Guide for Self Reflection: Social Work - Clinical Recognition Program - The Knight Nursing Center for Clinical & Professional Development - Patient Care Services

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One of the questions most frequently asked by clinicians when they hear about the Clinical Recognition Program is, "How will I know my practice level?" This question cannot be answered by completing a checklist or counting up the years of employment. It requires that you think about your practice and the impact you have had on patients, families, and colleagues.

To help you assess your level of practice, we recommend the following steps.

Read through the attached descriptions of each level of practice. You’ll find that the descriptions refer to "themes" or aspects of clinical practice: clinician/patient relationship, clinical knowledge and decision-making, and teamwork/collaboration. Within each theme, four levels of practice are described:

Entry
Clinician
Advanced Clinician
Clinical Scholar

As you read through the descriptions, make note of the differences between each level. Think of specific examples of clinical practice that would "fit" with the criteria being described.

Once you have a sense of the levels, reflect on your own experiences with patients. The more specific you can be in your reflection, the better. For example, as you review the theme of clinician-patient relationship, think about experiences you have had working with specific patients and families. Look at the criteria for the various levels of practice within this theme. What level of practice best characterizes your experiences with regard to the clinician/patient relationship? You might find it helpful to think about someone who represents your "ideal" in the way he/she relates to patients. How does this person’s practice fit the criteria described in the levels? How does it compare to your practice?

Similarly, as you think about your clinical knowledge and decision making, ask yourself which level best describes how you use your knowledge to make decisions about patient care, how you organize and prioritize your patient care responsibilities, or how you seek out and use resources.

In considering the collaboration/teamwork theme, think about how you work with your colleagues in clinical practice and how these interactions have evolved over time. Consider the nature of your professional relationships with colleagues within and outside of your discipline, how you contribute to an interdisciplinary approach to care, and how you help create an environment that supports excellence in patient care.

Having analyzed your own practice in light of the descriptions of the levels, ask yourself, "At which level do I practice most consistently?" You may well find that there is a range to your practice – that you generally practice at one level but, depending on the situation, may "visit" a different level. Ask yourself, "Where do I live in my clinical practice? Do I practice mostly at the Advanced Clinician level, or do I visit the Advanced level from time to time, with most of my practice being that of the Clinician?" You will likely find that your practice matches a particular level most consistently.

Look at the level where you think you practice most of the time. Challenge your findings. For example, closely examine the criteria at the next level. Can you think of examples from your own experience that fit this description? If so, how often do they occur?

Take your time in completing this reflection. It will give you an important starting point in thinking about where your clinical practice lies.

Once you have given some thought to your own practice, make an appointment to talk to your manager/director. Use the meeting to talk about your practice. Discuss specific examples.

Through your manager/director, you will be recognized at the Entry or Clinician level. If you and your manager/director agree that your practice is at the Advanced Clinician or Clinical Scholar level, decide if you would like to move forward and submit a portfolio to the Clinical Recognition Program’s peer review committee. The committee will review your portfolio, interview you about your practice, and determine whether you meet the criteria for the level you have identified.

To complete a portfolio for recognition at the Advanced Clinician or Clinical Scholar level, ask your manager/director for an application packet or click here to view the Application Packet.

