Teaching Practice Skills to Online MSW Students: The Blended Skills Lab Model

As social work considers teaching practice in a fully online environment, more consideration should be given to blended or hybrid learning formats for practice course delivery. There is a dearth of literature on the use of skills labs for teaching social work practice courses, particularly using a blended or hybrid approach. Using Carman’s five key constructs of blended learning (live events, online content, collaboration, assessment, and reference materials), this study examined the use of a blended skills lab to teach social work practice skills online to MSW students. As the number of online programs continues to expand in social work education, the blended skills lab model is examined as a case study, offering implications for others to consider as they formulate alternative models for online MSW students. A blended skills lab model takes full advantage of the benefits of each platform--online and face-to-face--in order to provide an educational opportunity that can promote student learning better than either platform alone.

Online education in social work has significantly expanded over the last two decades. Several factors have contributed to the growth of online education in social work, including the availability and use of new technologies, a changing student population, an increased societal focus on lifelong learning, and growing educational requirements for professional licensing and career advancement (Coe Regan, 2016;Hitchcock et al., 2019).  has further contributed to the growth in online education as many programs had to make a sudden shift to using digital platforms as campuses shut down around the world. Research suggests that online learning has been shown to increase retention of information, and take less time, so the changes coronavirus have caused might be here to stay (Li & Lalani, 2020). Online courses provide opportunities for widening and expanding access to social work education (Kurzman, 2013). This growth of online education within social work can also be seen as an effective response to the need for an increased workforce of social work professionals. According to the Bureau of Labor Statistics (2018), overall employment of social workers is projected to grow 16% from 2016 to 2026.
According to the Council on Social Work Education (CSWE) Annual Survey of Social Work Programs (Hitchcock et al., 2019), 22.9% of respondents indicated that their entire MSW program was available online, 42% responded that part of the MSW program was available online, and 13.9% stated that they were either developing online courses or would have courses in operation the following year. Just twelve years prior, a question regarding online programs was not even a part of the 2007 Statistics on Social Work Education report (CSWE, 2008).
Despite the growth of online education in social work, social workers and social work educators alike continue to express concerns regarding the effectiveness of online courses (Groshong et al., 2013;Jones, 2015;Vernon et al., 2009). Concerns regarding online social work education are especially raised around the teaching of practice courses online. Specifically, social work educators have expressed concerns about the effectiveness of learning practice skills solely in an online format (Jones, 2015). The Clinical Social Work Association (CSWA) questioned the effectiveness of online social work education to prepare social work practitioners without face-to-face instruction. Concerns were raised that the relational skills and integrative knowledge essential in social work practice are difficult, if not impossible, to convey in online education formats where there is little or no in-person dialogue between faculty and students (Groshong et al., 2013). These worries were also clearly expressed in a survey study by Vernon et al. (2009), where a number of student respondents expressed views such as "I firmly believe practice courses should never be online" and "Distance learning works best with courses that are primarily didactic; does not work well with practice" (pp. 272-273).
Nevertheless, a growing body of research literature confirms the effectiveness of teaching practice online (Collins, 2008;Cummings et al., 2015;Cummings et al., 2013;Jones, 2015;Petracchi et al., 2005;Siebert et al., 2006). Collins (2008) asserted that an online format may enhance social work students' ability to practice assessment and interviewing skills, since this technology allows students the benefit of performing in a less stressful environment. Cummings et al. (2013) compared the learning outcomes of students who participated in an online graduate level evidence-based class to students who selected the traditional face-to-face class. Evidence showed that online education was an effective tool for teaching social work practice skills and produced outcomes equivalent to face-toface courses. Forgey and Ortega-Williams (2016) found no significant differences in learning outcomes of students in an online generalist practice course versus those in a faceto-face generalist practice course taught by the same instructor.
As social work educators consider teaching practice in a fully online environment, more consideration may need to be given to blended or hybrid learning formats for practice course delivery. Although social work programs are teaching practice skills using simulations and standardized clients (Kourgiantakis et al., 2019;Logie et al., 2013), there remains a dearth of literature on the use of skills labs for teaching social work practice courses, particularly using a blended or hybrid approach. The purpose of this study was to examine the use of a blended skills lab model for teaching social work practice skills to online MSW students. As the number of online programs continues to expand in social work education, the blended skills lab model offers a case study that may have implications for other social work education programs to consider as they formulate new models for online students.

