Learning about Professionalism within Practice-based Education: what are we looking for?

Health and social care professions are being held to account concerning their professionalism in ways that would have been unprecedented in the recent past. Students of the School of Health Sciences (HSC) within the University of East Anglia (UEA) in the United Kingdom have professionalism taught and assessed in a number of ways and have overt opportunities to develop their professional performance during practice education. In order to augment this further, a UEA Professionalism Charter has been developed, which helps students to define, learn and apply professionalism in a particular way. Since professionalism is being scrutinised by a number of bodies it is important that there is agreement about its nature. Without an overt definition of professionalism from the Health and Care Professions Council (the regulatory body for occupational therapy, physiotherapy and speech and language therapy) this study set out to explore what could be learned about this body’s perspective through analysis of its Fitness to Practice hearings. The outcome revealed that a definition could be identified and that this bears a close resemblance to that used within the UEA Professionalism Charter. The study therefore supports the continued use of the Charte

Speech and language therapy students’ experience of peer assisted learning:Undergraduates investigate PAL as a means of enhancing academic and professional development

The implementation of Peer Assisted Learning (PAL) on healthcare courses in Higher Education Institutions has been explored in a number of studies. This paper presents research into the experience of PAL on a BSc Speech & Language Therapy (SLT) programme. The research was conducted by final year undergraduate SLT students to form the basis for their final dissertations. The focus for their research was on the effects of PAL on academic and professional development for both mentees and mentors on the same course. Data were generated from standard PAL evaluations and focus groups. Findings indicate that mentees benefit from PAL in terms of their university experience and learning. Mentors benefited from opportunities to develop and practice skills for their future employment. Engagement with PAL is attributed to its structured yet informal nature and the enthusiasm of the mentors. However, the collaborative nature of PAL takes time to develop, impacting on the behaviours of both mentees and mentors. Overall PAL offers mentees and mentors opportunities which enhance their academic learning and professional development

Speech and communication in Parkinson’s disease: a cross-sectional exploratory study in the UK

Objective: To assess associations between cognitive status, intelligibility, acoustics and functional communication in PD. Design: Cross-sectional exploratory study of functional communication, including a within-participants experimental design for listener assessment. Setting: A major academic medical centre in the East of England, UK. Participants: Questionnaire data were assessed for 45 people with Parkinson’s disease (PD), who had self-reported speech or communication difficulties and did not have clinical dementia. Acoustic and listener analyses were conducted on read and conversational speech for 20 people with PD and 20 familiar conversation partner controls without speech, language or cognitive difficulties. Main outcome measures: Functional communication assessed by the Communicative Participation Item Bank (CPIB) and Communicative Effectiveness Survey (CES). Results: People with PD had lower intelligibility than controls for both the read (mean difference 13.7%, p=0.009) and conversational (mean difference 16.2%, p=0.04) sentences. Intensity and pause were statistically significant predictors of intelligibility in read sentences. Listeners were less accurate identifying the intended emotion in the speech of people with PD (14.8% point difference across conditions, p=0.02) and this was associated with worse speaker cognitive status (16.7% point difference, p=0.04). Cognitive status was a significant predictor of functional communication using CPIB (F=8.99, p=0.005, η2 = 0.15) but not CES. Intelligibility in conversation sentences was a statistically significant predictor of CPIB (F=4.96, p=0.04, η2 = 0.19) and CES (F=13.65, p=0.002, η2 = 0.43). Read sentence intelligibility was not a significant predictor of either outcome. Conclusions: Cognitive status was an important predictor of functional communication—the role of intelligibility was modest and limited to conversational and not read speech. Our results highlight the importance of focusing on functional communication as well as physical speech impairment in speech and language therapy (SLT) for PD. Our results could inform future trials of SLT techniques for PD

Cognitive profile and determinants of poor cognition in people without dementia in Parkinson's disease

Background : The Montreal Cognitive Assessment (MoCA) has been recommended as a cognitive screening tool for clinical practice and research in Parkinson's disease (PD), yet no normative data have been published for MoCA in PD without dementia. Methods : We undertook a pooled secondary analysis of data from two studies (one cross-sectional design and one clinical trial) conducted in the East of England region. All participants were aged 18 years or over, met UK Brain Bank criteria for PD and did not have clinical dementia. Cognitive status was assessed using MoCA at baseline in both studies. The influences of age, gender, disease duration, medication load (LEDD) and mood (HADS) on cognition were examined using regression analysis. Results : Data from 101 people with PD without dementia were available (mean age 71 years, 66% men). Median (IQR) MoCA was 25(22, 27). Age was found as the only predictor of MoCA in this sample. People aged over 71 had poorer MoCA (Beta=0.6 (95%CI 0.44, 0.82)) and an increased odds of MoCA <26 (Beta=0.29 (95%CI 0.12, 0.70)) as well as poorer scores on several MoCA sub-domains. Conclusion : We present the normative data for MoCA in people with PD without clinical dementia. Age appeared to be the only associated factor for lower level of cognition, suggestive of Mild cognitive impairment in PD (PD-MCI) in PD without clinical diagnosis of dementia