Boosting the recruitment and retention of new graduate speech-language pathologists for the disability workforce

New graduate speech-language pathologists (SLPs) will play an integral role in meeting the anticipated growth in demand for a highly skilled disability workforce under the National Disability Insurance Scheme (NDIS). Despite the promise of the NDIS for making a real difference to the lives of people living with disability in Australia, implementation will have major implications for factors known to support new graduate recruitment and retention in the disability sector. In this article, we consider how the NDIS is likely to affect (a) clinical placements in disability while at university, and (b) access to clinical supervision and continuing professional development (CPD) in the workplace, and propose strategies to address these challenges

Developing the rural health workforce to improve Australian Aboriginal health outcomes: a systematic review

Objective: The aim of this study was to identify evidence based strategies in the literature for developing and maintaining a skilled and qualified rural and remote health workforce in Australia to better meet the health care needs of Australian Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) people. Methods: A systematic search strategy was implemented using the PRISMA statement and checklist. Exclusion and inclusion criteria were applied, and 26 papers were included in the study. These 26 papers were critically evaluated and analysed for common findings about the rural health workforce providing services for Aboriginal people. Results: There were four key findings of the study: the experience of Aboriginal people in the health workforce affects their engagement with education, training, and employment; particular factors affect the effectiveness and longevity of the non-Aboriginal workforce working in Aboriginal health; attitudes and behaviours of the workforce have a direct effect on service delivery design and models in Aboriginal health; and student placements affect the likelihood of applying for rural and remote health jobs in Aboriginal communities after graduation. Each finding has associated evidence-based strategies including those to promote the engagement and retention of Aboriginal staff; training and support for non-Aboriginal health workers; effective service design; and support strategies for effective student placement. Conclusions: Strategies are evidenced in the peer-reviewed literature to improve the rural and remote workforce for health delivery for Australian Aboriginal people and should be considered by policy makers, funders and program managers

Occupational Therapy with Australian Indigenous children and their families: A rural and remote perspective

Background/aim: Occupational therapy service delivery must be adapted when working with Indigenous communities, as there is a diversity of beliefs, values and customs. There are currently no evidence-based models of therapy service delivery to rural and remote Indigenous children and their families. This study aims to explore occupational therapy service delivery to rural and remote Indigenous children and their families. Methods: Semi-structured telephone interviews were conducted with seven occupational therapists with experience with Australian rural and remote Indigenous children and their families. A thematic analysis was conducted on each interview with constant comparison to refine themes across interviews. Results: A total of six service delivery themes emerged from the data gathered in the interviews; flexible and accessible services; tailored services; culturally sensitive therapist; culturally inclusive services; occupational therapy awareness; and collaboration. These results linked with the need for long-term solutions, as the limited access to occupational therapy within these communities is a social injustice. Conclusion: The findings demonstrate that each Indigenous community is unique. Therapists work in collaboration with the community and use their critical reasoning skills to adjust practice accordingly. Significance of the study: This study contributes to growing knowledge about occupational therapy service provision in rural and remote Indigenous communities with children and their families. The findings will assist therapist in these communities to provide culturally aligned services. They also advocate for these communities by emphasising the basic human right violations that Indigenous communities are experiencing by not having access to consistent and culturally appropriate occupational therapy services

Impact of placement type on the development of clinical competency in speech–language pathology students

"This is the peer reviewed version of the following article: Sheepway L, Lincoln M, McAllister S. Impact of placement type on the development of clinical competency in speech-language pathology students. International Journal of Language and Communication Disorders . 2014 Mar-Apr;49(2):189-203. doi: 10.1111/1460-6984.12059., online 1 Nov 2013, which has been published in final form athttp://dx.doi.org/10.1111/1460-6984.12059. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."Background: Speech language pathology students gain experience and clinical competency through clinical education placements. However, currently little empirical information exists regarding how competency develops. Existing research about the effectiveness of placement types and models in developing competency are generally descriptive and based on opinions and perceptions. The changing nature of education of speech language pathology students, diverse student cohorts, and the crisis in finding sufficient clinical education placements mean that establishing the most effective and efficient methods for developing clinical competency in students is needed. Aims: To gather empirical information regarding the development of competence in speech language pathology students, and to determine if growth of competency differs in groups of students completing placements which differ in terms of caseload, intensity and setting. Methods & Procedures: Participants were students in the third year of a four year undergraduate speech language pathology degree, who completed 3 clinical placements across the year and were assessed with the COMPASS® competency assessment tool. Competency development for the whole group across the three placements is described. Growth of competency in groups of students completing different placement types is compared. Interval level data generated from the students’ COMPASS® results were subjected to parametric statistical analyses. Outcomes and Results: The whole group of students increased significantly in competency from placement to placement across different placement settings, intensities and client age groups. Groups completing child placements achieved significantly higher growth in competency when compared to competency growth of students completing adult placements. Growth of competency was not significantly different for students experiencing different intensity of placements, or different placement settings. Conclusions and Implications: These results confirm that the competency of speech language pathology students develops across three clinical placements over a one year period regardless of placement type or context, indicating that there may be transfer of learning between placements types. Further research investigating patterns of competency development in speech language pathology students is warranted to ensure that assumptions used to design clinical learning opportunities are based on valid evidence

Engaging educators and students in the national roll-out of a new assessment tool (COMPASS).

