ‘benefits and barriers’ of inter-generational service learning; Browne et al2 described the development of ‘standardised learning competencies’ used in practice placements; Diepstra and Ames3 the identification of sites and older person volunteers for an oral history project, and Abramson et al7 placements in residential facilities. Four3, 4, 9, 10 paid at least some attention to the processes used to prepare students for field service interactions and two7, 15 described some of the incentives developed to encourage student engagement. On a more general level, Hooyman and St Peter16 gave an overview of four models of curriculum change – specialisation, integration, infusion and transformation, the latter going ‘beyond merely creating a course or a module on geriatric social work, to developing ways to fundamentally alter curriculum structure, organisation, and pedagogy’ (16, p 15), as did Corley et al,12 who described the development of ‘cross-cutting thematic modules’ to include a gerontological perspective in wider curriculum areas such as abuse,

caregiving and mental health. A detailed description and analysis of development work within a faculty to encourage increased attention to older people across the wider curriculum was provided in one paper.15 More limited attention was paid to assessment. Most of the six papers that included a focus on assessment described specific examples of HGDOP assessment tasks. The most frequently cited were tasks based on the use of oral histories and interviews with older people.3, 14, 20, 24 One suggested assignment integrated content about kinship care within a wider perspective17 and one made reference to the inclusion of an ‘ageing’ component in a mandatory diversity assignment.15 Three studies explicitly included self-reflection in the assessment process.14, 20, 24

There was no indication that users/carers/community members were involved in assessment processes – rather that work undertaken with them, such as oral history work, was a focus of assessment in some studies, for example, ‘a written and/or visual piece celebrating their partners’ lives and the events and circumstances that shaped them’ (6, p 727) was evaluated by instructors. Where assessment included a practice element, in two papers3, 14 this related to the inclusion of reports and write-ups of the oral history project. In the third15 a practice placement experience that included at least one older service user or an intergenerational case was part of a wider approach to the infusion of HGDOP across all elements of the programme. The papers reviewed included almost no information about how theoretical knowledge was assessed. One study14 reported that in their assessment task students are required to apply a developmental model to the mentor’s life history, as well as reflecting on their own experience.

3.4.2. Timing and organisation of HGDOP initiative

Stage of student education

Stage of student education Number of studies

Early (eg first year undergraduate/Master’s)

16

Middle (eg second year undergraduate) 3

Throughout 1

Not specified/n/a 6 Fifteen papers3, 4, 7, 11, 12, 14–20, 22, 24, 25 related to initiatives that took place at an early stage of undergraduate or postgraduate qualifying education, often as part of (for example, 3, 17, 19, 22) or linked with (for example, 14) introductory or foundation courses. A common concern was to engage students in considering issues related to ageing and older people at an early stage of their professional education on the assumption that this would have most impact on changing attitudes and increasing interest in this age group. One5 of the three studies focusing on a mid-stage initiative specifically situated it before the practice placement. Another paper23 identified as ‘mid-stage’ in the table above described a ‘mid-stage’ intervention but specified that the teaching and learning could also take place at other stages. The third study25 in this category covered both early and middle stages. One study discussed a specific curriculum intervention in which teaching and learning about gerontological social work, including HGD, was infused throughout the curriculum.15 This was also included as an early stage study since it reported on

some outcomes for the first year curriculum. Five studies1, 2, 8–10 did not specify the timing within the curriculum, although two of these1, 2 linked the teaching and learning described to practice placements. The review identified two approaches to curriculum organisation: the discrete and the embedded. Most papers (21 – all but 8, 15, 16) reported on discrete initiatives or significant module components of a substantial nature. Within this group of 21, six papers1–4, 10, 14 provided information on the length and extent of the component (or one of its elements). This ranged from, for example, four four-hour interactions with an older person,4 to a 90-minute focus group with a post group discussion.10 In four of these, one-to-one contact with an older person was central to the initiative described,2–4, 14 as it was in five other papers5, 7, 9, 11, 25 where less precise details were provided about the length and extent of specific components. A further nine papers12, 13, 17–20, 22–24 identified HGD teaching and learning as a discrete initiative (usually as part of a human behaviour in the social environment [HBSE] course) without providing detailed information on the amount of time devoted to it. Four of the US papers15, 16, 21, 25 were categorised as ‘embedded’ for the purposes of this review because their central argument was that the most effective means of changing attitudes towards older people and encouraging students to work with them was to ‘infuse’ or ‘embed’ gerontological teaching and learning across the curriculum. In Crewe et al,13 the fifth of the ‘embedded’ group, an embedded approach, was seen as the main vehicle for achieving increased attention to ethno-gerontology. There were examples of the discrete and embedded approaches being combined within the curriculum. Three of the studies focusing on an ‘embedded’ approach also gave examples of discrete initiatives,13, 21, 25 while nine of the papers categorised as discrete initiatives9, 12, 17–20, 21, 23, 24 identified the HGD initiative within a wider intervention to increase gerontological content across some or all foundation level courses, with HGD/HBSE teaching and learning used as one example of the approach. (In these US studies, foundation level courses typically included HBSE, preparation for practice, policy and research courses.) In all, 12 papers3, 5, 9–12, 15–17, 22, 24, 25 described initiatives that were supported by some funding from the Hartford Foundation Gero-rich project.52 This project has spearheaded attempts to infuse gerontological social work within the US social work curriculum. Where papers were linked to that initiative, the emphasis on HGD teaching and learning varied greatly. They included examples of service learning initiatives which involved significant periods of community-based learning,3 group and community work projects with a particular focus9 or, the shortest discrete initiative, a 60-minute observed focus group with a post-group discussion and class work.10 3.4.3. Participants in HGDOP Participants in HGDOP management, teaching, learning and assessment*

Participants Management (number of studies)

Teaching, learning and assessment (number of studies)

Social work educators 22 20 Social work practitioners/managers (including practice assessors) 5 7

Other practitioners/managers 4 3 Other (students and ex-students) 4 2 Users/carers/community members 2 11 Other educators 1 0 Not specified/n/a 2 3

Note: * Categories not mutually exclusive. Participants in course organisation The organisation of HGD teaching and learning in most papers22 was reported as undertaken, or (in theoretical studies) assumed to be undertaken by social work educators. Two of the theoretical papers made no comment on who should undertake this task.8, 13 It is striking that only one study16 reported other educators as involved in course management and organisation. Other than social work educators, the group most often reported as involved in the organisation of teaching and learning were social work practitioners (in five papers – 2, 7, 14, 16, 21), followed by other practitioners.2, 4, 11, 21 The numbers were small, but social work practitioners/managers were proportionately more likely to be involved in course organisation and management where the aim of the initiative was improving practice for users and carers.2, 14, 16 Two studies2, 21 included both social work and other practitioners in course organisation. ‘Elders’ were included as participants in course organisation in one paper16 and representatives of community-based agencies in another.21 It is interesting that none of the studies with the stated aims of changing student attitudes towards older people reported involving users, carers or community members in course organisation and management. Four papers10, 13, 16, 21 identified students as participants in the organisation of teaching and learning. Corley et al commented that ‘the faculty believed that students would learn from being involved in the planning, implementation, and evaluation of these focus groups’ (13, p 336). In their overview of the development of ‘infusion models’, Hooyman et al argued that with such a model ‘all key stakeholders … need to be involved in the process of planning, implementing, and sustaining the curricular changes’ (16, p 14) but the papers showed limited evidence of such engagement. The involvement of practitioners, managers, users and/or students in the management and organisation of HGDOP curricula did not seem to be linked to curriculum content in the papers reviewed. However, where the setting included a practice learning element, social work practitioners/managers2, 14, 16 and other practitioners/managers2, 4, 11 were more likely to be seen as involved in the organisation and management. Participants in teaching and learning Social work educators were identified as participating in teaching and learning in most (20) papers. Only four papers did not mention them as participants. Of these four, one7 identified a practice teacher as taking responsibility for teaching and learning input, who for 50% of her time ‘provides integration and support for the educational focus of the programme’ (7, p 6). Two of the other three did not specify who should be involved.8, 13 The fourth16 identified as participants all those involved, whatever their role or discipline. All participants in teaching and learning, including users, carers and community members, were almost equally likely to be involved in formal didactic as in experiential teaching, with practitioners proportionately more likely than other participants to be involved in group work approaches. Again, it is striking that not one of the reported papers mentioned a specific role in teaching and learning for other educators. It may be that this was taken for granted in descriptions of ‘infused’ or ‘embedded’ models, but it was not explored as an issue. Eleven papers3, 4, 5, 9–11, 14, 17, 20, 24, 25 specified roles for users, carers and/or community members in the teaching and learning of HGDOP. This included, for example, guest speaking in college-based courses by members of a local social history society to provide teaching input on oral history methods,4 lecture input by older people ‘who are adapting and coping successfully with the aging process’ (5, p 61), to ‘help promote healthy images of aging and refute myths’ (24, p 91 and 5, 9, 24), focus group participation10 and/or participating in one-to-one interactions with students,3, 4, 11, 14

frequently focusing on oral history. Two studies mentioned the potential for older people to be involved with assessment.17, 20

Seven studies identified a role, or range of roles, in teaching and learning for social work practitioners/managers.1, 2, 7, 9, 12, 14, 15 The papers indicated very little use of social work practitioners/managers in the classroom-based elements of the programmes discussed. Where the setting included both practice and classroom-based elements, the social work practitioners/managers seemed to be involved in the practice element only in all but two studies.9, 14 Sometimes practitioners were reported as working with materials provided by social work educators (for example, 1,

2), but more often they provided consultations, support and guest lectures. For example, Downey and Miles reported that ‘agency social workers provide educational opportunities and consultation … and serve as professional role models’ (14, p 99).

Users, carers and community members were more likely than social work practitioners/managers to be included as participants in papers describing purely classroom-based settings. Three of the 11 identifications of user, carer and/or community member involvement in teaching and learning were in classroom only settings.17, 20, 23 In contrast to the findings on course organisation, users, carers and community members were more likely to be participants in learning and teaching than social work or other practitioners and managers where the programme aims included improving understanding,3–5, 9–11, 14, 17, 20, 24, 25 changing attitudes3–5, 9–11, 14, 20,

24, 25 or improving quality of practice.9, 11, 14, 5, 20, 24 Around half of the studies with each of these aims included users and carers in the teaching and learning. It is notable also that those papers which referred to reflective practice activities as part of the course content were most likely to involve social work practitioners/managers,1, 2, 9, 14 other practitioners10, 11 and especially users, carers and/or community members, who were cited as involved in 10 of these studies.3–5, 9–11, 14, 20, 24, 25 Only three studies identified a teaching role for other practitioners and managers,10,

11, 12 one to provide expertise ‘in aging and cross-cultural issues’ (12, p 300). Another included the chaplain of a nursing care facility in a programme focusing on teaching and learning about spirituality in older age.11 The third included ‘service providers’ in focus groups.10 Two studies reported on student involvement in teaching and learning. One mentioned student class presentations.4 The other14 described learning groups facilitated by student ‘upperclassmen’ selected from the previous year’s class. Only one paper4 had a specifically inter-professional focus. The majority of studies (23) made no mention of professionals or student professionals other than social workers and social work students, although service providers were mentioned in several studies.

