Speech-language Therapy Students Research Articles

Is There a Place for Pseudostuttering Assignments in Speech-Language Pathology Training Within the Neurodiverse Paradigm?

Purpose: The continued use of pseudostuttering assignments, a disability simulation for speech-language pathology students, needs to be reexamined to align with neurodiversity and students' reluctance to participate in these studies. Stuttering, from a neurodiverse perspective, is regarded as a normal speech variation, rather than a disorder. The purpose of this research was for people who stutter, speech-language therapy students, and faculty members to respond to a survey to determine the future of these assignments, in terms of developing empathy and clinical skills of pseudostuttering. Method: A descriptive design electronic survey using typical case sampling was disseminated globally. A total of 134 participants, divided into three participant groups, completed the survey. The survey consisted of 84 closed- and open-ended questions. Percentages and thematic analysis were used to determine the results. Results: Quantitative and qualitative analyses indicated that 83% of speech-language pathology faculty members supported these assignments. Forty-eight percent of people who stutter and 58% of speech-language pathology students felt negatively toward pseudostuttering assignments. Students reported being more comfortable performing augmentative and alternative communication simulations than pseudostuttering or aphasia simulations. Students were concerned that pseudostuttering assignments were offensive and stigmatizing for people who stutter. Conclusions: The results reflect the benefits of partnering with all the constituent groups. Adaptations to pseudostuttering assignments, such as speaking with people who stutter and adopting a neurodiverse, inclusive approach to student education, are recommended.

Empathic communication training in healthcare using Virtual Patients

This project aims to build effective empathic communication training for healthcare students using conversational AI and Virtual Patients. An umbrella review of empathy training in healthcare will be used to create a framework for designing effective empathy training. We will investigate two different implementations of Virtual Patients through a pilot study with speech-language therapy students from the University of Auckland. We will engage students, educators and patients in theexperimental studies, following co-design and design-based research methodology.

Examination of depth of written reflective practice for speech-language therapy students; the impact of time and clinical competency

ABSTRACT Written reflective practice (WRP) is a teaching and learning activity utilized in clinical programmes. Identifying depth of WRP aims to provide an overall rating of students’ written reflective abilities. Engaging in reflective activities has been proposed to have a positive relationship with clinical competency. Aims: 1. To examine the impact of time on depth of WRP for SLT students across and within each year group of the SLT clinical programme. 2. To determine whether a relationship exists between depth of WRP and clinical competency of SLT students. Methods: Participants were 77 undergraduate SLT students (first, second or final professional year) in the clinical programme. Participants wrote reflections as part of their clinical education experiences. Depth of WRP was measured utilizing a modification of Plack et al.’s [2005. A method for assessing reflective journal writing. Journal of Allied Health, 34(4), 199–208] coding schema. This was completed at four time points across the academic year for each professional year. Level of clinical competency was assessed using the Competency Assessment in Speech Pathology (COMPASS®) at the end of both semesters. Results: There was a statistically significant association between time and development of depth of WRP for students in their final professional year (β = .66 (.30), z = 2.22, p < .05). There was no association between depth of WRP and level of clinical competency. Conclusion: A one-off judgement of WRP depth may be useful for supporting overall judgements of RP ability and provide observable behaviours for competency assessments. This research contributes to the evidence base examining how WRP is assessed and utilized in clinical programmes.

Communication partner training for SLT students: Changes in communication skills, knowledge and confidence

This paper describes the changes in communication skills, knowledge and confidence in Speech Language Therapy (SLT) students in conversations with People With Aphasia (PWA) after Training Con-tAct, a Dutch Communication Partner Training. MethodsOn a voluntary basis, nine SLT students (2nd yr) completed Training Con-tAct, in which People With Aphasia (PWA) were involved as co-workers. A mixed method design with pre- and post-measures was used to analyze the students’ communication skills, knowledge and confidence. A quantitative video analysis was used to measure changes in students’ communication skills. Besides, a self-report questionnaire was used to measure the changes in students’ knowledge and confidence regarding their communication with PWA. To evaluate the perspectives of the students on Training Con-tAct, additionally a focus group interview was held. ResultsRegarding students’ communication skills the outcomes revealed a significantly higher score on the ‘supporting’ competence in students who took part in Training Con-tAct. The mean scores for the ‘acknowledging’ and ‘checking information’ competences did not improve significantly. The outcomes of the questionnaire showed students gained more knowledge and confidence regarding communication with PWA. The focus group interview provided insights into: motivation for participating in Communication Partner Training, content and structure of the training, feedback in CPT, and learning experiences. ConclusionThe present study suggests that SLT students may benefit from Training Con-tAct as the training leads to better skills, more knowledge about aphasia and more confidence in communicating with PWA. Training Con-tAct could be a valuable addition to the curricula of all healthcare disciplines, and eventually support interprofessional collaboration, resulting in improved access to health care, which is important for communication vulnerable people. Further research with a larger sample size and a control group is required.

