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Strengthening the
Cancer Knowledge and Skills
of the Social Work Labor Force
Maureen Y. Lichtveld, MD, MPH
Alison P. Smith, BA, BSN, RN
©2009 National Association of Social Workers. All Rights Reserved.
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• 501 (3) c (not for profit) organization
• Organization of leaders
– Private – pharma, biotech, insurance
– Public – federal, state, local health agencies
– Not-for-Profit – professional, advocacy, care-giving
organizations
• Collaborate to address issues that can not be solved in isolation
• Work spans the continuum of research and care
©2009 National Association of Social Workers. All Rights Reserved.
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Learning Objectives
At the end of this session, participants will be able to:
• Articulate the significance of the health workforce shortages
effecting people at risk for and living with cancer
• Identify priority areas for cancer competency among LCSW
students and practicing clinicians
• Describe the practical utility and flexibility of the competency tools
for strengthening social worker’s cancer knowledge and skills
• Apply competency-based methods and tools to develop cancer
programs for social workers
©2009 National Association of Social Workers. All Rights Reserved.
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Challenge
The Cancer Workforce Shortage
©2009 National Association of Social Workers. All Rights Reserved.
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Supply of Social Workers
Health of the Profession - From NASW
• The social work labor force is older than most professions with nearly
30% of licensed social workers over 55 years of age
• Social workers employed in hospices are most likely to report
vacancies as common(19%), followed by those in hospitals (14%) and
health clinics (8%)
• They are more likely to serve clients of color than social workers
overall (52% versus 43%)
• Significantly less satisfied with client access to mental health services
than licensed social workers overall (43% versus 59%)
• Those practicing in rural areas are least satisfied with access to
resources
• There are approximately 1500 oncology social workers
©2009 National Association of Social Workers. All Rights Reserved.
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Supply of Cancer Team Members
Shortage of cancer specialists:
• Social Workers
• Physicians / Oncologists
• Nurses
• Pharmacists
• Technologists
• Researchers
• Cancer Registrars
©2009 National Association of Social Workers. All Rights Reserved.
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Demand for Cancer Services
• Cancer is the second most common cause of death by disease
claiming the lives of more than half a million people per year
(ACS, 2007)
• Cancer rates are expected to increase as baby boomers age
(CDC, 2000)
• The lifetime probability of developing cancer is 1 in every 2 men
and 1 in every 3 women (NCI, 2005)
• Five-year cancer survival rates have risen to 64% for adults
(CDC, 2005)
©2009 National Association of Social Workers. All Rights Reserved.
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Overview of Challenge
Supply, Demand, & Action
• Widespread shortages across the cancer workforce
• Demand for cancer services exceeds current and
projected needs
• Many organizations addressing discipline- or specialtyspecific cancer workforce issues
©2009 National Association of Social Workers. All Rights Reserved.
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Solutions
Strengthening the Non-Oncology
Health Workforce
©2009 National Association of Social Workers. All Rights Reserved.
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Untapped Opportunity
Oncology Specialists
Social Workers
1,200 AOSW Members
380 APOSW Members
Nurses
©2009 National Association of Social Workers. All Rights Reserved.
21,000
Oncology certified
All Professionals
320, 000
Licensed Clinical
Social Workers
2,000,000
Registered Nurses
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Cancer Core Competency Initiative
Goal:
Strengthen the basic cancer competency
(knowledge, skills, and attitudes)
of non-oncology health workforce
©2009 National Association of Social Workers. All Rights Reserved.
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Competency Standards
In order to reduce the nation’s burden of cancer, any health professional must be
able, within the scope of his/her professional practice, to:
Domain I – Continuum of Cancer Care
• Describe the components comprehensive cancer care, including team
communication , diagnosis and treatment, palliative care, survivorship
• Describe cancer prevention guidelines (e.g., USPSTF, ACS)
• Direct an individual to resources for cancer prevention
Domain II – Basic Cancer Science
• Define the purpose and requirements of cancer registries.