3.4.4. Setting of HGDOP teaching and learning

Setting of HGDOP teaching and learning*

Setting of HGDOP teaching and learning

Number of studies

Both 12

Classroom/higher education institute (HEI)

10

Practice learning 1

Not specified 1

Note: * Categories not mutually exclusive.

Twelve papers described approaches based in a combination of both practice and classroom settings.1–5, 9–11, 14–16, 25 Practice learning settings reported in this review included assessed practice placements (commonly referred to as the practicum in the US), but for the papers in this review they more usually referred to variable time-limited experiences in agency and/or community settings, such as ‘paired’ contact with older people, observational visits or volunteering (often termed ‘service learning’ in the US literature). These service learning experiences were usually assessed by social work educators as an element of a classroom/HEI-based module. Of the 12 papers combining settings, five seemed to refer to initiatives within formal practice placements/practicum.1, 2, 15, 16, 25 Three of these1, 2, 15 provided some details about the content of this element. The paper by Browne et al2 was the only one to focus on a HGDOP teaching and learning curriculum within a required practice placement. It described in detail a 13-week field-based curriculum for students during practice placement, to provide continuing education to all project partners (including practice teachers). The curriculum included practice-based integrated seminars led by practice teachers, the opportunity for students to practice assessment skills via case studies and to ‘address questions’ related to placement practice (2, p 701). Practice teachers and service managers were involved in the development of the practice learning and university-based curriculum through membership of a ‘consortium council’ – ‘the project’s working group’ (2, p 699) and contributed to the development of seven ‘standardised learning competencies’ involving knowledge and skills and practicum curriculum handbook. HGD formed a significant part of the seminar programme and an unquantified, but underpinning element of two university-based modules. Birkenmaier and colleagues1 described an initiative aimed at exploring and integrating spiritual beliefs in service provision for older people. The initiative was organised and provided by social work educators while students were on an elective practice placement. It included a group activity for students and practice teachers from a range of older people practice settings, combined with an expectation that students use the questionnaires and approaches learned with service users in their placement settings. Another paper15 outlined a model for infusing gerontological content across the curriculum that included an expectation that all students would undertake work with at least one older person or intergenerational family as an element of their field practicum. The other seven studies in this category reported on oral history projects where the settings were identified and selected by social work educators in consultation with agency staff,3–5, 14 interviews or focus groups with older people on specific topics10, 11 and observations and visits.5, 25 The resulting material was then used to complement learning and assessment in the classroom. The type of setting did not seem to be particularly relevant to curriculum content, status of initiative, stage of education or outcomes considered. However, it is interesting to note that where the aims described by papers included changing attitudes, a combination of classroom and practice was twice as likely to be used as classroom alone and a combination of both classroom and practice was slightly more likely to be used than classroom alone where the aim was improving quality of practice. Where assessment included a practice element, in two papers3, 14 this related to the inclusion of reports and write-ups of the oral history project. Ten of the papers specifying the setting for HGDOP referred to classroom-based learning only.12, 13, 17–24 Most of these papers13, 17, 18, 20, 23, 24 were in the ‘non-empirical descriptive’ category, describing general approaches or models of HGDOP. Pedagogical approaches were least likely to be specified in papers that where classroom/HEI was the sole identified setting.

Only one paper7 reported on a purely practice-based setting for a HGDOP project. This study described two programmes providing practice placements of unspecified length with chronically mentally ill older people in residential settings for four to six first year students each year. The placements were supervised by practice teachers who also provided the formal educational input. Students undertaking these placements were paid a stipend of US$3,300 and given a reduction in tuition fees. 3.4.5. Pedagogical methods

Pedagogical methods*

Pedagogical methods Number of studies

Formal didactic/received learning 12 Classroom-based experiential learning 11 Practice learning 10 Group work 5 Other 1 Not specified 10 Note: * Categories not mutually exclusive.

Fourteen papers provided some information on the pedagogical approaches used or advised. Some papers were very explicit on this element (for example, 5, 11, 12, 20) and on occasion this was the focus of the paper (for example, 3, 10, 25). Formal didactic approaches such as lectures were referred to in 12 studies2–5, 8, 10–12, 14, 19, 24, 25 but these were invariably used alongside a range of other methods, including case studies, classroom exercises and the use of video. Five studies had a particular focus on learning through group work, to support self-reflective discussion of practice experiences1, 9, 11, 14 or through observation of focus groups of service providers and users.10 No connection was found between pedagogical approaches and the aims of the study or the outcomes considered, and all participants, including users, carers and/or community members, were equally likely to be involved in formal didactic and experiential teaching. Pedagogical approaches were least likely to be specified in papers that concentrated on an overview, or general conceptual framework and where the classroom/HEI was the sole identified setting. Ten papers8, 12, 13, 15–18, 21–23 did not specify a particular teaching method in relation to HGD. A wide variety of approaches to experiential learning were described in the 11 papers1–3, 5, 9–11, 14, 20, 24, 25 that included this focus. Within this were two main emphases: self-reflection1, 5, 9–11, 14, 20, 24, 25 and discussion of practice/service-learning experiences.2, 3, 14 Examples were provided of a range of approaches used to encourage self-reflection, such as use of time lines,5, 20, 24 including reflective exercises on the ‘rationale for that projection’ (5, p 60), meditations,1 simulations,25 and other reflections on the student’s own ageing.12, 24 In some studies these approaches were described in detail. Waites and Lee25 considered the response of students to a range of simulations, such as wearing thick gloves to simulate the impact of arthritis, which they claimed students found particularly valuable in learning about physical impairments often associated with ageing – ‘you can kind of relate better when you are actually doing it’ (25, p 57). Birkenmaier et al1 described the detail of a meditation exercise to help reflect on later life and dying, and other techniques that challenged ‘binary thinking’ about spirituality and ageing. The use of reflective journals was mentioned by two studies.3, 4 Ames and Diepstra saw these journals as a way of integrating classroom material with oral history learning and ‘provid(ing) a mechanism for focussing class discussions’ (6, p 725). Six studies1, 10, 14, 20, 24, 25

reported pedagogical approaches that encouraged written self-reflective tasks of various kinds. Practice-based learning was mentioned as a pedagogical method in 10 papers and included varied and imaginative approaches. In four of these 10 papers1, 2, 7, 25 they related to formal placement experiences. These included the use in the classroom of material provided by students from their placements;9 a module on spirituality undertaken together by practice teacher and linked student;1 and practice placements alongside other service learning opportunities such as visits and volunteering.25 Six papers described between them a variety of ‘service learning’ initiatives in agency or community settings, such as scheduled reminiscence and oral history visits to matched3, 4, 14 – or perhaps unmatched5 – older people in nursing home or independent living settings; observations and ‘report back’ of day centre facilities;5 a module on spirituality undertaken together by practice teacher and linked student;1 and questionnaire interviews with older people.11 Cohen et al9 described a range of service learning approaches including planning an older women’s conference, a ‘spiritual legacy project’ and facilitating a ‘housing transitions’ focus group. These service learning experiences were usually assessed by social work educators as an element of a classroom/HEI-based module. In this group three papers identified service learning as an important method of integrating theory and practice3, 4, 25 with the service learning material used to complement learning and assessment in the classroom. One paper7 described two programmes providing field placements with mentally ill older people in residential settings, which took place prior to the first formal practice placement and focused on ‘life transitions’, ‘environmental pressures’ and ‘interpersonal processes’. The placement was assessed by a practice teacher and involved a payment and fee reduction for the student. 3.4.6. Curriculum organisation

Curriculum organisation* Curriculum organisation Number of studies Theory-based 15 Topic-based 7 Rights-based 6 Linear/sequential 4 Other 2 Not specified 1 Note: * Categories not mutually exclusive. The papers reflected some of the dilemmas related to organising a diverse and substantial range of material into an appropriate curriculum at an introductory point in the course. Nine papers were identified as approaching curriculum organisation from more than one perspective,5, 8, 11, 14, 17, 19–22 but the perspectives chosen bore no obvious relationship to study aims, pedagogical approaches or participants in teaching and learning.

Theory-based

As the table above shows, 15 papers2–5, 7–9, 11, 13, 14, 16, 19–22 of the 24 papers suggested that particular theories or approaches provided a framework for delivering the HGDOP curriculum although no prevailing theoretical approach emerged. Six studies identified ecological models as the overarching framework.2, 5, 7, 9, 19, 22 For some this framework was combined with other approaches such as lifespan theories (for example, 5), and phenomenology, conflict and empowerment theory.22

Other relevant HGD theories identified as providing the organisational framework for the curriculum included critical theories,8, 20 psychosocial/lifespan theory,3, 5, 11, 14, 16, 21 ethno-gerontology,13 service learning theories3, 4 and sociological theories of ageing such as disengagement or activity theory.23 Hooyman et al16 described a framework broadly situated in psychosocial theories but organised in a ‘spiral’ approach, beginning with aging and end of life (16, p16). Several of these papers also adopted more than one theoretical approach to curriculum organisation arguing that an eclectic approach was required to do justice to the complexity of the subject. For example, Crewe13 linked ethno-gerontology with an ecological perspective and Collins et al11 emphasised the link with social justice theories.

Topic-based

Seven papers were categorised as topic-based.1, 10, 12, 17–19, 23 Three of these papers argued for greater attention to be paid to a specific issue (such as mental health12, 18) and three focused on the needs of a particular service user group – grandparents in kinship care,17 older people with learning difficulties,19 older people with dementia.18 Kropf19 is included in this group because although the main organising framework was theory-based the focus was on a particular topic. Others1, 10, 23 focused on topics that related more specifically to development in later life. Examples of such topics were: the psychological dimensions of successful ageing including the management of stress,23 spiritual development and the environmental aspects of positive ageing1 including the availability of resources.

Rights-based

Six studies5, 8, 11, 17, 18, 22 included a rights-based approach as an important, but not the only, approach to curriculum organisation. All of these studies incorporated an anti-oppressive focus, with specific groups of discriminated-against older people the focus of attention in some papers (for example, women;8, 22 racial and cultural oppression;17 and older people with dementia18).

Linear (‘cradle to grave’)

The four linear and sequential (‘cradle to grave’) models18, 20, 21, 25 were linked to the promotion of ideas about positive ageing20, 21, 25 and attention to issues for the very old.18 The paper by Eun-Kyoung et al15 did not identify how teaching and learning might be organised. Vandsburger et al,24 on the other hand, explicitly stated that the stress and resiliency framework discussed was flexible enough to be adapted to any form of curriculum organisation. Downey and Miles14 included in their approach to curriculum organisation a focus on the programme’s older participants and providing ‘isolated individuals with support and companionship and the opportunity to contribute to the growth and development of the next generation of social works’ (14, p 95).