Implementing an interprofessional palliative care education program to speech-language therapy and dietetic students

ABSTRACT Palliative care education for allied health professionals has received minimal research attention. This longitudinal study followed the development of an education program for speech-language therapy (SLT) and dietetic (DT) students. The project comprised three stages. In Stage I, consenting SLT and DT graduates (n = 9) were interviewed 6 months after graduation exploring preparedness for working in palliative care. Interviews were transcribed, and topics were extracted through content analysis. In Stage II, a new palliative care curriculum was developed using the extant literature and gaps reported in Stage I. In Stage III, we implemented and evaluated the new curriculum. Students were surveyed before (n = 68) and after (n = 42) the new program and at 6-month post-graduation (n = 15) to capture student-reported changes in knowledge and confidence in palliative care. In Stage I, 10 topics were developed covering knowledge, roles, team, family-focused care, and feelings. In Stage II, a hybrid program was developed including e-learning modules, didactic lectures, and a simulated learning experience. In Stage III, student feedback demonstrated positive shifts in knowledge and confidence ratings from medians 3–6 to 5–8 (1 = none; 10 = excellent) across all domains. Gains in knowledge and confidence were consistently higher at 6-month post-graduation for final survey respondents. Mixed modality interprofessional palliative care education for allied health professionals has merit in improving knowledge, confidence, and perceived preparedness for practice.

Transformation of Higher Learning in South Africa: Perceptions and Understanding of Speech-Language Therapy and Audiology Undergraduate Students

The professions of speech-language therapy and audiology in South Africa developed under apartheid and historically consisted of and catered to a predominantly white English- or Afrikaans-speaking minority population. Over 25 years into democracy, there continues to be a stark incongruence between the demographic profile of the South African population and the speech-language and hearing (SLH) professions in terms of “race”, linguistic, and cultural diversity, and this has implications for training as well as clinical service provision within the South African context. This article explores undergraduate students’ perceptions and experiences of transformation within South African SLH university training programmes through a cross-sectional descriptive survey research design. A self-developed questionnaire was used to collect data from students enrolled in SLH programmes at South African universities. Thematic analysis identified two themes: 1) progress towards attainment of transformation and, 2) visibility of transformation. These findings highlight the need for diversity through inclusivity, redressing past injustices and incorporating local knowledge into current training and practice. These findings have global relevance for transformation in higher education, not just in the field of SLH. Implications for translation of theory and/or knowledge into practice, with more visible and deliberate application of policy in curriculum reform and institutional culture, are raised.

Māori aspirations following stroke: A pathway forward for the speech-language therapy field

ABSTRACT Background Attempts to improve Indigenous health outcomes are evident in the speech-language therapy (SLT) field, although they are restricted by a limited evidence base. Prior research has shown that SLT services do not always meet Indigenous stroke survivors’ needs, however, few studies have investigated this phenomenon and fewer have explored solutions. Consequently, the SLT field lacks knowledge of appropriate and optimal supports. Aims To identify and compare experiences and aspirations of Māori stroke survivors, whānau (family), and speech-language therapists (SLTs) in Aotearoa New Zealand regarding SLT service provision. Methods & Procedures Kaupapa Māori research and interpretive description methodologies underpinned this study. Four Māori stroke survivors, two whānau members, and five SLTs participated in semi-structured interviews. Data were analysed using constant comparative analysis and collaboratively interpreted during a hui (meeting) between researchers and participants. Outcomes & Results Analysis highlighted six themes spanning experiences and aspirations: (1) tautoko (support), (2) kaupapa Māori (Māori approach), (3) whanaungatanga (relationships), (4) tino rangatiratanga (autonomy), (5) taiao (environment), and (6) kōnekeneke (change). Positive aspects of SLT were described, however, Māori often did not receive optimal supports. Aspirations centred on changes to SLT services and the wider healthcare system. Conclusions Adaptations to SLT services are indicated to improve the quality of SLT received by Māori following stroke. To meet aspirations described in this study, the SLT profession may incorporate Māori approaches; prioritise strong, collaborative relationships; offer more autonomy to Māori stroke survivors; support the development of SLTs and SLT students; increase public awareness; and encourage change in the wider healthcare system. Many aspirations identified in the current study are consistent with those identified by Indigenous people in Australia, suggesting that some common solutions may exist to improving Indigenous SLT services.

