From block placement to blended model: the way forward for social work practicum in Ghana

ABSTRACT The extant literature on social work education has underscored several factors that hinder the satisfaction of social work students during practicum. Whether or not the adopted social work practicum model influences practice outcomes for students is unknown. Based on the contextual challenges of social work education and the need to ensure culturally relevant social work practice (aka indigenization) in Africa, we explored how the practicum model of a University in Ghana could be modeled to meet the learning outcome of social work students. Thematic analysis from interviews with 18 social work students who had completed their practicum at the Kwame Nkrumah University of Science and Technology, Kumasi-Ghana, showed a consensus on introducing a blended model to guide the social work practicum in Ghana. The findings from the study underscored students’ advocacy for a blended model, their displeasure with the mismatch of agency and area of interest due to the practicum model and the unexpected challenges and anxieties they face as novice practitioners. The study has profound implications for social work education in Ghana, including the need to introduce models such as ‘my first experience as a social worker’ into the practicum orientation programs for social work schools.


Introduction
Practicum, alternatively referred to as field practice and field education is a core component of the social work curricula and an essential requirement for students receiving social work education and training (Pawar et al., 2004;Ryan et al., 2011).Through field practice, students obtain experiential knowledge by participating in direct social work practice (Wayne et al., 2010).It presents the opportunity for students to connect theoretical knowledge (obtained in class) with practice situations.The practice component of social work education signifies the social work curricula's applied status, which sets it apart from other non-applied social science disciplines (Wilson, 2013).Evidence Students begin their practicum in third year with eight weeks of practice, preferably from June to July, with 320 credit hours and continue with 13 weeks (4 hours per day) of concurrent placement practice in their final year.The program mandated practicum students to attend group meetings, observe, discuss, and provide reflective reports on their learning outcomes (Avendal, 2011a).In 2011, the Kwame Nkrumah University of Science and Technology (KNUST) became the second University in Ghana to introduce a bachelor's degree program in social work.Other private universities, such as Methodist University and Central University, also introduced social work bachelor's degree programs in 2017 and 2018.Social work students in KNUST undertake three months of block placement practice during the second semester of their third-year social work education.The influx of social work training institutions in Ghana, evidence of disparities in practicum procedures, and the quest to ensure that the practicum framework meets students learning outcomes necessitate research to explore the suitability of the practicum model for promoting the learning outcomes for social work students in Ghana.The cultural and structural constraints of social work include the limited number of agencies that match students' interests and the apathetic nature toward social workers in Africa (who are seen as intruders in clients' affairs, especially in their private/family issues) (Canavera et al., 2020;Mwansa, 2010), further support research into this topic.Social work students' practicum reflexive reports adopted by KNUST would help inform the practicum model that best suits the social work curricula in Ghana and Africa despite agency constraints.Although social work education has been accredited by Ghana's Ministry of Education, the profession is yet to receive licensure for practice from the government of Ghana.The Ghana Association of Social Workers is currently taking the necessary step to legitimize the profession for practice, just like Ghana's medical profession.

