Using creativity, co-production and the common third in a communication skills module to identify and mend gaps between the stakeholders of social work education

The gap-mending concept

Gap-mending is a concept developed in 2011 by PowerUs – an international network of social work teachers and researchers from schools of social work and representatives from service-user organisations – to encompass methods of inclusion that result in more equal practice. PowerUs seeks to ‘develop methods of mutual learning in order to change social work practice to be more effective in supporting the empowerment of marginalized and discriminated groups in society’ (PowerUs, n.d.). The gap-mending concept is described as ‘an analytical tool that helps teachers, researchers, students and service users to reflect upon what, in their practices, increases, maintains or mends gaps between policies, services and professionals – and of course – service users and students’ (PowerUs, n.d.). Awareness of and interest in gap-mending approaches are growing (Askheim et al., 2017), offering a promising way forward for stakeholder collaboration that is consistent with the values of the social work profession.

The practice context

A long-standing arrangement between one English university and one small user-led organisation (ULO) to deliver a communication skills module is the practice context in which the gap-mending concept is being applied. The remit of the ULO is to support people with experience of housing, health and social care services to have a voice. Many of the service users and carers belonging to this organisation refer to themselves as ‘participants’, hence this terminology is used when referring to ULO members wherever possible. Participation can occur in a myriad of ways, including involvement in social work education. The communication skills module, taught on both the undergraduate and postgraduate courses, provides a means for participating in a sustained and ongoing way. Research shows that service-user and carer involvement is most frequently reported in teaching (Robinson and Webber, 2013), where historically the British model encourages service users and carers to ‘add their perspectives and input to the learning and knowledge provided for the students taking part’ (Askheim et al., 2017, p. 136).

Service-user and carer involvement provides people with lived experience the opportunity to educate students about the subjects that are important to them or where they have specific knowledge or expertise. The effective interpersonal communication skills of social workers remains central to service users and carers (Molyneux and Irvine, 2004; Beresford et al., 2008), which may explain why high levels of service-user and carer involvement can be identified in the teaching of communication skills specifically (e.g. Moss et al., 2010; Hitchin, 2016). The literature denotes considerable variation in service-user and carer involvement in taught sessions, ranging from one-off personal testimonies or guest lectures, which Hatton (2017) has identified as being very common, to a co-trainer model described by Manthorpe (2000) as a model of involvement whereby service users and carers contribute to curriculum design and delivery. The university and the ULO have adopted the latter approach.

Co-production

In order to avoid tokenistic practices, service-user and carer involvement and participation requires an approach based on equality and partnership (Hatton, 2017). Co-production, the broad strategy underpinning the collaborative endeavour of the design and delivery of the communication skills module, was employed to mend the gaps in the relationships between academics and service users and carers. The module, as well as contributing to the development of students’ communication skills, seeks to model social work’s commitment to social inclusion and social justice. It is aligned therefore to the principles inherent within social pedagogy, which, according to Hamalainen (2003, p. 76), seek to ‘promote people’s social functioning, inclusion, participation, social identity and social competence as members of society’.

Co-production has recently been identified as one of the grand challenges facing the social work profession, as recognised at the 2018 Joint Social Work, Education and Research Conference (JSWEC) as a challenge in its own right, and as a barrier to overcoming other grand challenges. Co-production can be defined as a particular form of partnership between people who use social care services and the people and agencies who provide them (Hunter and Ritchie, 2007, p. 9). Definitions of co-production do not transfer easily into social work education: when users of health and social care services take up the role of educator, they become part of the education provision, and the student social workers become the users or intended beneficiaries. Ultimately, however, service users and carers are the end users of the services and interventions which social work students are being educated to deliver.

Alternative ways of conceptualising co-production, which focus on the key features of co-production rather than on the relationships between the actors or the roles they undertake, appear to transfer more easily from social work practice to social work education. The SCIE (2015, p. 5) guide to co-production suggests defining people as assets with skills, building on people’s existing capabilities, ensuring reciprocity and mutuality and helping organisations become agents for change.

Co-production can also be understood in terms of its activities – co-design, co-delivery and co-evaluation (Löffler, 2009), a conceptualisation which perhaps provides a better fit for what is happening in social work education in the UK. Examples of co-produced teaching (Tew et al., 2012; Hitchin, 2016) demonstrate that co-production facilitates stakeholder collaboration and can close the gaps between service users and carers and other stakeholders, provided that involvement is meaningful.

