1
|
Harvey A, Mannette J, Sigall-Boneh R, Macintyre B, Parrott M, Cahill L, Connors J, Otley A, Haskett J, van Limbergen J, Grant S. Co-Development of Three Dietary Indices to Facilitate Dietary Intake Assessment of Pediatric Crohn's Disease Patients. CAN J DIET PRACT RES 2024:1-8. [PMID: 38634640 DOI: 10.3148/cjdpr-2024-005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Literature on dietary behaviours of the pediatric Crohn's Disease (CD) population and the relationship between dietary intake and CD activity is limited. Three dietary indices were developed and tested to conduct dietary pattern analysis in pediatric patients with CD consuming a free diet following remission induction via exclusive enteral nutrition (n = 11). Index scores underwent descriptive and inferential analysis. The mean adjusted scores (out of 100) for the Pediatric Western Diet Index, Pediatric Prudent Diet Index, and Pediatric-Adapted 2010 Alternate Healthy Eating Index (PA2010-AHEI) were 29.82 ± 15.22, 34.25 ± 15.18, and 51.50 ± 11.69, respectively. The mean Western-to-Prudent ratio was 0.94 ± 0.55. A significant correlation (r = -0.71) and relationship (F[1, 9] = 9.04, P < 0.05, R2 = 0.501) between the Western-to-Prudent ratio and PA2010-AHEI was found. The results suggest participants were not following a Western or Prudent diet, and were consuming foods not captured by the indices. More research is needed to describe dietary intake of individuals with CD, validate dietary indices in diverse samples, and explore the utility of these indices in CD assessment and treatment. The co-authors hope this work will stimulate/inspire subsequent interprofessional, dietitian-led research on this topic.
Collapse
Affiliation(s)
| | | | - Rotem Sigall-Boneh
- The E. Wolfson Medical Center, Pediatric Gastroenterology and Nutrition Unit, Holon, Israel
| | | | | | - Leah Cahill
- Dalhousie University, Halifax, NS
- Queen Elizabeth II Health Sciences Centre, Halifax, NS
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Anthony Otley
- Dalhousie University, Halifax, NS
- The E. Wolfson Medical Center, Pediatric Gastroenterology and Nutrition Unit, Holon, Israel
| | | | - Johan van Limbergen
- IWK Health Centre, Halifax, NS
- Dalhousie University, Halifax, NS
- Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Shannan Grant
- Mount Saint Vincent University, Halifax, NS
- IWK Health Centre, Halifax, NS
- Dalhousie University, Halifax, NS
| |
Collapse
|
2
|
Baker C, Ryan B, Rose ML, Kneebone I, Thomas S, Wong D, Wallace SJ. Developing consensus-based clinical competencies to guide stroke clinicians in the implementation of psychological care in aphasia rehabilitation. BRAIN IMPAIR 2024; 25:IB23091. [PMID: 38566294 DOI: 10.1071/ib23091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/30/2024] [Indexed: 04/04/2024]
Abstract
Background People with aphasia experience depression and anxiety associated with negative outcomes across a range of time post-stroke. Stroke clinicians are well-positioned to facilitate low-intensity psychotherapeutic interventions after aphasia (e.g. mood screening, behavioural activation, problem-solving therapy, relaxation therapy); however, they self-report a lack of knowledge, skills and confidence to do so. The Theoretical Domains Framework (TDF) provides a lens through which to view and target clinician behaviours and training needs in this area of practice. The aim of this study was to develop and gain consensus on items for a rating scale of clinical competencies in facilitating individual-based, low-intensity psychotherapeutic interventions for people with aphasia. Methods An e-Delphi methodology using focus groups and survey rounds was used to gain consensus on clinical competencies considered important. Results Eight stroke clinicians (speech pathologists and psychologists), two people with aphasia and three family members participated in one of four focus groups. Four themes were derived from the data: (1) Communication support, (2) Assessment and therapy structure, (3) Interpersonal skills, and (4) Needs of the significant other (family or friend). Themes informed an initial list of 23 self-rated and observer-rated competency items. Following two rounds of e-Delphi surveys, 11 stroke clinicians (six speech pathologists and five psychologists) reached consensus (80-100%) for 19 competencies. Conclusions The Psychological Care in Aphasia Rehabilitation Competency scale offers a preliminary list of items to guide and train clinicians to implement low-intensity psychotherapeutic interventions for people with aphasia.
