Interprofessional Education and Practice: Perspectives from Students in Speech-Language Pathology and Recreational Therapy

Interprofessional education and practice (IPE/IPP) are important components for undergraduate and graduate students to experience during their programs of study in speech-language pathology and related health professions. The American Speech-Language Hearing Association (ASHA) is a member organization of the Interprofessional Education Collaborative (IPEC) which promotes four core competencies required for effective practice: values/ethics, roles/responsibilities, interprofessional communication, and teams and teamwork. The purpose of this study was to gather the lived experiences from eight pre-professional students, four from speech-language pathology (SLP) and four from recreational therapy(RT), during focus groups and discussion forums conducted before, during, and after a 14-week IPE/IPP clinical experience. Students shared perspectives about providing collaborative therapy services as part of a team supporting adults with stroke or other acquired neurological conditions. Thematic analysis conducted from pre and post focus group transcripts revealed six primary themes: roles and responsibilities; interprofessional communication; collaborative teamwork; values and mutual respect; challenges to IPE/IPP; and benefits & impact of IPE/IPP. Students shared their clinical experiences engaging with students from SLP and RT, but also working with students from physical and occupational therapy. The qualitative data from this study provides important information to assist future students, educators, and clinical supervisors how to effectively access and engage in IPE/IPP learning experiences with a specific focus in the areas of teamwork, leadership, and conflict resolution.

Interprofessional Experience for Future Education Professionals: School Psychology and Speech-Language Pathology Students

Educational training programs are tasked with addressing potential barriers to interprofessional practice through experiences that promote interprofessional collaborations. The present study of interprofessional experiences (IPE) had both research and pedagogical purposes. The research purpose was to describe graduate student self-perceptions related to interprofessional teaming/collaboration before and after an IPE involving two educational training programs, school psychology and speech-language pathology. The pedagogical purpose was to convey a detailed description of a case-based IPE offered as a course assignment and offer implementation suggestions. Participants in this course-based IPE were 109 students in the school psychology and speech-language pathology graduate programs at a medium-sized midwestern university over a four-year period. Students in both programs engaged in the IPE as part of a graded class assignment involving case studies. Pre- and post-IPE surveys were used to determine changes in students’ perceptions of their own profession and training, others’ professions, and collaboration and teaming. Results indicated that the perception of students from both programs significantly improved following the IPE. Improved perceptions of collaboration, teaming, and one another’s professions were sustained over four years of implementation. Implications for research, practice, and training are discussed.

Clinical Education Outcomes and Research Directions in Speech-Language Pathology: A Scoping Review

Purpose: To describe what researchers are investigating and how they are measuring the constructs of their investigations within the speech-language pathology (SLP) clinical education literature. Method: A scoping review methodology (Arksey & O’Malley, 2005) was employed to develop a picture of clinical education articles which reported a measured outcome. Articles that met criteria were categorized by the purpose of the investigation and the outcome measures reported. Result: 124 articles met inclusion criteria. Analysis of study purposes revealed a wide breadth of foci that were grouped into four broad clusters: Outcome Measures, Student Perspectives, Educational Contexts, and Teaching Methods. Most of the studies in the corpus relied only on student self-report measures. In addition, any specific outcome measure was typically used only once and not found in subsequent studies. Trends indicate a variety of constructs are being studied at an exploratory level with limited in-depth investigation. Conclusion: Given the inconsistency of outcome measures and reliance on self-report measures, more research is needed to validate recommendations of best practices in clinical education. Areas of need include developing and implementing validated outcomes, more frequent investigation of clinical education using measures other than student self-reports, and testing theories found in other fields.