Social pedagogy’s concept of the ‘common third’ provides a useful way of understanding the rationale for developing a combined approach to developing the teaching, learning, assessment and evaluation activities within the communication skills module. According to Hatton (2017, pp. 163–4), Aabro has described the ‘common third’ ‘as a descriptive project or ambition within the pedagogical tradition of “relations in social work in which there is a deliberate focus on the object as something outside the subject. The object being a ‘common thing’ which both parts in the relation” can connect with’. Based on Kolb’s (1984) experiential learning theory, the module involves students undertaking a series of practical tasks, facilitated by ULO participants and academics together. The design and delivery of these joint activities constitutes the ‘common third’, bringing the ULO participants and academics together as co-educators.

Co-design

The genesis of the communication skills module came in response to a number of policy directives identified by the social work reform board and implemented by the social work task force in 2009. The module runs throughout the first year of both the BA and MA social work courses (comprising approximately 30 students each), although they are taught separately due to different start dates. The module comprises the majority of the mandatory 30 skills days (a national requirement for English social work courses), which at this institution includes 10 days of shadowing in a social care agency, and culminates in a readiness for practice interview. The focus is on developing communication skills, whereby ULO participants enable students to consider service-user and carer perspectives. These elements sought to fulfil the policy requirements and gave the module its structure.

The aim of the module is aligned to the standards against which student social workers are assessed, which at the time of writing are specified within the Professional Capabilities Framework. That is, ‘by the point of assessment of readiness for direct practice (prior to first placement), students should demonstrate basic communication skills, ability to engage with users, capacity to work as a member of an organisation, willingness to learn from feedback and supervision, and demonstrate basic social work values, knowledge and skills in order to be able to make effective use of first practice placement’ (BASW, 2018, p. 6). Both partners – the university and the ULO – subscribe to the module aim. The shared goal, which is to facilitate students’ development of their communication skills and improve their understanding of person-centred practice, helps make the involvement meaningful to academics, service users and carers alike.

Curriculum content is continually refined to keep up with new research and literature, to reflect the ever-changing policy context (including professional standards) and in response to feedback from students, ULO participants, practitioners and academics. At the end of the module, feedback and our own critical reflections are more formally reviewed, and proposed changes are considered. Simulated telephone calls, for example, were included at the request of students, many of whom had little or no experience of making a telephone call in a professional context.

In its present iteration the communication skills module comprises:

• theoretical input about communication theories, communication skills and active listening;

• the role of participation and advocacy and the qualities and values of social workers desired by service users and carers;

• opportunities to practice communication skills, including role-playing micro-skills with peers, followed by demonstrating basic communication skills in the social work role through simulated telephone calls, assessments and care-planning sessions;

• an introduction to more specialist communication skills (with people who are deaf or hard of hearing and with children and young people; dealing with conflict and communicating with professionals in an inter-agency context);

• the preservation and protection of the physical and psychological safety of self and others;

• the development of meta-competencies such as using feedback and reflective practice;

• ten days of shadowing in a social care or social work agency.

Although the module has always sought to respond to their feedback, the involvement of students in curriculum design has evolved more slowly than the involvement of service users and carers, reflecting differing policy trends. In the UK, student involvement in curriculum design is encouraged in higher education more generally, whereas service-user and carer involvement is mandatory for social work education specifically.

Co-delivery

The methods for teaching communication skills to student social workers are not prescribed, hence a wide range of pedagogic approaches are used (Dinham, 2006) and there is no coherent body of literature to inform programme design (Diggins, 2004; Trevithick et al., 2004). The approach used in this module is influenced by the ideas of Kolb (1984) and Schon (1987), with all stakeholders valuing a participatory ‘learning by doing’ approach. Taught input is intended to help students get the most out of the experiential learning activities, which simulate real-life case scenarios developed by stakeholders. ULO participants take on the role of a service user or carer, providing opportunities for every student to practise their communication skills through simulated telephone calls, assessments and care-planning sessions. Reading and reflection facilitate the development and mastery of core communication skills.