Collapse
Affiliation(s)
- Caroline Baker
- Speech Pathology Department, Monash Health Melbourne, Vic., Australia; and Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Vic., Australia
| | - Brooke Ryan
- Speech Pathology, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Miranda L Rose
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Vic., Australia; and School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Vic., Australia
| | - Ian Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, NSW, Australia
| | | | - Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - Sarah J Wallace
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; and Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Qld, Australia
| |
Collapse
|
3
|
Zhang Y, Churchill M, Mannette J, Rothfus M, Mireault A, Harvey A, Lackie K, Hayward K, Fraser Arsenault J, Lordly D, Grant S. Identifying and Mapping Canadian Dietetic Students' Interaction(s) with Simulation-Based Education: A Scoping Review. CAN J DIET PRACT RES 2023; 84:233-241. [PMID: 37436143 DOI: 10.3148/cjdpr-2023-016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
This scoping review mapped literature available on Canadian dietetics, nutrition, and foods students' and graduates' interaction(s) with simulation-based education (SBE) during undergraduate and/or practicum. One certified Librarian led the preliminary search (Summer, 2021), while three Joanna Briggs Institute-trained reviewers conducted the comprehensive search via MEDLINE (OVID), CINAHL (EBSCO), Academic Search Premier (EBSCO), Embase (Elsevier), Scopus (Elsevier), and Google (February 2022). A data extraction tool designed specifically for the study objectives and research inclusion criteria was used. We recorded 354 results and included 7. Seven types of SBE were recorded: (i) comprehensive care plan (n = 2); (ii) nutritional diagnosis/assessment (n = 2); (iii) body composition assessment (n = 1); (iv) introducing patient to dysphagia care (n = 1); (v) nutrition counselling session (n = 1); (vi) nutrition-focused physical examination (n = 1); and (vii) professional communications via social media (n = 1). Results indicate that Canadian dietitian-led SBE includes the use of simulated patients, nutritional diagnosis/assessment, and the creation of comprehensive care plans, among others. Students have been assessed for performance of trained tasks through exams, self-awareness surveys, and interviews, and SBE activities have been evaluated for effectiveness through questionnaires and interviews with users/students. Canadian literature is limited, and more can be learned by exploring the global context within and outside the profession.
Collapse
Affiliation(s)
- Yingying Zhang
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Megan Churchill
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
- Department of Obstetrics and Gynecology and Pediatrics, IWK Health Centre, Halifax, NS
| | - Jessica Mannette
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Melissa Rothfus
- WK Kellogg Health Sciences Library, Dalhousie University; Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS
| | - Amy Mireault
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Antonia Harvey
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
- Department of General Medicine, Cardiology, Dartmouth General Hospital, Nova Scotia Health Authority, Dartmouth, NS
| | - Kelly Lackie
- School of Nursing, Dalhousie University, Halifax, NS
| | | | | | - Daphne Lordly
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Shannan Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
- Department of Obstetrics and Gynecology and Pediatrics, IWK Health Centre, Halifax, NS
- Department of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, NS
| |
Collapse
|
4
|
Law T, Wei Y, Wong KHY, Hu Y, Tong MCF, Lee KYS. Feasibility and self-perceived effectiveness of an online training program on dysphagia in residential aged care homes in mainland China. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:1903-1911. [PMID: 37066521 DOI: 10.1111/1460-6984.12878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND With a rapidly aging population in mainland China, dysphagia has become one of the common geriatric disorders which creates a huge demand on speech and language therapists (SLTs). The major challenge is the shortage of SLTs in China. In addition, frontline practitioners in mainland China may not be well equipped with the knowledge and practical skills in dysphagia management due to lack of systematic training and the work nature. AIMS This study evaluates the self-perceived effectiveness and feasibility of an online training program that aims to enhance the self-assessed knowledge and skills of SLTs providing dysphagia care in residential aged care homes. METHODS AND PROCEDURES Sixteen SLTs working in a residential aged care homes in mainland China attended a three-hour pilot online training program which consists of didactic lecture and practical skills activity components. A total of 10 participants completed an online questionnaire one month after the training to evaluate the feasibility and effectiveness of this online training program. OUTCOMES AND RESULTS The preliminary results demonstrated participants' self-perception of high training effectiveness in theoretical knowledge and practical skills. A majority of the participants perceived that the training enhanced their theoretical knowledge and all of them perceived that they acquired practical skills. All respondents were satisfied with the online training approach. They also highlighted the advantage and challenges of the online training approach. CONCLUSIONS AND IMPLICATIONS Online training is an effective and feasible approach for theoretical knowledge and practical skills transfer in SLT training and could ultimately benefit the delivery of services for individuals with dysphagia in mainland China. WHAT THIS PAPER ADDS What is already known on the subject Previous studies have shown that online training approach is as effective as face-to-face training in increasing professional knowledge. Online training programs may be more cost efficient and time efficient when compared with face-to-face training. What this study adds The present study provided preliminary evidence to support the feasibility and effectiveness of using online training on dysphagia for speech and language therapists working in residential aged care homes in mainland China. What are the clinical implications of this work? From the participants' perception, online training approach is effective and feasible in delivering theoretical knowledge and practical skills. It may be a better training approach for mainland China considering the lack of expertise and accessibility to training.