Overview of Blended Education
Courses and programs that combine internet-based and traditional face-to-face education components are often referred to as hybrid, web-enhanced, mixed mode, or blended (Miller & King, 2003). The Online Learning Consortium's (2016) definition of blended (hybrid) online courses is one where most course activity is completed online, but there are some required face-to-face instructional activities such as lectures, discussions, labs, or other in-person learning activities. For purposes of this paper, the terms "blended" and "hybrid" are used interchangeably. Blended or hybrid courses are offered by nearly four out of five (79%) public institutions of higher education in the U.S. (McGee & Reis, 2012). Research suggests that blended courses can have a positive impact on efficiency, convenience, and learning outcomes (Stein & Graham, 2014). Blended courses may enhance student satisfaction and engagement (Kuo et al., 2014). When properly implemented, blended learning can result in improved student success, satisfaction, and retention (University of Central Florida, 2018). Blended courses have proven to be popular choices for students because they allow students opportunities to have the best of both worlds, the flexibility of an online course and the benefits of the face-to-face classroom (Drysdale et al., 2013). Jared M. Carman, a leader in instructional technology, developed an instructional design model for blended learning. Applying the learning theories of Keller (1987), Gagné (1985), Bloom (1956), Merrill (2002), Clark (2002), and Gery (2002), Carman's framework proposes five constructs (live events, self-paced learning, collaboration, assessment, and reference materials) that are important elements of a blended learning process. Live events are instructor-led learning events in which all learners participate at the same time, such as in a live virtual classroom. Self-paced learning addresses learning experiences that the learner completes individually, at their own speed and on their own time, such as interactive weekly assignments, internet-based training, as well as synchronous activities, such as discussion boards, reading assignments, and quizzes. Collaborations involve engagement with peers to develop problem-solving skills (Carman, 2005). Assessment, the fourth component of the Carman model, is a measure of the learners' knowledge and includes measurements of whether or to what extent learning has taken place. Finally, reference materials or performance support materials allow students to access reference materials that enhance learning retention and transfer. This includes online videos and optional content that is not covered in a traditional class due to time constraints, such as PDA downloads and PDFs. Carman's (2005) five key ingredients should be considered by social work programs in the development of blended learning courses. These ingredients may be especially helpful when developing blended skills labs to teach practice content to online MSW students. In the next section, we describe how we used the key ingredients of Carman's model to build a blended skills lab.

The Large Southern University: Online MSW Program
The University of Alabama is a large, public, research university located in Tuscaloosa, Alabama. The School of Social Work (SSW) recently celebrated its 50th anniversary. The SSW offers a full spectrum of social work education: BSW, MSW, DSW, and PhD programs. The MSW program, ranked 44th nationally by US News & World Report, has nearly 500 students (US News & World Report, 2019). Online students comprise approximately 75-80% of the student population. Students are located all over the US, with the largest numbers of students in the Southeast (Alabama, Mississippi, Tennessee, Georgia). The program offers two concentrations: Children, Adolescents, & Families (CAF) and Adults & Families (AF).