3.4.7. Curriculum content

Developmental processes, positive ageing, and values/attitudes /anti-oppressive practice (AOP) provided the core curriculum content. It was difficult to distinguish between these three attributes, as definitions were unclear in some papers where examples of content were not always detailed or specific. HGDOP curriculum content* Curriculum content Number of studies Developmental processes 19 Values/attitudes/AOP 17

Positive ageing 14 Reflective or evidence-based practice 12 Skills work 9 Professional practice/teamwork 5 Other 2 Not specified 1 Note: * Categories not mutually exclusive. Many papers provided relatively unexplored descriptions of HGD content on ‘developmental processes’. This is not surprising, perhaps, given that most of the papers included in the review did not focus their discussion on an overarching theoretical perspective on HGDOP within the curriculum. So, for example, Dorfman et al4 referred rather generally to a ‘basic aspects of aging’ curriculum that included ‘the biological, social, and psychological aspects of aging, and includes a broad variety of topics including health, economic status, social supports’ (4, p 223). Johnson-Dalzine17 comments that ‘the course is designed to assist students in their integration of knowledge about lifespan development’ (17, p 413). Others indicated a more specific approach to developmental processes. For Crewe,13 for example, the focus was on ethno-gerontology within a lifecourse perspective. Many papers that reported on curriculum developments (particularly in relation to HBSE modules) assumed that content on bio-psycho-social development was automatically included and therefore detailed exploration of material relevant to these areas was limited (for example, 4). Other papers referred to material drawing on the work of ‘standard’ developmental theorists such as Levinson51 and Erikson40, 41 and to social gerontologists such as Havighurst43 (for example, 5, 23). Values and attitudes In nine papers developmental processes and a lifespan perspective also included content on values and attitudes and on positive ageing.4, 5, 8, 11, 14, 17, 20–23 Content on values, attitudes and AOP was a strong theme, with all of the 17 papers in this group giving at least some attention to stereotypes of ageing.1–5, 7–11, 13, 14, 17, 18, 20–23 Some papers highlighted specific areas of anti-oppressive understanding and practice such as racial and cultural diversity2, 13, 17, 18 including migrants’ experiences.21 Two focused more particularly on older women’s experiences8, 22 and one included some attention to gay and lesbian older people.21 Positive ageing Positive ageing was discussed from a number of perspectives. Some (for example, 4,

8, 20) considered it mainly in relation to pedagogical methods and suggested narrative and biographical approaches as useful. Gray and Kabadaki5 also focused on methods and the merits of videos and vignettes. Others (for example, 1, 14, 17, 22–24) emphasised a ‘strengths and resilience’ framework, and/or the abolition of stereotypes and increased ‘appreciation for their (older adults) role and contributions to society’ (14, p 96). All of the nine papers that included skills work in curriculum content were among the 16 papers that identified changing attitudes as a programme aim. The skills content included in these nine papers1–4, 7, 9, 11, 14, 25 included communication, interviewing and listening skills;3, 9, 11, 14 training in oral history methods;4 and skills in assessment;1, 2, 25 with Waites and Lee25 specifically mentioning the ability to make bio-psycho-social assessments. Other skills mentioned included conference organisation,9 social action,9 network building,7 research skills7 and computer and computer-based research skills5, 7 (categorised as ‘other’ in the table above). In 12 of the 16 instances where changing attitudes was a teaching and learning aim, reflective or evidence-based practice was a stated element of the content.1–5, 9–11, 14, 20,

24, 25 From the details provided it would seem that in this group the emphasis was mainly on self-reflection, rather than evidence-based practice, although all but two

papers11, 14 also reported on the acquisition of knowledge and skills as an outcome. Two papers focused on spirituality and the spiritual needs of older adults1, 11 and Kane and Houston-Vega18 also addressed this area, but not as a main focus. A gap in the literature was the limited range of studies that situated or considered the impact of biological ageing and common chronic conditions within the HGDOP focus. There was little discussion about what to include in relation to age-related health/illness (with the exception of Kane and Houston-Vega’s 2004 paper18 on dementia) and end-of-life studies. 3.4.8. Main outcomes considered

The outcomes identified in this review reflect the main claims identified in the paper rather than the outcomes that the papers evaluated.

Main outcomes considered*

Main outcomes considered Number of studies

Acquisition of knowledge/understanding 19 Changed attitudes/perceptions to HGDOP 17 Participant reactions 8 Acquisition of skills 7 Improved professional behaviour/quality of practice 5 Other 5 Improved outcomes for users/carers 3 Not specified/n/a 1 Note: * Categories not mutually exclusive.

Acquisition of knowledge

Regardless of the underpinning theories and concepts used, the most significant outcome considered was the acquisition of knowledge and understanding (19 papers – 1–5, 8–10, 13, 15, 17–25). The focus was more often on increased ‘understanding’ through service learning and classroom-based experiential approaches rather than on knowledge of specific gerontological concepts or theoretical models, although at least 11 papers (including theoretical ones) focused on knowledge as well as understanding.2, 3, 5, 7–9, 13, 20, 22–24

Changing attitudes

Seventeen papers focused on changing attitudes as an outcome of HGDOP teaching and learning.1, 3–5, 7–10, 13–16, 18, 20, 21, 24, 25 This was very much in keeping with the central concern of the Gero-rich initiative in increasing understanding of the experience of older people with a view to increasing interest in gerontological social work. Indeed all five of the studies13, 15, 16, 21, 25 where HGDOP was described as ‘embedded’ in other modules, and which is such a feature of the ‘infusion’ approach of the Gero-rich project, had as an outcome changed attitudes and perceptions. Of these five papers all but Crewe13 declared some funding through the Gero-rich project. None of this group considered participant reactions or acquisition of skills as main outcomes.

Acquisition of skills

Confidence and skill building in areas such as listening and working with cultural diversity were outcomes considered in seven papers.1, 2, 3, 9, 14, 17, 24 Improved professional practice was a stated outcome of interest in five papers,8, 13, 18, 23, 24 all but one of which23 were theoretical in focus. The hope of improved outcomes for uses and carers underpins all developments in this as in other areas of social work

education. However, three papers explored this aspect specifically – two at a theoretical level8, 20 and one7 as an element of the evaluation of a practice intervention.

Other outcomes of interest included increasing interest in gerontology as a career10,

12, 15 and the development of the ‘infusion’ model of teaching and learning as a way of increasing understanding of older people and gerontological social work among all social work students.16

A relatively small number of papers (eight – 1–5, 9, 10, 20) considered students’ experience of teaching and learning as an outcome. Those that did were interested in the perceived usefulness of the course (for example, 5), reflections on course structure and content and suggestions for improvement.1, 2, 10 Student reactions in relation to assessment were a focus mentioned in only two studies.3, 20 Since half the papers identified both classroom and practice as teaching and learning settings and most also included more than one pedagogical method, it is not surprising that no significant relationship emerged between these factors and the outcomes considered.

3.5. Main claims to ‘findings’ reported about HGDOP

This section aims to present an overview of the claims made about HGDOP teaching and learning in the 24 papers. The studies were varied in terms of methodology and in the amount of detail they provided and unlike the studies discussed in Section 4 of this review they have not been quality assessed. Therefore no appraisal can be made of the trustworthiness of the claims of ‘findings’. Instead, presented here is a broad indication of the range of claims made in the papers.

Main claims to findings about HGDOP Main findings/claims Number of studies Predominantly positive 14 Other 2 N/A 8 What stands out most is that all of the 14 studies that evaluated or described findings in relation to the HGD curriculum have predominantly positive claims to make about the interventions described and/or their effectiveness, and none are predominantly negative, or even mixed. The highest proportion of positive findings was associated with changing attitudes (75%), followed by improved understanding (59%) and improved quality of practice (53%), but not all of these claims were backed up by clear empirical data. The seven empirical studies1–5, 9, 10 that included participant reactions all reported positive findings. For example, the students found the curriculum approach reported in one paper5 as a ‘change of pace from lecture, encouraged participation, and helped them to remember and understand concepts’ (5, p 62). Students undertaking the spirituality and ageing module outlined by Birkemaier et al1 were reported to have valued the knowledge input and felt that the guided meditations could be used in other settings. The one paper4 that evaluated outcomes for older people involved in an oral history project reported that the interaction was enjoyed by all. Older participants commented, for example, that it gave them a greater understanding of young people and an opportunity to make a contribution – ‘I think it gave her encouragement that you can get farther ahead in life’ (4, p 236). Ten of the 14 papers provided or referred to evidence to support predominantly positive changes for students. Eight of these 10 papers claimed an increase in students’ knowledge, understanding and skills.1–5, 9, 10, 15 Positive changes in student

attitudes were reported in six papers,1, 4, 7, 9, 10, 14 with, for example, Cohen et al10 describing the impact of the approach adopted as ‘a transformative experience’ (10, p 341) in which ‘students began to deconstruct their images of older adults and those practitioners who serve older adults’ (10, pp 341–2). Diepstra and Ames,3 on the other hand, reported positive findings but no statistically significant positive change in students’ attitudes towards older people. Two of the empirical evaluations reported findings of improved quality of practice skills2, 3 as did Downey,14 one of the empirical descriptive papers. Vandsburger et al24 also claimed improved quality of social work practice, but this was not explored in detail. Two papers1, 9 reported a diminished but continued student ‘discomfort’, one in integrating learning into practice1 and the other raising issues such as sexuality.9 A reduction in student fears of getting old was reported by Dorfman et al4, while Downey and Miles14 claimed that the oral history project provided ‘lessons in how to live one’s life more fully, dealing with pain and suffering’ (14, p 100). Six papers reported on changes in student interest in a career in gerontological social work. Of these, four reported increased interest4, 7, 10, 14 but the other two found no significant change in this area.3, 15 Some papers reported on students’ suggestions for programme improvements. Waites and Lee25 sought students’ views on the best method to encourage interest in working with older people and infuse gerontological content in the curriculum. Students identified greater use of experiential material and a greater emphasis on ‘normal’ or healthy ageing rather than on pathology and social problems ‘you can kind of relate better when you’re actually doing it’ (25, p 57). The students participating in the Birkenmaier et al1 study suggested that more examples and modelling of direct work with older people be included. In the Diepstra and Ames3 study students had some recommendations to make about the timings of visits and the selection of older people to ensure that they had sufficient memory to participate. Limited attention was paid to outcomes for practitioners, and social work staff. There were three exceptions: Abramson et al,7 who reported that student field placements in residential settings for chronically mentally ill older people brought benefits to the staff as well as the students involved. Ranney and colleagues21 claimed that the approach taken to the preparation of faculty staff to increase the gerontological content of the HGD and other aspects of the social work curriculum had ensured that the faculty were ‘less threatened’ (21, p 93). Browne et al2 reported ‘a high level of satisfaction with all project activities’ (2, p 703) among the programme consortium members.

