An Investigation of Agreement between Clinical Educators and Peers in Rating Speech Pathology Students’ Interview Skills

Peer assessment and feedback is being used more frequently in health science education as it has been shown to enhance self-directed learning. This study investigated the level of agreement between clinical educators and speech pathology student peers when rating students’ performance during standardised patient interviews. Participating in this study were 104 undergraduate speech pathology students and six clinical educators who were required to rate students’ foundation clinical skills on the Standardised Patient Interview Rating Scale (SPIRS). Students’ skills, including communication, interviewing and professional practice, were rated by a clinical educator and a peer. Data from two separate interviews in weeks 4 and 8 of a clinical placement were analysed to determine the agreement between clinical educators and peers in rating a student on individual items on the SPIRS. Results indicated that there were unacceptable agreement levels between clinical educators and peers in both opportunities of rating. Recommendations for improving agreement between peers and clinical educators were made including increasing explicit training with the rating tool, increased collaboration between clinical educators and student raters, and using peers with more clinical placement experience as raters. Further research is required to investigate the use of peer assessment for both formative and summative purposes in speech pathology student education

Students’ Perceptions of Simulation-Based Learning in Speech Pathology: A Pilot Study

Due to increased student numbers and workforce limitations, speech pathology students have fewer opportunities to develop skills in working with adult populations in traditional clinical placements.  Using simulation-based learning has proven to be advantageous in other disciplines. The use of simulation to develop clinical skills in speech pathology range of practice areas, including speech, language and swallowing in adults, has been less well researched. The aim of this study was to investigate students’ overall perceptions about simulation-based learning, particularly their confidence related to specific clinical skills and perceived anxiety about working with adult clients. Six final year speech pathology students enrolled in either a 4-year undergraduate or 2.5-year masters program participated in this research. Students engaged in five simulation-based learning activities across one day. Purposefully developed pre- and post- surveys were completed to explore students’ anxiety levels and perceptions of confidence regarding clinical skills across domains of foundation knowledge, case history, assessment, intervention, interaction and clinical reasoning, and anxiety levels. The Satisfaction with Simulation Experience (SSE) Scale was completed post-simulation experience. Students also participated in a focus group discussion following the simulation experience. Student median ratings of clinical skills improved from pre- to post-simulation across the six domains. All students reported that the simulation-based learning experience was valuable and reported increased levels of confidence and enhanced preparedness for their clinical placements. Findings from this study suggested that students value simulation-based learning and future research should explore learning outcomes from a longer, more intensive simulation program

Simulation-based Learning Experiences in Stuttering Management Delivered Online: What Do Students, Clinical Educators and Simulated Patients Think?

Speech pathology students are required to demonstrate competency across a range of practice areas. There are, however, limited opportunities for students to access clinical placements in the area of stuttering. Simulation-based learning (SBL) activities have proven to be effective in increasing students’ clinical experience in this area. Due to the COVID-19 pandemic, the delivery of in-person SBL programs was not feasible, resulting in a shift to online provision. The aim of this study was to investigate the perceptions of students, clinical educators and simulated patients who participated in an online adult stuttering SBL experience. Ten first-year graduate entry Masters program speech pathology students participated in the study alongside four clinical educators and four simulated patients. The experience involved two online SBL sessions and one online tutorial via videoconferencing from separate locations. Each participant group engaged in focus group interviews exploring their perceptions of the online SBL activity. Thematic network analysis of the focus group interview data was conducted. Overall interpretation of the data from the perspectives of students, clinical educators and simulated patients revealed an overarching global theme that online SBL offers a positive, comfortable and comparable experience to enable students to build client-centred, clinical and telepractice skills. The positive outcomes of this study suggest that together with in-person clinical experiences, online SBL has an important role in the education of speech pathology students.

