An optimal environment for placement learning: listening to the voices of speech and language therapy students

Exploring the thoughts and feelings of novice speech-language pathology students: A qualitative investigation

PURPOSE

To explore the thoughts and feelings of novice Australian speech-language pathology students about undertaking their first therapy placement.

METHOD

Data was collected with Australian novice graduate-level speech-language pathology students immediately prior to their first therapy placement via open-ended responses to two questions on a questionnaire. The data was analysed using inductive qualitative content analysis.

RESULT

265 students participated in the study. Data analysis led to the construction of two themes: "I hope that my placement will support me on my way to becoming a confident speech-language pathologist" and "I hope my clients do well, but I fear that I might be inadequate". The analysis of these results led to the development of guidelines for supporting novice students on clinical placement.

CONCLUSION

Novice speech-language pathology students are keen to apply their knowledge to authentic clinical cases but are concerned about their own personal circumstances and whether they will receive sufficient support during their placement. An enhanced understanding of students' concerns and hopes may help practice educators implement appropriate support strategies.

Development of the Hybrid Clinical Practicum Environment Scale for Nursing Students

PURPOSE

This study aimed to develop a Hybrid Clinical Practicum Environment Scale for Nursing Students (HCPES-NS) and verify its validity and reliability.

METHODS

The HCPES-NS was constructed following the DeVellis guidelines. The initial items were written based on a literature review and individual in-depth interviews. Content validity was verified through an expert panel review. To confirm the validity and reliability of the scale, a survey was conducted with 449 nursing students enrolled in 12 nursing colleges. Data were analyzed using item analysis, exploratory factor analysis, confirmatory factor analysis, concurrent validity, and reliability tests.

RESULTS

Factor analysis showed that the HCPES-NS consists of 15 items on five subdomains: clinical site atmosphere, interpersonal relationship, alternative online practicum contents, provision of learning information, and clinical performance facilitation. A higher score indicated a more positive perception of the clinical practicum environment. The concurrent validity of the HCPES-NS was confirmed by its positive correlation with the Clinical Learning Environment Scale (r = .77). The Cronbach's α reliability of the HCPES-NS was .84.

CONCLUSION

The HCPES-NS is both valid and reliable. This scale reflects the clinical practicum environment and includes an online practicum factor. It may be used effectively by faculty members and educators to evaluate nursing students' perceptions of clinical practicum environments.

Designing a Module on Stuttering and Cluttering: A Guide for Speech-Language Pathology Educators

PURPOSE

Due to the scope of practice of speech-language pathology (SLP) expanding considerably in recent times, there is reduced emphasis on certain communication conditions within the curricula of SLP university programs. Stuttering and cluttering are neglected components of such curricula, despite the complex clinical skill set required to work with these client groups. Evaluation of the content and quality of modules on stuttering and cluttering is warranted to ensure that SLP students are graduating with adequate competence and confidence for supporting people with these conditions. This tutorial, based on a review of the literature, aims to provide guidance to educators who are designing or revising such modules.

METHOD

The All Ireland Society for Higher Education (AISHE) model for module design provides a practical and theoretically underpinned guide to educators in higher education on the design of a new module or the review of an existing one. The model's seven key components are discussed, and their application to a module on stuttering and cluttering is outlined.

RESULTS

The AISHE model provides a systematic and user-friendly approach to module design in SLP university programs. It supports educators who are designing a new module or revising a module currently being taught on stuttering and cluttering.

CONCLUSIONS

Educators are encouraged to familiarize themselves with the seven components of the AISHE model and to use it as a tool to design or revise modules on stuttering and cluttering. This will ensure that SLP students are graduating with increased competence and confidence in working with these client groups.

Education programmes on performance-based assessment for allied health and nursing clinical educators: A scoping review protocol

Background

Performance-based assessment (PBA) is a complex process undertaken in the workplace by healthcare practitioners known as clinical educators, who assist universities in determining health professional students' readiness for independent practice. Preparing healthcare professionals for PBA is considered essential to ensuring the quality of the assessment process in the clinical learning environment. A preliminary search of the literature indicated a paucity of research guiding the development of education programmes that support practice educators to understand and implement PBA.