Collapse
Affiliation(s)
- Thomas Law
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
- The Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yifeng Wei
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
- The Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kay H Y Wong
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
- The Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yunyi Hu
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
- The Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michael C F Tong
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
- The Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kathy Y S Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
- The Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
5
|
Marshall J, Raatz M, Ward EC, Penman A, Beak K, Moore M, Hill AE. Development and Pilot Testing of Telesimulation for Pediatric Feeding: A Feasibility Study. Dysphagia 2023; 38:1308-1322. [PMID: 36692653 PMCID: PMC9872075 DOI: 10.1007/s00455-023-10556-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
Simulation enables learners to practice new skills in a supportive environment. Largely driven by the COVID-19 pandemic, simulation via telepractice, i.e., telesimulation, has emerged. Viable delivery of telesimulation requires consideration of the adaptations needed to conduct simulation via telepractice. The aim of this study was to design and pilot test the feasibility of using telesimulation to provide training in infant feeding management. An iterative process was used across four phases: (1) simulation design, (2) telesimulation adaptations, (3) user testing, feedback, and modifications, and (4) user testing of modified simulation, feedback, and final modifications. During Phases 1 and 2, team members worked together to design and test telepractice adaptations for a simulation experience. During Phases 3 and 4, the telesimulation was pilot tested with a group of speech pathologists, with feedback sought via open-ended survey questions and/or an optional focus group. Manifest content analysis was used to interpret user feedback. In Phase 2, several adaptations were explored to optimize telesimulation delivery and engagement, including Zoom® functions (e.g., 'spotlighting,' digital backgrounds) and supplementary video/auditory files. There were 11 participants across Phases 3 and 4. Specific feedback centered around simulation preparation and structure, session practicalities, supports for realism, Zoom® functions, group dynamics, participants' experiences, and future enhancements. An overall list of recommendations for telesimulation was generated. Telesimulation for feeding management was considered feasible and participant feedback was favorable. Further research is required to investigate if the learner outcomes of telesimulation are comparable to in-person simulation for infant feeding management.