Appendix 8: Stakeholder consultations and questionnaires 1. First consultation with stakeholder group We are at the stage in the research on qualifying social work education about human growth and development of older people (HGDOP) where we are completing a detailed protocol that will shape the research process. Both the research review and the practice survey will explore a number of questions in an attempt to map the current state of teaching and learning, and what is known about it. From your experience we would like your comments on any particular issues that should be highlighted in exploring the following questions: • What should be the key aims of teaching and learning about HGDOP? • What should be the content of HGDOP? • How should teaching and learning be organised? Is there a balance to be struck

between college and practice-based teaching and learning? • Who should be involved in the teaching and learning? • What should the main theoretical approaches be underpinning the teaching and

learning? We would also like to hear your views on any other issues that you think are particularly relevant to the research questions we have identified. Thank you very much. Margaret Boushel and Pat Le Riche [email protected] [email protected] Department of Social Care and Social Work University of Sussex 2. Invitation to student and practitioner stakeholders to comment on draft practice survey questionnaires Email: 7 March 2008 Dear Colleagues I contacted you recently to update you and send you the interim report about the SCIE research exploring social work teaching and learning about older people and human development. I mentioned that the next stage of the work is the practice survey. We are just about to begin the survey, which will involve telephone interviews with educators and students so that we can map existing practice. We will then link that information with the research findings. We have attached drafts of the two interviews we have drafted for educators, one for those who convene human growth and development (HGD) modules and another for those who teach about work with older people. We have drafted the schedules for these interviews and would be very interested to hear your views on the drafts before we finalise them. In particular, could you let us know if you think there are any key points we have not included.

mailto:[email protected]


Sorry to burden you with two requests for views so close together. If you have to prioritise, then at this stage the practice survey questionnaire is the more pressing, because we need to start the survey as soon as possible. So, if you were able to let us have your views within the next two weeks, we would be very grateful indeed. We look forward to hearing your views and thank you very much for taking the time to respond. Best wishes Pat Le Riche and Margaret Boushel 3. Stakeholder questionnaires: consultation with student and practitioner stakeholders We are doing research for the national Social Care Institute for Excellence to find out what social workers are taught about the human growth and development of older people (HGDOP) during their social work training. We are interested in finding out what is being taught and what is found to be most helpful. We have now looked at what has been written about this topic and we are contacting some social work training programmes to talk to the staff involved to get their views and to see what students find helpful. From your experience we would like your comments on any particular issues that you think should be highlighted in what social workers are taught about older people’s growth and development. For example: • What should social work training programmes be aiming for in their teaching

about older people’s development? (eg improving understanding about ageing, and how it may effect people differently; improving attitudes towards older people; improving skills in listening and responding to older people etc)

• What should students be taught and learn about? (eg what happens as we age and what makes ageing different for different people; positive aspects of ageing; how older people can be discriminated against; how to relate well to older people; how to learn from older people and the experience of working with them, etc)

• How should students’ learning be organised? Should it all happen in college or in the community or both?

• Who should be involved in the teaching and learning? (eg college staff, older people, people from other professional backgrounds like nurses, etc)

• What are the key strengths and weaknesses of the HGDOP teaching and learning that you have experienced?

We would also like to hear your views on any other issues that you think need to be included in social work training about older people’s growth and development. Thank you very much. Margaret Boushel and Pat Le Riche [email protected] [email protected] Department of Social Care and Social Work University of Sussex 4. Stakeholder questionnaires: consultation with older people stakeholders



We are doing research for the national Social Care Institute for Excellence to find out what social workers are taught about the human growth and development of older people (HGDOP) during their social work training. We are interested in finding out what is being taught and what is found to be most helpful. We have now looked at what has been written about this topic and we are contacting some social work training programmes to talk to the staff involved to get their views and to see what students find helpful. We are also very interested in hearing the views of older people who may have used social care services or who are carers. From your experience we would like your comments on any particular issues that you think should be highlighted in what social workers are taught about older people’s growth and development. For example: • What should social work training programmes be aiming for in their teaching

about older people’s development? (eg improving understanding about ageing, and how it may effect people differently; improving attitudes towards older people; improving skills in listening and responding to older people etc)

• What should students be taught and learn about? (eg what happens as we age and what makes ageing different for different people; positive aspects of ageing; how older people can be discriminated against; how to relate well to older people; how to learn from older people and the experience of working with them, etc)

• How should students’ learning be organised? Should it all happen in college or in the community or both?

• Who should be involved in the teaching and learning? (eg college staff, older people, people from other professional backgrounds like nurses, etc)

• From your experience, what do you think social workers seem to understand well about getting older and where are the gaps?

We would also like to hear your views on any other issues that you think need to be included in social work training about older people’s growth and development. Thank you very much. Margaret Boushel and Pat Le Riche [email protected] [email protected] Department of Social Care and Social Work University of Sussex 5. Questionnaire used by non-governmental organisation (NGO) member with minority ethnic group elders University of Sussex Questions about older people and social work We are hoping to find out what older people think social workers should be taught in their training. We are particularly interested in how they learn about people’s life experience and their development so they can be better at helping people. Please could you answer the following questions. 1. Should social work training programmes be:

Helping people know more about growing old Helping people understand how to listen and talk to older people



Helping students understand that all older people are different Helping students have a more respectful way of working with older people

Are there other things you think are important? 2.Do you think students should learn about:

What makes old age different for different people? What is good about being old? How to learn from older people’s experience Why older people are not always treated well

Are there other things you think are important? 3. Are there things that you think social workers do well when they work with older

people? What are the things you think they could do better? 4. Are there any other things you think are important that you would like to tell us

about? Thank you very much for answering these questions. Margaret Boushel and Pat Le Riche Department of Social Care and Social Work University of Sussex

App

endi

x 9:

Sta

keho

lder

resp

onse

s Su

mm

ary

of s

take

hold

er g

roup

mem

ber r

espo

nses

to h

uman

gro

wth

and

dev

elop

men

t and

old

er p

eopl

e (H

GD

OP)

qu

estio

nnai

re

Q1.

Wha

t sho

uld

be th

e ke

y ai

ms

of te

achi

ng a

nd

lear

ning

abo

ut H

GD

OP?

Q1.

Mai

n fe

edba

ck p

oint

s St

uden

t sta

keho

lder

s (4

resp

onse

s)

• In

clus

ion:

old

er p

eopl

e ne

ed to

be

seen

as

peop

le (2

) •

Old

er p

eopl

e ne

ed to

be

seen

as

cont

ribut

ing

to s

ocie

ty (2

) •

We

are

all d

evel

opin

g th

roug

hout

our

live

s •

Exa

min

e ex

istin

g th

eorie

s on

HG

DO

P in

the

light

of t

he c

hang

ing

cont

ext o

f old

er p

eopl

e’s

lives

and

co

ntrib

utio

ns to

soc

iety

•

Eco

logi

cal a

nd s

ocia

lly in

tegr

ated

app

roac

h –

ensu

re th

at h

ealth

nee

ds a

re n

ot d

ivor

ced

from

soc

ial n

eeds

•

Age

ism

, mar

gina

lisat

ion

and

its s

ocia

l con

stru

ctio

n So

cial

wor

k pr

actit

ione

r (1

resp

onse

) •

Incl

usio

n: o

lder

peo

ple

need

to b

e se

en a

s pe

ople

•

Ow

n at

titud

es/p

reju

dice

in o

rder

to ta

ckle

age

ism

•

Impa

ct o

f age

ism

on

orga

nisa

tion

and

deliv

ery

of s

ocia

l wor

k se

rvic

es

• P

repa

ratio

n to

cha

lleng

e m

yths

and

ste

reot

ypes

abo

ut a

gein

g •

Pre

pare

stu

dent

s to

be

advo

cate

s So

cial

wor

k m

anag

er (1

resp

onse

) •

Ena

ble

stud

ents

to b

egin

to u

nder

stan

d in

divi

dual

resp

onse

s to

the

univ

ersa

l exp

erie

nce

of a

gein

g w

ithin

sp

ecifi

c so

cial

and

cul

tura

l con

text

s Se

rvic

e us

ers/

care

rs (7

resp

onse

s)

• G

ood

liste

ning

and

com

mun

icat

ion

skill

s (4

) •

Kno

w m

ore

abou

t gro

win

g ol

d (3

) •

Und

erst

and

dive

rsity

in c

apac

ity, c

ompe

tenc

e an

d co

nfid

ence

in o

ld a

ge (3

) •

Res

pect

ful w

ays

of w

orki

ng w

ith o

lder

peo

ple

(2)

• S

uppo

rt ol

der p

eopl

e in

acc

essi

ng ri

ghts

, ser

vice

s an

d op

portu

nitie

s to

impr

ove

qual

ity o

f life

•

Und

erst

andi

ng o

f im

pact

of p

over

ty in

old

age

•

Und

erst

andi

ng c

hang

es th

at o

lder

peo

ple

have

exp

erie

nced

in th

eir l

ives

and

in fa

mily

and

frie

ndsh

ip

rela

tions

hips

•

Und

erst

and

impa

ct o

f iso

latio

n •

Und

erst

and

chan

ging

and

incr

ease

d ex

pect

atio

ns o

f ‘ne

w o

ld’

• In

clus

ion

and

agei

sm

• U

nder

stan

d ho

w to

pro

vide

info

rmat

ion

and

incl

ude

olde

r peo

ple

in a

sses

smen

ts a

nd o

ther

pro

cess

es in

a

mea

ning

ful w

ay, t

akin

g ac

coun

t of p

artic

ular

circ

umst

ance

s, fo

r exa

mpl

e, il

lnes

s N

on-g

over

nmen

tal o

rgan

isat

ion

(NG

O) c

oord

inat

or/e

x-ch

air (

2 re

spon

ses)

•

Mul

ti-pe

rspe

ctiv

e aw

aren

ess

of is

sues

aro

und

agei

ng a

nd a

geis

m (2

) •

Ope

n-m

inde

d, p

erso

n-ce

ntre

d, e

clec

tic a

ppro

ach

• E

mpa

thy

and

resp

ect t

hrou

gh in

volv

emen

t with

old

er p

eopl

e

Q2.

Wha

t sho

uld

be th

e co

nten

t of H

GD

OP?

