Geriatric Enrichment in Social Work Education: Lessons Learned from the GeroRich Projects

Abstract

The Geriatric Enrichment in Social Work Education (GeroRich) initiative was a critical step in addressing the national shortage of social workers interested in gerontological practice. Sixty-seven social work programs participated in the 3-year GeroRich project designed to infuse gerontological content into the BSW and MSW curriculum. This study analyzed the lessons learned by participating institutions about the curriculum enrichment effort. Five themes emerged from the qualitative analysis of GeroRich final reports: (a) obtaining faculty buy-in and faculty development, (b) increasing student interest and engagement, (c) developing community partners, (d) developing interdisciplinary linkages, and (e) facilitating institutional commitment and sustainability. The findings from this study provide valuable information on the implementation of curricular enrichment efforts in gerontology that can benefit social work and other health care disciplines.

KEYWORDS:

• Gerontology
• education
• social workers
• infusion
• geriatric enrichment

The number of older adults in the United States is growing at a staggering rate. It is expected that one of five Americans, or almost 70 million individuals, will be age 65 by 2030 (Administration on Aging, 2005). The fastest growing segment of older adults is those over the age of 85, with this population exhibiting the greatest healthcare needs and assistance from social service providers. Demographic factors, such as changes in work force participation and geographic mobility, are resulting in fewer social supports available to help older adults. Therefore, there is an increased demand for professionals, including social workers, to become involved in the care of older adults (Berkman, Gardner, Zodikoff, & Harooytan, 2005). Despite this demand, a national shortage of social workers willing to work with older adults continues to exist (National Association of Social Workers, 2006).

The call to address the shortage of social workers committed to practice with older adults started over 35 years ago, when Brody (1970) identified the lack of responsiveness of the field to gerontology. As Brody warned, the lack of responsiveness has created a crisis situation, with many considering this to be a shortcoming by the profession to prepare students for gerontological practice. As of 2001, only 5,000, or 3%, of the 150,000 members of the National Association of Social Workers identified their primary area of social work practice as gerontology (Rosen & Zlotnik, 2001). This is particularly troubling, given that as early as 1987, it was predicted that 60,000–70,000 geriatric social workers would be needed to meet the needs of older adults by 2020 (National Institute of Aging, 1987).

Since 1998, the John A. Hartford Foundation has worked with the leaders within gerontological social work education and research to rectify this situation, primarily through the creation of initiatives to address the shortage of social workers pursuing practice with older adults. Through five different programs, entitled the Geriatric Social Work Initiative (GSWI), all levels of social work education (BSW, MSW, and PhD) have been targeted to address the shortage of geriatric social workers. The Hartford Foundation plans to generate not only a greater awareness of the health and well-being of older adults, but also interest among students, clinicians, and faculty alike in addressing the needs of this growing population.

One of the key programs developed with Hartford Foundation funding was the Geriatric Enrichment in Social Work Education (GeroRich) project, designed to infuse geriatric content into the BSW and MSW social work foundation curriculum (Hooyman, 2006; Hooyman & St. Peter, 2006). Sixty-seven institutions were selected to participate in this program that began in 2002 and ended in 2004. Programs spent the first year developing their infusion plan, the second year implementing their plan, and then their third, unfunded, year developing protocols for the sustainability of the infusion effort and disseminating the results from their institution (Hooyman, 2006; Hooyman & St. Peter, 2006). Through this process, GeroRich institutions learned valuable lessons that will aid in future curricular enrichment efforts in gerontology, as well as in other substantive areas of social work. This study examines these lessons and provides recommendations for future curriculum enrichment efforts in social work and related fields.

LITERATURE REVIEW

Curriculum Enrichment Strategies

With 75% of practicing social workers reporting that they have older adults on their caseloads (National Association of Social Workers, 2005), the need for a curricular enrichment effort to prepare future social workers for their future practice career was clear. Rosen, Zlotnik, and Singer (2002) recommended a “strategic” infusion process to ensure institutional support and sustainability over time. To create a strategic infusion process, the literature has documented general infusion strategies not specific to the GeroRich initiative, as well as strategies that were implemented by different GeroRich sites. General strategies, including reducing the anxiety of faculty and building on pre-existing curricular structures, have been identified as critical to successful infusion (Alexander, 1991). Other general strategies, such as ensuring organizational commitment, understanding competition from other substantive areas (i.e., child welfare, mental health), determining faculty comfort with the change/infusion effort, educating faculty about available resources, identifying the cultural context of the program, and developing incentives to initiate and sustain the curricular infusion effort, have also been encouraged (Green, Dezendorf, Lyman, & Lyman, 2005; Nichols-Casebolt, Figueira-McDonough, & Netting, 2000; Rosen et al., 2002). Rosen et al. (2002) stressed the importance of infusion occurring throughout the curriculum, such as in course syllabi, educational materials, and faculty training in an attempt to create faculty and institutional buy-in.