Collapse
Affiliation(s)
- Jeanne Marshall
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Madeline Raatz
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- Speech Pathology Department, Logan Hospital, Metro South Hospital and Health Service, Brisbane, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Australia
| | - Adriana Penman
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Kelly Beak
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Madison Moore
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Anne E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
6
|
Rivelsrud MC, Hartelius L, Speyer R, Løvstad M. Qualifications, professional roles and service practices of nurses, occupational therapists and speech-language pathologists in the management of adults with oropharyngeal dysphagia: a Nordic survey. LOGOP PHONIATR VOCO 2023:1-13. [PMID: 36786502 DOI: 10.1080/14015439.2023.2173288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 01/10/2023] [Accepted: 01/22/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE To identify the qualifications, professional roles and service practices of nurses, occupational therapists (OTs) and speech-language pathologists (SLPs) in the management of adults with oropharyngeal dysphagia (OD) in the Nordic countries. METHODS A web-based survey was developed that consisted of 50 questions on respondent demographics, education, experience, roles and service practices provided for adults with OD. The survey was distributed to practicing nurses, OTs, and SLPs in five Nordic countries via professional associations, social media, online networks and snowballing. RESULTS Data from 396 nurses, OTs and SLPs whom provided services for adults with OD revealed that the majority of respondents worked in acute care and inpatient rehabilitation facilities. Most respondents had minimal undergraduate education and practical clinical training in OD. Notable variances in roles and service practices in OD between professions and countries were found. OTs were the primary service provider for OD management in Denmark, while SLPs had this role in the other Nordic countries. Nurses were mainly involved in screening and some compensatory treatments in most Nordic countries. Limited use of evidence-based screening, non-instrumental or instrumental clinical assessments and rehabilitative therapeutic methods was evident. CONCLUSIONS Study results highlight challenges in education and training of professionals responsible for the management of adults with OD in the Nordic countries. Increased use of evidence-based assessment and exercise-based treatments to improve swallowing are warranted. Adherence to European and international clinical practice guidelines for the management of adults with OD is recommended.
Collapse
Affiliation(s)
- Maribeth Caya Rivelsrud
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Hartelius
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Research, Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway
- Skaraborgs Hospital, Skövde, Sweden
| | - Renée Speyer
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Western, Australia
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| |
Collapse
|
7
|
Squires K, Heaney S, MacDonald-Wicks L, Johnston C, Brown L. Mapping Simulated-Based Learning Experiences Incorporated Into Professional Placements in Allied Health Programs: A Scoping Review. Simul Healthc 2022; 17:403-415. [PMID: 34966129 PMCID: PMC9722386 DOI: 10.1097/sih.0000000000000627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
SUMMARY STATEMENT Emerging literature continues to demonstrate the use of innovative practices such as simulated-based learning experiences to prepare students for professional placements. This scoping review aimed to provide a broad overview of how simulated-based learning experiences have been implemented within or immediately before the professional practice placements of entry-level allied health programs. Four databases (MEDLINE, EMCARE, CINAHL, and Scopus) were searched up to August 2020. Kirkpatrick's evaluation framework was used to categorize outcomes, and the Simulation-Based Research Extension for the CONSORT statement was used to appraise the quality of simulation reporting. The search revealed 6584 unique abstracts with 321 full-text articles reviewed. Forty-eight studies met the inclusion criteria. This review has shown a clear trend toward using simulation within or immediately before the professional practice placements of allied health programs. Using Kirkpatrick's evaluation framework, most studies reported on student reaction (level 1) and learning (level 2) obtained during the simulation experience. There was limited evidence showing how the benefits gained in simulation translated to the clinical environment (level 3) or impacted the organization (level 4). Further research is required to review the optimal proximity of simulation to allied health professional placements and how gains are obtained from simulation transition to the clinical environment. In addition, more consistent reporting of simulation methodologies and evaluation methods are needed to strengthen the evidence base.
Collapse
|
8
|
Nagdee N, Sebothoma B, Madahana M, Khoza-Shangase K, Moroe N. Simulations as a mode of clinical training in healthcare professions: A scoping review to guide planning in speech-language pathology and audiology during the COVID-19 pandemic and beyond. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e13. [PMID: 36073069 PMCID: PMC9452917 DOI: 10.4102/sajcd.v69i2.905] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 12/25/2022] Open
Abstract
Background Simulation plays an important role as an alternative method for training of students, particularly in health education. As a result of coronavirus disease 2019 (COVID-19) restrictions of face-to-face interactions, traditional teaching methods have been disrupted, increasing the need for alternative methods to supplement modes of student clinical training in healthcare programmes. Objectives The scoping review aimed to determine what has been documented about simulation as a mode of clinical training in healthcare professions (HCPs) in order to guide speech-language pathology and audiology (SLP&A) professions during the COVID-19 pandemic and beyond. Method A scoping review was conducted. Electronic bibliographic databases including Science Direct, PubMed, Scopus MEDLINE, ProQuest, Google Scholar and WorldCat were searched to identify peer reviewed publications, published in English, between January 2011 and December 2021, and related to the use of simulation in HCPs clinical training programmes. Results A total of 32 articles met the inclusion criteria for this scoping review. Three themes emerged when reviewing the studies: (1) face-to-face simulations as a mode of clinical training, (2) virtual reality simulation and telesimulation as modes of clinical training and (3) simulation as a complementary mode of clinical training. Evidence suggests that whilst simulations are cost-effective, accessible and efficacious as clinical training modes, they need to be combined with other modes of training such as the traditional clinical training to yield better learning outcomes. Conclusions Current findings highlight the role and value of simulation as a clinical training mode during COVID-19 and beyond. However, there are aspects that need to be considered to ensure that this mode of clinical training is effective, with endorsement and regulations by the SLP&A Professional Board of the Health Professions Council of South Africa (HPCSA). Simulations need to be complemented with traditional clinical training methods. In the context of SLP&A, particularly in low- and middle-income countries (LMICs), simulation can be used to better prepare students for their clinical placement where clinical training platforms are limited and where simulation combined with teletraining or telesupervision can be utilised to increase access to training.