• Describe the clinical trial process beginning with informed consent
Domain III – Communication & Collaboration
• Incorporate cross-cultural communication strategies in conveying cancer
information
• Describe the contribution of each professional perspective in the development of a
cancer care plan
©2009 National Association of Social Workers. All Rights Reserved.
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Breadth & Depth of Competency Standards
Advocacy Organizations
Domain I
Continuum of Care
Prevention / Early Detection
Treatment / Survivorship
Palliative Care
©2009 National Association of Social Workers. All Rights Reserved.
Work Setting
Competency
Standards
Domain II
Basic Cancer Science
Etiology / Epidemiology
Clinical Trials
Cancer Surveillance
Discipline
Administration
Ambulatory Clinics Academics
Acute Care Clinics
Cancer Centers
Home Health Agencies
Professional Societies
Allied Health
Medicine
Nursing
Pharmacy
Public Health
Research
Social Work
Students
Residents/Fellows
Field Faculty
Practicing Professionals
Domain III
Communication & Collaboration
Interdisciplinary Care
Psychosocial Communication
Cross-Cultural Communication
Grieving
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Cancer Core Competency Initiative:
Program Elements
• Planning
– Competency Standards
– Program design tools
• Implementation
– Educational encounter
• Evaluation
– Knowledge
– Skills
– Attitudes
©2009 National Association of Social Workers. All Rights Reserved.
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Pilot Site Findings:
Marshall University - Huntington, WV
•
•
•
•
•
©2009 National Association of Social Workers. All Rights Reserved.
Medical Students
Breast cancer screening & patient
communication
Standardized patient examination &
communication
Improvement in Knowledge: 119% 
from pre-post test
Measureable clinical & interpersonal
skill increases
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Pilot Site Findings:
California University of Pennsylvania - California, PA
• Social Work Students & Field Instructors
• Cancer-related Anxiety and Depression
• Classroom, on-line, and standardized patients
• Improvement in Knowledge: 136%  from pre-post test
• Measurable increases in ability to recognize and manage
anxiety and depression
©2009 National Association of Social Workers. All Rights Reserved.
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Pilot Site Findings:
Audrain Medical Center - Mexico, MO
• Public health nurses working in rural counties
• Skin cancer screening & early detection
• Course and clinical rotation
• Improvement in Knowledge: 39%  from prepost test
• Measureable increases in differentiating
between benign and malignant lesions
©2009 National Association of Social Workers. All Rights Reserved.
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Pilot Site Findings:
University of Pittsburgh Medical Center - Pittsburgh, PA
• Primary care practitioners working in rural areas
• Survivorship
• Workshop, enduring Webcast, and toolkit
• Improvement in Knowledge: 20%  from pre-post test
• Measurable increases in ability to assess and manage
survivorship issues
©2009 National Association of Social Workers. All Rights Reserved.
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Pilot Site Findings: Qualitative Outcomes
Professional
 Professional
development





Learner
Institution
Increased
Community
 Enhanced
knowledge
 Enhanced
visibility/
Increased
relationship with
credibility
confidence
institution
 Provided
Received tangible
foundation for  Addressed needs
reference materials
future trainings  Benefits of better
Enhanced academic
prepared/
experience
increased
Enhanced
workforce
professional selfreflection
©2009 National Association of Social Workers. All Rights Reserved.
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Cancer Core Competency Initiative:
Pilot Site Findings
UTILITY
• Pilot sites found the cancer core competencies to be highly useful
FLEXIBILITY
• Implementation of the competencies was feasible across cancer
core continuum, professional settings, and disciplines
©2009 National Association of Social Workers. All Rights Reserved.
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Getting the Results
Investing in a Competency-Driven
Approach to Improve Cancer Care
©2009 National Association of Social Workers. All Rights Reserved.