Reports of curriculum enrichment strategies used for GeroRich projects have presented a picture of the curriculum change process that was implemented at individual institutions. For instance, Dorfman and Murty (2005), at the University of Iowa, used a diffusion of innovations approach developed by Rogers (2003) as the basis for their curriculum enrichment strategy. Dorfman and Murty outlined a conceptual model that included faculty education to increase competence in aging, infusion of gerontological material in all foundation social work courses, development and maintenance of community partnerships, encouragement of intergenerational service-learning opportunities, and the expansion of aging-related field sites. They found that through a diffusion of innovations approach the strengths of the program and the work of other ongoing school initiatives were not compromised, but enhanced through the inclusion of gerontological material. Similar to the diffusion of innovations approach, Lee and Waites (2006) developed a three-tiered approach to geriatric curriculum enrichment at North Carolina State University. Their approach focused on curriculum development and innovation, knowledge building among faculty, and the creation of a learning environment supportive of gerontology. Lee and Waites found that this model supported gerontology competence building among BSW students, even if the students were not primarily interested in aging. Fredriksen-Goldsen, Bonifas, and Hooyman (2006) emphasized a multigenerational approach for the University of Washington GeroRich project. Through this model, they found that increased student interest in multigenerational issues and gerontology occurred. Ranney, Goodman, Tan, and Glezakos (2006) approached curriculum developed from the lifespan perspective, which was already well-received within their social work department at California State University, Long Beach. Expanding upon this existing model enabled the GeroRich team in working with faculty to infuse additional content on aging.

Challenges to Geriatric Curriculum Enrichment in Social Work

The climate of social work is slowly changing and becoming more receptive to the infusion of gerontological material in the field. Hooyman and Tompkins (2005) stated that:

As a result of the Hartford GWSI [geriatric social work initiative], it is no longer accurate to state that social work faculty are resistant to learning and teaching about aging. Instead, more faculty and practicum/field supervisors affiliated with both BSW and MSW programs are prepared to teach and conduct research on issues facing older adults than at any point in the history of social work education. (p. 372)

Despite this, challenges still exist that have impacted GeroRich projects. The structure of many social work programs presents barriers to the infusion of geriatric content. According to Green et al. (2005), barriers stem from the “lack of curriculum structures that lead students to appropriate gerontological content, places students in field settings with older adults, and guides students to see opportunities in electives and other specialized [aging] educational opportunities” (p. 106). Many programs lack a prominent focus on gerontology, which is highlighted by the significant number of programs without a concentration or a specialization in aging. Lubben, Damron-Rodriguez, and Beck (1992) indicated that only one-third of social work programs had specific tracks in gerontology. More recent statistics indicate a more concerning trend. Of the 146 accredited-MSW programs listed by CSWE at the time of their study, only 40 (27%) had specializations, concentrations, or certificates in gerontology (Cummings & DeCoster, 2003). This represents a substantial decline from the findings reported by Lubben and colleagues only 10 years earlier.

Another barrier to geriatric curriculum enrichment deals with faculty interest. Although progress has been made in getting faculty committed to the enrichment process, there continues to be a lack of faculty with a specific focus in gerontology (Kropf, 2002). As recently as the 1990's, 50 to 75% of all social work programs lacked a faculty member with expertise in gerontology (Damron-Rodriguez & Lubben, 1997; Kropf, Schneider, & Stahlman 1993). As stated by Berkman, Silverstone, Simmons, Volland, and Howe (2000), “There are … serious questions about the capacity of current faculty to educate social workers to deliver the comprehensive and complex services the older population and their families require” (p. 15). Waites and Lee (2006) learned from students that aging content was “rarely mentioned and seldom promoted as a significant area for practice in the social work curricula (prior to the GeroRich Initiative)” (p. 54). Similarly, Kolomer, Lewinson, Kropf, and Wilks (2006) found that, across both BSW and MSW foundation courses, aging content was seriously lacking in classroom discussions and lectures. Hooyman and St. Peter (2006) argued that for curriculum to be infused with gerontological content, faculty must share in the process: “Even if faculty are unable to commit to making changes themselves, their buy-in regarding the need for aging-based infusion is essential” (p. 18).

One of the most significant and concerning challenges facing geriatric curriculum enrichment is the lack of student interest in working with older adults. Hooyman and Tompkins (2005) noted that “recruiting students to careers in aging remains an intractable challenge” (p. 375), despite the work of the Hartford initiatives. It is estimated that only 5% of BSW students are interested in working with older adults, and only 3% of MSW students graduate with a concentration or specialization in gerontology (Scharlach, Damron-Rodriguez, Robinson, & Feldman, 2000). Recent research has shown that only 12% of students had an interest in aging post graduation (Cummings, Cassie, Galambos, & Wilson, 2006). Scharlach et al. (2000) argued that almost 25%, or 5,000 students, per year need to graduate with a focus or concentration in gerontology to meet the future demand of older adults, but at the current time only 3% of MSW students are part of an aging track (Lennon, 1999; Scharlach, et al., 2000). Moreover, aging has been identified as the fifth choice for a concentration among MSW students (Scharlach et al., 2000). These statistics translate into not only a very small number of students, but few gerontological social work practitioners. Some estimates suggest that only 4% of MSW graduates will work in gerontological settings (Gibelman & Schervish, 1997). The lower salary of social workers in aging settings, compared to other substantive areas (National Association of Social Workers, 2006), may contribute to this lack of interest.