Q

2. M

ain

feed

back

poi

nts

Stud

ent s

take

hold

ers

(1 re

spon

se)

• P

erso

nal a

nd c

ultu

ral a

war

enes

s of

age

ist a

ttitu

des

and

beha

viou

rs

• D

iver

sity

and

resi

lienc

e of

old

er p

eopl

e •

Old

age

and

impa

ct o

f gen

der,

clas

s, c

ultu

re o

n fa

mily

dyn

amic

s •

Res

pect

and

stre

ngth

s-ba

sed

appr

oach

•

Sex

ualit

y •

Pro

fess

iona

l val

ues

in m

ulti-

disc

iplin

ary

cont

exts

•

Com

mun

icat

ion

skill

s •

Aw

aren

ess

of c

ogni

tive

chan

ges/

impa

irmen

ts/d

emen

tia

• S

kills

of e

mpo

wer

men

t So

cial

wor

k pr

actit

ione

r (1

resp

onse

) •

Life

span

dev

elop

men

t •

Aw

aren

ess

of c

ogni

tive

chan

ges/

impa

irmen

ts/d

emen

tia

• R

ight

s-ba

sed

appr

oach

es

Soci

al w

ork

man

ager

(no

com

men

t) Se

rvic

e us

ers/

care

rs (7

resp

onse

s)

• R

espe

ct a

nd d

o no

t pat

roni

se (3

) •

Ski

lls in

elic

iting

and

und

erst

andi

ng o

lder

peo

ple’

s pe

rson

al a

nd s

ocia

l his

tory

(3)

• G

ood

liste

ning

ski

lls (3

) •

Age

ism

(2)

• A

dvan

tage

s an

d di

sadv

anta

ges

of o

ld a

ge (2

) •

Div

ersi

ty a

nd re

silie

nce

in o

lder

peo

ple

– vi

a, fo

r exa

mpl

e, ‘d

ay in

life

of’

expe

rienc

e of

wel

l-fun

ctio

ning

ol

der p

eopl

e (2

) •

Kno

w w

hat i

s on

offe

r and

how

to a

cces

s (2

) •

Mul

ti-fa

cete

d na

ture

of d

isab

ility

and

nee

d fo

r hol

istic

app

roac

h •

Ski

lls in

em

pow

erin

g ol

der p

eopl

e to

ove

rcom

e fe

ars

and

impr

ove

qual

ity o

f the

ir liv

es

• S

imul

ated

exp

erie

nces

of p

hysi

cal r

estri

ctio

ns o

f age

ing

and

age-

rela

ted

disa

bilit

ies

• U

nder

stan

d th

at th

ere

is n

o au

tom

atic

con

grue

nce

betw

een

men

tal a

nd p

hysi

cal c

apac

ities

/inca

paci

ties

• P

sych

olog

ical

impa

ct o

f phy

sica

l illn

ess

and

vice

ver

sa

• C

ontin

uity

of p

erso

nalit

y tra

its

• O

pen-

min

dedn

ess

and

lack

of p

resu

mpt

ions

rega

rdin

g ol

der p

eopl

e’s

wis

hes

and

need

s •

How

to p

rese

rve

dign

ity a

nd q

ualit

y of

life

and

sup

port

com

pani

onsh

ip a

nd in

depe

nden

ce

• C

reat

ive,

late

ral t

hink

ing

‘in th

e m

omen

t’, p

erso

nalis

ed a

ppro

ach

and

prob

lem

-sol

ving

ski

lls

• B

eing

pos

itive

•

Cul

tura

l div

ersi

ty

• A

bilit

y to

lear

n fro

m o

lder

peo

ple

NG

O c

oord

inat

or/e

x-ch

air (

2 re

spon

ses)

•

Eco

logi

cal p

ersp

ectiv

e on

age

ing,

incl

udin

g sp

iritu

al/h

uman

istic

and

tran

sper

sona

l •

Equ

ality

, tak

ing

acco

unt o

f lan

guag

e ba

rrie

rs a

nd c

ultu

re

• G

ood

com

mun

icat

ion

skill

s •

Kno

wle

dge

of re

sour

ces

Q3.

How

sho

uld

the

teac

hing

and

lear

ning

be

orga

nise

d? Is

ther

e a

bala

nce

to b

e st

ruck

be

twee

n co

llege

and

pr

actic

e-ba

sed

teac

hing

an

d le

arni

ng?

Q3.

Mai

n fe

edba

ck p

oint

s St

uden

t sta

keho

lder

s (4

resp

onse

s)

• B

oth:

a b

alan

ce (4

) •

Pra

ctic

e-ba

sed

lear

ning

to h

elp

abso

rb a

nd p

roce

ss in

form

atio

n in

‘rea

l life

’ situ

atio

ns a

nd ‘t

rue

awar

enes

s of

old

er a

ge’ (

3)

• C

olle

ge to

pro

vide

theo

ries

and

conc

epts

•

Mor

e cu

rric

ulum

tim

e in

col

lege

on

HG

DO

P to

focu

s on

key

life

eve

nts

such

as

bere

avem

ent,

trans

ition

s,

end

of li

fe

• M

ix o

f tea

chin

g an

d pr

actic

e-ba

sed

lear

ning

to p

rovi

de fi

rst-h

and

expe

rienc

e of

theo

ries

in p

ract

ice

and

to

high

light

com

plex

ities

(stu

dent

s m

ay h

ave

less

firs

t-han

d ex

perie

nce

of o

lder

peo

ple

than

of c

hild

ren)

•

Pra

ctic

e el

emen

t may

cha

nge

attit

udes

•

Gue

st s

peak

ers

• P

ract

ice

visi

ts

Soci

al w

ork

prac

titio

ner (

1 re

spon

se)

• M

ore

time

on o

lder

peo

ple

in c

urric

ulum

Soci

al w

ork

man

ager

(1 re

spon

se)

• S

igni

fican

t pra

ctic

e or

ient

atio

n •

(App

ropr

iate

) use

r inv

olve

men

t in

colle

ge-b

ased

teac

hing

Se

rvic

e us

ers/

care

rs (3

resp

onse

s: S

omal

i eld

ers

not a

sked

this

que

stio

n)

• M

ix b

etw

een

prac

tice

and

book

lear

ning

(3)

• P

ract

ice

lear

ning

ver

y im

porta

nt, w

ith o

lder

peo

ple

in g

ener

al a

s fo

cus,

not

old

er p

eopl

e w

ho a

re s

ervi

ce

user

s, to

see

at f

irst h

and

how

old

er p

eopl

e liv

e (2

) •

Mix

of c

olle

ge-b

ased

and

pra

ctic

e to

lear

n ‘s

ubtle

’ ski

lls a

nd a

void

take

over

by

bure

aucr

acy

• Tu

tors

nee

d re

gula

r pra

ctic

e ex

perie

nce

also

to u

nder

stan

d ch

ange

s •

Vid

eos,

cas

e st

udie

s et

c us

eful

to d

emon

stra

te in

cla

ssro

om w

hat i

t is

like

in th

e fie

ld

NG

O c

oord

inat

or/e

x-ch

air (

2 re

spon

ses)

•

Bot

h co

llege

and

pra

ctic

e-ba

sed

(2)

• N

eed

also

refle

ctiv

e ex

plor

atio

n of

the

pers

onal

impa

ct o

f iss

ues

of a

gein

g •

Opp

ortu

nity

to e

xper

ienc

e an

d le

arn

how

to d

eal w

ith e

xpos

ure

to a

gein

g is

sues

and

thei

r per

sona

l re

sona

nce

esse

ntia

l •

Mor

e in

com

mun

ity th

an in

col

lege

, to

mak

e it

a ‘li

ve e

xper

ienc

e’ (1

)

Q4.

Who

sho

uld

be

invo

lved

in th

e te

achi

ng

and

lear

ning

?

Q4.

Mai

n fe

edba

ck p

oint

s St

uden

t sta

keho

lder

s (4

resp

onse

s)

• C

arer

s (3

) •

Soc

ial w

ork

prac

titio

ners

from

sta

tuto

ry a

nd v

olun

tary

ser

vice

s (2

) •

Col

lege

sta

ff w

ith k

now

ledg

e of

are

a (2

) •

Old

er p

eopl

e: s

ervi

ce u

sers

and

non

-ser

vice

use

rs (2

) So

cial

wor

k pr

actit

ione

r (1

resp

onse

) •

Old

er p

eopl

e •

Ser

vice

use

rs

• C

arer

s •

Org

anis

atio

ns li

ke A

ge C

once

rn, v

olun

tary

and

inde

pend

ent a

genc

ies

So

cial

wor

k m

anag

er (n

o co

mm

ent)

Serv

ice

user

s/ca

rers

(3 re

spon

ses:

Som

ali e

lder

s no

t ask

ed th

is q

uest

ion,

but

see

Q7

belo

w)

• S

ervi

ce u

sers

(2)

• C

arer

s •

Tuto

r •

Old

er p

eopl

e •

Oth

er p

rofe

ssio

nals

N

GO

coo

rdin

ator

/ex-

chai

r (2

resp

onse

s)

• E

xper

ienc

ed p

ract

ition

ers

• O

ther

pro

fess

iona

ls

• S

ervi

ce u

sers

• O

lder

vol

unte

ers

Q5.

Wha

t sho

uld

be th

e m

ain

theo

retic

al

appr

oach

es u

nder

pinn

ing

the

teac

hing

and

le

arni

ng?

Q5.

Mai

n fe

edba

ck p

oint

s St

uden

t sta

keho

lder

s (4

resp

onse

s)

• Li

feco

urse

per

spec

tives

(2)

• A

ttach

men

t – to

peo

ple

and

plac

es (2

) •

Ber

eave

men

t, lo

ss a

nd g

rief t

heor

ies

(2)

• La

belli

ng th

eory

in o

rder

to ta

ckle

dis

crim

inat

ion

• Te

achi

ng a

nd le

arni

ng th

eorie

s •

Theo

ries

on s

ucce

ssfu

l age

ing

• A

geis

m

• A

ppro

ache

s to

wor

king

with

old

er p

eopl

e, fo

r exa

mpl

e, re

min

isce

nce

theo

ry

• Id

entit

y •

Dis

abili

ty

• Th

eorie

s on

stru

ctur

ed d

epen

denc

y •

Crit

ical

per

spec

tives

on

risk

• S

yste

ms/

ecol

ogic

al th

eorie

s So

cial

wor

k pr

actit

ione

r (no

com

men

t) So

cial

wor

k m

anag

er (n

o co

mm

ent)

Serv

ice

user

s/ca

rers

(non

e as

ked

this

que

stio

n)

NG

O c

oord

inat

or (1

resp

onse

– e

x-ch

air n

ot a

sked

this

que

stio

n)

• P

erso

n-ce

ntre

d pr

actic

e, fo

r exa

mpl

e R

oger

s •

Life

span

, for

exa

mpl

e, E

rikso

n •

Sel

f-act

ualis

atio

n, fo

r exa

mpl

e, M

aslo

w

• P

ersp

ectiv

es o

n be

reav

emen

t •

Per

spec

tives

on

empo

wer

men

t and

dis

empo

wer

men

t

Q6a

. Wha

t are

the

key

Q6a

. Mai

n fe

edba

ck p

oint

s

stre

ngth

s an

d w

eakn

esse

s of

the

HG

DO

P te

achi

ng a

nd

lear

ning

that

you

hav

e ex

perie

nced

?