Blended Skills Lab Model
The online MSW program is advertised as a primarily online program. Students are able to complete most coursework in an asynchronous format. Practice courses (2 credit hours) are offered asynchronously and require concurrent enrollment in a practice skills lab (1 credit  The skills labs are held at regionally convenient locations around the state of Alabama. Skills labs are held on college campuses in each city. Students are able to register for the skills lab that is most convenient for travel. The labs are held on 4 Saturdays once a month from 8:00am-12noon or 1:00-5:00pm, allowing students to complete 2 skills lab courses in one day. Students register for no more than 2 practice courses in the semester, therefore requiring registration for only 2 skills labs in any given semester. At most, students are required to spend one full Saturday a month in skills labs. For example, students may enroll in Social Work Practice with Adults Mental Health skills lab from 8:00am-12noon and Models & Methods of Gerontological Social Work Practice skills lab from 1:00-5:00pm.
Practice courses are primarily taught by full-time faculty and skills labs are primarily taught by adjunct faculty. Full-time faculty develop the content for both the practice courses and skills labs to ensure that the courses are in sync. Instructor meetings are held at the beginning of each semester to ensure that full-time faculty and adjunct faculty are on the same page with content delivery. Practice course content focuses on knowledge and theory development while skills lab content focuses on applying the knowledge and theory to practice through the demonstration of specific skills. Practice course enrollment is capped at 25 students, while skills lab enrollment is capped at 15 students.
In order to expand the national reach of the MSW online program, a new blended skills lab model was introduced for Atlanta, Georgia and Jackson, Mississippi. The new blended skills lab model requires travel to the skills lab site only 2 Saturdays during the semester. Skills labs 1 (beginning of semester) and 4 (end of semester) are offered face-to-face, while skills labs 2 and 3 are held virtually. Skills labs 1 and 4 follow a similar format as the Alabama labs, 8:00am-12noon or 1:00-5:00pm. The virtual skills labs use a blended approach, with both asynchronous and synchronous components. The skills lab content is separated by pre-lab work, lab work, and post-lab work. The pre-lab and post-lab assignments are completed asynchronously while the lab work is done synchronously, using video conferencing software, on Saturdays from 9:00am-11:30am or 1:00-3:30pm. Students are expected to complete the pre-lab assignment one week prior to the synchronous lab and the post-lab assignment one week after attending the synchronous lab. Students who attend the Atlanta and Jackson labs are also concurrently enrolled in an asynchronous practice course, similar to students attending labs in Alabama.
Collaboration. Pre-lab work gives students opportunities to collaborate peer-to-peer, which is a strength of a blended learning model (Carman, 2005). For example, in the Social Work Practice with Individuals and Families skills lab, students work in pairs to complete an interview assignment. Students work together to identify an interview time and use video conferencing software to record the interviews. The interviews are uploaded into a cloud-based program for the instructor to review and give feedback.
Live Events. Live synchronous, instructor-led events are also an important ingredient of a blended learning model (Carman, 2005). The blended skills lab model uses a live synchronous approach during virtual labs 2 and 3. During the live synchronous labs, the instructor reviews any required content completed for pre-lab work. The instructor may also divide students into groups to practice their interview skills. For example, using the video conferencing software, the instructor may move students into virtual breakout rooms to watch them demonstrate assessment skills. Students can record the breakout sessions during the live synchronous lab. The instructor can give feedback as students are demonstrating the skills (instructor-student collaboration) or offer direct feedback to students by email or through the learning management system.

Self-Paced Learning.
The blended skills lab model allows students to complete work online at their own pace. Self-paced learning is another component of an effective blended learning model (Carman, 2005). The self-paced learning is accomplished through the use of a learning management system (LMS) to deliver online content to students. Students are assigned asynchronous pre-lab work such as case study reviews, review of content from the practice course, or sample assessments. Self-paced post-lab work may include selfreflections on the video recording of the student demonstrating a skill or reflections on skills demonstrated during the synchronous lab session.

Assessment.
Assessments are the measures taken to ensure that students successfully understand the content presented. Carman (2005) sees this as a critical ingredient of learning. In this blended skills lab model, students are assessed on their ability to demonstrate specific practice skills. Students can earn up to 25 points per lab. Pre-lab work, such as discussion posts or video recordings of interviewing skills, is submitted for grading and instructor feedback. Student skills are also assessed and graded during the synchronous lab session. Post-lab work, including self-reflections on overall skill development for each lab, is also submitted for assessment. Students also have opportunities to give feedback to their partner after specific skill-building exercises such as role-plays. This peer feedback is not graded.
Performance Support. The fifth and final ingredient of Carman's blended learning model is performance support material. Students have access to reference materials that enhance learning retention and transfer. Within the learning management system used for this blended skills lab model, students can access additional resources such as case studies, video content, sample assessments, and other resources to support continued practice skill growth and development. Students can refer back to this material at any time. Students who desire additional readings or content may access additional information that the instructor is unable to cover during the synchronous sessions or face-to-face sessions.