Clinical Recognition Program

Patient Care Services

Massachusetts General Hospital

Levels of Practice

Social Work

	Entry	Clinician	Advanced Clinician		Clinical Scholar
Clinician/Patient Relationship The interpersonal engagement or relational connection between the clinician and the patient and/or family	Able to demonstrate empathic understanding of patients/families Ability to engage with diverse patient population (differing personalities, illnesses, social, economic, and cultural factors) Ability to identify own personal reactions and seek appropriate support and supervision Learning to manage the professional relationships	Able to be present; stay with; sit and listen to patient’s story and underlying affect; bearing witness to patient’s story Able to sit with and respond to strong affect Capacity to work within the therapeutic relationship to develop mutually agreed upon goals with the patient Capacity to encourage patients in self reliance, maintaining a reasonable expectation of growth and change Ability to identify need for and to set appropriate boundaries with diverse patient populations	Capacity to use the self to enable effective working relationship Capacity to work skillfully with a designated population of patients considering a multiplicity of factors (biological, psychological, social, cultural and environmental) Ability to enable patient to develop self-reliance, self- knowledge and self-awareness; to become empowered in their own treatment and care Ability to step back and objectively perceive the patient, the self, and the dynamics of interaction		Innovatively and creatively engages patients and families Purposefully integrates transference/counter-transference to further the therapeutic alliance Establishes working relationships with help resistant, difficult, complicated, multi-problem patients and families Integrates theoretical knowledge, clinical skills, and active and purposeful use of the self to guide the therapeutic intervention with patients and families
Notes:
	Entry	Clinician		Advanced Clinician	Clinical Scholar
Clinical Knowledge and Decision-Making Understanding attained through formal and experiential learning.	Ability to gather psychosocial information from a variety of sources and use a broad theoretical framework to make an assessment Able to employ relevant interventions based on assessment Able to provide patient and family education regarding community and hospital resources Seeks appropriate supervision and consultation Appropriately uses protocols for clinical decision making	Ability to simultaneously process patient/family information and social work theory Ability to perform biopsycho-social assessments integrating theory and setting appropriate treatment plans (biopsycho-social, cultural, etc.) Ability to intervene with patients and families using more than one treatment modality Ability to recognize need for and provide psycho-education to patients and families Demonstrates confidence and competence in familiar situations Ability to transfer skills and knowledge into unfamiliar situations Ability to prioritize based on patients’ need Ability to mentor colleagues		Demonstrates working knowledge of multiple theories relevant to practice Demonstrates expertise in diagnosis and clinical interventions Demonstrates clinically sound risk taking Ability to discern/prioritize those patients and families that can benefit from clinical interventions Incorporates in-depth patient and family education in area of own expertise Demonstrates confidence and competence in unfamiliar situations Ability to teach/supervise colleagues Ability to refer to and/or seek consultation from other appropriate health care providers	Demonstrates expertise in theory relevant to social work practice Demonstrates ability to confidently, competently, and creatively treat patients and families using a variety of modalities Ability to focus and prioritize treatment interventions in complex, multi-problem patient situations Sought out to teach, supervise, and provide consultation to colleagues in own and other disciplines Demonstrates wisdom in decision-making based on theoretical, clinical, and experiential knowledge Demonstrates professional contributions to clinical knowledge and practice
Notes:

Entry

Clinician

Advanced Clinician

Clinical Scholar

Collaboration/Teamwork Collective work for the good of the patient and family; built on communication of clinical and ethical understandings between healthcare providers.

Identifies problems and seeks consultation

Team membership characterized by thoughtful observation and information sharing
Works collaboratively and problem solves with individual team members
Joins actively in the work of the Collaborative Leadership Team

Actively shares clinical knowledge (obtained from many sources) and own clinical impressions to keep others informed in order to provide quality, team-oriented patient care
Able to articulate the social work perspective to promote problem solving
Actively shares responsibility for getting the work of the Collaborative Leadership Team done
Provides support to social work and multi-disciplinary colleagues
Understands the roles of other disciplines
Attracts referrals and is sought out by colleagues for collaboration.

Incorporates multi-disciplinary perspective in promoting quality, team-oriented patient care
Able to articulate a point of view on the team that enables the team to comprehensively problem solve
Assumes leadership in departmental Collaborative Leadership Teams
Understands roles of other disciplines and able to articulate the limitations of social work
Sought out by colleagues for consultation and referral
Provides consultation to interdisciplinary colleagues re: psychosocial issues and patient/family behavior
Chairs committees and task forces focused on patient care
Utilizes conflict resolution skills in response to difficult situations and conflicts with colleagues

Able to effectively mobilize the interdisciplinary team to provide quality patient care
Uses knowledge of the organization to identify and solve system and patient problems
Articulates the clinical expertise of social work on the team
Sought for clinical expertise (consultation and referral)
Promotes team building in all its diversity
Promotes creativity and growth of peers
Chairs interdisciplinary committees and task forces focused on patient care

Notes: