Scoping Review: Medical Education Interventions Optimizing Social Workers in the Emergency Department

Abstract

Introduction: As the significance of social workers (SW) in improving healthcare delivery in the emergency department (ED) continues to expand, emergency physicians will increasingly be expected to effectively partner with SWs in both academic and community settings. In this scoping review we sought to provide evidence-based recommendations for effective emergency clinician educational interventions on how to incorporate SWs in the ED to address health-related social needs while also identifying directions for future research. Methods: We conducted a systematic literature review of publications in PubMed, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and APA PsycINFO. A search strategy was designed in accordance with Peer Review of Electronic Search Strategies (PRESS) guidelines. Using the scoping review framework by Arksey and O’Malley, we applied consensus-based inclusion and exclusion criteria to guide study selection. A Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) flow chart delineating the selection process was generated using Covidence. Results: Our search strategy identified nine qualifying articles for further analysis out of an initial sample of 2,119 articles. Of the nine articles that underwent full text review, 89% (8/9) evaluated a short educational didactic with or without a hands-on component to reinforce learning. Barriers to successful implementation of curricula discussed in all articles included time constraints, lack of buy-in from clinical faculty, lack of knowledge of appropriate referral sources once a problem is identified, and perceived distraction of the training from more standard clinical topics. Facilitators of curricula implementation and training success included the presence of a pre-existing and structured weekly conference schedule, ability to complete the training in a relatively short time frame or during intern orientation, presence of simulation resources, and residents’ overall perceived interest in the topics. Conclusion: Ultimately, we found that interdisciplinary learning with SWs is generally well received by participants, and we offer various suggestions on incorporation into student and resident education. Moving forward, we recommend that a standardized curriculum of working with SWs be developed using didactic sessions, simulation, and/or direct observation with feedback.

Complexity of care in the emergency department: Shall we treat the whole person to prevent revisits?

“…Estos últimos ya incorporados en muchos centros, dado que la conciliación de medicamentos podría ser otro factor de complejidad más a estudiar. La presencia de trabajadores sociales 18 durante las guardias proporcionaría una cartera de servicios adicional, que serviría de apoyo en la toma de decisiones de los facultativos a la hora del alta y evitaría la reconsulta en muchos casos. En este punto, es fundamental exponer la condición de los servicios de emergencias médicas prehospitalarias 19,20 (SEM) como fuente primaria de información sobre las necesidades sociales de los pacientes trasladados: condición de la vivienda, situaciones de maltrato de género o infantil, indigencia, situaciones de soledad sin cuidadores responsables del individuo tras el alta hospitalaria, barreras idiomáticas, barreras de movilidad, situaciones de discapacidad para el autocuidado, conocimiento de los problemas de salud y trata-…”