Challenges of Blended Skills Lab Model Implementation
Based on our experiences implementing a blended skills lab, we describe some of the challenges and opportunities we encountered and offer some recommendations regarding areas to consider when developing a similar blended skills lab for online MSW students. Although all MSW online programs are different, the lessons learned may offer important implications, regardless of program size. When implementing a blended skills lab model for online MSW students, multiple challenges arose, such as developing course content, identifying skills lab locations, training skills lab instructors and students to use technology, and identifying adjunct faculty to teach the skills labs.

Course Development
The first challenge was the development of the skills lab course. The blended skills lab course was developed as part of a special innovation project with the College of Continuing Studies (CCS). The innovation team consisted of the MSW Program Director, the Social Work Adjunct Instructor who had taught the traditional campus-based skills labs, the SSW Distance Coordinator, and members of the CCS Innovation Team. Both members of the Innovation Team had backgrounds in instructional technology and online education. One of the greatest challenges with course development was identifying ways to deliver the same content that was offered to students in Alabama. Although the method of delivery would change, faculty wanted to ensure that all students enrolled in the skills labs, regardless of location, were receiving the same curriculum content. The team reviewed each skills lab manual to determine what content from labs 2 and 3 would be best offered in an asynchronous format and what content would be best delivered during the synchronous session. This step took quite a bit of time and processing. The team also identified the best tools to use to deliver different aspects of the course content. For example, the team determined that Flipgrid, a social learning platform, would be used for discussions during the asynchronous portion of the course instead of traditional discussion boards. After the first blended skills lab was developed, the course was piloted in Tuscaloosa, which is where the main campus is located. The blended skills lab model was later expanded to Atlanta and Jackson and is only offered in these two locations.

Skills Lab Locations
A second challenge in using a blended skills lab model is identifying locations for the skills labs to be held on Saturdays. Initially, skills labs were held in hotel conference rooms. This proved to be very expensive and did not seem to be the best educational environment for students. The decision was made to reach out to colleges/universities in Atlanta and Jackson regarding contracts for classrooms. The SSW Distance Program Manager is responsible for reaching out to sites and securing contracts. The Distance Program Manager works with event planners on each campus to coordinate contracts. The College of Continuing Studies pays for the rental of the classrooms as a part of an agreement with the SSW. The MSW Program Assistant is then responsible for assigning rooms and creating a Skills Lab Information Sheet for faculty and students. The Skills Lab Information Sheet contains detailed information, such as skills lab dates and times, names and addresses of the locations, room numbers, campus contact persons, and information on faculty members teaching the skills lab. This information is emailed to faculty and students and posted in the LMS.

Training Skills Lab Instructors and Students to use Technology
A third challenge in offering a blended skills lab model is ensuring that adjunct faculty and students are trained to use the technology needed to deliver the content for both asynchronous activities and the synchronous sessions. Adjunct faculty and students had to be trained to use tools such as Flipgrid (video discussions program) and Zoom (video meeting program). The Innovation Team initially scheduled meetings with adjunct faculty and students to introduce the tools prior to the start of the semester. Faculty especially had challenges with teaching the required content and simultaneously navigating the technology. For example, during the synchronous sessions, faculty are required to move students into breakout rooms to conduct skill-building exercises. Faculty have to move in and out of the rooms virtually to observe student interactions. They ensure that students record the sessions and then move students back into the main room for full group discussions. As the number of sections of skills lab courses expanded, it became no longer feasible to offer these trainings each semester. Resource materials were created for faculty and students, and posted in the LMS, offering a step-by-step guide for using each tool. Technical support is available for questions that arise during the semester, including the days of the synchronous sessions. The two most common technology issues include challenges with rural students accessing Wi-Fi to support the video conferencing software during the synchronous class session, and students not understanding instructions on how to record sessions and upload videos. To address these challenges prior to future sessions, students are encouraged to meet individually with technology specialists to test the software on available Wi-Fi networks. Students could also receive individual assistance on recording and uploading videos.

