Speech-language Pathology Education Research Articles

Moving Beyond Rapport: The Importance of Active Facilitation of Therapeutic Alliance in Adult Acquired Brain Injury Rehabilitation.

Therapeutic alliance (TA) is critical to rehabilitation outcomes for adults with acquired brain injuries (ABIs). The purpose of this viewpoint article is to review factors that contribute to TA and to suggest ways speech-language pathologists (SLPs) can integrate these factors into their ABI rehabilitation practice. We evaluated literature describing client and clinician factors shown to affect-or not affect-TA in ABI rehabilitation and mapped findings onto suggested practices that SLPs may use to actively promote TA with their clients. Informed by our findings and TA frameworks, we integrated findings into a novel clinician self-reflection tool: the Therapeutic Alliance Reflection Checklist. TA is a key ingredient in ABI rehabilitation. We contend that SLPs can, and should, actively facilitate TA with clients; the self-reflection checklist can assist. We advocate for continued TA research and improved measurement across rehabilitation settings. We further contend that training in active TA-promoting skills is a critical component of speech-language pathology education.

‘Each person’s experience is different’: speech-language pathologists’ perspectives regarding their pathway to the Australian rural workforce

ABSTRACT In Australia, difficulty recruiting speech-language pathologists (SLPs) into the rural health workforce contributes to reduced accessibility of services and inequitable communication and swallowing outcomes in rural communities. This research explored the experiences and perspectives of speech-language pathology graduates from a regional university regarding their pathway to the rural health workforce. Using a qualitative research design involving semi-structured focus groups, the role and interaction of factors that influenced their rural pathway were examined. The study also investigated how the pathways of speech-language pathology graduates reflected and/or deviated from those identified within other health professions. Participants included eight graduates from a regional university. All participants were female, grew up in rural areas and worked rurally. Reflexive thematic analysis with an inductive approach was conducted to identify and analyze recurring patterns of meaning. Three key themes were identified: returning home and coming ‘full circle back’, ‘having [… the] opportunity’, and working in a team is ‘very important’. A key finding of this study was that connectedness to family, friends, partners, rural communities, supervisors, and other health professionals was strongly influential in participants’ pathway to the rural health workforce. This study also revealed individualized, unique interactions between factors and variations across life stages. The findings of this study suggest that providing accessible speech-language pathology education to rural students and providing quality support and professional development in workplaces may be beneficial in addressing current workforce shortages.

Clinical Practice Patterns in Childhood Apraxia of Speech and Augmentative and Alternative Communication: Implications for Speech-Language Pathology Education

Purpose: The purpose of this study was to describe speech-language pathologists' (SLPs') clinical practice patterns related to childhood apraxia of speech (CAS) and augmentative and alternative communication (AAC). Method: A survey study was conducted with a total of 52 SLPs. Survey questions were related to SLPs' education, clinical experiences, and perceptions of CAS and AAC and implementation of AAC. Results: Most SLPs reported having had a dedicated AAC class during graduate school and are regularly pursuing continuing education in both CAS and AAC. SLPs reported varied clinical experiences, perceptions, and implementation of AAC in clients with CAS, with 86.54% reporting recommending AAC at some point to a client with CAS. The percentage of clients with CAS who were recommended AAC was significantly less for clinicians who pursued less continuing education in CAS ( p = .023). SLPs were significantly more likely to report comfort with AAC if they pursued continuing education in AAC ( p = .025) or had an AAC class in graduate school ( p = .007). Conclusions: SLPs' educational and clinical experience influence their clinical practice patterns related to clients with CAS and implementation of AAC. Based on the needs and skills of clients with CAS, graduate clinical education and continuing education courses regarding treatment of CAS should include information on AAC, particularly in the context of supporting receptive and expressive language skills, alongside speech development.