This qualitative study builds on the overview of lessons learned in GeroRich, presented by Hooyman and St. Peter (2006) by using data from year 3 final reports for 63 participating GeroRich programs to analyze, in depth, lessons learned in the process of implementing a comprehensive curriculum enrichment program. Analysis of the lessons learned garnered from a wide variety of institutions, instead of just an individual institutional analysis, will produce a wealth of knowledge about ways to continue to rectify the lack of interest among students, faculty, and programs in gerontology. Furthermore, the lessons learned from the GeroRich programs will provide critical information on how to approach and successfully implement curricular enrichment efforts in the future. This study was designed to answer the following research question:

What were the major lessons learned and challenges experienced by GeroRich programs in regard to faculty involvement, student interest, community support, and institutional commitment/sustainability?

METHODOLOGY

A qualitative methodology was employed to analyze written text provided by GeroRich sites about lessons learned during their geriatric curriculum enrichment process.

Sample

Of the 611 social work programs that were eligible to apply for GeroRich funding, 103 applied and 67 colleges and universities from across the United States were selected to receive funding (Hooyman, 2006). Of these 67 GeroRich projects, 63 provided data on their lessons learned, which were analyzed in aggregate. The programs were distributed across the United States, with 29% (n = 18) located in the Northeast, 27% (n = 17) in the Midwest, 22% (n = 14) in the Southeast, and 22% (n = 14) in the West. They represented a mix of geographic settings: 11% (n = 7) were in rural areas, 40 % (n = 25) were in urban areas, and 49% (n = 31) were in mixed geographic locations (both rural and urban). The programs represented BSW programs (37%, n = 23), MSW programs (21%, n = 13), and joint BSW/MSW programs (43%, n = 27). The mean number of faculty in the 63 programs was 18.60 (SD = 14.00), with the rural programs averaging 11.4 faculty (SD = 4.54), the urban averaging 19.28 faculty (SD = 13.86), and the programs in mixed geographic settings averaging 19.68 faculty (SD = 15.30). The BSW programs had fewer faculty (M = 8.04, SD = 5.41) as compared to the MSW (M = 32.15, SD = 17.81) and joint BSW/MSW programs (M = 21.07, SD = 9.97).

Instruments

GeroRich projects submitted a final report in which they were asked to identify the lessons that were learned through the implementation of curricular enrichment at their institutions. To facilitate this process, the sites were asked to reflect on the lessons learned during year 2 of the grant cycle, based on each of their identified goals for the project. They were asked to specifically concentrate on answering three questions: “1) What did you attempt to do? Did it work? If not, what are some of the reasons for this? 2) What modifications, if any, did you make in your original plans? Why did you choose these modifications? and 3) What new lessons learned emerged over this past year?” Although not specifically asked, challenges that the GeroRich institutions encountered also emerged from the questions about the lessons learned.

Data Analysis

Content analysis was used to analyze the data. Content analysis takes segments of the qualitative text and divides them into meaning units. These meaning units are then grouped into common themes and categories (Glaser & Strauss, 1967; Lincoln & Guba, 1985). Constant comparison, or the technique of comparing different segments of coded text, was used to ensure continuity in coding and consistency in the analytic process and the presentation of findings (Lincoln & Guba, 1985).

Two researchers coded the data separately and then developed a preliminary list of meaning units. These meaning units were compared for consistency in interpretation and then organized into eight main categories, some of which have subcategories (in parentheses): (a) curriculum infusion (curricular enhancements, infusion constraints); (b) intergenerational/lifespan perspective; (c) faculty development (stipends, education, resources, leadership, release time); (d) engaging students (exposure, experiential learning, motivational opportunities); (e) community partnerships (advisory boards, field settings/agencies, older adults as partners); (f) interdisciplinary collaborations; (g) outreach/dissemination; and (h) sustainability. The lessons learned were then reanalyzed by both researchers to determine which categories emerged from the data.

The coded material from both researchers was then given to a third researcher to compare the list of codes. Each of the codes was tallied to determine the use of the codes. The reliability was calculated to determine the consistency between the two researchers in coding text; however, this number was artificially low (0.48), given the great variability and detail in the reports provided by the GeroRich projects. A decision was made to only include a coded segment of text in the final analysis if both researchers had coded it the same way in the preliminary analyses. The eight categories used to code the text were collapsed into five themes: (a) obtaining faculty buy-in and faculty development, (b) increasing student interest and engagement; (c) developing community partnerships; (d) developing interdisciplinary linkages; and (e) facilitating institutional commitment and sustainability. Table 1 provides the frequencies for the lessons learned for each theme and sub-theme.

TABLE 1 Lessons Learned Reported by GeroRich Programs (n = 63)

	Lessons learned
Qualitative code	n	%
Theme 1: Faculty buy-in and faculty development
Faculty stipends	10	16
Faculty education	11	18
Faculty resources	23	37
Faculty leadership	15	24
Intergenerational/lifespan approach	12	19
Theme 2: Increasing student interest and engagement
Student exposure	35	56
Experiential learning	6	10
Motivational opportunities	12	19
Theme 3: Developing community partnerships
Community advisory board	18	29
Field placements/agencies	23	38
Partnering with older adults	9	14
Theme 4: Developing interdisciplinary linkages	14	22
Theme 5: Institutional commitment/sustainability	13	21
Note. More than one category could be chosen.

RESULTS

Of the 63 projects for which data were available, the vast majority of programs (90%) reported that they had learned lessons about the aforementioned five themes during the process of curriculum infusion; some of these lessons concerned challenges that programs faced. The discussion that follows provides excerpts from program final reports and illustrates the range and quality of the responses to the lessons learned concerning faculty buy-in and development, engaging students, developing community partnerships, interdisciplinary linkages, and sustainability.