Social work practicum models: the how and when
Concurrent, block placement, a combination of concurrent and block placement, and inservice placement approaches are the common practicum models adopted by social work training schools (Dhemba, 2012;Hunter & Hollis, 2013;Ring & Rock, 2010).In concurrent field practicum, students undertake practice alongside classroom lessons; thus, students usually spend two or three days on the field and the remaining days in the classroom (Dhemba, 2012).With block placement, students are required to complete the majority of their coursework models before going to the field (Dhemba, 2012;Liu et al., 2013).Usually, a semester is designated for practicum.The rationale is that completing most of the coursework requirements will provide students with the necessary theoretical knowledge for practice (Liu et al., 2013).Students usually complete the coursework requirements in their third or final years before the three to four months practicum.Inservice-placement is when students practice at an institution where they are already working or have worked before (Dhemba, 2012).
The concurrent approach is common among schools in the United States (US), Canada and the United Kingdom (UK) (cf.Liu et al., 2013;Wayne et al., 2010), whilst there is evidence of block placement practice among schools in New Zealand (Hay & O'Donoghue, 2009).Each practicum model may have varied impacts on students.For instance, a block placement model may provide a high concentration level as students work full-time, employing what they have been taught in the classroom.On the other hand, Hunter and Hollis (2013) argue that the concurrent model might obstruct social work students' completion of their program.However, students in such placement benefit from dual supervision.When necessary, they can clarify practice issues with their agency supervisors and their course tutors.The concurrent placement also enables students to engage in theory-informed reflective practice, thus, employing theories taught in class to understand the complex nature of social problems.In-service practice supports the specialization of students in their area of interest, building on their skills in this area.Nonetheless, students risk losing the diversity, eclectic knowledge, and abilities that they receive during their field practicum, which is a key component and expectation of their training (Council on Social Work Education, 2015).Our review did not identify any study in Africa or Ghana that investigated the nature and types of practicum models used by schools of social work across the continent and students' experiences of this model.This study seeks to fill that gap and contribute to the burgeoning discourse on the indigenization of social work practice in Africa.Johnson et al. (2012) report that there could be constraints on social service agencies due to the increasing number of social work training institutions.This situation is highly expected in Ghana as social work training schools increased from 2 in 2011 to 5 in 2020, with an estimated increase in student population from 300 to more than 2000.Students could also be affected when limited specialized institutions (e.g.child welfare agencies) do not meet their interests (Pawar et al., 2004).Students' mental health, psychological make-up, and open-mindedness are common individual factors affecting their practicum learning outcomes (Collins, 2006).Fortune and Abramson (1993) reported that students' confidence and involvement in agency activities hinged on their area of interest and the activities of the agency that matched this interest, enhancing their learning satisfaction (Dhemba, 2012;Sun, 1999).
Notwithstanding, field instructors argue for a more deliberate effort by various awarding institutions of social work to expose students to practicum early on (blended model) to instill in them the core values of social work, which will help them in their practice (Street, 2019).Students are usually nonchalant when they start their practicum after spending some time in the classroom with little connection and empathy for clients (Street, 2019).Hence, a blended approach will help field supervisors to work together with faculty members to bridge the theory and practice gap.
According to the International Federation of Social Workers (2020), of which Ghana is a member, practicum needs to amount to one-fourth of the overall social work curriculum summed up in credit hours, months, weeks, and days students spend on the field.To further substantiate this, the Council on Social Work Education (2015) opined that bachelor of social work students are expected to spend a minimum of 400 and a maximum of 900 hours on practicum as partial fulfillment of their undergraduate degrees in Social Work.However, there is evidence of nuances in implementing field practice based on the framework adopted.Skolnik et al. (1999) study in 163 schools from 67 countries reported variances in the number of hours for field practice.Evidence from schools practicing the concurrent frameworks in the US indicates that students undertake 21 hours per week fieldwork duties (for a semester) concurrently with their coursework (Buck & Sowbel, 2016).In India, third-year social work students spend 30 days in social welfare organizations of their choice, whilst students in Trinidad and Tobago undertake 226 hours of block placement practice in the second and third years of their bachelor of social work education, after a preparatory 168 hours in-house practice in the first year (Johnson et al., 2012).Amadasun (2020) asserts that social work students in Nigeria are expected to undertake 300 hours of field placement in human service agencies as part of a bachelor's degree requirement.Despite these nuances, no study in Ghana has sought the views and experiences of social work students on practicum models.This study aims to fill this gap, drawing on social work students' experiences in a public university in Ghana on their views of the practicum model and suggestions for improving the model to meet students' learning outcomes and satisfaction.