Building diversity in the speech-language pathology workforce through a blended online Master of Speech Pathology

Purpose: A lack of diversity in the speech-language pathology profession is widely recognised internationally. The role of speech-language pathology education in reproduction of this homogeneity and as a barrier to diversification is little understood. The potential of blended online education to increase access to education and diversify the speech-language pathology profession is yet to be explored. The purpose of the study was to investigate the profile of students engaging in the first blended online speech-language pathology course in Australia, including motivations for studying, experiences of studying via a blended online mode, and intentions for future practice. Method: Data were collected from 44 students in the first Australian blended online Master of Speech Pathology via an online survey. Quantitative data were analysed using descriptive statistics in SPSS and a content analysis of the qualitative data was conducted using NVivo. Result: With over 92% of participants choosing the course because it was offered online, flexible blended online study provided opportunity for those who would not have otherwise accessed speech-language pathology education, including rural students and those balancing work and home commitments. Participants found face to face elements of the course essential to their learning, but also the most challenging to manage and to fit around other commitments. Participants’ ideal work scenarios revealed that 82.9% wished to practice within 50kms of their current location, indicating that provision of tertiary education to people in rural areas is contributing to establishing and retaining a rurally focussed speech-language pathology workforce. Conclusion: Blended online study provides an opportunity to diversify the speech-language profession by providing access to students such as rural students and those balancing work and home commitments with tertiary education. By reducing barriers to studying speech-language pathology, flexible learning is helping address issues of access and equity in service delivery across Australia.

Promoting the Internationalization of Speech-Language Pathology Education: The Bulgarian-American Cooperative Experience

Several collaborative projects between South-West University in Blagoevgrad, Bulgaria, and 8 universities in the USA have worked well to improve the overall competence of students in speech-language pathology programs and practicing clinicians to better meet the needs of individuals with fluency and voice disorders. The US Fulbright Senior Specialist and EU Erasmus+ exchange programs serve as effective instruments that provide systemic and long-term impact supporting innovation and fostering contemporary teaching methods. These international projects prepare students and faculty succeed in a global, multicultural society, and in doing so, advance speech-language pathology as an evidence-based allied health science discipline.

Opportunities to Learn Transgender Voice and Communication Therapy in Graduate Speech-Language Pathology Education: Preliminary E-Survey Findings

Purpose Clear guidelines are needed for the inclusion of transgender voice and communication services in speech-language pathology graduate curriculum. Standardized training on how to support gender diverse individuals' communication appears to be lacking in graduate curriculum. To better understand current trends in transgender voice and communication training in speech-language pathology graduate programs across the United States, this cross-sequential e-survey study assessed experience with, attitudes toward, and student learning opportunities in transgender voice and communication services among voice instructors and clinic directors. Method An open online survey distributed in 2015 was completed by 24 voice instructors and 13 clinic directors. The same survey was completed by 15 voice instructors in 2018. Results Based on 2015 findings, a majority of voice instructors and clinic directors in speech-language pathology graduate programs reported that services for transgender voice and communication were not addressed in their graduate education curriculum. Findings from 2018 were similar to results in 2015. Almost all voice instructors included transgender voice and communication therapy in their graduate voice course. There is unanimous agreement that transgender voice and communication services should be part of SLPs' scope of practice. Conclusions Findings from 2015 to 2018 suggested an improvement in instruction time spent on transgender voice and communication. Yet, some voice instructors continued to report that the topic was not covered in their coursework. A need exists to adjust guidelines on voice and communication services for gender diverse individuals and offer learning opportunities for this area in graduate speech-language pathology curriculum. Supplemental Material https://doi.org/10.23641/asha.12640409

Simulation can replace part of speech-language pathology placement time: A randomised controlled trial