Faculty Buy-In and Faculty Development

Because most faculty involved in geriatric curriculum infusion were not gerontologically-prepared, it was important for the projects to develop strategies that would facilitate both faculty buy-in and faculty education so that the process of geriatric curriculum enrichment could occur. GeroRich programs reported that they had learned numerous lessons about facilitating faculty buy-in and faculty development, including the importance of providing curricular resources (37%), faculty leadership for the project (24%), educational opportunities (18%), and financial incentives (16%) for faculty. Here is how two programs described the faculty leadership required to get faculty on board for their projects, and some of the constraints that they faced:

The GeroRich project director met frequently (one-to-one) with them [faculty members] and was available to answer their questions and offer support, including making visits to classes at the faculty's request. Some of the instructors wanted immediate feedback and validation of their efforts. They preferred to test some of their ideas before they “officially” revised the syllabi and the course. Providing this one-to-one interaction with the faculty worked well, [which] indicated to us that in order for our goal to be reached we needed to be more sensitive to the level of comfort and motivation of the faculty.

Continued, regular, one-on-one contacts with faculty and staff to support infusion and commitment to the project are necessary to maintain enthusiasm. However, time is a challenge due to the multiple demands on faculty.

Part of faculty leadership was to demonstrate how “gerontologizing” the curriculum could enhance the existing educational programs. Nineteen percent of programs reported that placing an emphasis on intergenerational issues in curriculum infusion was a useful strategy for integrating aging content with content on other parts of the life span. For example, grandparent–grandchild relations could be linked to issues of child welfare; family violence could include abuse of individuals across the life span. The advantages of this approach are illustrated by the following three comments by three different GeroRich Project Directors:

Developing a curriculum around an intergenerational model is a great opportunity. The intergenerational perspective is so important to understanding aging, has broad appeal, and provides a great opportunity to increase people's awareness of aging-related issues.

Content focusing on intergenerational aspects of gerontology is the most effective way of infusing content in foundation and advanced practice in direct services. In particular, instruction in grandparenting (e.g., grandparents as parents) and parent and adult-child relationships were most frequently in demand in these classes… . It is also possible that some instructors feel that children are a higher priority for intervention, and that the needs of older adults are important only as they relate to the needs of either children or the family.

We realized that some of the initial hesitance on the part of the faculty was due to our emphasis on “gerontologizing the curriculum.” They were not interested in this, noting that we were not adding content on other age groups. When we shifted to an intergenerational approach rather than a gerontological one, the full faculty was very interested in this. This perspective fit very well with their view of social work practice, which is a social system perspective that goes beyond serving individual elders.

As mentioned earlier, 18% of programs identified the need to educate faculty who had little or no background in gerontology and geriatrics. Although many faculty attended the GeroRich Faculty Development Institutes, some programs learned that additional steps, such as bringing in outside consultants or faculty trainers, enhanced program-specific faculty development. The following two examples are illustrative:

A contract was established with a faculty member and practitioner with gerontological expertise from a neighboring state. She was a Council on Social Work Education/Sage-SW Faculty Development Program Expert Trainer and Curriculum Developer. The consultant reviewed the social work program's course syllabi prior to coming to campus to present a one-day Faculty Development Institute. Five of six full-time and both part-time faculty were in attendance. The Institute included an overview of current and future demographic trends relative to the older population in the United States, useful curriculum resources that could be obtained by faculty, and infusion strategies.

We held a faculty workshop which focused on the infusion of intergenerational and aging-related concepts in foundation courses within the School of Social Work BSW and MSW curricula… . [A well-known social work gerontological expert] facilitated this workshop for twelve of our faculty members. Her visit was well received.

More than one-third of programs (37%) learned lessons about providing faculty with the curricular resources needed to infuse geriatric content into their courses, as well as acquainting faculty with major resources, such as the Hartford GeroRich Web site. Here is what two programs learned not only about disseminating curriculum resources, but how faculty could build upon those resources to enhance their courses:

I learned that there has been a hunger for information and resources. Some faculty went beyond the “Hartford Resources” and sought out resources of their own such as speakers and videos. This demonstrates a growing commitment of the faculty to continuing to include aging-related content in their courses, and also validates that if we “lit the fire, they would fan the embers.”

Faculty members were encouraged to enrich their own courses, and were given resources to do so. No directives were sent out as to how or to what extent courses were to be enriched… . The picture that the project director hoped faculty members would hold in common was that the program would, as a whole, tweak its content so that emerging practitioners would have a better understanding of working with older adults and the requisite skills to do so.

Programs learned, however, that providing curricular resources was not always a guarantee of actual incorporation of aging-relevant content into courses. There were challenges of time, staffing, and geography, as noted in the following two observations:

While they may pay lip service, faculty don't always cover what is indicated in their syllabi. While a wealth of materials is currently available to be shared with faculty, only a limited amount is infused.

We provided instructors of all BSW and Foundation-level MSW classes with copies of age-related readings, videos, guest speakers, web-sites, case studies, and class exercises that fit the particular classes that they were teaching. Instructors were then encouraged to include as many as these as possible into their classes. Most faculty did enhance their classes with aging-related materials. However, the University also uses a good deal of adjuncts. Although the adjuncts were given all the age-related materials mentioned above related to their courses, they were not present at the faculty retreat and faculty meetings where the GeroRich project was discussed and encouraged. Therefore, their involvement was more spotty. The University is also located in three locations within the state, each separated from the others by three to six hours. The adjuncts teaching in the location where the GeroRich PI/Faculty Consultant was located knew more about the project and were more likely to incorporate aging-related materials.