Stud

ent s

take

hold

ers

(1 re

spon

se)

Wea

knes

ses/

need

s •

Insu

ffici

ent t

ime

and

atte

ntio

n gi

ven

to H

GD

OP

•

Insu

ffici

ent f

ocus

on

olde

r peo

ple

in a

ttach

men

t and

iden

tity

teac

hing

•

Nee

ds ‘i

nfus

ion’

app

roac

h to

old

er p

eopl

e’s

issu

es a

cros

s cu

rricu

lum

, rat

her t

han

emph

asis

on

child

ren

(ref

lect

s st

aff b

ackg

roun

d, re

sults

in la

ck o

f kno

wle

dge

rega

rdin

g ol

der p

eopl

e an

d re

info

rces

neg

ativ

e at

titud

es)

Soci

al w

ork

prac

titio

ner

Wea

knes

ses/

need

s •

Nee

ds c

ouns

ellin

g sk

ills re

gard

ing

olde

r peo

ple

• N

ot ju

st ta

sk-c

entre

d ap

proa

ch

• P

ract

ition

er in

put n

eede

d re

gard

ing

imag

inat

ive

appr

oach

es to

gro

ups

with

‘sec

ond

clas

s’ s

tatu

s So

cial

wor

k m

anag

er (n

o co

mm

ent)

Serv

ice

user

/car

ers

(not

ask

ed th

is q

uest

ion)

N

GO

coo

rdin

ator

(1 re

spon

se –

ex-

chai

r not

ask

ed th

is q

uest

ion,

see

Q6b

bel

ow)

“Can

’t co

mm

ent [

rega

rdin

g te

achi

ng a

nd le

arni

ng] b

ut s

ome

stud

ents

hav

e m

ade

exce

llent

use

of t

he th

eore

tical

te

achi

ng th

ey h

ave

rece

ived

… th

ose

who

hav

e do

ne le

ss w

ell w

ere

thos

e w

ho w

ere

less

abl

e to

inte

grat

e th

eory

w

ith p

erso

nal e

xper

ienc

e an

d re

flect

ion.

” Q

6b. F

rom

you

r ex

perie

nce

wha

t do

soci

al

wor

kers

see

m to

un

ders

tand

wel

l abo

ut

getti

ng o

lder

and

whe

re

are

the

gaps

?

Q6b

. Mai

n fe

edba

ck p

oint

s St

uden

t sta

keho

lder

s (n

ot a

sked

this

que

stio

n)

Soci

al w

ork

prac

titio

ner (

not a

sked

this

que

stio

n)

Serv

ice

user

s/ca

rers

(5 re

spon

ses)

S

treng

ths

• M

ost s

ocia

l wor

kers

hav

e go

od li

sten

ing

skill

s an

d ar

e go

od c

omm

unic

ator

s (2

) •

Mos

t soc

ial w

orke

rs h

ave

good

und

erst

andi

ng o

f old

er p

eopl

e’s

need

s •

One

had

goo

d ov

ervi

ew re

gard

ing

loca

l ser

vice

s

• S

ome

show

con

cern

and

ded

icat

ion

• In

tere

sted

in g

ettin

g in

touc

h w

ith o

lder

peo

ple

(all

likel

y to

app

ly m

ore

ofte

n to

mor

e m

atur

e la

te tw

entie

s-ea

rly th

irtie

s so

cial

wor

kers

) •

Not

hea

rd a

nyth

ing

bad,

but

com

mun

ity n

ot fo

rthco

min

g w

ith in

form

atio

n, s

o so

cial

wor

kers

hav

e to

ask

an

d as

k to

get

info

rmat

ion

– ca

n be

har

d fo

r bot

h si

des

Wea

knes

ses/

need

s •

One

soc

ial w

orke

r was

‘mon

ey s

avin

g, n

ot ri

ghts

-bas

ed’

• Li

aiso

n be

twee

n so

cial

wor

kers

in h

ospi

tal a

nd lo

cal c

omm

unity

are

ver

y im

porta

nt

• S

ocia

l wor

ker i

nput

nee

ds to

be

timel

y to

be

effe

ctua

l (fo

r exa

mpl

e, ta

ke a

ccou

nt o

f oth

er ti

me

scal

es,

such

as

bene

fit s

yste

m) –

one

soc

ial w

orke

r was

not

•

Nee

d to

be

prep

ared

to a

sk q

uest

ions

to g

et g

ood

advi

ce

• A

ge o

f soc

ial w

orke

r can

be

a ga

p –

if yo

ung,

may

not

hav

e ha

d m

uch

expe

rienc

e of

old

er p

eopl

e, n

eed

to g

et o

ut a

nd ta

lk to

old

er p

eopl

e •

Soc

ial w

orke

rs u

nder

stan

d th

eir r

ight

s bu

t not

alw

ays

good

at t

ellin

g ot

her p

eopl

e th

eir r

ight

s •

Soc

ial w

orke

rs d

o no

t alw

ays

know

thei

r dut

ies

N

GO

ex-

chai

r (1

resp

onse

) S

treng

ths

• S

ocia

l wor

kers

und

erst

and

the

law

W

eakn

esse

s •

Soc

ial w

orke

rs u

nder

stan

d th

eir r

ight

s bu

t are

not

goo

d at

telli

ng o

ther

peo

ple

thei

r rig

hts

Q

7. W

e w

ould

als

o lik

e to

he

ar y

our v

iew

s on

any

ot

her i

ssue

s th

at y

ou

thin

k ar

e pa

rtic

ular

ly

rele

vant

to th

e re

sear

ch

ques

tions

we

have

id

entif

ied.

Q7.

Mai

n fe

edba

ck p

oint

s St

uden

t sta

keho

lder

s (1

resp

onse

) •

Nee

d to

refle

ct v

alue

s re

gard

ing

and

know

ledg

e ab

out o

lder

peo

ple

acro

ss c

ours

e to

pro

mot

e po

sitiv

e at

titud

es a

nd n

on-a

geis

t app

roac

h So

cial

wor

k pr

actit

ione

r (1

resp

onse

) •

Dra

w o

n K

itwoo

d’s

appr

oach

to ‘p

erso

n-ce

ntre

d’ p

ract

ice,

whi

ch s

ees

dem

entia

as

‘blip

’, no

t men

tal

heal

th p

robl

em

• S

olut

ion-

focu

sed

appr

oach

es u

sefu

l So

cial

wor

k m

anag

er (1

resp

onse

) •

Bew

are

of u

nint

ende

d av

oida

nce

of d

iffic

ult g

ener

aliti

es o

r pot

entia

lly n

egat

ive

expe

rienc

es a

ssoc

iate

d w

ith

the

phys

ical

pro

cess

es o

f age

ing

whi

ch, i

f soc

ial w

ork

stud

ents

are

to b

e ad

equa

tely

pre

pare

d fo

r pra

ctic

e w

ith o

lder

peo

ple,

they

nee

d to

hav

e a

(crit

ical

) gra

sp o

f. Im

pairm

ent i

s re

al a

nd h

as e

ffect

s on

indi

vidu

als’

re

latio

nshi

ps to

the

wor

ld (s

ee, f

or e

xam

ple,

Tom

Sha

kesp

eare

’s w

ork

on d

isab

ility

) Se

rvic

e us

ers/

care

rs (7

resp

onse

s)

• R

ead/

know

mor

e ab

out d

iffer

ent c

ultu

res

(3)

• B

ecom

e m

ore

invo

lved

with

diff

eren

t com

mun

ities

– s

ocia

l wor

kers

sho

uld

go to

eth

nic

grou

ps a

nd s

pend

tim

e w

ith th

em (2

) •

Soc

ial w

orke

rs n

eed

to k

now

abo

ut s

ervi

ces,

esp

ecia

lly b

enef

its s

ervi

ce a

nd h

ow to

acc

ess

them

•

Ask

old

er p

eopl

e an

d ca

rers

abo

ut h

ow it

is a

nd h

ow it

cou

ld b

e •

Acc

ess

med

ia a

nd o

ther

mat

eria

ls, f

or e

xam

ple,

NH

S ‘e

xper

t pat

ient

pro

gram

mes

’ •

Kno

w a

bout

and

ack

now

ledg

e th

e di

vers

e in

tere

sts

and

capa

citie

s of

old

er p

eopl

e •

Soc

ial w

orke

rs s

houl

d be

‘up

front

’ and

real

ly li

sten

to o

lder

peo

ple

• In

clud

e re

lativ

es in

ass

essm

ents

at o

lder

peo

ple’

s in

vita

tion

• M

ore

frequ

ent a

sses

smen

ts

• N

ot a

goo

d id

ea fo

r Som

ali e

lder

s to

go

to u

nive

rsity

as

they

mig

ht n

ot b

e co

mfo

rtabl

e th

ere

• U

se tr

ansl

ator

s to

tran

slat

e co

mpl

ex id

eas

and

impr

ove

com

mun

icat

ion

N

GO

coo

rdin

ator

/ex-

chai

r (2)

•

Giv

e ca

refu

l atte

ntio

n to

issu

es o

f mor

talit

y be

caus

e th

ese

unde

rpin

a fu

ndam

enta

l asp

ect o

f all

hum

an

expe

rienc

e ar

ound

age

ing

– so

cial

wor

kers

nee

d to

be

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Appendix 10: Practice survey methodology 1. Sources of information The practice survey offers illustrative examples of practice from each country, and additionally seeks to present where possible examples of innovative practice, of cases where critical perspectives are prominent, and/or cases where emphasis has been placed on evaluating effectiveness. For reasons of resources and logistics, the practice survey did not seek to map current education practice across the regions, nor make claims to represent wider consensus or trends. Participants: the practice survey reports directly the perspectives of social work (higher education institute, or HEI) educators, and of students. It also reports on the views of members of the stakeholders group which included students, social work service users and carers, practitioners and staff/volunteers in voluntary organisations working with older people, including older people from Black and minority ethnic backgrounds. It was not feasible within the resources to gather directly the views of practice assessors. Informants were, however, asked to report on practice learning experience, where relevant, and on any feedback obtained from service users and carers. Documentary sources: experience from a previous practice survey of social work education (Taylor et al, 2006)61 confirmed that programme documentation was neither the most accessible nor useful source of information about current education practice. Response rates were limited, data collection time-consuming, and the information gleaned of highly variable utility. The scoping study for the present review suggested that these limitations would be greater in the current project since human growth and development and older people (HGDOP) is likely to be taught and learned in diverse parts of the qualifying curriculum, with different documentation associated with each. For the purposes of this review, therefore, documentation was sought as a complement to other data gathered from participant HEIs, but not from other providers.

Participant recruitment – HEI educators: the review team recruited participants from six centres of social work education (HEIs), to explore in depth the provision and effectiveness of HGDOP at qualifying social work level. Four centres in England, and one each in Wales and Northern Ireland, were included. Centres were selected on both pragmatic and purposive bases. Representatives of three centres (one in each country) included in the scoping study had already agreed in principle to participate in a study focused specifically on HGDOP. Two of these were included. In addition, four other centres were identified through the following means: • research reports retrieved in the research review • stakeholder and contact information • invitation to self-identify, via Social Policy and Social Work Subject Centre

(SWAP )newsletter and Joint University Council's Social Work Education Committee (JUCSWEC) mailing list.