Collapse
Affiliation(s)
- Nabeelah Nagdee
- Department of Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
| | | | | | | | | |
Collapse
|
9
|
Rosa M, Giroux I. Dietetic Students' Perceptions of Learning Professional Competencies with Four Simulations Throughout a Semester. CAN J DIET PRACT RES 2022; 83:139-143. [PMID: 35503902 DOI: 10.3148/cjdpr-2022-006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In nursing and medicine, taking part in simulation activities has been shown to be beneficial for students' learning; however, little has been documented in dietetics. This study aimed to document the perceived effect of 4 simulations on development of professional competencies by dietetic students. A mixed-method convergent approach was used with pre- and post-questionnaires, interviews, and a focus group discussion to look at dietetic students' perceptions of learning as part of a Nutrition Assessment course. Nonparametric tests for questionnaires and theme analysis for transcripts were used to examine data. After analysis, data were compared and merged for interpretation. Results showed that participants perceived a significant increase in comprehension of various competencies with simulations. In interviews and a focus group, a participant subgroup (n = 7) perceived an enriched understanding of some dietetic competencies compared with pre-simulations. Simulations seemed to have transformed classroom concepts to a more practical understanding of dietetic practice. More studies are needed to identify if these results could be replicated in different settings. Simulations had a positive effect on students' perception of competencies development and may be an andragogical tool of choice to support preparing future dietitians for entry to practice.
Collapse
Affiliation(s)
- Mylène Rosa
- School of Nutrition Sciences, University of Ottawa.,Faculty of Education, University of Ottawa
| | - Isabelle Giroux
- School of Nutrition Sciences, University of Ottawa.,Institut du Savoir Montfort, Ottawa
| |
Collapse
|
10
|
Penman A, Hill AE, Hewat S, Scarinci N. Speech-language pathology students' perceptions of simulation-based learning experiences in stuttering. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:1132-1146. [PMID: 34185338 DOI: 10.1111/1460-6984.12645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/30/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Research suggests that some speech-language pathologists are uncomfortable treating people who stutter. Accessing quality clinical education experiences in stuttering is difficult given the ongoing rise in students enrolled in speech-language pathology programmes and the limited number of stuttering-specific placements available. Simulation-based learning is a viable option for providing speech-language pathology students with practical experience in a safe learning environment. Whilst research has found that simulation-based learning experiences in stuttering assist in the development of students' clinical skills, students' perceptions of participating in stuttering simulation-based learning are yet to be explored. AIMS To investigate speech-language pathology students' comfort, anxiety, knowledge and confidence in the management of stuttering at the commencement of an academic stuttering course and before and following participation in a stuttering simulation-based learning programme. METHODS & PROCEDURES This study used a cross-sectional survey design. Participants were 105 undergraduate and graduate entry masters speech-language pathology students enrolled at an Australian university. Students engaged in a stuttering simulation-based learning programme embedded within an existing academic course on the management of stuttering. A purposefully developed survey was administered at three time points: pre-course (T1), pre-simulation (T2) and post-simulation (T3) in order to explore students' comfort and anxiety levels, and perceptions of their knowledge and confidence in stuttering management. Descriptive statistics were used to report the medians and range of students' responses. Changes across all time points and between each of the time points were determined using the Friedman test and the Wilcoxon signed rank test, respectively. OUTCOMES & RESULTS Statistically significant differences (p < 0.001) were observed on all matched survey items (n = 96) across all time points. Between each time point, a significant difference in students' perceived knowledge levels was found with small to large effect sizes. However, there was no difference in students' perceived comfort and anxiety levels between the time points of pre-course and pre-simulation. Open-ended responses on the post-simulation survey revealed that students valued learning about stuttering within a simulation-based learning environment. CONCLUSIONS & IMPLICATIONS Simulation-based learning experience in stuttering management was valued by students. When accompanied by theoretical content, participation in a stuttering simulation-based learning programme supported students to feel more comfortable and less anxious about working with people who stutter. This finding has implications for the development of clinical skills in the assessment and treatment of adults