Participants and procedure
Undergraduate social work students (n = 18) from 2019/2020 and 2020/2021 cohorts who completed their mandatory three-month practicum at the Kwame Nkrumah University of Science and Technology, Kumasi-Ghana, were recruited for the study.Considering that our interest was to explore the practicum model and students' experiences of the practicum, students who had completed their field practicum in the last six months were sampled.These students were deemed to have the ability to recall their practice experiences, share with the researchers their reflections on significant events, reduce distortion of participants' narratives and how their experience is linked to their university's practicum model.
Flyers of the study were shared on the WhatsApp platforms of participants (social work students in third and final years) through their course leaders (also known as course reps).Course reps served as gatekeepers through whom interested participants contacted the researchers to express their interest and scheduled interviews.The researchers were contacted by 21 participants from 177 eligible participants for the study.After engagement and consultation with the eligible participants, 3 of the 21 participants decided to opt-out of the study due to personal reasons.The final number of participants who accepted to be interviewed for the study was 18. Telephone interviews were conducted due to the Covid-19 pandemic and the risks of having face-to-face interactions.
The interview protocol and study procedure passed the Kwame Nkrumah University of Science and Technology's rigorous ethical requirements.The authors received official clearance from the institution on 30 January 2020 to commence interviews.Practically, the protocol required that all participants were fully informed of the rights, risks and benefits associated with their participation.An e-mail containing a detailed consent form was sent to each participant four days before the scheduled interviews.The participants were required to complete the consent form electronically and return it to the researchers 24 hours before the interview.Parts of the consent form stated that 'you have the right to withdraw from the study or decide not to answer some questions from the researchers, even after you have agreed and signed this form'.In the consent form, measures included using aliases in place of participants' names and agencies.Also, the consent form requested participants' permission for the interviews to be audio recorded.Eighteen social work students between nineteen (19) to twenty-three years ( 23) participated in the study.These students had completed their field practice with relevant social service agencies in Ghana.Most participants (n = 15) had additional practice experience from voluntary internships.The added practice experience obtained through internships with diverse social service agencies gave students some familiarity working with clients and field supervisors in their placement agencies.It also helped students settle in agencies early-minimizing unexpected challenges and practice shocks that students usually face during their first few weeks of the practicum.The added voluntary experience of students also further strengthens the study findings with narratives of students backed by their experiential knowledge from their field practice.Details of participants' demographics have been included in Table 1 below

Data collection and measures
In-depth telephone interviews averaging 50 minutes were conducted with 18 social work students from 1 March to 31 May 2020.The semi-structured interview guide was developed based on the research objective, insights from the literature reviewed and input from two social work faculties.The use of semi-structured interviews in exploratory qualitative studies enables the researchers to have the capacity and flexibility to explore participants' responses in detail (Silverman, 2013).Questions on the interview guide included: 1) In what ways did the practicum model impact your experience on the field 2) When given a chance, what changes will you make to your institution's field practicum model?3) What specific things do you think should be done to improve your curriculum's field practicum component based on your context?4) What are some of the challenges students face during their field practicum?All telephone interviews were conducted in English based on the participants' choice.

Analytic procedure
Audio recordings of the interviews were transcribed using Microsoft Word 16.All research team members vetted the transcripts against the audio records to check accuracy.We followed Braun and Clarke's (2006) thematic analysis procedure to analyze and identify common themes from the participants' narratives.First, each transcript's coherent sentences were coded with short phrases that captured the narratives' actual meaning.This is known as line-by-line coding (cf.Charmaz, 2014).The line-by-line codes from all 18 interviews were organized under the research objective (and subobjectives) using a master codebook.Codes in the master codebook enabled the researchers to read, reflect and merge those with similar meanings under initial themes and subthemes.The initial themes were vetted and organized by members of the research team.At this stage, names for each theme were provided to capture what was contained in the themes.The main themes included 1) extension of practicum duration, 2) mismatch of agency and area of interest, and 3) practice shocks.The coding and theme development procedure involved some disagreements among the researchers, especially on what should be the name of the themes, but this was keenly discussed for compromise.Taguette open-source software was used to organize transcripts, keep master codebooks, and merge codes (known as tags in Taguette) into themes.

Qualitative rigor
Measures were taken to enhance the credibility and trustworthiness of the findings.First, the codes and master codebook were shared with seven research participants for their corroboration.Inputs from the participants enhanced our trust in the data and codes developed.Shenton (2004) described this process as member checking.The involvement of all researchers in the analysis process ensured that biases and subjectiveness were minimized.Silverman (2013) and Shenton (2004) described this strategy as triangulation by the investigator, a key mechanism to enhance trustworthiness in qualitative studies' findings.