From the above, the six centres identified ensured a range of provision and focus at undergraduate and postgraduate level, with representation from all three countries. The key HEI participants were nine HEI-based educators, representing between them the six centres. Given curriculum structures, it was thought likely that in each centre information would need to be gathered from two educators: one with responsibility for teaching and learning about human growth and development (HGD), the other about social care for older people. In three of the identified centres

two educators participated on this basis. In two centres, following discussion with the centre this proved not to be necessary, and in one centre there was no response from the second educator invited to participate. The respondents were in turn asked to forward to relevant cohorts of students the invitation, explanation and tools to participate in the study, as indicated below. Participants – stakeholders: the stakeholder group was established to act in an advisory capacity throughout the review. The group brought together a range of perspectives from relevant user groups, along with providing opportunities for specialist input from particular individuals (for membership, see Appendix 9). The stakeholder group played a key role throughout the review. Student, practitioner and educator members acted as critical friends and commented on draft questionnaires etc. Service users and carers and all other members, with the exception of the social work educator, were invited to engage as informants and complete a questionnaire or telephone interview focusing on the aims, content, delivery and direction of HGDOP education. 2. Data collection methods All data collection tools were designed to explore the review questions and were developed in consultation with stakeholders. They covered the same topic areas and issues as in the research review, with a specific focus on current practice, contexts, experience, developments and challenges. Issues of informed consent, confidentiality and anonymity were addressed in accordance with sponsor guidelines, as indicated in Sub-section 3 below. 2.1. Telephone interviews – HEI social work educator participants: telephone interviews using a semi-structured questionnaire (see Appendix 11) were conducted with nine social work educators from six HEIs. The participants were identified on the advice of their HEI colleagues as those best placed to report on management and organisation, teaching, learning and assessment of HGDOP within the classroom and, as far as possible, practice learning curricula. Interviews also focused on perceived impact and effectiveness. The interview questionnaire was made available to participants in advance and the interviews were conducted by two of the research team members. The six centres included representation from qualifying social work education programmes at both undergraduate (four) and postgraduate (three) levels, including one programme with both undergraduate and postgraduate strands. All six provided full-time programmes, two provided work-based and one a part-time route to qualification. The largest programme represented enrolled 100 students in each year, the smallest, 20 students. Four of the social work educator participants identified their primary roles in relation to the review topic as coordinator or convenor of modules on teaching and learning about older people (and/or adults), and three as coordinator or convenor of HGD modules (or modules in which the main HGD teaching and learning took place). 2.2. Semi-structured questionnaires – HEI participant students: semi-structured questionnaires (see Appendix 11) were forwarded via educators, by email, to relevant cohorts of students. Questionnaires were tightly focused on student experiences of HGDOP, perceived impact, strengths and weaknesses. Students were invited to return questionnaires either direct to the review team or via a course administrator. This could be undertaken by email or (to retain anonymity) by post.

The return rate on this element of the survey was disappointing, with only one response. This was partly explained by student placements and assessments at the time the questionnaire was sent out, but may also be a reflection of the perceived importance of the topic area. The response received has been included with the student stakeholder data. 2.3. Course and programme documentation was sought from each participating HEI to complement other data. This was provided by four programmes and included in the practice survey data analysis. 2.4. Semi-structured questionnaires – stakeholder participants: stakeholder participants were invited to complete a questionnaire (Appendix 8), forwarded to them by email. Service user/carer stakeholders, and stakeholders representing voluntary sector organisations were given the option of undertaking a telephone interview based on the questionnaire. One, a voluntary sector staff member, chose to complete the written questionnaire. The remainder opted for a telephone interview. Questionnaires were tightly focused on stakeholder views of the aims, content delivery and direction of HGDOP education. Service users/carers were also invited to comment, from their experience, on the strengths and weaknesses of social work practice with older people. 2.5. Telephone interviews – stakeholders: telephone interviews using a semi-structured questionnaire (see Appendix 8) with the three stakeholder service user/carers members of the University of Sussex/Brighton Service User Network and the voluntary sector organisation ex-chair were conducted by members of the review team. The interview questionnaire was made available to participants in advance and the interviews were conducted by two of the research team members. A further four service users who were members of a minority ethnic elders group were asked for their views by the voluntary sector organisation ex-chair using an adapted and shortened questionnaire format, who then translated and telephoned their responses to one of the review team. This allowed the inclusion of some reflections from this community, despite the language difficulties involved. 3. Confidentiality, bias and ethics Respondents to the questionnaires and the telephone interviews were identified by name in the returns but all personally identifying information has been removed in analysing and reporting on the data for this review. All contributors of good practice examples are named with their knowledge and written consent. One of the practice survey researchers is a social work educator with a specialism in the research area. As a result, attention was paid to possible sources of bias in the selection of respondents for telephone interviews and questionnaires, the choice of questions asked, the data analysis and reporting of findings. This meant that where a researcher was well known to the respondents, another member of the research team undertook the telephone interview. Every effort was made to ensure that service users and carers and students were adequately informed about the research prior to interviews and that appropriate information was available from project letters (see Appendices 8 and 11) and/or from on-site social work educators.

4. Data coding and analysis In order to address the central review questions, practice survey data was coded using thematic manual analysis based on schema compatible with the keywording and data

extraction strategies of the research review, and informed by preliminary findings from the mapping stage of the research review. Most of the telephone interviews were tape-recorded and the tapes transcribed prior to analysis of the data. The remainder were recorded in handwritten notes, typed up prior to analysis. The majority of the transcripts of the telephone interviews were shared with the HEI or stakeholder/service user interviewee concerned in order to verify its accuracy and interpretation and invite further comment. Key concerns, themes and issues were identified from repeated reading of the transcript material by two of the research team. The data has been organised to present specific, illustrative examples of education practice and experience, highlighting where possible issues of effectiveness, innovative practice and evidence of critical, social gerontological perspectives in the teaching and learning of HGDOP, in classroom and/or practice learning settings. The analysis also seeks to explore dilemmas and challenges suggested by the research literature, along with any gaps identified in the research evidence base.

Appendix 11: Practice survey letters and questionnaires 1. SWAP/JSWEC flier Human growth and development of older people in qualifying social work education Is this a subject that interests you? Would you like to contribute? The University of Sussex has been commissioned by the Social Care Institute for Excellence (SCIE) to complete a knowledge review of teaching and learning about human growth and development and older people (HGDOP) in qualifying social work education. As part of the review we are completing a practice survey. We would be interested to hear from anyone with a particular interest in this area of work who can tell us about any interesting and innovative approaches to learning either in college or in practice. We would also be interested in receiving any examples of course materials or other teaching resources that are currently being used in teaching. Please contact: Pat Le Riche or Margaret Boushel [email protected] 2. Telephone interview schedule for educators teaching about older people Human growth and development and older people The University of Sussex has been commissioned by the Social Care Institute for Excellence (SCIE) to undertake a research review examining the teaching, learning and assessment of human growth and development and older people (HGDOP) in qualifying social work education. The review aims to identify relevant evidence from research literature, education practice and relevant policy documents. A key component of the review is a practice survey that will map current practice in this area and attempt to identify examples of ‘good practice’. As part of the practice survey a small number of telephone interviews are being completed to access the perspectives of higher education (HE) providers in England, Wales and Northern Ireland. Material gained during the interviews will be anonymised but where we identify ‘good practice’ examples we will seek consent to include these in the final report. Context information Name of respondent Course location Level Undergraduate/postgraduate/both (please identify which course is the subject of the interview) Number of students on each programme

Role/responsibility of respondent (in relation to the organisation and delivery of teaching about older people) I would like to start by exploring teaching about older people. i) In terms of the structure of the sequence/module:

• Do you have a separate sequence/module about older people, or is the teaching of this topic integrated into other sequences? If so, which sequence(s)?

• Is the sequence/module core or elective? If elective, then how many students have chosen this module this academic year and how does this relate to the size of groups choosing other modules?

• At what point(s) in the course does the teaching take place? • Are students also involved in practice learning when the classroom teaching

about older people takes place? • What proportion of the sequence/module teaching focuses specifically on

older people? • Does the teaching about older people take place with social work students

alone or does it involve other disciplines? If so, which disciplines? • Apart from social work educators, who is involved in the organisation and

delivery of the teaching – practitioners, older people, users and carers, educators from other disciplines, managers? Others?

• Is the teaching mostly classroom or practice-based or a mixture of both? • How is the classroom-based learning assessed?

ii) What are the main aims/outcomes of teaching and learning about older people – improving theoretical understanding, developing skills, changing attitudes, increasing interest in this area of practice, improving the quality of practice, improving outcomes for users and carers? Other aims? iii) In organising the content:

• How would you characterise the module’s organising framework in relation to older people? Is it topic, theory or equalities/rights-based? Or do you have a different organising framework?

• How would you characterise the theoretical base of the teaching about older people? (eg psychological, sociological, socio-biological, ecological, equalities/rights-based) Other? A mixture?

• How would you characterise the pedagogical approach? (eg formal didactic learning, classroom-based experiential learning, problem-based learning, other forms of group work) Other? A mixture?

How do you integrate issues of equality and diversity into teaching and learning

about older people? I would now like to focus specifically on teaching and learning about human growth

and development (HGD) within the sequence/module about older people. iv) Is content on older people and HGD included in this sequence/module? (If Yes, move on to the following)

• What are the main aims/outcomes of teaching and learning about HGD in the context of working with older people – improving theoretical understanding, developing skills, changing attitudes, increasing interest in this area of practice, improving the quality of practice, improving outcomes for users and carers? Other aims?

• How would you characterise the theoretical base of the teaching? (eg psycho-social, socio-biological, ecological, equalities/rights-based) Other? A mixture? (prompt: seek specific examples)

• Which aspects of ageing are included in the content? (eg relationships, chronic conditions, end of life issues) (prompt: seek specific examples)

• How would you characterise the pedagogical approach? (eg formal didactic learning, classroom-based experiential learning, problem-based learning, other forms of group work) Other? A mixture? (prompt: seek specific examples)

• Apart from social work educators, who is involved in the teaching – practitioners, older people, users and carers, educators from other disciplines, managers? Others? Where others are involved can you please give examples of their involvement.

• How is the learning about HGDOP assessed? (prompt: seek specific examples)

v) Can you think of other examples of teaching and learning content about HGDOP not already mentioned? (prompt such as relationship work, end of life issues) (if No, move on to the following)

• Could you explain why HGD content is not included in this module/sequence?

• Can you think of other examples of teaching and learning content about HGDOP in other parts of the programme that has not already been mentioned?

In relation to practice learning: • Can you give examples of material from practice being used as part of HGDOP

teaching and learning in the classroom? (prompt: seek specific examples) • Can you think of any specific examples of where your programme requires

HGDOP to be demonstrated in practice learning? (prompt: check if this is the case with all service user groups and, if relevant, seek specific examples)

vi) What particular strengths and weaknesses of the teaching and learning have been identified from evaluation processes?

Can you think of any additional examples of good or innovative practice in your teaching of HGDOP? Would you be happy for these to be identified in the final report?

Would you be prepared to send us any relevant teaching material? vii) Can you think of any particular resources – research, articles, websites etc – that you have found useful in developing teaching and learning about HGDOP? viii) We would like to include the views and ideas of students about HGDOP teaching and learning. Are you happy for us to send a brief questionnaire to students who have completed HGDOP course elements? What would be the best way to access these students? Thank you for taking part in this interview.