who stutter. WHAT THIS PAPER ADDS What is already known on this subject Simulation is a teaching approach used within speech-language pathology to support the development of students' clinical skills. Simulation provides a safe learning environment for students, an opportunity for repeated practice and is valued by students. What this paper adds to existing knowledge This study explored students' perceptions of their comfort, anxiety, knowledge and confidence in working with people who stutter before and following participation in a simulation-based learning programme. It describes a stuttering simulation-based learning programme that can be embedded into speech-language pathology programme curricula. What are the potential or actual clinical implications of this work? The stuttering simulation-based learning programme detailed in this study can be applied and embedded in speech-language pathology curricula. It can be used to support the development of students' confidence in the assessment and management of stuttering.
Collapse
Affiliation(s)
- Adriana Penman
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Anne E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Sally Hewat
- School of Humanities and Social Sciences (Speech Pathology), The University of Newcastle, Newcastle, NSW, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| |
Collapse
|
11
|
Penman A, Hill AE, Hewat S, Scarinci N. Does a simulation-based learning programme assist with the development of speech-language pathology students' clinical skills in stuttering management? INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:1334-1346. [PMID: 34519389 DOI: 10.1111/1460-6984.12670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/19/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Simulation-based learning can be used in university programmes to provide speech-language pathology students with essential clinical experiences. However, limited research has explored the use of simulation to support students' development of skills in clinical practice with people who stutter. AIMS (1) To evaluate students' clinical skills in managing stuttering within a simulation-based learning programme; (2) to develop an assessment tool, the Standardised Patient Interview Rating Scale for Stuttering (SPIRS-Stuttering); and (3) to conduct a preliminary investigation of its validity in measuring students' performance. METHODS & PROCEDURES Speech-language pathology students (n = 114) participated in a simulation-based stuttering programme in addition to academic coursework in fluency disorders. Students' clinical skills were assessed over two simulation sessions using the SPIRS-Stuttering tool, adapted from an earlier iteration of the SPIRS tool. Content validity, intra-rater reliability and internal consistency of the SPIRS-Stuttering tool were also explored. OUTCOMES & RESULTS Students demonstrated a statistically significant improvement in stuttering clinical skills between sessions 1 and 4 of the simulation-based stuttering programme. Good content validity was achieved for the SPIRS-Stuttering tool with a low level of intra-rater reliability and variable internal consistency. CONCLUSIONS & IMPLICATIONS This study identified that students' clinical skills in stuttering improved during participation in a simulation-based programme undertaken in conjunction with an academic course on fluency disorders. The results of this study support the inclusion of this learning modality in university programme curricula. Whilst the SPIRS-Stuttering tool enabled assessment of speech-language pathology students' clinical skills in stuttering management, further exploration of reliability is required. WHAT THIS PAPER ADDS What is already known on this subject Within speech-language pathology, simulation-based learning is a teaching approach used in university clinical programme curricula. Simulation-based learning is used as an opportunity for students to gain specific clinical skills, particularly if clinical experiences are readily not available. Research in speech-language pathology has revealed that students value simulation because it provides a safe learning environment. What this study adds to existing knowledge There are fewer opportunities for students to gain clinical experience in the management of stuttering in adults. This study explored students' clinical skill development within a stuttering simulation-based learning programme. Additionally, it detailed the development and preliminary investigation of validity of the SPIRS-Stuttering, an assessment tool used in a simulation-based learning environment. What are the potential or actual clinical implications of this work? Students' clinical skills in the assessment and management of stuttering in adults, as measured by the SPIRS-Stuttering, improved during participation in the stuttering simulation-based learning programme. Further investigation of validity of the SPIRS-Stuttering tool is required to confidently measure students' performance. The stuttering simulation-based learning programme can be used to provide students with an opportunity to develop their clinical skills in stuttering, a practice area in speech-language pathology that is not always available to students.