Findings
KNUST employs the block model of practicum framework where students spend three months (6 weeks each) in two agencies.Students are assessed by their reports, reflective seminars and feedback from field instructors

Advocacy for a blended model
Majority of students who participated in the study recommended that their department switch from block to a blended model for their practicum.The endorsement by the students stemmed from the leverage a blended model of training offers students, allowing them to incorporate reflections from their field practice along with coursework which will help them clarify contradictions between theories with practice situations during inclass discussions and seminars.
A student has provided clarification on why such a blended model of practicum is essential: . . . the usual thing of submitting your report after your practicum, doing your viva voce and continuing with normal academic work like nothing ever happened is not working, and we need to adopt new ways such as working at an agency for a week in order to add to our knowledge and clarify our pending questions.Because I feel like the practicum is there for us to know the relevant issues on the ground as students, so after you have gained that knowledge, what next?There should be a conscious effort to apply what we learned during our practicum to our academic work and vice versa (Student 15,Female,19 years).
Some students argued that a blended model helps provide immediate clarification on contradictions between theoretical postulations and practice application.Another student shed more light on this topic: One thing I have noticed from my experience of working with more than three agenciescombining field internships and the mandatory practicum here in school is that, in some agencies, the theory we learn and real practice are worlds apart.So if you do not allow students to clarify some of these challenges and misconceptions, they might head to their final year confused and unsure exactly what the profession stands for.Myself, I nearly opted to switch my minor program (Sociology) to be my major program because I didn't get the point.I felt like we were wasting our time studying things that were not used in real life.And you know final year is the crucial year for all students-where students prepare to step out to the real world alongside the pressure of submitting your thesis before the deadline, submitting assignments and preparing for exams.Hence some of these questions and contradictions may be left unanswered-that is why I feel we need the blended model to allow students to be on the same page.
Some students suggested practical ways to integrate the blended model into the social work program to let students have a feel of what they signed up for.The quotation below highlights some of the students' narration of the possible ways of improving the practicum aspect of the social work program in Ghana: I believe that during each academic semester, there should be one week set aside in a month aside from the full semester we go for our actual field practice that is graded.This will make students cognizant of the issues on the ground.We cannot wait until it is time for practicum before going on the field.Let's say if we spend one week each month on the field in the course of the semester, we can know what is happening, the diverse and relevant issues we need to pay attention to.This will also fully prepare students adequately because if the semester is for four months, that is four weeks of full practice on the field.Multiply that by seven semesters and tell me if students won't be competent enough after (Student 4, Male, 22 years).
. . . the usual thing of submitting your report after your practicum, doing your viva voce and continuing with normal academic work like nothing ever happened is not working and we need to adopt new ways such as working at an agency for a week in order to add to our knowledge and clarify our pending questions.Because I feel like the practicum is there for us to know the relevant issues on the ground as students, so after you have gained that knowledge what next?There should be a conscious effort to apply what we learned during our practicum to our academic work and vice versa (Student 15, Female, 19 years).