Initially, the social work academics tended to lead on the theoretical components and the ULO participants taught the skills practice sessions. This created a disconnect between theory and practice, and inadvertently reinforced the ‘us’ and ‘them’ divide between social workers and service users in practice – one of the very issues the module was seeking to challenge. Some degree of co-facilitation was introduced to close these gaps, and some occurred out of necessity – to cover absence and sickness or to manage the technological challenges encountered in the simulated telephone call sessions. The change enabled both partners to experience and appreciate the merits of co-facilitation. A joint presence in discussions means that when issues are raised, about confidentiality for example, students benefit from hearing social worker perspectives from the academics’ practice experiences and service-user and carers’ perspectives as reflected in ULO participants’ experiences. Co-facilitation of a number of sessions has become the normal mode of delivery. The move towards co-facilitation was not to undermine ULO input but to co-produce knowledge by offering different perspectives side by side, a deliberate strategy intended to mend gaps both in knowledge and in relationships. Over time we have come to realise that the pedagogic practices that we use to teach communication skills, and the rationale behind them, are just as important as the content that we cover. Teaching that involves co-design and co-delivery supports the mending of gaps between academics and service users and carers, and models effective co-production, participation and inclusion to students. In the process of becoming joint educators responsible for co-creating innovative teaching and learning activities, the gap between academics and ULO participants closed. However, the gaps between the educators and other stakeholders – students and practitioners – became increasingly more apparent. As Marynowicz-Hetka (2019, p. 290) has explained, ‘social pedagogy sensitizes us to discover what is hidden’.

Co-evaluation

It is not unusual for communication skills or preparation-for-practice modules to be well received by students or viewed in a positive light by stakeholders; however, robust evaluation of the outcomes for students’ learning is lacking (Diggins, 2004; Trevithick et al., 2004), a criticism that has been levelled at social work education more generally (Carpenter, 2005, 2011, 2016). Given the importance of effective communication in social work practice and education, the module leader identified a need for evaluation research, to investigate the effectiveness of teaching communication skills to social work students. Co-evaluation appears to be under-utilised in social work education and remains very much on the periphery of the service-user and carer involvement agenda, a reflection of a wider concern that many service users and carers feel ‘they have not been properly involved in influencing or participating in research’ (Tew et al., 2006, p. vi). For this partnership, it was a logical step, from the co-design and co-delivery of the teaching, to engage ULO participants in the evaluation research.

Co-evaluation was also identified as a strategy to mend the gap between the co-educators (social work academics and ULO participants) and students. Gaps between service users and students have been identified in the literature, with some innovative examples of gap-mending strategies in social work education and research beginning to emerge (Askheim et al., 2017; Heule et al., 2017). Gaps between academics and students, whilst little documented in gap-mending literature to date, have certainly been recognised in higher education more generally. As Healey et al. (2014, p. 12) suggest, ‘engaging students and staff effectively as partners in learning and teaching is arguably one of the most important issues facing higher education in the twenty-first century’. The rationale for involving students in their own education is hard to ignore, and is particularly relevant to social work, given the humanitarian and democratic ideals on which social work is based (BASW, 2012). Collaborative research has recently been identified as an important pedagogic practice across a range of disciplines (Crawford et al., 2015), so for the ULO and the university, including students in the evaluation research provided an opportunity to further extend the gap-mending strategies.

Two academics, three ULO participants and ten students across different cohorts were involved in the co-evaluation, with each person’s contribution determined by their interests and availability. The module leader, an early-career academic, lacked knowledge and expertise in research – a position she was honest about from the research project’s inception – so this was an opportunity for students, ULO participants and the academic to learn together about evaluation research. A range of research questions, designs and methods were considered, and different ideas and perspectives were incorporated. The author and main academic involved in this project was keen to establish changes in learning, and therefore proposed an outcomes-focused research question: ‘To what extent does teaching communication skills to social work students improve their communicative abilities?’ Inclusion of the student perspective in the design of the research was unanimously favoured, resulting in the development of a process-focused question: ‘What factors help or hinder the development of students’ communication skills?’ The research questions informed the mixed-methods evaluation research design, which is well suited to incorporating multiple stakeholder perspectives, and can support a gap-mending approach.

Decisions about methods attracted the most interest from everyone involved in the research project and were informed by multiple influences. Koprowska’s (2010) empirical study, which sought to identify the outcomes of her own communication skills module at the University of York, influenced the outcome measures. Koprowska’s self-efficacy measures were adopted after being piloted by one student cohort. Replicating videoed simulated interactions received unanimous support, harnessing the skills, creativity and enthusiasm of the ULO participants to role-play the service user perspective. Two ULO participants and one student volunteered to pilot the measure, to ensure consistency, build confidence and refine the case scenarios. The same student was later employed as a research assistant, enabling her to contribute to the data collection and analysis. In addition to helping run the statistical analysis for the quantitative data, she also took on the role of peer researcher – developing the interview schedule, conducting and transcribing the interviews and contributing to the analysis of the qualitative data. In terms of wider student involvement, a number of students volunteered to be research participants, several students were involved in discussions about how the research should be conducted and others have been involved in dissemination events. The academic co-ordinated the project and was involved in almost all of the activities in order to develop her own research knowledge and skills.