Clinical Educators’ Perceptions of Students Following a Simulation-Based Learning Program

Purpose: Clinical education is a key component of speech-language pathology university curriculum, whereby students have the opportunity to apply theoretical knowledge and practical skills learned in the classroom into a real workplace. However, more recently the availability of high quality, consistent clinical placements and learning experiences across the range of practice areas in the discipline is reducing. Therefore, alternative clinical learning opportunities that enable students to develop skills and competencies are being explored. Recently, replacing clinical time with a simulated learning program has been shown to achieve equivalent levels of clinical competency in speech pathology. However, it is unknown how simulation impacts on student learning in traditional clinical placements. Therefore, this research explored clinical educators’ perceptions of students undertaking clinical placements in their workplace immediately following a five-day simulation-based learning program related to the same area of practice. Method: Thirty-five clinical educators who supervised students in the workplace immediately after they completed the simulation program participated in semi-structured interviews. All interviews were transcribed verbatim and analyzed using qualitative methods described by Graneheim and Lundman (2004). Result: The analysis identified four key themes related to the impact of students in the workplace, simulation priming students for learning, the importance of the transition from simulation-based learning to the workplace, and the role of simulation in clinical education programs. Conclusion: The use of simulation to support student learning and develop clinical skills and competencies in adult speech pathology practice is supported by workplace clinical educators. However, results of this study suggest that the simulation program needs to be embedded within the curriculum and clinical education program to enhance transition between learning experiences and maximize benefits of learning experiences in real workplace contexts

“Same But Different”: The Role and Perceptions of the Simulation Clinical Educator

Simulated learning programs are an important component of allied health education. Although the role of simulation clinical educators has been highlighted as critical for student learning within simulation, their perceptions of their role have not yet been investigated. This study aimed to explore the experiences of simulation clinical educators. Participants were ten simulation clinical educators who had supported speech-language pathology students’ learning during a 5-day simulation program focussed on speech-language pathology practice with adult clients in acute hospital and rehabilitation settings. Educators participated in individual semi-structured interviews exploring their role and their perceptions of the simulation-based learning program. Data were analysed using inductive thematic analysis. Three inter-related themes emerged from participants’ views. The major theme of Unique teaching and learning environment incorporated five subthemes: focus on teaching; safe learning environment; authenticity and engagement; structure and intensity of learning, and; feedback opportunities. Two additional themes were identified: Clinical educator role same but different, and Simulation bridges the gap between theory and practice. This study offers new insights into simulation clinical educators’ perceptions of their role when supporting students within simulation and highlight the importance of harnessing the unique benefits of simulation as a teaching pedagogy to maximize its impacts on student learning and justify its costs

Diversity of HLA Class I and Class II blocks and conserved extended haplotypes in Lacandon Mayans.

Here we studied HLA blocks and haplotypes in a group of 218 Lacandon Maya Native American using a high-resolution next generation sequencing (NGS) method. We assessed the genetic diversity of HLA class I and class II in this population, and determined the most probable ancestry of Lacandon Maya HLA class I and class II haplotypes. Importantly, this Native American group showed a high degree of both HLA homozygosity and linkage disequilibrium across the HLA region and also lower class II HLA allelic diversity than most previously reported populations (including other Native American groups). Distinctive alleles present in the Lacandon population include HLA-A*24:14 and HLA-B*40:08. Furthermore, in Lacandons we observed a high frequency of haplotypes containing the allele HLA-DRB1*04:11, a relatively frequent allele in comparison with other neighboring indigenous groups. The specific demographic history of the Lacandon population including inbreeding, as well as pathogen selection, may have elevated the frequencies of a small number of HLA class II alleles and DNA blocks. To assess the possible role of different selective pressures in determining Native American HLA diversity, we evaluated the relationship between genetic diversity at HLA-A, HLA-B and HLA-DRB1 and pathogen richness for a global dataset and for Native American populations alone. In keeping with previous studies of such relationships we included distance from Africa as a covariate. After correction for multiple comparisons we did not find any significant relationship between pathogen diversity and HLA genetic diversity (as measured by polymorphism information content) in either our global dataset or the Native American subset of the dataset. We found the expected negative relationship between genetic diversity and distance from Africa in the global dataset, but no relationship between HLA genetic diversity and distance from Africa when Native American populations were considered alone