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Anatomy of a Competency Standard
Competency statements define what a professional
should know or do:
Define palliative and end-of-life care
Level of complexity
and/or independence
Targeted cancer content
Within context:
Scope of Practice
Level of Expertise
Role and Responsibilities
©2009 National Association of Social Workers. All Rights Reserved.
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Bloom’s Taxonomy
EVALUATION
Increasing
level of
independence
SYNTHESIS
ANALYSIS
APPLICATION
COMPREHENSION
KNOWLEDGE
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Adult Learning Practices
• Adult learning environments are designed
to minimize dependence and maximize
independence.
• Adult instructional strategies adapt to the
learners’ previous experiences including
skills and content.
• Faculty in adult learning settings function
as both instructors and facilitators.
©2009 National Association of Social Workers. All Rights Reserved.
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Competency to Curriculum
Verb
Instructional
Design
Describe
Dialogue
Short Answer
Apply
Case Study
Role Play
Synthesize
Table Top
Essay Question
Peer Review
Standardized
Patients
Evaluate
Learner
Assessment
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Planning, Implementation & Evaluation
Tools: Logic Model
INPUTS
Program
resources
OUTCOMES
OUTPUTS
Activities
Participation
Efforts on the part of the program
or intervention staff
Short
Medium
Changes in the participants
Changes in the learner’s
knowledge, attitudes, beliefs
The logic model assures that all of the program resources
directly support the achievement of the desired competency outcome.
©2009 National Association of Social Workers. All Rights Reserved.
Longterm
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Planning, Implementation & Evaluation
Tools: Validation Template
©2009 National Association of Social Workers. All Rights Reserved.
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Steps for Program Development
Sustain
Efforts
Through
Sharing
Define
Audience &
Topic Area
Complete Needs
Assessment
& Interpret
Findings
Evaluate
and Interpret
Data
Implement
& Manage
with Attention
to Details
Build a
Balanced
Leadership
Team
Develop
Logic Model
& Validation
Template
Refine
Competency
Focus
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Steps for Program Development
Define
Audience &
Topic Area
Build a
Balanced
Leadership
Team
Needs
Assessment
& Interpret
Findings
Are there colleagues who would benefit from a
competency program?
What cancer topic would help professionals meet
the needs of clients/patients?
Who are the topic experts?
Who can foster support for the program?
What will motivate participants?
What will translate learning into practice?
©2009 National Association of Social Workers. All Rights Reserved.
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Steps for Program Development
Refine
Competency
Focus
Logic Model
& Validation
Template
Implement
& Manage with
Attention to
Details
What do I want the professionals to know or do?
What resources will support my program?
What programmatic activities will occur?
What are the desired changes in participants?
Does IRB approval need to be obtained?
Can CME/CEU credit be provided?
©2009 National Association of Social Workers. All Rights Reserved.
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Steps for Program Development
Evaluate
and Interpret
Data
Sustain
Efforts
Through
Sharing
How can participants be evaluated through pre-post
tests, skills tests, and/or participant perceptions?
How can project activities be shared within and
outside of the professional community?
©2009 National Association of Social Workers. All Rights Reserved.
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Summary
Resources and Next Steps
©2009 National Association of Social Workers. All Rights Reserved.
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Examples &
Templates
Program Resources
Overview & “How to” Guidance
Pilot Site Report
Universtiy of Pittsburgh Medical Center
Summary Publications
Pilot Site Report
Marshall University School of Medicine
Pilot Site Report
California University of Pennsylvania
School of Social Work
Pilot Site Report
Audrain Medical Center
Addressing the Cancer Workforce Crisis
Using a Competency-Based Approach
with Non-Oncology Professionals
Pilot Project Evaluation Report
July 2008
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Cancer Core Competency Initiative
Summary
• Effective method to address the cancer workforce shortage
• Applicable in a variety of professional disciplines and settings
• Bolsters professional development and retention efforts
• Provides numerous resources for competency-based program
development
• www.cancercorecompetency.org
• [email protected]
©2009 National Association of Social Workers. All Rights Reserved. 1
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