Mismatch of agency and area of interest due practicum model
One of the key issues that students (n = 13) raised concerning their field practice and its relevance to their training was that some students were placed in agencies that did not align with their interests.This was attributed to the type of practicum model (block placement model), which demanded that students complete their field practicum before the end of the second semester of their third year in Social Work.The focus then was on finding social service agencies not necessarily based on their interests to meet this requirement.Hence, students were placed in agencies that did not match their proposed area of expertise and interest.This prompted a lack of concentration from the students due to disinterest in the agency activities.One participant reflected on her experience with such mismatch placement.
I think students need to be placed at agencies according to their chosen elective courses in third year.Some get placed at agencies, and they are disappointed even before they start.Myself, for instance, I read a course on working with children and was placed in a child welfare agency and the Department of Social Welfare.Fair enough, but some of my colleagues are not lucky enough to get such a combination.That's unfair.The process is fairly rushed because we need to show that we worked for more tha two agencies during that semester as partial fulfillment of our undergraduate degree.Although we are trained to be generalist practitioners where we are taught to have an eclectic knowledge base, we all have our interests, and we need to be placed in agencies according to our interest (Student 1, Female 22 years).
Although the students acknowledge the challenges with the limited number of social service agencies in Ghana, they feel disappointed when they are not placed in at least one of their preferred agencies.
Actually, I was expecting to be placed at an agency in relation to the third-year elective courses I read-Industrial Social Work and International Social Work.I was expectant and excited about how working in a Non-governmental and International agency would be like to have a feel of how my future engagements in these agencies would look like and apply what I was taught in my third year electives.But then, in my first placement, I was placed in a daycare where I had no idea about working with children.I was mad (Student 6, Male, 22 years).
Aside from not getting their preferred agencies due to its limited number, some participants mentioned agencies they feel are irrelevant to their areas of interest and social work practice in general.As a result, they questioned the field practice's quality and relevance when students are placed in such 'irrelevant' agencies.
I think there are a lot of irrelevant agencies that we need not be placed there as social work students.Agencies like radio stations, I don't know the duties of social workers there.They should take it out of the agency list for our practicum because I don't see any relevance of going there and its impact on our training as social work students.Although I think it might limit the number of agencies during that semester, it should not be an option.All these can be controlled if we are to do our practicum during the course of our undergraduate degree and not just a single semester (Student 2, Female, 22 years).
Regardless, others who were placed in agencies outside their preferred choices and areas of specialization who were open took that as an opportunity to learn and broaden their scope of practice: With my second placement, frankly speaking, I did not want to have anything to do with the hospital setting, but that was where I was placed; I had no option than to go because if you don't go, what else will you do because that is the only option you have to do your field practicum.So I decided that why don't I give it a try as well, because you don't have an option anyway.At least I will get to know how social workers practice in the hospital setting, which will keep me to be well informed in future (Student 3, Male, 24 years).

Unexpected challenges
The majority of the students (n = 14) underscored factors that impede their learning outcomes from fieldwork.These factors mainly focused on their lack of knowledge and skills on unexpected challenges they encountered during the initial days of fieldwork.
Though it is a known fact that students will experience these challenges due to their lack of experience, it appears our study participants were not given the necessary education on what to expect and how to address these challenges.The students found them strange and explained how they affected their fieldwork practice.A student recounted experiences of working with street children in the first couple of weeks with her agency.
I think before we went on the field, we were taught the practice, principles and ethics of the profession, but I think one thing we weren't taught and did not focus on is how we as individuals can relate with individuals during our field practice.For instance, when I first went to the agency (working with girls connected to the street), the first day I went close to the girls on the streets and held their babies, I felt I had been covered with dirt, and I couldn't even eat with my bare hand for two weeks because I felt that they were filthy.Whenever I got home, I quickly bath before touching anything because I felt like I wasn't clean.You know why because these people mostly spend almost all their lives on the street and usually do not care about hygiene.But after the 4th week, I became used to the place and working with them.I can say that from that time, I had my best experience there.Sometimes I will be holding the baby and be eating at the same time because I understood their plights now.This shows how easily I could have adjusted to the agency if I had some form of experience with this group (Student 9, Female, 20 years).
Students emphasized that these unexpected challenges would have had less implication on their outputs during the early stages of their field practicum if they had a blended model where they could clear all their doubts and misconceptions about their clients and agencies: I was very unproductive during my first two weeks at my first agency.This was because I felt this was not something I had bargained for, and most of the things I was seeing felt so new and strange to me.At that point, if we were having our viva, I would have had a lot of things to say about the structure of our field practicum because you cannot place students at an agency and leave them to figure out how to cope and adapt at these places for more than six weeks.That is very much unfair.That is why I advocate for our field practicum to be done side-by-side with our classes.That way, we can ask all our questions and clear our doubts (Student 17,Male,21 years).
Also, the students indicated the need for social work students to be taught about the uniqueness of people when discussing practice skills required for fieldwork: One thing that struck me throughout this experience is that everyone has a way they relate to people, but when we are being taught about nondiscrimination, respecting our clients, and empathizing with them, lecturers tend to generalize these ethics and principles, forgetting that everyone has their unique way of doing things and even interacting with people.Some people are antisocial and have atypical qualities, others are also pro-social.It is important that we are taught the difference between these people and the ways they handle practice situations.This will help to avoid the shocks we experience in practice as student practitioners (Student 11,Male,21 years).
Narratives from research participants revealed the importance of students being adequately prepared and taught nuances in human behavior before field practice.