Sixteen percent of programs used financial incentives to help facilitate faculty buy-in and shared ownership of the curriculum change effort. Some, like this program, felt that stipends and other forms of compensation contributed positively to the change process in many ways: “Including faculty as partners in this grant and compensating them for their contributions to this project ensured cooperation, accountability, pervasiveness, and sustainability in this endeavor.” Another program reported, “The mini-grant program [involving summer support for eight faculty] created a great deal of energy and new curricular ideas. This activity worked well in terms of productivity and outcomes.”

Increasing Student Interest and Engagement

The majority of programs (56%) reported they had learned lessons about increasing student exposure to gerontological content; additionally, nearly one-fifth of programs (19%) said they had learned that it was necessary to provide specific motivators and/or rewards to encourage student engagement. Those motivators included financial stipends, awards for high performance, and opportunities to attend professional conferences. Some programs (10%) learned that providing experiential learning opportunities, such as service-learning, served to stimulate student interest in working with older adults. The three programs quoted in the following illustrate lessons learned about increasing student exposure, including the link between classroom and practice, emphasizing the diversity of older people, and inclusion of specific teaching strategies:

We learned that increased exposure to content on older adulthood appears to have an effect on student interest and competency in working with this population. Students seem to influence each other with regard to choice of placement experiences, i.e., if one student has a good experience working in a placement with older adults, they share this with other students who then look forward to that placement experience. Once interest is sparked within students, they are able to relate well to elderly…

Another important lesson we learned is to present older adults as multifaceted individuals and family members. Unfortunately students come with a simplistic conception of older adults. They respond well when exposed to the diversity of life experiences, personalities, and life styles of older adults.

A case was developed for use in each practice course (three cases in all). A teaching casebook with supporting material to help faculty easily and effectively use the case was developed for each case. We were quite successful in achieving the project outcome. However, we were not 100% successful. To be 100% successful required the cooperation of all the members of our large faculty teaching the practice courses. We know that two of the full-time faculty did not use the case in their class.

Of the nearly one-fifth of programs (19%) that created specific motivators or rewards to encourage student interest in aging, some learned that financial incentives were useful, as did this university: “Structured educational programs with built-in incentives (i.e., stipends) are an effective means of engaging students in gerontological learning.” Another program learned that it was useful to employ financial incentives to increase student interest, but also warned that other methods might need to be used to sustain this interest beyond the short term:

We aimed to increase field and practicum placements in aging and develop new gerontological field sites. One strategy was to offer stipends to MSW students in practicum placements to introduce them to working with elders. We learned, however, that without sustained funding, other methods have to be used to increase student interest in geriatric social work as a field of practice.

Programs that gave awards to recognize student achievement also learned valuable lessons about the process, as did this program:

Our efforts to interest students in working with older adults included annual student awards for Social Work with Older People. Seniors enrolled in the block-placement practicum are eligible to compete for one $200 award for an aging-based practicum-linked research project; the student must also be enrolled in our Aging Option in the major. Juniors and seniors in the major are eligible to compete for one $100 award for an aging-based research project from a lifespan perspective. Initially, we created only the former award. By creating both awards, we found that we could bring attention to both aging and aging across the lifespan… . We also found that our recruitment effort should occur earlier than we had anticipated, and plan to make more of an effort to target our first-year and sophomore students.

And, sometimes it was easier to involve students in the curriculum change effort than it was to involve faculty members, as this program learned: “The overall lesson has been that inspiring students is a lot easier than inspiring the faculty. I feel that faculty began to respond more when it was student driven. The aging curriculum had to be consumer-driven for it to take off.”

Developing Community Partnerships

Lessons learned regarding community-institutional relationships included ones about student field placements and agency ties (reported by 38% of programs), relationships with community advisory boards (29%), and partnering with older adults (14%). Programs learned the importance of developing more diverse gerontological student field placements and, importantly, how to work better in partnership with community agencies, as reflected in the following two observations:

Increasing numbers of placement sites that involve substantive work with older persons means looking forward beyond the traditional skilled nursing facility to the community-based programs with older adults. Students and field instructors consider the operationalization of the objectives in designing the learning contract. Those must be GeroRiched in order to achieve integration for students in the field.

What I have learned is that the practice community is very interested in working with the School and will step up to the plate whenever asked. Isolating ourselves as academics is a mistake and we need to look to our stakeholders to help identify the areas in our curriculum that need better integration with best practice methods.

Providing positive feedback and recognition to community stakeholders was essential: “A new lesson learned is that these community members are very willing to work hard to help increase knowledge and skills related to aging in social work students and that a little recognition and thanks go a long way.”

Almost one-third of programs (29%) also learned that positive relationships may be fostered and curricula enriched through use of community advisory boards. As one program observed, “The advisory board presented expertise to the faculty since they surveyed the pre-infusion content of the curriculum and recommended the competencies that needed to be incorporated; they also provided a gentle pressure to the faculty to maintain the change effort.”