Choice, interest, time and availability, rather than equality considerations, influenced the type and extent of people’s contributions. Writing about researcher subjectivity, positionality and power, Cleaver et al. (2018, p. 70) have acknowledged that whilst we cannot design such issues out of educational enquiry, self-awareness and reflection enable the potential impact to be recognised and potential negative effects to be contained. The academic was the principal investigator, and – as the only member of the research team employed on a permanent contract – had ultimate responsibility for the research. It would be disingenuous to claim otherwise. However, this research project was a genuine attempt to bring some of the stakeholders together to evaluate a module in which we are all invested. From the academic’s perspective, the research did not feel as co-produced as the teaching, but was a step in the right direction. What was most striking about this endeavour was the value of mutual learning processes and the change in power dynamics and relationships that mutuality affords. For example, undertaking the T-tests together transformed the relationship, from academic and student to co-researchers, working collaboratively to produce statistical analysis. Similarly, all of the stakeholders involved in the dissemination events experienced nervousness about presenting at a conference, irrespective of their role. The impact of these ‘common third’ experiences, wherein different stakeholders produced something together, was very powerful.

Experiencing the values and principles of co-production and having opportunities to learn together in social work education and research potentially has a transformative effect.

Being involved in teaching and researching this module is a step forward in my own recovery.

(ULO participant)

Including students and service users in the research project allowed for their unique perspectives on the effectiveness of teaching communicating skills. Without this, how could you measure their developing skills? Working together removed barriers and enabled a working relationship that promoted inclusion, respect and a desire from students to work harder to become better social workers in the future.

(Student)

The experience of undertaking research that is co-produced has really opened my eyes to the idea of extending partnerships within the academy to include students. Far from being over, I feel like what we’re doing here has only just begun.

(Academic)

Bringing stakeholders together in research and evaluation activities appears to be an effective gap-mending strategy. However, it has prompted us to reconsider the extent to which the co-produced communication skills module actually includes students as stakeholders, an issue which may resonate in social work education in the UK and beyond. In teaching sessions where academics and service users and carers are simply imparting their knowledge to students, the co-trainer model does little to disrupt the somewhat outdated traditional transmission-oriented model of teaching. Contrary to the widespread move in higher education from a teacher-centred concept of the learning process to a student-centred one (Cleaver et al., 2018, p. 11), the British co-trainer model, which mends gaps between academics and service users and carers, might inadvertently be contributing to or reinforcing the gap between the co-educators and students. Drawing on Tilly’s (1998) work, which considers how the common practice of grouping people into binary or categorical pairs serves as a mechanism for reinforcing inequality, Heule et al. (2017, p. 398) have explained that ‘the danger of such categorical pairs is that they are seen as opposites and that one is often seen as stronger, more powerful and more legitimate than the other’. In their article, the authors are referring to social workers and service users as the opposite pairs. However, if we apply this concept to social work education, students and educators can also be conceived of as a categorical pair. For many social work academics, this is an uncomfortable thought, but acknowledgement of the power imbalances inherent in our educational institutions and organisational practices is an important step in overcoming them. Within our existing partnership, we have started to challenge our own practices, to ensure we are not stifling opportunities for student participation and inclusion in curriculum design and delivery, and in recognition of the shift to engage in wider collaboration between multiple stakeholders. Building on our shared values and collaborative relationships, we have begun to consider how co-production could increase the agency of our student stakeholders within mainstream teaching and learning activities.

Gap-mending strategies

The next challenge for this partnership, and for social work educators more generally, is to move small-scale student participation and involvement beyond discrete projects and into the mainstream curriculum, so that the benefits are available to everyone. In spite of the increased appetite for student engagement and involvement, there are few examples in the UK literature of students becoming partners in designing the curriculum and giving pedagogic advice and consultancy (Healey et al., 2014). To close the gap in social work education, we need to identify opportunities for academics, service users and carers, students and also practitioners to engage in mutual learning processes within joint teaching, learning and assessment activities.