Discussion
This study, which is the first in Ghana, explored social work students' experiences and views on the practicum framework practiced by the Kwame Nkrumah University of Science and Technology, Kumasi-Ghana.The students shared their experiences and views about ways the current framework can be revised to promote learning outcomes for social work practicum students.The students advocated for stakeholders to incorporate a blended model of training, which will help extend the time students spend on the field to gain more experience working with clients and offer them the opportunity to clarify the incongruence between theory and practice in that area.The current three months block practicum model, with six weeks each of practice at two agencies, limits students' involvement in agency activities (cf.Baird, 2016;Didham et al., 2011;Fortune & Abramson, 1993;Lewis & King, 2019;Pawar et al., 2004).Students' preference for having at least a week set aside to have some practice experience indicates their passion for the profession, their quest to have more practice experiences to satisfy their training needs and have a feel of working in their preferred area of interest.Students' desire to have this kind of arrangement stems from their commitment to becoming effective generalist practitioners (Miley et al., 2016).All baccalaureate social work holders are trained as generalist practitioners who are equipped with the skills set and knowledge to practice in all fields of the social work profession (Council on Social Work Education, 2015;Miley et al., 2016).Thus, when the duration is extended, the students will have the opportunity to practice with diverse social service agencies to meet their training requirements and agency expectation.However, the lack of adequate social service agencies could prevent students from having the practicum duration extended.This extension may also come at the cost of sacrificing essential classroom modules.Courses such as research methods for social work, which is a core component of the social work program, may be sacrificed because of the extended duration of the field practicum.
The study also found that introducing a concurrent practice module alongside the current block placement framework (Dhemba, 2012;Hunter & Hollis, 2013;Ring & Rock, 2010) could help students achieve their learning outcomes.The study suggests that students can clarify confusions and contradictions between theory and practice under the concurrent model.Undoubtedly, the concurrent model enables students to promptly connect practice situations with theories and practice approaches taught in class (Dhemba, 2012;Hunter & Hollis, 2013;Ring & Rock, 2010).For instance, a student who was taught that assessment begins with a needs assessment would quickly raise questions and seek clarifications from their Professors when they observe that their supervisors or co-practitioners begin the assessment with a different approach.The kind of question-to-clarification scenario created through the concurrent model augments students learning outcomes.Although students could obtain such clarifications from their field supervisors even under the block placement model, it appears clarifying from their Professors and colleagues through class discussions and seminars are preferred by the students.In connection with common practices across the globe, particularly in the US, Canada and the UK (cf.Liu et al., 2013;Wayne et al., 2010), this study revealed that students are desirous of increased learning opportunities that may accrue from the concurrent model of field practicum and coursework.Another advantage of introducing the blended model is that it will allow social work training in KNUST to meet some of the international standards for social work education.For instance, the Council on Social Work Education (2015) recommends a minimum practicum hour of 400 for undergraduate students.Currently, the block placement model practiced in KNUST allows students to attain 360 hours.Thus, introducing the blended approach will increase the hours of experiential knowledge that social work students get from the practicum while enabling the students to meet international training standards.The model may also heighten students' interest in social work practice and improve the client-student relationship (Hunter & Hollis, 2013).
Furthermore, the block placement model at KNUST is challenged by how students are placed with agencies.Students in this study indicated that mostly they are not placed in agencies of their choice, interest, or those that align with their area of specialization.Existing studies have shown that students placed in agencies not of their choice often report low satisfaction levels (Fortune & Abramson, 1993;Pawar et al., 2004).The practice of placing students outside their preferred choices could be due to a lack of adequate social service agencies, including specialized agencies (Pawar et al., 2004).Effects from such structural constraints on practicum placement are deemed to be more pronounced in sub-Saharan Africa, where professional social work services and agencies are limited (Canavera et al., 2020;Mwansa, 2010;Rankopo & Osei-Hwedie, 2011), and often undertaken by traditional families, communities and paraprofessionals (Avendal, 2011a).The findings revealed that the lack of specialized social service agencies propelled practicum placement officers to place some students at non-traditional social service agencies, such as Radio stations.This heightened students' levels of dissatisfaction and made them question the relevance of the social work practicum.Students labeled Radio stations as irrelevant to social work practice.However, it is important to highlight that social workers have had a longstanding role in the media (Ayre, 2001;Brawley, 1997;Chan & Sage, 2021) through advocacy and using the media as a medium for community education/intervention.Especially in the 21 st century era of technology and the COVID-19 pandemic (Cudjoe et al., 2021), the media has become avenues for knowledge dissemination and intervention delivery as Tele interventions (Brawley, 1997).Thus, the students' views on the media and social work practice suggest they lack adequate information on social workers' role in the media.Students' proposition to set aside days of the week for field practice may also give students the chance to work at their preferred agencies and broaden their knowledge in these areas.
Finally, the study findings revealed that students are concerned about their lack of knowledge and skills to deal with shocks and anxieties from their early days of field practice.Students lacked the skills and experience to engage with vulnerable children and establish relationships with some clients.Essentially, the findings suggest that first-time practicum students or novice practitioners face anxieties and shocks from their encounters with clients.A body of existing literature has underscored the anxieties and shocks experienced by first-time social work practitioners, including practicum students.Nisivoccia (1990) reports that the feeling of incompetence and overreliance on supervisors are significant sources of anxiety for practicum students.Also, Sun's (1999) interview with 23 students at the end of their practicum revealed that they lacked confidence and the ability to establish a relationship with clients.This mostly happens when the students are not adequately oriented before their placement and monitored during their placement (Didham et al., 2011).Suggesting that proper supervision and orientation on handling anxieties from field placements are needed to ensure students have better outcomes from their practicum.