Objective

The aim of this scoping review is to investigate and describe education programmes delivered to allied health and nursing clinical educators, to develop PBA knowledge and skills.

Methods

This review will follow the Joanna Briggs Institute (JBI) methodology for conducting scoping reviews. Electronic databases relevant to this research topic will be searched including, EMBASE, ERIC, MEDLINE (Ovid), Web of Science and CINAHL and other targeted databases for grey literature. Studies that include PBA as the main focus or a component of the education programmes, of any format, delivered to clinical educators in allied health and nursing will be included. Studies may report the design and/or implementation and/or evaluation of PBA education programmes. Relevant English language publications will be sought from January 2000 to October 2022. Two reviewers will screen all titles and abstracts against the inclusion/exclusion criteria, and publications deemed relevant will be eligible for full text screening, confirming appropriateness for inclusion in the scoping review. Data will be charted to create a table of the results, supported a by narrative summary of the findings in line with the review objectives.

Evaluation of a pilot to introduce simulated learning activities to support speech and language therapy students' clinical development

BACKGROUND

Speech and language therapy (SLT) education must meet the needs of the future workforce, training enough students who are competent practitioners able to meet the workforce demands. Increasing student numbers and the impact on placement providers mean students must be equipped for learning on placement. Simulation is a way of supporting students to develop their clinical skills and decision-making in a safe, supportive environment.

AIMS

To explore the perspectives of SLT students who were introduced to simulation during their undergraduate degree at a UK university as part of a pilot study. The aim of the pilot was to listen to the students' voices to begin to understand their lived experiences of simulation and to gather views on how simulation can support their clinical learning.

METHODS & PROCEDURES

Focus groups and semi-structured interviews were carried out with second-year BSc SLT students in semester 2 following the simulated learning activities and clinical placement. Qualitative data were gathered and thematic analysis was applied to the data to identify the barriers and enablers to students' clinical learning in simulation.

OUTCOMES & RESULTS

A total of 11 students responded out of a cohort of 38. Three key themes were identified from the analysis: individual learning needs, facilitator skill and programme-level organization.

CONCLUSIONS & IMPLICATIONS

Student experience of simulation was positive. One of the key elements students found to support their clinical skills was the importance of the safe space; support for learning instead of correction led them to engage in active learning. Key barriers to simulation related to having sufficient prior knowledge, the skills of the facilitator, group size and the wider learning landscape of the programme. In response to this pilot, there are plans to continue developing this model of simulation and embed simulation across the programme, led by a sound pedagogical approach with clear preparation and planning and building the necessary infrastructure. Other SLT programmes and practice educators developing simulation as part of their programmes or placement may wish to consider some of these findings to support the use of simulation in their workplace.

WHAT THIS PAPER ADDS

What is already known on this subject Simulation as a teaching methodology is widely used in medicine and nursing programmes. It is now used in various allied health professions and in some SLT programmes. There is evidence to suggest simulation increases student confidence and clinical skills without increasing the capacity on those offering clinical placements in practice. What is already known on this subject This study offers a practical example of introducing simulation in an established undergraduate programme for SLT students. It explains the background to this innovative way of teaching clinical skills and explains why this approach could be beneficial for the future speech and language therapist. What are the clinical implications of this work? This study gives practical examples of how simulation can work to facilitate student clinical learning and knowledge. It may offer ideas to those working in clinical practice to organize placements differently or add simulation elements to improve the student experience. Other educational establishments and placement educators may find the recommendations helpful in developing their own simulation approach.

Increasing capacity by moving away from one-to-one clinical supervision: using peer-assisted learning and a group model of student placements in community paediatric speech and language therapy to enable student-led service delivery

BACKGROUND

Health Education England (HEE) and the Royal College of Speech and Language Therapists (RCSLT) have identified the need to increase placement capacity. Speech and language therapy is a shortage profession in the UK, so services need to consider innovative placement models to increase their placement offers without increasing the time burden on speech and language therapists (SLTs).