A Pilot Investigation of Critical Thinking in Undergraduate Students of Communication Sciences and Disorders

Speech-language pathologists use critical thinking on a daily basis to identify, evaluate, and implement evidence-based practices with their clients. Currently, however, there are minimal data describing the critical thinking of undergraduate students in the field of communication sciences and disorders. Without these data, it is unclear if and how students’ critical thinking differs at various points during their pre-service training. In the present study, we used the Cornell Critical Thinking Test – Level Z to describe the general critical thinking skills of 142 undergraduate students enrolled in two lower- (n = 95) and upper- (n = 47) level courses at a single university. We found no statistically significant differences between these two groups on the CCTT regarding their overall critical thinking performance (p = .068) or their skills of induction (p = .970), deduction (p = .160), observation (p = .384), assumptions (p = .342), or meaning interpretation (p = .155). Upper-level students, however, did consistently score slightly higher than their lower-level counterparts. Faculty should continue to develop undergraduate students’ critical thinking during their course of study. Although critical thinking appears to develop over the course of students’ undergraduate careers, formal instruction might be necessary to develop the skills necessary for successful practice as speech-language pathologists.

Fostering Clinical and Academic Faculty Collaborations to Improve Graduate Education

Accredited graduate programs in Communication Sciences and Disorders (CSD) work to integrate academic coursework, a breadth of clinical experiences, and an overarching capstone project (e.g. summative assessment). The best graduate programs focus on integrating these three elements through high quality collaborations between academic and clinical faculty. These collaborations are fostered when clinical and academic faculty attempt to provide students with experiences that intersect academic, research, and clinical areas of speech language pathology. The purpose of this paper describes the collaborative efforts undertaken by the CSD department at the Pennsylvania State University. We present a model for collaborations in graduate education and discuss examples of our current integrative projects.

Three Speech-language Pathology Graduate Programs, One Model: Using Systematic Instruction to Develop Students’ Clinical Decision-making Skills

To prepare graduate students to implement evidence-based practice effectively, educators must integrate instruction on rational clinical decision-making into course curricula. Three faculty members at different universities adopted an educational approach derived from the Rehabilitation Treatment Specification System (RTSS) to teach and assess clinical decision-making in the context of treating acquired cognitive-communication disorders for people with traumatic brain injury. Using treatment theory illustrated in the RTSS, the authors piloted instruction and assessment materials to examine potential usefulness of the approach and effects on student knowledge and confidence in clinical decision-making. The results indicated that the instructional approach effectively bolstered students’ knowledge of and confidence implementing memory-based cognitive-communication intervention. Additionally, using a case-based assessment tool, the authors were able to measure how students modified treatment activities in response to different contextual variables. Implications and suggestions for implementing theory-based instruction in graduate education are discussed.

A Pilot Study Investigating the Effect of the Supervision-Questioning-Feedback Model of Supervision on Stimulating Critical Thinking in Speech-Language Pathology Graduate Students

Purpose The purpose of this study was to investigate the effect of the supervision-questioning-feedback (SQF) model of supervision on critical thinking in graduate students studying speech-language pathology. The researchers hypothesized that students who were provided with the SQF model of supervision would score higher than students who received the non-SQF (NSQF) style of supervision on the selected critical thinking measures. Method Seventeen out of 24 first semester graduate students in speech-language pathology completing their on-site university-based clinical practicum experience consented to participate in the study. Of the 17 participating first semester students, 9 were randomly assigned to 1 of 3 SQF trained supervisors, and the other 8 were randomly assigned to 1 of 2 NSQF trained supervisors for the duration of 1 semester. Additionally, 3 out of 24 fourth semester graduate students completing their off-site externship experience and their supervisors consented to participate in the study. Four additional study participants served as independent SQF-trained raters charged with the task of analyzing video recorded student-supervisor conferences to determine whether the SQF model of supervision was being implemented. Prior to and at the conclusion of the clinical experience, all participating students completed two measures of critical thinking: (1) California Critical Thinking Skills Test (CCTST) and (2) two Simucase® clinical simulations. At the conclusion of the clinical experience, seventeen out of 20 participating students (11/12 SQF students and 6/8 NSQF students) completed a post-survey rating their supervisory experience . Results For participating first semester students, there were no overall statistically significant differences between SQF and NSQF groups as measured by pre to post completion of (1) CCTST (p=.544) and (2) two Simucase® clinical simulations (p=.781). The 3 participating fourth semester students who received the SQF model of supervision also showed no statistically significant differences on pre to post completion of the (1) CCTST (p=.827) and (2) two Simucase® virtual cases (p=.879). Results from SQF ratings revealed variability in the implementation of the SQF model across supervisors with a moderate level of inter-rater agreement. Results from post surveys completed by students showed that students preferred the SQF model of supervision over the NSQF model (p=.044). Conclusion Results from this preliminary study indicated that the SQF model did not influence the overall outcomes on the selected critical thinking measures. Student preference for the SQF model may support existing evidence that learning clinicians want to be actively engaged in the supervisory process. There were several limitations to this study including the small sample size, variability in the implementation of the SQF model across supervisors, sensitivity of the selected critical thinking measures, and timing of post-intervention procedures. Further investigation of the effects of SQF on students’ critical thinking is warranted.