Four strategies have been identified within the communication skills module so far, although we recognise that this is just a starting point. First, opportunities to present in the personal testimonies session have been opened up to anyone with lived service-user or carer experience. Student care-leavers in particular often have a wealth of very recent knowledge and experience from which everyone else can learn. The opportunity now exists for ULO participants, academics and students to share their personal testimonies side by side, creating a more mutual learning experience that recognises the multiple identities individuals hold. Sharing responsibility for educating others can engage and empower students who are deemed to be marginalised. A similar approach works well in sessions that address discrimination and oppression, providing ground rules have been established and a safe learning environment has been created. Reconceptualising the relationships encourages students to adopt collaborative responsibility for learning and teaching with staff (Healey et al., 2015).

Second, we have increased opportunities for formative peer feedback on students’ developing skills throughout the module, so that tutors and ULO participants no longer have the monopoly on feedback-giving practices. Peer feedback on formative activities is widely supported in pedagogic research about developing communication and pre-placement skills (Krause et al., 2017; Tompsett et al., 2017). The benefits of peer support were identified in our own evaluation, prompting us to develop this strategy further. Although peer feedback comes with its own challenges, our students were instrumental in creating effective strategies to overcome the anxieties associated with the feedback-giving role. For example, critiquing exemplar work together and collectively producing ‘top tips’ gave students the confidence to generate useful feedback to each other.

Third, students, academics and ULO participants have started to co-produce video exemplars (a suggestion made by a research participant in the evaluation research), which contributes to the teaching of subsequent cohorts. To support the theoretical input for skills such as paraphrasing and summarising (one of the more transmission-oriented sessions), the delivery is now punctuated with students’ video clips, demonstrating the skills in action. In addition, interview exemplars modelling whole interactions have been made available in the virtual learning environment, giving new students something to aspire to. Warren and Boxall (2009, p. 282) described service users, students and tutors being engaged in knowledge production within the classroom as a ‘participatory and emancipatory learning methodology’. Communication skills modules, which tend to involve experiential learning activities, may be particularly well suited to this approach. As well as providing useful outputs, it is the process of creating the educational materials, the ‘common third’, that seems to be important. Building on ‘reciprocal relationships and the co-production of knowledge’ (Askheim et al., 2017, p. 130) helps underpin the value of the ‘common third’.

Fourth, to strengthen the collaboration with practitioners, we are aligning our Practice Educator course and social work qualifying programmes, holding some joint sessions to trial mutual learning activities between the student cohorts, some of whom will be matched in the next round of placements. Discussing together the attributes of a successful student–practice educator relationship, and clarifying roles and expectations, has particular value. The impact of these endeavours will need to be evaluated to determine whether or not they contribute to the students’ self-efficacy and developing communication skills as well as meeting the learning needs of the trainee practice educators, but initial feedback from both stakeholder groups has been positive.

Conclusion

Social work needs academics, service users and carers and practitioners to maintain a continuous dialogue, learning with and from each other (McLaughlin et al., 2016, p. 864). We have come to realise that students also need to be included in the dialogue and learning. Describing a vision for the future, Healey et al. (2015, p. 162) have stated that ‘it should be the norm not the exception, that students are engaged as partners in learning as teachers, scholars and change agents and that co-creation, co-designing, co-researching and co-learning should be common practice between staff and students across higher education’. Involving students in curriculum design and delivery is at an embryonic stage in social work education and we have a long way to go before we can truly challenge traditional power dynamics within the learning environment. However, our professional value base and our strong tradition of service-user and carer involvement means we already have some experience of co-producing curriculum content and design. ULOs may well be able to use their experiences and expertise to extend existing collaborations. In the UK, the mainstreaming of service-user and carer participation in all stages of social work education is firmly embedded (Askheim et al., 2017), demonstrating that academics and service users and carers can successfully move beyond traditional role boundaries. Now we need the courage to enable students to do the same – not just in their practice with others, but also for themselves, starting inside the academy. Widening and strengthening collaborations to mend gaps between students, academics and service users and carers, and also practitioners, will require us to create disciplinary communities of practice: a challenge that promises to be ‘both difficult and destabilising, effortful and provocative’ (Healey et al., 2014, p. 21). Whilst social pedagogy is an approach without fixed recipes (Rothuizen and Harbo, 2017), it has been proposed in this article that creativity, the common third and co-production offer some potential strategies through which the effective collaboration of different stakeholders can be achieved.