3. Telephone interview schedule for educators teaching human growth and development Human growth and development and older people The University of Sussex has been commissioned by the Social Care Institute for Excellence (SCIE) to undertake a research review examining the teaching, learning and assessment of human growth and development and older people (HGDOP) in qualifying social work education. The review aims to identify relevant evidence from research literature, education practice and relevant policy documents. A key component of the review is a practice survey that will map current practice in this area and attempt to identify examples of ‘good practice’. As part of the practice survey a small number of telephone interviews are being completed to access the perspectives of higher education (HE) providers in England, Wales and Northern Ireland. Material gained during the interviews will be anonymised but where we identify ‘good practice’ examples we will seek consent to include these in the final report. Context information Name of respondent Course location Level Undergraduate/postgraduate/both (please identify which course is the subject of the interview) Number of students on each programme Role/responsibility of respondent (in relation to the organisation and delivery of HGDOP) I would like to start by exploring the teaching of human growth and development (HGD) in general. i) In terms of the structure of the sequence/module:

• Do you have a separate sequence/module on HGD or is the teaching of this topic integrated into other sequences? Both?

• At what point(s) in the course does the teaching take place? • Are students also involved in practice learning when the classroom teaching

takes place? • What proportion of the HGD teaching focuses specifically on older people? • Does the HGD teaching take place with social work students alone or does it

involve other disciplines? If so, which disciplines? • Apart from social work educators, who is involved in the organisation and

delivery of the teaching – practitioners, users and carers, educators from other disciplines, managers? Others?

• Is the teaching mostly classroom or practice-based or a mixture of both? • How is the classroom-based learning assessed?

ii) What are the main aims/outcomes of the teaching and learning – improving understanding, changing attitudes, improving the quality of practice, improving outcomes for users and carers? Other aims?

iii) In organising the content: • Does the teaching follow a linear/sequential pattern (birth to death)? Is it

topic, theory or equalities/rights-based? Or do you have a different organising framework?

• How would you characterise the theoretical base of the teaching? (eg psycho-social, socio-biological, ecological, equalities/rights-based) Other? A mixture?

• How would you characterise the pedagogical approach? (eg formal didactic learning, classroom-based experiential learning, problem-based learning, other forms of group work) Other? A mixture?

iv) How do you integrate issues of equality and diversity into the teaching of HGD? v) I would now like to focus specifically on teaching and learning about older people within HGD:

• What are the main aims of teaching and learning about HGDOP – improving understanding, changing attitudes, improving the quality of practice, improving outcomes for users and carers? Other aims/outcomes?

• Apart from social work educators, who is involved in the teaching – practitioners, users and carers, educators from other disciplines, managers? Others? Where others are involved can you please give examples of their involvement

• How would you characterise the theoretical base of the teaching? (eg psycho-social, socio-biological, ecological, equalities/rights-based) Other? (prompt: seek specific examples)

• How would you characterise the pedagogical approach? (eg formal didactic learning, classroom-based experiential learning, problem-based learning, other forms of group work) A mixture? (prompt: seek specific examples)

• How is the learning about HGDOP assessed? (prompt: seek specific examples)

vi) How do you integrate issues of equality and diversity into the teaching of HGDOP? (prompt: seek specific examples) vii) In relation to practice learning: • Can you give examples of material from practice being used as part of HGDOP

teaching and learning in the classroom? (prompt: seek specific examples) • Can you think of any specific examples of where your programme requires

HGDOP to be demonstrated in practice learning? (prompt: check if this is the case with all service user groups)

viii) Can you think of any additional examples of good or innovative practice in your teaching of HGDOP? Would you be happy for these to be identified in the final report? Would you be prepared to send us any relevant teaching material? Thank you for taking part in this interview. 4. Covering email sent to students on programmes where staff contributed to the practice survey To all xxx BA students

We know you are very busy but we would be grateful if you could complete the attached short questionnaire. We are very interested in finding out about your experience of teaching and learning about human growth and development and older people (HGDOP) in college and in placement. This is part of a research project that has been commissioned by the Social Care Institute for Excellence (SCIE). We will treat any information you provide as confidential. You need not provide your name and if you would prefer not to reply by email you can reply by post at the address below and we will refund the cost of postage. We hope you can spare a few minutes to complete this questionnaire. Thank you in advance. Pat Le Riche and Margaret Boushel Social work researchers [email protected] [email protected] Department of Social Work and Social Care Sussex Institute University of Sussex Falmer, Brighton BN1 9RH 5. Questionnaire sent to students on programmes where staff contributed to the practice survey (along with covering email)

University of Sussex Human growth and development and older people

Student questionnaire

The University of Sussex has been commissioned by the Social Care Institute for Excellence (SCIE) to undertake a research review examining the teaching, learning and assessment of human growth and development and older people (HGDOP) in qualifying social work education. The review aims to identify relevant evidence from research literature, education practice and relevant policy documents. A key component of the review is a practice survey that will map current practice in this area and attempt to identify examples of ‘good practice’. As part of the practice survey we are seeking the views of students on a small number of social work courses in England, Wales and Northern Ireland. Any material gained from the questionnaire will be anonymised. We would very much appreciate it if you would complete and return this questionnaire so that student views are fully included in the review. Context information Name of respondent (optional) Course name and location Level Undergraduate/postgraduate Before you came on the course did you have any experience of working with older people, either as a volunteer or in paid work? If you have experience, please give details.



During the course, have you chosen electives or specific modules on work with older people (which might have been included in a module on work with adults)? If you have, please give details. i) In which modules, teaching sequences, practice learning or other parts of the course did teaching about human growth and development and older people (HGDOP) take place? ii) Looking back to the teaching of human growth and development in relation to older people what do you think was the most important learning for you in terms of:

• Knowledge of HGDOP • Skills • Social work values • Other aspects of learning

Can you please give us an example and tell us why this learning was important?

Iii) Can you tell us about any teaching and learning approaches you found particularly useful? (eg thinking about your own future old age, oral history work, films, role-play etc) iv) Can you tell us about any learning materials you found particularly useful? (eg books/articles, websites, material from placement or prepared by your practice assessor) v) Have you completed or are you completing a placement with older people? If not, have your placements provided you with any opportunity to consider the experiences of older people? (eg grandparents as foster carers, family members as providers of community resources) vi) If you have answered yes to either of these questions can you please give us an example(s) of where you were able to apply college-based learning to your practice? vii) Are there any other points or suggestions you would like to make about your HGDOP teaching and learning? viii) Are there any other points or suggestions you would like to make about HGDOP teaching and learning more generally? Thank you for completing this questionnaire. Pat Le Riche and Margaret Boushel University of Sussex

Appendix 12: Practice survey additional good practice examples of pedagogical tasks (including stakeholders’ ideas) 1. Engaging interest and challenging stereotypes University of Teesside Observation Walk down to and into the Cleveland Centre. Observe older people. Try unobtrusively to note the following: How many ‘older people’ have you seen? How many of those had evident mobility problems? How many others seemed to have some difficulty in carrying bags etc? How many were accompanied by people of a similar age? How many were accompanied by younger people? In noting ‘older people’ what assumptions/recognition features were you drawing on? Did you note any exceptions? University of Northumbria Service and community learning: interview an older person above retirement age Discuss with them the following subjects:

• What have they enjoyed about getting older? • What, if anything, has surprised them about getting older? • What used to worry them about being older when they were young? • What worries them now? • What are their views of services provided for older people?

Record the responses then consider the following:

• At what stage of old age is the person? • How contented is s/he? • How much is s/he affected by negative stereotypes of older people?

How might what you have found out in this interview influence your social work practice with older people and their carers? University of Teesside Perceptions of ageing quiz Here is a short quiz to start you off: say whether you agree or disagree. You might also like to add a comment: 1. Older people always push in front of queues 2. Older people are old-fashioned and conservative 3. Older people are all wrinkly 4. When you get old you lose interest in sex 5. Older people are boring 6. Older people are nice, they give you presents 7. Older people are always criticising 8. When you get old you just accept what happens to you 9. You lose interest in people when you get older 10. You never feel old University of Teesside ‘Getting old’ agelines

Major sporting retirement 35? Grandparent (technically possible at about) 40+ Able to apply for Saga services (holidays, insurance etc) 50 Known in research as ‘older voters’ 50+ Able to apply to Anchor Housing 55 Other housing associations 60 Travel subsidy (bus pass) 60 Winter fuel allowance 60 Pensionable age (women) 60 Pensionable age (men) 65 Default retirement age 65 Ineligible as magistrate or juror 70 Free television licence (and help with digital) 75 Often refused motor insurance (new customer) 75 Extra pension, extra winter fuel allowance 80 Queen’s telegram 100 2. Self-reflection tasks University of Teesside Reflective task ‘I just ask them what are they dreading and what are they perhaps looking forward to about getting old themselves. And point out that it is really important to think about ageing in relation to yourself, or we can’t really begin to understand because otherwise the fear and denial for ourselves takes over.’ University of Northumbria Questionnaire on death and dying 1. What do you believe about death? 2. What experiences/people have shaped and influenced your views on death and dying? 3. In your culture what rituals are there to help the bereaved? 4. Are you aware of any changes in your culture in relation to the way dying,

death and bereavement are dealt with? 5. How might these changes be beneficial/detrimental?

6. What kind of support is helpful to people who are dying – adults, children or both?

7. What kind of support is helpful for people who are bereaved? 3. Increasing empathy University of Teesside Time line: who is this older person and what might they have lived through?

Aged 0 Aged 3 Aged 14 Aged 18 Aged 40

• 1927 born • 1930 depression • 1941 left school (Second World War) • 1945 rationing • Korea 1950–53, Suez 1956 • 1965+ ‘pop culture’ • ‘Sexual liberation’

Aged 80

• 1987/92 retirement • 2007

4. Stakeholders’ ideas Service users, service user educators and carers suggested the following ideas relevant to teaching and learning: Simulated experiences of some of the common physical restrictions of older age to “help understand that one group of older people can be mentally alert but bodies giving out, others mentally struggling, but physically fit…. Also that ‘physical illness’ can have a psychological impact and vice versa…”. Older people’s ‘visibility’: students need to “think about a cross-section of young people they know … and understand that these traits are still there when older ... older people can become invisible”. Day in the life of…: “It would be a good idea for students to do ‘day in the live of’ exercise and spend time with an older person who was functioning well despite some problems.” Social history: “Social workers need to be able to help older people talk about these things [the past]. Social history helps social workers empathise and allows older people and social workers to have an intelligent conversation.”

ADULTS’ SERVICES knowLEDgE REVIEw 24DECEMBER 2008

Teaching and learning human growth and development in social work

education: older people

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Teaching and learning human growth and development in social work education: older people

This knowledge review examines the nature of qualifying social work education about human growth and development with regard to older people (HGDOP), looking particularly at what promotes or hinders successful outcomes.

HGDOP is a central requirement of qualifying social work education, but has not previously been the focus of any knowledge review. Policies relating to older people are receiving increasing attention, which has important implications for the training and education of HGDOP.

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This publication is available in an alternative format upon request.

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