Purpose Simulation is increasingly used within speech-language pathology education. Research has primarily explored students’ perceptions of learning in simulation. The aim of this study was to determine if speech-language pathology students achieved a statistically-equivalent level of competency when a mean of 20% of placement time was replaced with simulation compared to placements without a simulation component. Method This non-inferiority randomised controlled trial involved students from six Australian universities. Students were randomised to either a simulation + traditional placement group attending 5 days of simulation prior to their traditional placement, or a traditional only placement group. Their end-placement clinical competency was assessed using Competency Assessment in Speech Pathology (COMPASS®). Result Final data were available for 325 students: 150 students in traditional placements, 138 students in protocol-compliant simulation + traditional placements, and 37 students in non-protocol simulation + traditional placements. There were no statistically significant differences between groups (traditional vs protocol-compliant simulation + traditional Mann–Whitney–Wilcoxon z = 1.23, df = 286, p = 0.22; traditional vs intention-to-treat simulation + traditional Mann–Whitney–Wilcoxon z = 0.23, df = 323, p = 0.81). Conclusion This research contributes to the evidence base which suggests that simulation can partially replace traditional placement time for speech-language pathology students without loss of competency, substantiating its value as an alternative placement model in speech-language pathology programmes.

Systems Thinking and Systems-Based Practice Across the Health Professions: An Inquiry Into Definitions, Teaching Practices, and Assessment

ABSTRACTPhenomenon: Systems thinking is the cornerstone of systems-based practice (SBP) and a core competency in medicine and health sciences. Literature regarding how to teach or apply systems thinking in practice is limited. This study aimed to understand how educators in medicine, physical therapy, physician assistant, nursing, and speech-language pathology education programs teach and assess systems thinking and SBP. Approach: Twenty-six educators from seven different degree programs across the five professions were interviewed and program descriptions and relevant course syllabi were reviewed. Qualitative analysis was iterative and incorporated inductive and deductive methods as well as a constant comparison of units of data to identify patterns and themes. Findings: Six themes were identified: 1) participants described systems thinking as ranging across four major levels of healthcare (i.e., patient, care team, organization, and external environment); 2) participants associated systems thinking with a wide range of activities across the curriculum including quality improvement, Inter-professional education (IPE), error mitigation, and advocacy; 3) the need for healthcare professionals to understand systems thinking was primarily externally driven; 4) participants perceived that learning systems thinking occurred mainly informally and experientially rather than through formal didactic instruction; 5) participants characterized systems thinking content as interspersed across the curriculum and described a variety of strategies for teaching and assessing it; 6) participants indicated a structured framework and inter-professional approach may enhance teaching and assessment of systems thinking. Insights: Systems thinking means different things to different health professionals. Teaching and assessing systems thinking across the health professions will require further training and practice. Tools, techniques, taxonomies and expertise outside of healthcare may be used to enhance the teaching, assessment, and application of systems thinking and SBP to clinical practice; however, these would need to be adapted and refined for use in healthcare.

Concept map analysis in the assessment of speech-language pathology students’ learning in a problem-based learning curriculum: A longitudinal study

The aim of this study was to track students’ critical thinking performance longitudinally through concept map analysis in a problem-based learning (PBL) curriculum. Concept map analysis has been employed in the assessment of students’ critical thinking in medical education. Little is known concerning concept mapping (CM) in speech-language pathology (SLP) education. In this quantitative study, students in a 4-year SLP education program (N = 38) were followed until the completion of a fully-integrated PBL curriculum from Years 1 to 3. Students’ concept maps were analyzed using a tool developed for this study, the Concept Map Assessment Profile (CMAP). There was an increase in concept map scores across the 3 years at the beginning of the academic year. The CM performance over the 3 years predicted 21.0% to 33.6% of variance in three measures of learning outcomes. The CMAP is a reliable measure, with strong inter-rater and intra-rater reliability (r = 0.85 and r = 0.96, respectively). In addition to its use as an assessment tool, the CMAP might be used to facilitate students’ learning as feedback concerning strengths and weaknesses in the development of critical thinking can be provided.