Implications for social work education
The study findings have implications for social work education in Ghana, specifically the practicum framework and measures required to promote the learning outcomes for students.Firstly, the findings lend support for us to argue for the need to shift from the current block placement practice to a blended framework that provides both block and concurrent placement experiences for students.The blended model could help curtail some of the challenges with the block placements.Specifically, it would help extend the practicum duration when additional hours are allocated for concurrent practice.Extending the practicum duration could have added benefits, including 1) enabling students to obtain practice experiences from diverse social service agencies and 2) ensuring that the social work practicum at KNUST meets the standard requirement set by the Council on Social Work Education (2015).Secondly, the findings show that efforts are being made to curtail the structural constraints (lack of appropriate social service agencies) confronting the practicum program by placing students in nontraditional social service agencies, such as Radio stations.Whilst such mechanisms are strongly supported, students must be oriented on social workers' roles and relevance in non-traditional social welfare agencies before their placements.It appears that many students lack adequate knowledge of the relevance of such non-traditional social welfare agencies, which impedes their satisfaction and learning outcomes.Finally, we advocate for practicum students' orientation programs to include modules on 'my first experience as a social worker', explicitly teaching students the skills to handle shocks and anxieties as first-time practitioners.These modules should include practice techniques required to handle unexpected anxieties and shocks.

Limitations
Though the study provides valuable insight into the social work practicum program in Ghana, it is limited to only evidence from 18 social work students.The small sample undermines the validity and statistical generalization of the study findings.However, the study provides a premise for analytical generalization.Findings from this study open new insights on social work education and training, which could be strengthened with studies that include views of social work faculties, practicum coordinators and field supervisors in Ghana.Further, large-scale quantitative research on the same subjects would be relevant to inform decisions on social work education.
The general theories we learn in class, you go to the field, and you realize that it is a different story, and you have to adjust to what they work with on the field.On the field, it is like they have created their theory they work with; they are not working with the theories we know and learn in the classroom.Practitioners work with what they feel is workable for them.So, what they feel is right is what they do, so it is sometimes confusing.And it is important that we get clarifications from our Professors and colleagues (Student 17, Male, 21 years).