Partnering with older adult community stakeholders to enrich classroom learning, serve as members of advisory boards, and be a general resource on aging, proved to be both rewarding and challenging. Among the 14% of programs who used older adults to enhance classroom learning, one observed: “We learned that seniors in the area are very willing to share their knowledge, opinions, and experiences with investigators; however, the time, place, and situation must be flexible enough to allow for the continuation of regularly scheduled activities without the addition of stress or rescheduling.” Another said, “Matching elder expertise with course need is a complex and time-consuming process. Faculty require assistance in opening the horizon to the myriad ways older persons can support the instructional goals of the class.” These comments reveal that programs learned that partnering with elders must be sensitive toward and respond to the realities of aging if older people are to be used as a resource in curriculum enrichment.

Developing Interdisciplinary Linkages

Although not an expressed goal of the overall GeroRich initiative, more than one-fifth (22%) of GeroRich programs strove to enhance their curriculum enrichment efforts through interdisciplinary linkages and collaborations with other campus units. Such linkages could serve to increase a social work program's aging presence within the institution and in turn provide benefits to the program, as described in the following two examples:

The Hartford initiative has better positioned the School within the University with respect to aging. We are now an integral component of the University's new certificate in aging—including some of our Social Work courses [which] will be used. The Dean's Center for Race and Social Problems now has an aging and mental health research track.

The decision to focus early in the planning year and throughout the life of the project on the development of linkages with other schools and programs in the University proved to be a highly successful strategy—more than we had anticipated at the start… . The School had had limited involvement with the gerontological research community on campus in the years directly preceding the advent of the initiative. Our contacts at the Schools of Medicine and Nursing and the Institute on Aging welcomed the involvement of Social Work and worked to formalize the relationship by inviting faculty at the School to become part of new and on-going interdisciplinary research and curriculum development efforts. The possibility of increased visibility and involvement in cross-campus efforts, in turn, encouraged the School to view the addition of faculty with expertise in aging, as well as the cultivation of doctoral student interest and post-doctoral level expertise in gerontological research, as a priority.

Institutional Commitment/Sustainability

Sustainability of curriculum enrichment efforts over time is a desired key outcome of curricular change efforts, and was an important goal of the GeroRich initiative. GeroRich programs spoke both of their need for continued institutional support and specific strategies they had developed to help ensure sustainability after the grant period ended. Twenty-one percent of programs described lessons they had learned about sustaining and institutionalizing the curriculum enrichment effort. The following two responses exemplify general lessons learned about maintaining administrative and faculty support:

“Time” and “commitment” are the two themes that stand out as we bring the third and final year of this project to a close. Time and commitment are the backbone of our successes, and the blueprint for the continuation of the work begun with this project. TIME—Infusion is an ongoing process… . As teaching faculty turn over and course coordinators change, time must be taken to bring these newcomers on board to our endeavor… . COMMITMENT—For the infusion process to be successful, a commitment to the process on the part of both teaching faculty and administration is absolutely critical… . Administration must be behind the infusion and seek ways to support the Steering Committee in their efforts, and offer new ways to deliver the message of the importance of the project to various audiences… . The teaching faculty must continually be offered training and educational opportunities where they can add gerontological/intergenerational knowledge to their area of expertise to enable them to share this information with their students.

This project director continues to keep the College Dean and Directors informed of aging-related resources and opportunities in an effort to maintain their support. In addition, with a significant number of faculty retirements, maintaining support from the College leaders has been one way to help insure that new faculty continue to integrate aging-related content into their courses.

Programs said they learned lessons about utilizing specific strategies to ensure sustainability, including strategies to maintain stakeholder interest, insure continued infusion of aging content, and engage new faculty, as described by these three programs, respectively:

Continual renewal of the GeroRich initiative requires two central elements: 1) the advocacy of a focal group of interested faculty, community professionals, and students; and 2) the structural inclusion of geroenrichment as a normative element in the curriculum transformation process. To address the first element, the School of Social Work established and funded the Institute of Gerontological Studies and retained a full-time director… . Under his leadership, a geroenrichment task force will monitor the infusion of geriatric and gerontological content in the curriculum …

We adopted the strategy of reviewing all foundation courses' master syllabi for aging content by the Curriculum Committee of the School. These master syllabi provide a general model for faculty to follow in developing their individual course outlines. Review of course syllabi by a major committee of the School helped achieve faculty buy-in and institutionalization of the innovation. The process has worked well, but was not completed by the end of Year 3, as had been hoped.

We have learned the importance of making sure that new faculty members are included in the change effort. During our project, three faculty members retired. We have hired three new professors, and several more part-time adjunct faculty members have been added as well. It is apparent that it will be an ongoing effort to keep them all involved and invested in the program, which has actually become institutionalized and normalized at this point.

Interestingly, one program found that the GeroRich project contributed to a committee recommendation for structural transformation of its entire MSW curriculum, which, in turn, would guarantee its sustainability:

Perhaps the longest-lasting effect of the GeroRich project, however, is the recommendation of our MSW Curriculum Review Committee to totally realign the MSW curriculum around a life course perspective. If this change is adopted, it will mean a fundamental philosophical reorientation around curriculum involving gerontological issues. Instead of five concentrations, the school will offer two: one focused on children and families and the other focused on adults and families. The adult concentration will have a heavy emphasis on older adulthood.