An Aphasia Mentoring Program: Perspectives of Speech-Language Pathology Students and of Mentors With Aphasia

In contrast to clinician-as-expert models, social models of clinical practice typically acknowledge people with aphasia as equal partners in intervention. Given this, there may be a place within speech-language pathology education for programs situating people with aphasia as experts. This paper describes an aphasia mentoring program that was implemented as part of a speech-language pathology graduate program. Qualitative research methods with thematic analysis of interviews, focus groups, questionnaires, and participant observation were used to develop a description of the mentoring program, including the experiences and perspectives of the participants-both mentors (people with chronic aphasia) and students. Five themes, including getting better, aphasia advocacy, group as versus for therapy, we're a team, and focus on mentoring, emerged from the mentors' data. Five themes, including shifting the power dynamic, getting to know the person, seeing members as mentors, making classroom learning real, and connecting with a community, emerged from the students' data. There were significant overlaps and intersections between the 2 data sets. Findings revealed how an aphasia mentoring program that positions people with aphasia as experts can make a significant contribution to student education while supporting mentors' own goals, with implications for improved quality of life.

Simulated learning environments in speech-language pathology: An Australian response

The rising demand for health professionals to service the Australian population is placing pressure on traditional approaches to clinical education in the allied health professions. Existing research suggests that simulated learning environments (SLEs) have the potential to increase student placement capacity while providing quality learning experiences with comparable or superior outcomes to traditional methods. This project investigated the current use of SLEs in Australian speech-language pathology curricula, and the potential future applications of SLEs to the clinical education curricula through an extensive consultative process with stakeholders (all 10 Australian universities offering speech-language pathology programs in 2010, Speech Pathology Australia, members of the speech-language pathology profession, and current student body). Current use of SLEs in speech-language pathology education was found to be limited, with additional resources required to further develop SLEs and maintain their use within the curriculum. Perceived benefits included: students’ increased clinical skills prior to workforce placement, additional exposure to specialized areas of speech-language pathology practice, inter-professional learning, and richer observational experiences for novice students. Stakeholders perceived SLEs to have considerable potential for clinical learning. A nationally endorsed recommendation for SLE development and curricula integration was prepared.

A systematic program of research regarding the assessment of speech-language pathology competencies

This paper explores the nature and development of competence in speech-language pathology and is informed by the development and validation of a competency-based assessment tool to assess Australian speech-language pathology students' professional performance in the workplace (COMPASS®). Background is provided on speech-language pathology competency frameworks in Australia and a systematic program of research to validate this assessment tool. Findings relevant to understanding the nature and development of speech-language pathology competency are described. The domains of competence considered important for practice were found to extend beyond specific processes of professional practice to include generic competencies of Reasoning, Communication, Lifelong Learning, and Professionalism. The achievement of competency was identified as developmental, and clinical educators were found to validly and reliably identify seven levels of competency development. Competency may transfer across the scope of practice, and marginal students' performances were characterized by a high degree of variability. These findings are discussed in relation to the profession's understanding of competency and speech-language pathology education, professional development, and further research.

Strategic Planning in CSD Programs: The San Francisco State Example

Strategic Planning in CSD Programs: The San Francisco State Example

Preparing Clinicians to Treat Stuttering: Looking to the Future

Abstract Recently, at the ASHA-sponsored Speech-Language Pathology Education Summit, clinicians and academicians explored issues affecting the preparation of future speech-language pathologists. From this discussion emerged several faculty, academic, practice, and student considerations for educating future generations of clinicians to treat stuttering. Preparing this next generation of clinicians will require identifying and supporting faculty as they share, in ways that are relevant to today’s students, their passion for understanding and treating stuttering. Academic models preparing both undergraduate and graduate students will need to be flexible, less linear, and more integrated with clearly delineated preparation outcomes in stuttering. Partnerships with externship supervisors treating people who stutter should be valued and supported. Further, recognizing and appreciating generational differences in work views will enhance student recruitment and retention in the area of stuttering. The multiple roles and activities associated with stuttering treatment along with the complexities of the disorder may be appealing to current students and speak to their attraction to multitasking and doing work that is meaningful. Pedagogical approaches should integrate technology in meaningful and effective ways. Finally, a Weighted SLP formula is proposed to remind us of the need for multiple strategies in addressing the multidimensionality of these issues.