Collapse
Affiliation(s)
- Adriana Penman
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Anne E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Sally Hewat
- School of Humanities and Social Sciences (Speech Pathology), The University of Newcastle, Callaghan, NSW, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| |
Collapse
|
12
|
Pillay T, Pillay M. Contextualising clinical reasoning within the clinical swallow evaluation: A scoping review and expert consultation. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2021; 68:e1-e12. [PMID: 34342487 PMCID: PMC8335787 DOI: 10.4102/sajcd.v68i1.832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/30/2021] [Accepted: 06/02/2021] [Indexed: 11/08/2022] Open
Abstract
Background This study explored the available literature on the phenomenon of clinical reasoning and described its influence on the clinical swallow evaluation. By exploring the relationship between clinical reasoning and the clinical swallow evaluation, it is possible to modernise the approach to dysphagia assessment. Objectives This study aimed to contextualise the available literature on clinical reasoning and the CSE to low-middle income contexts through the use of a scoping review and expert consultation. Method A scoping review was performed based on the PRISMA-ScR framework. The data was analysed using thematic analysis. Articles were considered if they discussed the clinical swallow evaluation and clinical reasoning, and were published in the last 49 years. Results Through rigorous electronic and manual searching, 12 articles were identified. This review made an argument for the value of clinical reasoning within the clinical swallow evaluation. The results of the study revealed three core themes related to the acquisition, variability and positive impact of clinical reasoning in the clinical swallow evaluation. Conclusion The results of this review showed that the clinical swallow evaluation is a complex process with significant levels of variability usually linked to the impact of context. This demonstrates that in order to deliver effective and relevant services, despite challenging conditions, healthcare practitioners must depend on clinical reasoning to make appropriate modifications to the assessment process that considers these salient factors.
Collapse
Affiliation(s)
- Thiani Pillay
- Discipline of Speech-Language Pathology, School of Health Sciences, University of KwaZulu-Natal, Durban.
| | | |
Collapse
|
13
|
Taylor N, Wyres M, Green A, Hennessy-Priest K, Phillips C, Daymond E, Love R, Johnson R, Wright J. Developing and piloting a simulated placement experience for students. ACTA ACUST UNITED AC 2021; 30:S19-S24. [PMID: 34251853 DOI: 10.12968/bjon.2021.30.13.s19] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
COVID-19 and rising student numbers are affecting healthcare education, particularly access to clinical placements. As healthcare education is increasingly supported by technology and non-traditional teaching methods, educational experiences gained through clinical placement also require new approaches. This article explores and discusses the use of a simulated clinical placement for a dietetic student cohort. During this virtual placement, students were able to explore and experience a virtual clinical setting and immerse themselves in a placement experience. A vast range of virtual resources were linked to the online placement portal, including statutory and mandatory training, dietetic resources, patient journeys and interprofessional communication. Advantages of this approach include that all students experience a given situation, unlike in traditional placements where workloads, variety and engagement vary; there is also no risk to patient safety. The aim is to enhance the learning experience to create effective, efficient clinicians. This virtual placement for dietetics is part of a bigger project to develop and evaluate the use of a virtual placement framework in a range of professions. The concept of virtual placement may have been brought forward by the COVID-19 crisis but was inevitable with the move to more technology-enhanced learning tools.