Identifying Opportunities for Peer-Assisted Learning In Speech Language Therapy Clinical Education

Peer-assisted learning (PAL) is a potential approach for clinical education that can reduce the burden of clinical supervision and enhance learning. This study aims to identify opportunities for PAL through investigating how speech language therapy students perceive and already participate in PAL within a range of clinical practicum settings. The Speech Sciences students across all years at one institution were invited to participate in a cross-sectional survey that was adapted and revised from Tai et al. (2014). Speech Sciences students reported they applied PAL as part of their learning strategy in their clinical practicums, but still relied on supervisors as the main source of. PAL occurred more frequently in contexts where students already had some clinical experience and spent substantial amounts of time together. Students agreed that PAL enhanced their learning and emphasized a few advantages of PAL, such as having the opportunity to share their ideas, experiences, and knowledge, and providing a positive learning environment without pressure. Confidence to provide information or feedback to peers was cited as a shortcoming in PAL. PAL is a viable teaching approach that can be used in speech-language therapy clinical education program to reduce the supervisory burden. The findings from our study show that PAL is largely self-initiated among speech-language therapy students. However, PAL must be tailored to suit different clinical education year levels and clinical settings to benefit. Case discussion may be one area where scaffolded PAL activities could represent a feasible first step to increasing PAL. Keywords Peer-assisted learning, speech-language therapy, clinical education, clinical supervision.

Reliability of a script agreement test for undergraduate speech-language therapy students.

To estimate the reliability of scripts designed for undergraduate Speech-Language Therapy students. A descriptive cross-sectional study was carried out. Qualitative variables were summarized by frequency or proportion and quantitative through means (CI 95%). Reliability was estimated through Cronbach's α coefficient, and inter-rater agreement was determined using Fleiss's Kappa index. The analytical tests considered a significance level of p<0.05. 80 scripts organized in four areas of speech-language therapy were validated by 41 speech-language pathologists. The average experience of the professionals was 17.1 years. The reliability of the corpus was α: 0.67 (min= 0.34; max: 0.84), and the inter-rater agreement κ: 0.29 (min: 0.07; max: 0.45). The corpus's reliability scores were similar to those reported by previous studies in different health professions. Having validated strategies aimed at developing proficiency and supporting classic training actions in undergraduate courses will contribute to increasing the quality of future health professionals.

Validación de constructo y reproducibilidad de una prueba de concordancia de guiones para estudiantes de pregrado en fonoaudiología

ABSTRACT Purpose To estimate the reliability of scripts designed for undergraduate Speech-Language Therapy students. Methods A descriptive cross-sectional study was carried out. Qualitative variables were summarized by frequency or proportion and quantitative through means (CI 95%). Reliability was estimated through Cronbach's α coefficient, and inter-rater agreement was determined using Fleiss’s Kappa index. The analytical tests considered a significance level of p&lt;0.05. Results 80 scripts organized in four areas of speech-language therapy were validated by 41 speech-language pathologists. The average experience of the professionals was 17.1 years. The reliability of the corpus was α: 0.67 (min= 0.34; max: 0.84), and the inter-rater agreement κ: 0.29 (min: 0.07; max: 0.45). Conclusion The corpus's reliability scores were similar to those reported by previous studies in different health professions. Having validated strategies aimed at developing proficiency and supporting classic training actions in undergraduate courses will contribute to increasing the quality of future health professionals.

Written reflective practice abilities of SLT students across the degree programme.