Identifying Adjunct Faculty to Teach the Skills Labs
Identifying adjuncts in Atlanta and Jackson to teach the blended skills labs was the fourth challenge. Both locations are over 200 miles from the main campus in Tuscaloosa so it was not a feasible option to have local adjuncts travel to these sites. The MSW Program Director reached out to the Director of Field to identify field instructors in both communities. MSW Program graduates were also identified as prospective instructors. Having field instructors and graduates of the program to serve as adjunct instructors at these sites has proven to be very beneficial for both. Students have an opportunity to meet program graduates and learn of their post-graduate practice experiences and program graduates enjoy meeting new students and giving back to the program.

Opportunities of Blended Skills Lab Model Implementation
Despite the challenges experienced implementing the blended skills lab, several opportunities with model implementation were identified. The ability to integrate both modes of learning, asynchronous and synchronous, often enhances the online learning experience (Farrel et al., 2018) for students. One student shared, "I enjoyed the fact that we had two onsite labs because I enjoyed meeting my peers and instructor in person and also being on campus. I also enjoyed doing the two middle labs virtually. It saved on time traveling and money." Another student shared, "The ability to avoid travel from neighboring states was a great benefit. Additionally, the online interaction was equally as beneficial in terms of learning as were the onsite meetings. It was a great joy to work together as a group and our instructor was excellent!" Integrating both modes of learning in the blended skills lab model allowed the expansion of the MSW Program to a national audience. The large international airport in Atlanta makes travel two times in the semester very affordable for students. Students have the option to select from multiple airlines that fly into the Atlanta airport. This approach has allowed the program to attract students from states such as California, New York, and North Carolina, and has increased enrollment in Georgia. One student shared, "I live in Oklahoma and without this setup I would not have been able to fully participate in the course. This provided me with an opportunity to be part of an amazing school!" Another opportunity of the blended skills lab model is the engagement of MSW program graduates in Atlanta and Jackson. Many of the graduates had not been actively involved with the program since graduation and were excited about the opportunity to reconnect with the program. A final opportunity of the blended skills lab model was the introduction of new technology to faculty and students. These tools can be used in practice settings for meetings and assist students in other courses with group assignments. At the end of the course , one student stated, "The virtual skills lab most definitely took me out of my comfort zone and challenged me as it relates to this type of technology. Initially, it was frustrating, not from the technology standpoint, but me navigating through the assignments. As time progressed, I was able to navigate with ease. I look forward to more virtual labs as I progress in this program."

Implications and Conclusions
In the new Standards for Technology in Social Work Practice, those who deliver social work education are challenged to "use student-centered instructional strategies that are connected to real-world practice applications to engage students in learning, such as peerbased learning, inquiry-based activities, collaborative learning, discussion groups, selfdirected learning, case studies, small group work, and guided design" (NASW et al., 2017, p. 45). A blended skills lab model approach presents a unique opportunity to use technology that allows students to engage in these kinds of practice opportunities. Further, "social workers who develop, design, and deliver education and training programs using technology" should also "use a range of existing and emerging technologies that effectively support student learning and engagement in the online environment" (NASW et al., 2017, p. 46). A blended skills lab model uses technology to support the development of student practice skills in an online environment.
As the number of social work programs offering distance programs continues to expand, more consideration to blended or hybrid learning formats for practice course delivery is suggested. A blended skills lab model takes full advantage of the benefits of each platform--online and face-to-face--in order to provide an educational opportunity that can promote student learning better than either platform alone.
Further research should be conducted on this blended skills lab approach for teaching practice skills to social work distance students. A study that compares student outcomes in a fully face-to-face skills lab versus participants in a blended skills lab model could yield useful information. Special consideration should be given to how to effectively train faculty members and students to implement this model across multiple practice courses and multiple course sections.