The Association of Social Work Board’s (ASWB) release of their long-requested report on licensure exam passage rates has prompted industry outrage. Professional response has been fierce with calls for action by every sector, especially for social work regulatory boards across the states and territories to stop giving and requiring licensure exams.The report’s appearance forced me to pause, especially as a clinical social worker with 40 years committed to patient and professional empowerment. Add my roles as a former ASWB clinical exam item-writer, social work educator, and clinical supervisor to the mix, and know I’ve engaged in my share of reflection.
Historic challenges
Systemic racism has long been attributed to standardized tests across education levels, academic programs, and professional licensure and credentialing entities. The National Education Association calls for more authentic means of assessment, viewing the exams as “instruments of racism and a biased system”. Ibram X. Kendi states,” The tests have failed time and again to achieve their intended purposes: measuring intelligence and predicting future academic and professional success. The tests, not the black test-takers, have been underachieving”. Students who are English Language Learners (ELL), persons with disabilities, and Black males are all identified among persons least likely to receive a passing score.
Social work is not alone in its outcry over licensure exams passage rates and the associated disparities. There are countless studies, including a recent release by the American Bar Association in May 2022. The report revealed how Whites pass the Bar exam as first-time test takers (and within two years of graduation) at higher rates than graduates from other racial and ethnic groups.
The Ultimate Dilemma
What should happen next? Herein lies the $64 M question. Social work is a regulated profession, the primary purpose of which, is protection and safety of the public; the secondary purpose is to protect the profession. Yet, I’m confident most have met individuals who are expert test takers, but less than effective practitioners.
Is exam passage necessary? If yes, what becomes the best method to “test” that an individual has the level of didactic knowledge, critical thinking, and professional maturity required to intervene as an independent clinician? If no, are other licensure requirements alone sufficient to denote competency to practice in a state, such as graduating from an accredited school of social work, fulfilling the requisite practicum hours, completion of a requisite number of clinical (direct) and work (indirect) hours, plus a set number of supervision hours? How should the minimum standard for clinical practice be defined by state boards, considering the different requirements across them?
From a liability standpoint, standardized exams were thought to provide an objective measure of the minimum standard of practice expected for that licensure/credential, though this is not the case. Protecting patient’s from harm has been a priority of licensure, but what of practitioner harm? From an ethical standpoint, conclusive data shows standardized exams in their current form, obstruct access to (independent) licensure, especially for persons of color, certain ethnic groups, and those with disabilities, among others. Practitioner harm and trauma are direct outcomes when these individuals are unable to pass the exam; professional reputation and financial status are impacted through loss of promotions or jobs, as well as dollars spent on prep courses and repeated exam application. This action fails to ensure attainment of a diverse workforce that can provide the concordant care warranted across patient populations.
The Response
From social work’s lens, if the ASWB exam is removed, what will replace it? That premise is a central consideration. Some states, as Illinois, charted that course prior to the ASWB report; the LSW no longer requires a person take an ASWB exam. Other states are actively considering their next steps.Petitions to eliminate the ASWB and the exam are circulating and gaining momentum. Other suggestions include passing those persons who took the exam multiple times and missed passage within 10 questions. Social work strives to identify and fix systems that are broken. The licensure exam process is broken, and we are beholden to fix it.
The National Association of Social Workers (NASW) released their formal response, emphasizing concern over racial disparities and need to address the “systemic racism within the profession”. Further statements have appeared from the Social Work Hospice and Palliative Care Network, and are expected from other groups.
Whatever happens next, one action is certain; strategic, coordinated, and equitable action is mandated; too much is at stake. That action must ensure social work’s professional path is not laden with the same disparities and obstacles faced by populations served by the profession itself.
Ellen's Interprofessional Insights 