Written reflective practice (WRP) is a teaching tool used across speech-language therapy (SLT) clinical education programmes. The process aims to support the development of reflective skills required for the workplace (e.g., problem-solving and self-evaluation). This cross-sectional and repeated-measures study design investigated students' demonstration of breadth of WRP across the clinical education programme. The participants were 77 undergraduate SLT students in their first, second or final professional year of the clinical programme. Participants wrote critical reflections following an interaction with a client/s as part of their clinical education experiences. Formative feedback was provided after each written reflection (WR). In total four WRs per participant were coded for breadth of WRP using a modification of Plack etal.'s coding schema from 2005. This was completed for each of the four time points across the academic year for each professional year. There was a statistically significant association between time (i.e., professional year of the programme) and likelihood of demonstration of breadth of reflection for the lower level reflective element of 'attend' and higher level reflective element of 're-evaluate'. A positive trend between time and likelihood of demonstration of breadth of reflection was seen for the lower level element of 'reflection-for-action'. Final-professional-year students exhibited significant enhancements in the higher level elements (e.g., 'premise') compared with first- and second-professional-year students. This group of SLT students exhibited significant change in breadth of WRP across the degree programme. This finding has positive implications for facilitating WRP with students and using the current coding framework in clinical programmes. What is already known on this subject WRP is one form of reflective practice (RP) used in SLT, allied health, medical and nursing clinical education programmes. Researchers have suggested that RP skills develop over time for students. Previously, studies examining WRP have focused on one off assessment of skill or over a timeframe of 6-10 weeks. Here, we examine SLT students' WRP skills across the degree programme. What this paper adds to existing knowledge SLT students exhibited significant positive change in breadth of WRP across the degree programme as their clinical experience increased. Our results provide quantitative information in support of using RP as a learning tool throughout clinical education programmes for SLT. What are the potential or actual clinical implications of this work? This study offers support for educators of SLT students; for example, how educators can assess WRP, and how educators can foster SLT student skill development with formative feedback and reflective questioning. This study also offers support for student SLT, for example, describing how WRP can be part of their individualized learning approach and provide a purposeful examination of self and clinical skill development.

Speech-Language Therapy Clinical Services, Student Education, and Practical Training in the Time of COVID-19: The Rise of Telepractice, Telesupervision, and Distance Learning in Cyprus

Purpose This study aimed to outline the changing forms of speech-language pathology practices, for both clinical services, as well as the profession's education and practicum training in the time of COVID-19 at the European University Cyprus (EUC). This study also aimed to document the steps taken to continue service delivery safely and effectively for both the EUC's Speech, Language and Hearing Clinic's clients and the speech-language therapy students completing their practicum. Method The steps for the access to and continuity of speech-language therapy services and education/training are outlined chronologically, throughout the different phases of the COVID-19 pandemic status in the country. The rise of telepractice, telesupervision, and distance learning, adapted as solutions to the obstacles caused by the pandemic, are explained in detail, while the benefits and limitations are discussed at each step. The professional development that had to take place before this rise is also described. Conclusions The utilization of online/telecommunication technology for education, practical training, and speech-language pathologist service delivery during the time of COVID-19 in Cyprus is here to stay and will probably affect the future of the profession's clinical practice, and consequently, training programs in Cyprus in the years to come. It is uncertain if the effects of such adaptations can generalize in other populations or countries, especially where regulations and policies are already in place, or where the technological foundation is not similar. Through the benefits and limitations presented, conclusions are drawn for the future applications of telepractice, telesupervision, and distance learning post–COVID-19. Suggestions are made for the possible areas of future research, concerning clinical practice and clinical practicum training, as well as for the need to define regulations and establish these types of services in the country. Supplemental Material https://doi.org/10.23641/asha.15057396

French speech-language therapy students' interest in evidence-based practice: A survey.