DISCUSSION AND IMPLICATIONS

Historically, social work curricula have not presented a balanced view of the life course, with minimal attention being given to older adulthood. This, combined with the lack of faculty and student interest, has led to the low number of social workers interested in pursuing a career in gerontology (Cummings, Alder, & DeCoster, 2005; Cummings & Galambos, 2002). The GeroRich project was a critical step in ensuring that social work students are exposed to aging content in the curriculum.

This study provides not only insight into the lessons that emerged from the curriculum infusion effort, but also the challenges that program encountered throughout this process. This study builds upon previously reported lessons learned (see Hooyman & St. Peter, 2006) from the GeroRich project by providing detailed examples from the participating institutions about their infusion process. Gerontological curriculum enrichment proved challenging, even difficult, in terms of mobilizing key stakeholders (faculty, administration, students, community), and keeping them invested in the project over the course of the 3 years. The question many programs asked themselves at the end of the project was, “How well did it work?” The following comment illustrates what many programs discovered in one way or another—that the grant period provided the impetus for what they hoped would be a continuing process:

It is a work in progress. The past three years have been the start of a major paradigm shift in the community, university, among faculty, students, and administration. We envision an environment where the interest and energy would be self-sustaining, not dependent upon an individual. We are not there yet, although the process is taking root and growing within the university. We still need to develop leadership within the community and university to continue with this work… . It is extremely important that we remain visible and continue to nurture relationships.

The results of this study revealed that GeroRich programs learned many lessons during the process of geriatric curriculum enrichment; chief among them were lessons regarding faculty buy-in and faculty development that are essential for geriatric curriculum infusion; stimulating student interest and engagement; developing community and interdisciplinary partnerships; and, importantly, developing and implementing mechanisms that would sustain and institutionalize the curriculum change effort over time.

As found in this study and the results from individual GeroRich programs (Shank & Herman, 2006), obtaining faculty buy-in and support for the project was critical to the success and sustainability of the projects. As a staff member from the National Center for Gerontological Social Work Education (Gero-Ed) Center recently stated, “Ownership is facilitated by a process that involves faculty in defining the vision of curriculum change, encouragement, one-on-one consultation, and tailoring of resources to faculty's individual research and teaching interests” (Council on Social Work Education, 2006. p. 1). Providing assistance and resources to faculty can help address the time and staffing constraints repeatedly mentioned by faculty. Regarding faculty leadership, key faculty involved in the project generally served as innovators who were then able to get other faculty on board so that the curriculum innovation could became diffused throughout the curriculum (Rogers, 2003). In some programs, this meant that lead faculty needed to spend considerable time with other faculty on a one-on-one basis, and provide continued encouragement and support over time. This was seen as lead faculty worked to move other faculty from a stance of “I will do this” to “How I will do this,” as indicated by Hooyman (2006). Faculty leadership was also key when new faculty members were hired or adjuncts taught foundation courses that had not been previously infused with gerontological content. This is particularly important as replacement faculty members are hired in many programs to replace the large number of retiring faculty hired in the 1960's and 1970's. Providing new faculty and adjuncts with infused syllabi, aging resource materials, and examples of assignments that involved aging issues were crucial to ensuring that the content remained in the courses. These findings suggest that lead faculty, who have the ability to encourage and inspire other faculty, are critical for the success of a curriculum change project, and need to be identified early if the project is to succeed.

Many programs also learned that new curricular resources and education needed to be provided to faculty and tailored to the needs of individual faculty and courses for change to be implemented. In other words, programs learned that one size did not fit all. Programs varied in size of faculty and program, nature of the student body, program level, and location. Thus, the way that the GeroRich program engaged in curriculum infusion varied greatly (Hooyman, 2006). Results indicated that one way of engaging faculty across program types was through an intergenerational or lifespan approach to curriculum development; some programs were able to convince faculty that aging content could be integrated with existing course content, and thus enrich their courses. Because most faculty today are not trained in gerontology (Kropf, 2002; Lubben & Harootyan, 2002), it is imperative to demonstrate how aging content can be incorporated into existing course content to get faculty on board for a curriculum change effort and to keep them invested in the project (Hooyman & St. Peters, 2006). Brainstorming with faculty on ways to enhance their curriculum can often lead to greater faculty ownership and excitement about the process.

GeroRich programs took extensive steps to include students in the curriculum change effort and encourage interest in gerontological practice through experiential learning and service-learning, which has produced positive results (Joyner & DeHope, 2006). Including students was a critical ingredient to better meet the “demand for gerontology-competent social workers” for practice in the future (Bures, Toseland, & Fortune, 2002, p. 125). Although some programs focused their efforts on monetary motivators (Shank & Herman, 2006), others found that increased exposure through educational opportunities, such as service-learning or greater interaction with older adults, were more beneficial strategies in generating interest among students in gerontology. Such strategies must be developed and maintained to develop a cadre of students committed to gerontology. As other research has found (Cummings et al., 2005; Hooyman, 2006), GeroRich sites learned that exposure to content on older adults and the positives of gerontological practice were crucial elements in developing student interest. Additionally, spending time processing students' reactions to older adults and the specific course examples and assignments are critical to continue breaking down the stereotypes that students have about older adults (Hooyman, 2006). Having an understanding of student resistance about gerontological practice is another crucial step in overcoming student lack of interest (Hooyman & St. Peter, 2006). As future cohorts of students enter social work education, programs will need to monitor the interest of their students in gerontology to determine if their level of exposure to older adults is adequate to maintain interest in the field. It is not unusual for student interest in gerontology to ebb and flow. Regardless of student interest, it is crucial for programs to maintain similar levels of exposure to older adults because all students, regardless of practice area, will interface with elders or their families during their social work career.

