The (Inter)Professional Identity of Hospital Social Workers: Integration and Operationalization of Profession-Specific Knowledge, Skills, and Values with Boundary-Spanning Competencies

Abstract

Purpose: This dissertation examines the professional identity narratives of hospital social workers in a way that is conceptually grounded and relevant to efforts to engage with interprofessional collaborative practice. Although significant literature exists to describe the roles and contributions of hospital social workers, less is known about their perceptions of their professional identity as it relates to their efforts to collaborate with interprofessional healthcare teams. This study helps to fill that gap by analyzing interviews conducted with hospital social workers. Methods: Data include interviews (n=20) with Masters in Social Work-trained hospital social workers from three large university-affiliated hospitals in the Pacific Northwest region of the United States. Interviews were conducted in the summer of 2012 as part of the University of Washington TL1 Translational Research Training Program. Data were analyzed using the qualitative method of interpretive thematic analysis. Results: Three analyses were conducted in this study. First, was the examination of the unique elements of professional social work identity (knowledge, skills and values). This analysis yielded three themes: 1) Social Workers as “Bigger Picture People”, 2) Soft Skills Pervade, and 3) The Influential Code of Ethics. Second, was the examination of boundary spanning competencies required for effective collaboration. This analysis yielded four themes: 1) Collaborative Spirits, 2) Cross-Profession Synthesizers, 3) Boundary-Spanning Communicators, and 4) Owners of Practice Domains. Third, was the examination of social workers’ experiences working on interprofessional teams. This analysis demonstrated that facilitators and barriers to collaboration are impacted by variables across multiple levels. Five themes emerged: 1) Social Workers’ Confidence, 2) Role Ambiguity, 3) Time for Collaboration, 4) Institutional Support, and 5) Hierarchy and Power. Together, the analyses present a depiction of the “dual identity” or “interprofessional identity” of hospital social workers, and their experiences operationalizing this identity in their practice settings. Discussion and Implications: Findings from this study demonstrate strengths and possible areas of weaknesses related to the professional grounding and boundary-spanning capacities of hospital social workers. Several social workers were able to articulate a strong sense of what it means to “belong” to the profession, but at the same time social workers described challenges with their professional identities. Most provided positive reports related to their ability to work alongside their team members and effectively collaborate. However, some provided examples of feeling misunderstood, under-utilized, or unappreciated by other health care professions. Role ambiguity and overlap were commonly cited barriers to collaboration. Findings have implications for social work education and research priorities.