An investigation of agreement between clinical educators and peers in rating speech pathology students’ interview skills

Peer assessment and feedback is being used more frequently in health science education as it has been shown to enhance self-directed learning. This study investigated the level of agreement between clinical educators and speech pathology student peers when rating students’ performance during standardised patient interviews. Participating in this study were 104 undergraduate speech pathology students and six clinical educators who were required to rate students’ foundation clinical skills on the Standardised Patient Interview Rating Scale (SPIRS). Students’ skills, including communication, interviewing and professional practice, were rated by a clinical educator and a peer. Data from two separate interviews in weeks 4 and 8 of a clinical placement were analysed to determine the agreement between clinical educators and peers in rating a student on individual items on the SPIRS. Results indicated that there were unacceptable agreement levels between clinical educators and peers in both opportunities of rating. Recommendations for improving agreement between peers and clinical educators were made including increasing explicit training with the rating tool, increased collaboration between clinical educators and student raters, and using peers with more clinical placement experience as raters. Further research is required to investigate the use of peer assessment for both formative and summative purposes in speech pathology student education

Students’ perceptions of simulation-based learning in speech pathology: a pilot study

Due to increased student numbers and workforce limitations, speech pathology students have fewer opportunities to develop skills in working with adult populations in traditional clinical placements. Using simulation-based learning has proven to be advantageous in other disciplines. The use of simulation to develop clinical skills in speech pathology range of practice areas, including speech, language and swallowing in adults, has been less well researched. The aim of this study was to investigate students' overall perceptions about simulation-based learning, particularly their confidence related to specific clinical skills and perceived anxiety about working with adult clients. Six final year speech pathology students enrolled in either a 4-year undergraduate or 2.5-year masters program participated in this research. Students engaged in five simulation-based learning activities across one day. Purposefully developed pre- and post- surveys were completed to explore students' anxiety levels and perceptions of confidence regarding clinical skills across domains of foundation knowledge, case history, assessment, intervention, interaction and clinical reasoning, and anxiety levels. The Satisfaction with Simulation Experience (SSE) Scale was completed post-simulation experience. Students also participated in a focus group discussion following the simulation experience. Student median ratings of clinical skills improved from pre- to post-simulation across the six domains. All students reported that the simulation-based learning experience was valuable and reported increased levels of confidence and enhanced preparedness for their clinical placements. Findings from this study suggested that students value simulation-based learning and future research should explore learning outcomes from a longer, more intensive simulation program

"I felt more prepared and ready for clinic": connections in student and clinical educator views about simulation-based learning

Clinical placements supported by a clinical educator in real clinical environments are beneficial for student learning. Student preparedness for placements has been examined across health professions. Simulation-based learning (SBL) is recognised as a valuable means of preparing students for practice. Whilst students’ perceptions of SBL activities has been investigated, insights from clinical educators are less researched. This study aimed to explore speech pathology students’ perceptions of clinical learning immediately following a SBL experience and perceptions of both the student and clinical educators following a subsequent clinical placement. Thirteen third year undergraduate speech pathology students and five clinical educators participated in this research. Students completed an SBL program prior to a six-week clinical placement. A student focus group discussion was held following the SBL experience and semistructured interviews were conducted with individual students and clinical educators at the completion of placement. Thematic analysis of the data was conducted and themes were summarised using a thematic network tool. Overall interpretation of data from the students’ and clinical educators’ perspectives revealed an overarching global theme suggesting that simulation offers unique learning benefits to prepare students for typical clinical placement. As students and clinical educators demonstrated shared perceptions that SBL offers unique learning benefits for speech pathology students, this finding further supports the inclusion of SBL within university program curricula