Perceptions of Immediate Written Feedback Provided to SLP Graduate Clinicians During Tele-Therapy Sessions

Given the status of clinical practice and the heavy reliance on technology due to COVID-19, it is important to investigate clinical supervision practices. The purpose of this study was to determine whether immediate feedback using technology was beneficial for a university clinical setting specifically where current supervision of students is undertaken via a virtual platform. The chat function via the Zoom teletherapy platform was used to deliver immediate written feedback to SLP graduate clinicians. Utilizing technology allowed supervisors to provide immediate, in-session written feedback to SLP graduate clinicians. The objective was to investigate the perceptions of immediate feedback for the SLP graduate clinicians and their supervisors. The objective was met through the utilization of surveys at the end of the study which indicated a preference for immediate feedback for both the supervisors and the SLP graduate clinicians. Having the ability to use technology helped supervisors support the SLP graduate clinicians discretely, especially given the nature of remote supervision. Immediate written feedback utilizing technology should be considered as a means of supporting the SLP graduate clinicians in developing their clinical skills.

Intercultural Competence Gains from Study Abroad in India

Participation in a study abroad program to Zambia with intentional intercultural activities embedded in the course curriculum has been shown to enhance cultural competence as measured by the Intercultural Development Inventory (IDI®) (Krishnan, Masters, Holgate, Wang & Calahan, 2017). The purpose of this study was to assess whether a new program to India, developed using a. similar model, was effective in increasing student intercultural competence and to compare student outcomes with the previous program to evaluate possible differences in outcomes related to the destination country. Participants included 21 students who participated in the SLHS in India study abroad program, and 20 students who have not travelled abroad. Quantitative data included a pre- and post-program administration of the IDI® for both groups. Qualitative data included pre-departure and final reflection papers completed by participants in the intervention group. Results indicated a significant increase in intercultural competence in the intervention group and no change in score in the control group participants. The increase in group score is similar to increases seen in students who had travelled to Zambia. Results indicate that an intensive, service learning study abroad program can be a mechanism for students to enhance intercultural competence, possibly regardless of destination country.

Enhancing Intercultural Competence: Can it be done without Studying Abroad?

Participation in intensive, immersive, service-learning study abroad programs with intentional intercultural activities embedded in the course curriculum has been shown to enhance cultural competence as measured via the Intercultural Development Inventory (IDI®) (Krishnan, Masters, Holgate, Wang & Calahan, 2017; Krishnan, Lin & Benson, 2020). The purpose of this study was to evaluate the relative impact of embedding intercultural learning activities on students’ intercultural competence when included in an on-campus course compared to a study abroad program. The intervention group consisted of 34 students enrolled in the on-campus course which incorporated intentional intercultural activities. Forty-one students who did not take the course comprised the control group. Comparison of the pre- and post-IDI® scores showed a significant increase in intercultural competence in the intervention group and no change in score in the control group participants. Qualitative data supported these findings. The increase in group mean score is slightly lower than group mean score increases in study-abroad students. Results indicate that incorporating intentional intercultural learning activities in an on-campus course can be an effective mechanism for students to enhance intercultural competence without travelling abroad.