AIMS

To increase capacity for pre-registration practice-based learning by using peer-assisted learning (PAL) in a group model of student placement to enable student-led service delivery which provides high standards of clinical care and student experience and is an efficient use of SLT time.

METHODS & PROCEDURES

A paediatric speech and language therapy service hosted eight student speech and language therapists (SSLTs) for their final pre-registration placement. SSLTs completed pre- and post-placement confidence ratings for a range of clinical skills; SSLTs and SLTs rated how useful different types of support were, and education settings provided feedback about working with the SSLTs. The number of clinical sessions completed by the SSLTs and the percentage of outcomes achieved for children with speech, language and communication needs were calculated. SLTs completed time-trackers for placement-related activities.

OUTCOMES & RESULTS

The impact of the placements was assessed using a tri-vector methodology consisting of: self-reporting by the student (using an evaluation form), feedback from the placement sites (schools) and analysis of targets set for individual children. SSLTs reported increased confidence in all clinical areas in their post-placement evaluation form. SLTs reported increased confidence in SSLTs working independently and an increase in the perceived benefit to the service for having SSLTs in comparison with the time invested in supporting SSLTs. SSLTs and SLTs found all types of support provided during the placement useful. Schools reported high levels of satisfaction for working with SSLTs. SSLTs completed more clinical sessions than an SLT would have been able to in the time SLTs invested in placement-related activities. Children achieved 60% of the targets set by SSLTs.

CONCLUSIONS & IMPLICATIONS

This placement model increased the capacity for SSLT placements by using PAL in a group model of student placement to enable student-led service delivery. The model provided high standards of clinical care and student experience and was an efficient use of SLT time. Wider use of this placement model would increase placement capacity and could also address vacancies in services.

WHAT THIS PAPER ADDS

What is already known on the subject SSLTs and SLTs are positive about the benefits of paired placements in comparison with individual placements. Other allied health professions have demonstrated that larger placements can be an effective way to support students and have used students to deliver student-led services. What this study adds to existing knowledge This paper is the first to look at whether PAL in a group model of student placements can be used in speech and language therapy to enable student-led service delivery which provides high standards of clinical care, maintains high standards of student experience and is an efficient use of SLT time. What are the potential or actual clinical implications of this work? This paper demonstrates that PAL can be used effectively in a group model of student placements in a paediatric SLT service to increase student capacity and enable student-led service delivery. The proposed placement model provides a high-quality placement for SSLTs and the children they work with, and is also an efficient use of SLT time.

Education programmes on performance-based assessment for allied health and nursing clinical educators: A scoping review protocol

Background: Performance-based assessment (PBA) is a complex process undertaken in the workplace by healthcare practitioners known as clinical educators, who assist universities in determining health professional students’ readiness for independent practice. Preparing healthcare professionals for PBA is considered essential to ensuring the quality of the assessment process in the clinical learning environment. A preliminary search of the literature indicated a paucity of research guiding the development of education programmes that support practice educators to understand and implement PBA.  Objective: The aim of this scoping review is to investigate and describe education programmes delivered to allied health and nursing clinical educators, to develop PBA knowledge and skills. Methods: This review will follow the Joanna Briggs Institute (JBI) methodology for conducting scoping reviews. Electronic databases relevant to this research topic will be searched including, EMBASE, ERIC, MEDLINE (Ovid), Web of Science and CINAHL and other targeted databases for grey literature. Studies that include PBA as the main focus or a component of the education programmes, of any format, delivered to clinical educators in allied health and nursing will be included. Studies may report the design and/or implementation and/or evaluation of PBA education programmes. Relevant English language publications will be sought from January 2000 to October 2022. Two reviewers will screen all titles and abstracts against the inclusion/exclusion criteria, and publications deemed relevant will be eligible for full text screening, confirming appropriateness for inclusion in the scoping review. Data will be charted to create a table of the results, supported by narrative summary of findings in line with the review objectives.