Taking into account international studies interested in the development of evidence-based practice (EBP) in the speech and language therapy field, this survey investigated key issues with regard to students' perception of EBP. To determine how final-year students in France conceive EBP; to know if they feel competent in this area; to investigate any barriers to the use of EBP; and to assess their intention of using the EBP approach in their professional practice after graduating. Between January and April 2019, 182 advanced French students from 15 French speech-language university training centres (SLUTC) completed an online survey addressing these questions. The results show that 68.7% of students in the sample had a positive perception of the EBP. Between 54.9% and 73.6% of students felt rather competent to apply part of the approach, and 17% were sure to implement it in their own practice later on. Step 3 'Critically evaluating the evidence' was the most difficult. Regardless of the different EBP steps, the most important barrier for students who felt competent was the lack of practice; for students who did not feel competent, the major barriers were both the lack of theoretical knowledge and the lack of practice. A total of 61% of students reported not seeing EBP being practised by their clinical practice placements supervisors; 55% reported never having used their EBP knowledge during their clinical practice placements. The students interviewed had a positive perception of EBP. Nevertheless, these results demonstrate a need to improve the EBP curricula and to include EBP in clinical education, under the guidance of clinical practice placements supervisors. What is already known on the subject Despite the fact that EBP is widespread, previous studies have shown that it is not sufficiently used in the practice of speech and language therapists (SLT) and that young professionals tend to seek advice from experienced professionals rather than use EBP. Some students, despite their programme, do not feel competent enough to implement EBP. What this study adds to the existing knowledge French SLT students had a positive opinion of EBP despite barriers to implementation in their future professional practice, especially regarding the critical analysis of evidence. Moreover, the study reveals a need to practise EBP during clinical practice placements, and to create specific pedagogical framework for EBP. What are the potential or actual clinical implications of this work? The potential implication of this study is the use of the questionnaire to investigate the students' perception of EBP from a theoretical and a practical point of view, in collaboration with clinical practice placement supervisors, with the aim of promoting the task value and the self-efficacy as the two best factors to enhance students' motivation in favour of EBP.

Speech-language therapy students and attitudes towards disability: impact of past experiences, clinical experiences and development over time

ABSTRACT The aims of this study were to describe the type and amount of experiences students have in the area of disability and determine whether significant differences in attitudes towards disability were present across three groups of students engaged in clinical practice and if attitudes changed over time. Twenty-two first professional year undergraduate, twenty-three first year postgraduate and twenty-three final year undergraduate speech-language therapy students participated in the study. A mixed method, cross-sectional pre-test post-test design was employed for all groups. Participants took part in part-time clinical placement experiences over a twelve-week period. Pre and post clinical placement, participants completed a questionnaire, including The Scales of Attitudes towards Disabled Persons (SADP) (Antonak [1982]. Development and psychometric analysis of the scale of attitudes toward disabled persons. Journal of Applied Rehabilitation Counselling, 13, 22–29), that was designed to examine experiences and attitudes towards disability and change over time. Overall, students reported almost all had personal experience with people with disabilities and over half of students sampled reported prior or current workplace experience. Students perceived their attitudes towards disability to be positive. In contrast to our hypotheses, student attitudes towards disability did not change significantly over time. Furthermore, first year postgraduate students held more positive attitudes towards disability compared to other student groups. Implications for clinical teaching and supervision in the workplace are discussed.

The COVID-19 pandemic and the implementation of telehealth in speech-language and hearing therapy for patients at home: an experience report.

We present an experience report on the implementation of real-time telehealth in speech-language and hearing therapy for patients who were previously seen on an outpatient basis in a primary health care service. The Speech-Language Therapy (SLT) team was monitoring twenty-five users when the first cases of COVID-19 were notified in southern Brazil. Of these, it was judged that twelve patients required at least a monitoring call every two weeks. Teleconsultations were available in this first stage, on an emergency basis, during the implementation of the project in this format. The idea was to guarantee, due to the suspension of the SLT sessions, the maintenance of the care service for patients who could suffer worsening of their cases or even comorbidities. The appointments were carried out by video calls by SLT students, therapists of the extension project, and supervised by a speech-language therapist, synchronously. All conversations and orientations during the teleconsultation were conducted as calmly as possible and, in the case of infant patients, permeated by some playful activities. Telehealth has shown to be an efficient resource for the care of patients with SLT demands, enabling remote care with the same quality as face-to-face care. Besides, it has relevant potential, once there is a significant number of patients, who need SLT assessment and live in regions where there is a shortage of qualified professionals.