This paper presents key results of an evaluation of a project (funded by ALTC), that led the integration of a newly developed competency based assessment tool (COMPASS™) within all 13 speech pathology education programs nationally. As part of the roll-out process, workshops were provided to close to 1,000 speech pathology clinical educators and students were introduced to the new tool through their lectures and tutorials. In order to provide formative feedback in the early stages of the project (end 2006 – early 2007); a questionnaire (designed to elicit both quantitative and qualitative data) was used following the first 6 workshops (214 educators) and after the first lectures to students at 2 universities (145 students). Most educators (95-97%) and students (74-85%) reported understanding the main concepts that inform key components of COMPASSTM (behavioural descriptors, generic competencies, and use of the Visual Analogue Scale). Qualitative feedback indicated a need for further support in relation to understanding the need for direct observation and the use of the Visual Analogue Scale. Toward the completion of the project (end 2007 – early 2008), a similar questionnaire was distributed to clinical educators (33 respondents) and to students in 3 universities (76 respondents). Results continued to be positive for understanding of main concepts for educators (79-100%) and for students (75-92%). An important finding was the close similarity between educators and students in relation to their understandings about the tool, the areas in which they reported wanting more support/training, and the ways in which they would like to obtain further experience. The implications of these findings for the further embedding of the new assessment tool are discussed.Adelaid

An evaluation of screening measures for cognitive impairment after stroke

Objectives: to assess the sensitivity and specificity of a screening battery for detecting cognitive impairment after stroke. Design: a randomized controlled trial. Methods: stroke patients were recruited from hospitals in three centres. Patients were screened for cognitive impairment on the Mini‐Mental State Examination, the Sheffield Screening Test for Acquired Language Disorders and Raven's Coloured Progressive Matrices and received a further battery of assessments of cognitive function. Sensitivity and specificity values were calculated for the three screening measures for overall conclusions regarding cognitive impairment reached from a comprehensive assessment. Receiver Operating Characteristic Curves were plotted. Conclusion: the Mini‐Mental State Examination was not a useful screen for memory problems or overall cognitive impairment after stroke. The Sheffield Screening Test for Acquired Language Disorders was an appropriate screen for language problems. The Raven's Coloured Progressive Matrices was appropriate as a screen for perceptual problems and visual inattention but not for executive deficits

Informing Evidence-Based Health Policy for Rural Australia

NHMRC and Department of Human Services NSW, Ageing, Disability and Home Car

Speech pathologists’ perspectives on transitioning to telepractice: What factors promote acceptance?

Little is understood about factors that influence speech-language pathologists’ (SLPs’) acceptance of telepractice. The aim of this study was to investigate SLPs’ perceptions and experiences of transitioning to a school-based telepractice service to identify factors that contributed to positive clinician attitudes. In-depth interviews were conducted with 15 SLPs who recently commenced providing school-based telepractice services. Interviews were recorded and transcribed verbatim, and thematic analysis was used to interpret interviews, with themes compared and contrasted across the group. Results indicated that although SLPs reported initially having mixed feelings towards telepractice, they later evaluated telepractice positively and viewed it as a legitimate service delivery mode. The overarching theme was that positive beliefs about telepractice were associated with perceptions of its consistency with the underlying principles of face-to-face therapy. In evaluating telepractice, SLPs considered: (a) therapeutic relationships with children; (b) collaboration with parents and teachers; (c) adequacy of technology and resources; and (d) access to support for learning telepractice. Therapy assistants and specific clinician attributes emerged as key strategies used to manage threats to acceptability. Preparation of SLPs transitioning to telepractice should address factors that support positive experiences with, and attitudes towards, telepractice to ensure that training achieves the greatest, most sustained change

Telepractice for children with complex disability: Guidelines for quality allied health services

Telepractice has the potential to spread allied health professionals’ (AHPs’) reach further into rural Australia. There are fewer AHPs in rural and remote Australia compared to metropolitan areas. This means that children with disabilities living in rural areas may not receive the therapy services they need. Providing therapy services via telepractice could reduce these inequities and ensure that all children receive the supports they need, regardless of where they live. Telepractice guidelines in allied health rightly insist that telepractice services should be equivalent in quality to those delivered in-person (Speech Pathology Australia [SPA], 2014). Therefore, telepractice services should not simply be an option of last resort, but should be a quality option for disability services. Yet, how can AHPs ensure that their telepractice services are equivalent in quality to those they deliver in-person? As a first step towards exploring this issue, we conducted a research study funded by the auDA Foundation in 2016-17, and in partnership with Therapy Connect, a private allied health practice. We collected information about the allied health telepractice services received by four children with complex disabilities and their families living in rural or remote Australia. We found that AHPs, despite being geographically remote from children and families, could deliver services consistent with contemporary practice and supported children to achieve positive, functional outcomes. We identified the essential components of successful telepractice models needed to achieve real outcomes for children with disabilities through this and other research conducted by the Wobbly Hub Rural Research Team. Our key learnings from this research informed the development of guidelines for telepractice delivery of allied health services to children with complex disability, as summarised in this document.auDA Foundation Grant, 2016-201