Educating Students for a Changing Health Care Environment: An Examination of Health Care Practice Course Content

By Kadushin, Goldie; Egan, Marcia | Health and Social Work, August 1997 | Go to article overview
Save to active project

Educating Students for a Changing Health Care Environment: An Examination of Health Care Practice Course Content

Kadushin, Goldie, Egan, Marcia, Health and Social Work

Students in the health care concentration are the third largest group of students in graduate social work programs (Lennon, 1992). Social work educators are confronting several challenges in preparing students for health care practice. Given the changing environment in which health care social workers practice and the changing nature of practice itself (Berkman, 1996; Strom & Gingerich, 1993), it is surprising that there have been no surveys of the health care curricula since the 1980s (Caroff & Mailick, 1985; Marshack, Davidson, & Mizrahi, 1988). Consequently, social work has no current information on what is taught in graduate schools to prepare students for practice. This issue prompted this survey of the initial graduate-level health care practice course.


Five trends in the health care environment are affecting practice roles: (1) deinstitutionalization, (2) a growing elderly population, (3) the more frequent occurrence of biomedical ethical issues in health care delivery, (4) the AIDS epidemic, and (5) a growing population of people from diverse cultural backgrounds.


Drastic changes in health care financing - such as the adoption of the Medicare prospective payment system and the emergence of managed care - have resulted in fewer hospital admissions and reduced length of patient stays. An increasing amount of care is being provided outside hospitals in community-based, ambulatory, and long-term care settings (Berger et al., 1996; Berkman, 1996; Poole, 1995; Rosenberg, 1994; Simmons, 1994).

The current tendency to reduce inpatient stays suggests that discharge planning will remain an important focus for hospital social workers (Kadushin & Kulys, 1993). The need to coordinate care more efficiently while a patient is hospitalized and after discharge makes care coordination and case management a pivotal social work role (Berger et al., 1996; Berkman, 1996; Rosenberg, 1994; Simmons, 1994). Skills in interdisciplinary collaboration are important both within the institution and in the community (Abramson & Mizrahi, 1996; Berkman, 1996). As patients receive more care in their own homes, social workers will need to provide support to families, who bear most of the burden for community-based care (Lurie, 1995; Poole, 1995; Rosenberg, 1994). The emphasis of managed care and the prospective payment system on outcomes, profits, and regulation of service delivery creates a need for practitioners to be skilled in short-term treatment and practice evaluation (Vourlekis & Leukefeld, 1989; Strom & Gingerich, 1993).

Elderly Population

The proportion of people older than age 65 increased from 4 percent of the U.S. population in 1900 to 13 percent in 1994 and is expected to increase to 17 percent by 2020 (Keigher, 1995). As people live longer, they are more likely to suffer from chronic rather than acute illnesses (Rosenberg, 1994). Health care for this population should be focused on primary care with an emphasis on disease prevention and health promotion (Berkman, 1996). These clients also will require an array of supportive services to remain in the community (Simmons, 1994). Thus, there will be a demand for social workers trained in aging and gerontology (Keigher, 1995).

Ethical Issues

Issues such as patient rights, advance directives, and ethics review committees have become a part of the practice arena. Social workers are increasingly called on to respond to practice situations involving biomedical ethical decisions. Concerns related to the rationing of health care resources and the implementation of advance directives have been identified as areas in which social workers require more education and training (Foster, Sharp, Scesny, McLellan, & Cotman, 1993).


New diseases, most notably AIDS, are becoming part of the health care environment. The need to train social workers to provide services to people with HIV/AIDS has received increasing attention in the literature (Dane & Miller, 1990; Diaz & Kelley, 1991; Miller & Dane, 1990; Schinke, Schilling, Krauskopf, Botvin, & Orlandi, 1988; Silberman, 1991; Steiner, 1995; Taylor-Brown & Garcia, 1995; U.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Educating Students for a Changing Health Care Environment: An Examination of Health Care Practice Course Content


Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?