Speech and Language Therapists' Perspectives of an E-Learning Course on Providing Feedback in the Clinical Learning Environment

BACKGROUND

A fundamental component of supervising a student speech and language therapist (SLT) on placement is the provision of feedback. There are numerous identified challenges to ensure the delivery of high-quality feedback to optimise student learning and student success. Supervisors can help overcome these challenges and engage in evidence-based feedback processes if they are supported to develop the necessary knowledge and skills. E-learning is one possible means to provide this professional development to a large number of practising SLTs who are geographically dispersed and have conflicting schedules.

AIMS

This study aimed to capture and evaluate the perspectives of SLTs who completed an e-learning course on providing feedback in the clinical learning environment, including the suitability and effectiveness of the e-learning tool used.

METHODS AND PROCEDURES

An innovative e-learning course was designed to provide asynchronous video and interactive content on evidence-based theories and practices for effective feedback processes. Clinical scenarios relevant to the discipline of speech and language therapy were included. Participants were invited to complete optional, anonymous pre- and post-evaluation surveys. Data were analysed quantitively (descriptive and inferential statistics) and qualitatively (thematic analysis).

OUTCOMES AND RESULTS

Participants indicated that the e-learning course supported them to enhance their feedback processes in the clinical learning environment through identified changes to their practices. The increases in confidence providing feedback they reported were statistically significant. In addition, the e-learning course was rated highly on numerous variables related to quality. Recommendations for adaptations and additions were also highlighted.

CONCLUSIONS AND IMPLICATIONS

An e-learning course on effective and evidence-based feedback processes provides an opportunity to provide professional development to a large number of geographically dispersed practitioners in a cost-effective and flexible way. This could ensure more SLTs are confident and competent in their role as supervisor of students, which requires distinct knowledge and skills from that of a practitioner. Ultimately, this will help maximise educator and student success in the feedback process and consequently improve clinical performance and healthcare delivery.

-A cross-sectional study of clinical learning environments across four undergraduate programs using the undergraduate clinical education environment measure

BACKGROUND

The clinical learning environment (CLE) influences students' achievement of learning outcomes and the development of their professional behaviors. However, CLEs are not always optimal for learning because of clinical productivity expectations and a lack of support from supervisors. The purpose of this study was to describe and compare students' perceptions of their CLEs across four undergraduate programs.

METHODS

This study is cross-sectional. In total, 735 students who were registered in the medical, nursing, physiotherapy, and speech-language pathology (SLP) programs were invited to participate. Data were collected using an online survey, which included demographics and the Undergraduate Clinical Education Environment Measure (UCEEM). The UCEEM consists of 26 items congregated into two overarching dimensions-experiential learning and social participation-with four subscales: opportunities to learn in and through work and quality of supervision, preparedness for student entry, workplace interaction patterns and student inclusion, and equal treatment.

RESULTS

In total 280 students (median age 28; range: 20-52; 72% females) returned the questionnaire. The mean total UCEEM score was 98.3 (SD 18.4; range: 91-130), with physiotherapy students giving the highest scores and medical students the lowest. The mean scores for the dimensions experiential learning and social participation for all the students were 62.8 (SD 13.6; range 59-85) and 35.5 (SD 6.2; range 13-45), respectively. Medical students rated the lowest for all subscales. The items receiving the highest ratings concerned equal treatment, whereas those receiving the lowest ratings concerned supervisors' familiarity with the learning objectives. There were few statistically significant differences between the semesters within each program.

CONCLUSIONS

The students generally hold positive perceptions toward their CLEs. However, the students from the medical and nursing programs rated their learning environment lower than did the students from the physiotherapy and SLP programs. Importantly, in several aspects, the medical students provided significantly lower ratings for their CLE compared with the students from the other programs. The medical students' low ratings for their supervisors' familiarity with the learning objectives underscore the need to ensure that the prerequisites for optimal supervision are met.