Community partners played an important role in the GeroRich initiative. As Ivry, Lawrance, Damron-Rodriguez, and Robbins (2005) suggested, community partners expand the knowledge and skill of students about gerontological practice. The community partners involved with GeroRich sites provided multiple assets to programs, such as additional field placements and recommendations on the curricular infusion efforts. Furthermore, the involvement of community partners created opportunities for organizations and agencies to become better integrated in the education of future gerontological social workers. It is important that social work educators not isolate themselves in the so-called ivory tower and that they take full advantage of the opportunities provided by institutional–community partnerships. Working with community partnerships has been found to help with the marketing of the social work program to future individuals who are interested in gerontological practice (Hooyman, 2006). The community partners involved in GeroRich provided insights into how institutions needed to evolve to ensure that the inclusion of gerontological content is occurring. For some institutions, the involvement of community partners may be the necessary ingredient for maintaining curricular infusion efforts given not only their expertise in the area of aging, but also the type of gerontological exposure that they can provide to students. This was particularly seen in the area of advisory boards, which have been identified as a one of the key mechanisms for institutions to use to ensure future sustainability of the infusion effort (Hooyman & St. Peter, 2006). Finally, it is also important to try to involve community elders in the classroom and on advisory boards. However, involvement must be structured so that it is flexible and sensitive to the realities of aging.

The lessons learned by GeroRich projects suggested that interdisciplinary linkages are critical in maintaining institutional commitment and sustainability. Practice with older adults is not restricted to social workers; instead, it involves the use of an interdisciplinary team, which also brings a necessary level of expertise to the care of the client. As found in this study, programs learned that including other disciplines in their project enhanced the presence of the social work program at the institution. This also led to the development of additional aging programs within the institutions. Sustainability of curricular infusion must go beyond the boundaries of the social work program. Identifying opportunities for collaborations within the institution, as well as outside (i.e., community partners), generates increased enthusiasm and momentum about the curriculum enrichment process that may have a ripple effect in the future.

Finally, the importance of administrative support should not be underestimated in maintaining sustainability and institutionalization of the curriculum change effort. Part of gaining institutional support was developing an infrastructure within the programs to ensure that the content remained in the curriculum even if the project director or other leaders in the infusion process were not spearheading the effort. Institutional support also required educating individuals beyond the social work program about the importance of gerontological practice in the future. Informing college/university administration about the GeroRich initiative also assisted in educating them about the importance of including curriculum on older adults and the types of resources (e.g., faculty) that the program needed to ensure that the curriculum enrichment process continue.

For the field of social work to adequately serve the older adults of tomorrow, the gerontological enrichment effort must be sustained well beyond the GeroRich initiative. Programs need to ensure that curriculum infusions efforts continue beyond the actual process of curricular change. As Hooyman (2006) indicated, “Planned sustainability … meant that gerontological … content would be institutionalized and remain in the curriculum and organizational structure, even when faculty, student, field supervisor, and academic administrator turnover has occurred” (p. 69). To ensure this, periodic reviews of course outlines, continuing to provide faculty with aging updates and relevant gerontological research, continuing to mentor new faculty and adjuncts, and identifying gerontological social workers in the community who can be field mentors for students need to occur postinfusion-effort. Although time consuming, this process is crucial to the continual exposure of students to aging content.

Future research should focus on the long-term impact of the GeroRich initiative for not only sustaining the infusion of gerontological material in the social work curriculum, but also for the effects that it may have on generating more interest among students for pursuing a social work career in gerontology. Research should consider if geriatric curriculum enrichment is sufficient to generate greater interest in gerontology or if additional educational types of programs are needed to maintain student interest in the field. Moreover, with GeroRich program sites stating that the role of the community partners was critical to the infusion effort, future research should also examine how community partners can be better used to create interest in gerontology among students.

This study has several limitations. First, results are not necessarily generalizable to other social work programs, given that the number of institutions who participated in the GeroRich initiative are only a small fraction of the 700 accredited social work programs in the United States and they are not representative of all undergraduate and graduate programs. Additionally, there were no consistent guidelines provided for the way that the GeroRich programs should be implemented across institutions. Consequently, although the themes that were identified in this study reflect the perspectives of multiple programs, they may not be applicable to all social work programs. Given the discretion that was allowed in the way the projects could be implemented, consistency and detail in the recording of the lessons learned varied greatly among institutions. Despite these limitations, however, this study contributes to the understanding of gerontological curriculum change efforts by presenting an overview of the lessons learned from many institutions in one of the first national efforts to enrich the curriculum of a particular discipline with gerontological content. The study thus provides information that can be used by other social work programs and by other disciplines in future geriatric curriculum enrichment efforts. Through lessons learned from the GeroRich initiative, other institutions will gain greater insight into some of the elements to consider prior to initiating their own curriculum enrichment process.

This project was supported by a John A. Hartford Foundation/CSWE Geriatric Enrichment in Social Work Education grant. We thank Nancy Hooyman for her valuable suggestions and contributions to this article.