Speech-language therapy students’ auditory-perceptual judgements of simulated concurrent hypernasality and articulation disorders

ABSTRACTAuditory-perceptual judgements are regarded as the standard method for assessing speech disorders. However, the results of auditory-perceptual evaluations and rater reliability can be affected by various factors, such as concurrent problems in multiple speech subsystems. This study investigated the effect of a co-occurring articulation disorder on auditory-perceptual judgements of hypernasality and the effect of co-occurring hypernasality on judgements of an articulation disorder. The speech stimuli were sentences produced by a male speaker who simulated four levels of hypernasality (typical nasality, and mild, moderate, and severe hypernasality) at four levels of disordered articulation (typical articulation, and mild, moderate, and severe articulation disorder). Thirty speech and language therapy students used visual analogue scales to rate the severity of hypernasality and articulation disorder for each speech sample. Results showed that the hypernasality ratings were significantly higher when articulation disorder co-occurred compared to those without. However, there was no significant difference between mild, moderate and severe concurrent articulation disorder on hypernasality ratings. The speech samples with typical articulation and those with severe articulation disorder were rated as more severe in terms of articulation problem when combined with severe hypernasality. However, there was no significant hypernasality effect on articulation ratings for speech with mild or moderate articulation disorder. The present results generally agreed with previous findings regarding the effect of co-occurring speech problems on auditory-perceptual judgements. Clinicians are advised to be cautious of the potential impact. If possible, speech evaluation using instrumental techniques should be used to supplement auditory-perceptual judgements.

Educator–student talk during interprofessional simulation-based teaching

BackgroundSimulated learning environments are increasingly common in interprofessional education (IPE). While reflection is key to simulated learning, little is known about the nature of these conversations during simulation. The aim...

Transcribing and Transforming: Towards Inclusive, Multilingual Child Speech Training for South African Speech-Language Therapy Students

Objective: Phonetic transcription may encourage engagement with language diversity in multilingual settings. We describe how transcription can be used to help South African speech-language therapy (SLT) students engage with the many languages spoken in their country. Objectives were to describe (a) the local context, (b) transcription in the curriculum, and (c) participant observations from staff facilitating the Child Speech course. Method and Materials: A case study approach was used to investigate teaching and learning transcription in a real-life context, the undergraduate second-year Child Speech course in an SLT programme. Document review of curriculum and university documents, national policies, and international best practice guidelines took place, together with participant observations from facilitators. Results: We describe 4 activities that show how transcription skills can be developed while introducing local languages into the curriculum. These activities give students the opportunity to develop transcription skills for a range of local languages, while at the same time encouraging them to learn the languages, construct communal resources, and promote a problem-solving attitude to their practice. Conclusion: Calls to transform higher education in South Africa and “decolonise” curricula are key drivers underpinning this work. Transcription may be a useful tool in preparing students to practise in a multilingual context.

Speech therapy students' perceptions of authentic video cases in a theory module on child language disorders.

BackgroundUndergraduate speech-language therapy students often find it difficult to see the relevance of theoretical module content, which may negatively influence their motivation to learn. The real world of their future profession can be brought to life in the theory classroom by including authentic case study examples. Video case studies are well suited to illustrating communication disorders and may also be easier to remember and relate to information already in the long-term memory.ObjectivesThis article describes the perceptions of undergraduate students regarding the inclusion of authentic video cases in a theoretical module on developmental communication disorders.MethodsA qualitative, interpretivist research design was followed. Focus-group interviews were conducted with 22 second-year students in the programme B Speech-Language and Hearing Therapy. A modified contextualised content analysis approach was used to analyse interview data.ResultsThe use of authentic video cases was perceived positively by participants. Seeing a realistic example of a person with communication difficulties made it easier to understand, remember and engage with the module content. Participants also felt they could more easily imagine themselves in that clinical context, which seemed to (re-) awaken in them a sense of purpose and motivation. Being presented with real-life communication problems made them realise the relevance of their profession. However, participants experienced cognitive overload at times when the processing requirements of a task exceeded their available cognitive capacity.ConclusionVideo cases are valuable tools to enhance students’ engagement with theoretical content. To avoid cognitive overload, a scaffolded multimedia learning experience needs to be provided.

Rehabilitation Sciences Doctoral Education: A Study of Audiology, Speech-Language Therapy, and Physical Therapy Students’ Research Self-Efficacy Beliefs

Rehabilitation Sciences Doctoral Education: A Study of Audiology, Speech-Language Therapy, and Physical Therapy Students’ Research Self-Efficacy Beliefs