Problem-based learning, critical thinking and concept mapping in speech-language pathology education: A review

Despite speech-language pathology (SLP) education undergoing many innovative changes over the years, there has been little research about learning or outcomes in SLP programs. Critical thinking in clinical decision-making, however, has been identified as a critical skill in SLP. Several recent studies have shown that concept mapping can be used to assess, and perhaps enhance, critical thinking. Problem-based learning (PBL) is reported to be one way to encourage critical thinking and life-long learning. Here we review the literature in PBL, concept mapping, and critical thinking, focusing on the education of SLP students. The review illustrates the close and complex interactions amongst problem-based learning, critical thinking and concept mapping. The aim of the review is to provide a better understanding of the mechanism of PBL, and to increase understanding regarding why the employment of PBL in SLP programs may facilitate critically-thinking graduate clinicians. The evidence indicates that PBL allows more meaningful learning that promotes better integration between theory and clinical practice.

Dysphagia and Medical Speech Language Pathology Education at the University of Pittsburgh

Dysphagia and Medical Speech Language Pathology Education at the University of Pittsburgh

Supervisees' Perceptions of Supervisors' Social Power in Speech-Language Pathology

Most speech-language pathologists function as supervisees and supervisors at various points in their careers (Anderson, 1988). This study investigates supervisees' perceptions of their current and ideal supervisors' social power during the clinical supervisory process in speech-language pathology education. Perceived social power was measured by two modified versions (Wagner, 1994) of the Rahim Leader Power Inventory (Rahim, 1988). This inventory measures the five French and Raven (1959) social power bases: expert, reward, referent, legitimate, and coercive. Graduate supervisees completed one version of the inventory by rating their current supervisor and a second version of the inventory indicating their ideal supervisor. Results revealed significant differences among supervisees' perceptions of current versus ideal supervisors relative to expert, reward, referent, and legitimate power. Overall, these results have implications for supervisors in speech-language pathology who may wish to modify their perceived social power in order to enhance supervisory relationships.

Speech-Language Pathology Education and Training for Rural Areas: A State and University “Goodness of Fit” Model

This paper describes the 3-years Summer-Only Master of Arts Degree Program in Speech-Language Pathology of a culturally diverse university in a rural state. The program was designed to address problems identified by the State Department of Education relative to the dearth of speech-language pathologists available to serve the needs of persons with communication disorders in rural communities and the quality of service provided by waivered personnel.

The Development of a New Era of Speech-Language Pathology in Greece

Speech-language pathology services in Greece continue to expand, and it is an exciting time to be a speech-language pathologist within the existing structure. The role of speech-language pathologists in Greece has changed over the years from therapist, to include educator, advocate, and politician. The many tasks facing speech-language pathologists in Greece have been difficult ones. It has taken patience and persistence to educate the general public about communication disorders and the role of speech-language pathologists in treating these problems. It has also been arduous to convince the government to recognize our profession and its value within the community. We believe that by the establishment of a speech-language department at a Greek university, our profession will be fortified and renewed. The development of a university-based training program will aid in the creation of posts in educational and hospital settings, as well as bridge the gap that exists between the current number of speech-language pathologists and the number of people requiring treatment. Furthermore, the creation of a university department will allow for much needed research within the Greek community. In particular, it may aid in the gathering of normative data and the standardization of tests for the Greek population. The path in establishing speech-language pathology education and services in Greece is a long one, but through our commitment and our energetic and earnest approach, we hope to reach our goals.