Experiences of People with Aphasia Receiving Enhanced Community-Based Speech-Language Pathology Provided by Speech-Language Pathology Students.

INTRODUCTION: Treatment intensity for people with aphasia (PWA) is a significant factor in enhancing recovery. Personal factors such as fatigue, physical endurance, and motivation as well as clinician availability have been described as barriers to increased intensity. The use of student therapists has been shown to assist with addressing service gaps. METHODS: The aim of the study was to explore the experiences of PWA who received enhanced community-based treatment delivered by speech-language pathology (SLP) students. Enhanced community-based treatment was defined as three or more treatment sessions per week targeting communication. Semi-structured interviews were conducted with 10 PWA living in New Zealand. Interview data were analysed with reflexive thematic analysis. RESULTS: Two themes and six sub-themes were developed. Theme 1 related to intensity and included more treatment is better than less (sub-theme 1), there's a "right time" for more intensive treatment (sub-theme 2), the hard work is worth the effort (sub-theme 3). Theme 2 related to working with SLP students; it didn't feel like they were students (sub-theme 4), we just got on so well (sub-theme 5), and they listened to what I wanted (sub-theme 6). CONCLUSIONS: The findings confirm that PWA value access to more intensive treatment and desire involvement in decisions about flexible treatment schedules. PWA have positive experiences when treatment is provided by SLP students. Implications for clinical practice and future research directions are discussed.

"Take Us Into Account": Perspectives of Family Members of People With Parkinson's Disease Regarding Speech-Language Pathology Intervention.

PURPOSE: While communication changes associated with Parkinson's disease (PD) have been documented, research on the impact of these changes on family members is just beginning to emerge. With this new focus on family, questions arise as to how well speech-language pathology services address their needs communicating with their loved one with PD. The purpose of this study was to explore the experiences of family members of people with PD (PwPD) and their recommendations for speech-language pathology services that incorporated their needs. METHOD: Seventeen spouses/partners of PwPD participated in focus groups that were recorded, transcribed, and analyzed using thematic analyses. RESULTS: Three themes emerged, all focusing around the central tenet that the experiences of family members, and hence their need for speech-language pathology support, transitioned through the stages of PD progression. Theme 1 summarized increasing burdens on family to manage communication as PD progressed beyond a brief period of independent strategy use by PwPD. Theme 2 highlighted multifactorial contributors to communication burdens on families, with cognitive impairments being the most underrecognized. Theme 3 illustrated how families wanted more intervention options from speech-language pathologists (SLPs) that included them, but with a tailored approach for PD stages and personal preferences. CONCLUSIONS: When SLPs provide families with either generic communication strategies or strategies that do not fit the individualized needs of PwPD and their families, we may inadvertently be increasing the burden on families. There is a need for systematic, evidence-based, family-centered interventions that include, but go beyond, current speech-focused interventions to meet the shared communication needs of PwPD and their families.

A qualitative study of reflective practice in the workplace. Speech-language pathologists have their say.

PURPOSE: Engaging in reflective practice (RP) and demonstrating reflective abilities is an essential graduate skill for speech-language pathologists (SLPs), yet limited studies have examined the perspectives of practicing SLPs and how and why they engage in RP. This qualitative study aimed to examine SLPs' experiences and perspectives of RP in diverse workplaces. METHOD: Individual semi-structured interviews were conducted with 30 SLPs working in health, education, or private practice sectors. Interviews were analysed using thematic analysis. RESULT: Three themes were developed from the data, describing what SLPs use RP for, what SLPs perceive as important in order to engage in RP in the workplace, as well as the barriers they have identified, and how SLPs have observed a change in engaging in RP as they have progressed in their careers. CONCLUSION: SLPs described that RP is valued in the workplace for supporting client focused care, problem-solving, and lifelong learning. SLPs wanted time to be protected for RP at all stages of their career and valued the relationships with others as contributing positively to RP. Perceptions of and engagement in RP changed in relation to SLPs' clinical experience. Implications for clinical practice are discussed.

Written reflective practice abilities of SLT students across the degree programme.

BACKGROUND: Written reflective practice (WRP) is a teaching tool used across speech-language therapy (SLT) clinical education programmes. The process aims to support the development of reflective skills required for the workplace (e.g., problem-solving and self-evaluation). AIMS: This cross-sectional and repeated-measures study design investigated students' demonstration of breadth of WRP across the clinical education programme. METHODS & PROCEDURES: The participants were 77 undergraduate SLT students in their first, second or final professional year of the clinical programme. Participants wrote critical reflections following an interaction with a client/s as part of their clinical education experiences. Formative feedback was provided after each written reflection (WR). In total four WRs per participant were coded for breadth of WRP using a modification of Plack et al.'s coding schema from 2005. This was completed for each of the four time points across the academic year for each professional year. OUTCOMES & RESULTS: There was a statistically significant association between time (i.e., professional year of the programme) and likelihood of demonstration of breadth of reflection for the lower level reflective element of 'attend' and higher level reflective element of 're-evaluate'. A positive trend between time and likelihood of demonstration of breadth of reflection was seen for the lower level element of 'reflection-for-action'. Final-professional-year students exhibited significant enhancements in the higher level elements (e.g., 'premise') compared with first- and second-professional-year students. CONCLUSIONS & IMPLICATIONS: This group of SLT students exhibited significant change in breadth of WRP across the degree programme. This finding has positive implications for facilitating WRP with students and using the current coding framework in clinical programmes. WHAT THIS PAPER ADDS: What is already known on this subject WRP is one form of reflective practice (RP) used in SLT, allied health, medical and nursing clinical education programmes. Researchers have suggested that RP skills develop over time for students. Previously, studies examining WRP have focused on one off assessment of skill or over a timeframe of 6-10 weeks. Here, we examine SLT students' WRP skills across the degree programme. What this paper adds to existing knowledge SLT students exhibited significant positive change in breadth of WRP across the degree programme as their clinical experience increased. Our results provide quantitative information in support of using RP as a learning tool throughout clinical education programmes for SLT. What are the potential or actual clinical implications of this work? This study offers support for educators of SLT students; for example, how educators can assess WRP, and how educators can foster SLT student skill development with formative feedback and reflective questioning. This study also offers support for student SLT, for example, describing how WRP can be part of their individualized learning approach and provide a purposeful examination of self and clinical skill development.