Collapse
Affiliation(s)
- Natasha Taylor
- Associate Professor, School of Nursing, Midwifery and Health, Coventry University
| | - Martyn Wyres
- Associate Professor, School of Nursing, Midwifery and Health, Coventry University
| | - Abbie Green
- Associate Professor, School of Nursing, Midwifery and Health, Coventry University
| | | | - Carla Phillips
- Associate Professor, School of Nursing, Midwifery and Health, Coventry University
| | - Emily Daymond
- Physiotherapist, Torbay and South Devon NHS Foundation Trust
| | - Rachel Love
- Senior Lecturer, Faculty of Health, Education and Society, University of Northampton
| | - Rebecca Johnson
- Associate Professor, School of Nursing, Midwifery and Health, Coventry University
| | - Jane Wright
- Lecturer, School of Nursing, Midwifery and Health, Coventry University
| |
Collapse
|
14
|
Luo Y, Geng C, Chen X, Zhang Y, Zou Z, Bai J. Three learning modalities' impact on clinical judgment and perceptions in newly graduated registered nurses: A quasi-experimental study. Nurs Health Sci 2021; 23:538-546. [PMID: 33864331 DOI: 10.1111/nhs.12842] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
Newly graduated registered nurses face numerous challenges stemming from high patient workload, complicated interpersonal relationships, and a lack of nursing competence, which can lead to transitional shocks. Clinical judgment and confidence are well-known keys to successful role transitions for these nurses. Simulation training is proposed as a new modality for enhancing comprehensive clinical competence of nurses, but current evidence on the impact of different simulations on nurses' clinical judgment and confidence are still limited or inconsistent. This study compared the impact of three types of learning modalities on newly graduated registered nurses' clinical judgment, perceptions of self-confidence, and evaluations of the design features of the learning modalities. A quasi-experimental design was used. Fifty-nine participants were randomly assigned to three groups: (1) high-fidelity simulation, (2) virtual simulation, and (3) case study. Scales were used after the simulation. The virtual simulation group showed a higher level of clinical judgment. The high-fidelity simulation group felt more confident than the virtual simulation and case study groups. Both the high-fidelity simulation group and virtual simulation group reported higher scores in the domain of fidelity.
Collapse
Affiliation(s)
- Yiqing Luo
- Wuhan University School of Health Sciences, Wuhan, China
| | - Cong Geng
- Wuhan University School of Health Sciences, Wuhan, China
| | - Xiaoli Chen
- Wuhan University School of Health Sciences, Wuhan, China
| | | | - Zhijie Zou
- Wuhan University School of Health Sciences, Wuhan, China
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia, USA
| |
Collapse
|
15
|
Bartlett RS, Bruecker S, Eccleston B. High-Fidelity Simulation Improves Long-Term Knowledge of Clinical Swallow Evaluation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:673-686. [PMID: 33705671 PMCID: PMC8740723 DOI: 10.1044/2020_ajslp-20-00240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/08/2020] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
Purpose Clinical swallow evaluation (CSE) is a critical skill that speech-language pathologists who manage swallowing impairment must learn. The objective of this mixed-methods study was to determine if using a human patient simulator (HPS) to train speech-language pathology graduate students in CSE improved knowledge, preparedness, and anxiety as compared to traditional instruction alone. Method This was a controlled trial with repeated measures. Participants included graduate students from two cohorts who were enrolled in a swallowing disorders course in consecutive academic years (n = 50). Students in the experimental group participated in a simulation experience in which they performed a CSE on an HPS, generated a treatment plan, and communicated in real time with the HPS, the patient's wife, and a nurse. Quantitative results included quizzes that measured short- and long-term CSE knowledge, and qualitative findings included written feedback from instructors and students. Results Students who participated in simulation training had significantly higher long-term quiz accuracy than the control group, but their short-term quiz scores did not differ. Student ratings of preparedness and anxiety did not differ between the two groups. Many students reported that they appreciated practicing the use of patient-friendly language and preferred clinical simulation over traditional teaching methods. Facilitators reported that simulation increased student engagement and critical thinking skills more than traditional teaching methods. Conclusions CSE simulation provided objective and subjective advantages over traditional teaching methods. Recommendations from students and instructors for improving the CSE simulation training are reported.
Collapse
|
16
|
Hill AE, Ward E, Heard R, McAllister S, McCabe P, Penman A, Caird E, Aldridge D, Baldac S, Cardell E, Davenport R, Davidson B, Hewat S, Howells S, Purcell A, Walters J. Simulation can replace part of speech-language pathology placement time: A randomised controlled trial. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:92-102. [PMID: 32098509 DOI: 10.1080/17549507.2020.1722238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE Simulation is increasingly used within speech-language pathology education. Research has primarily explored students' perceptions of learning in simulation. The aim of this study was to determine if speech-language pathology students achieved a statistically-equivalent level of competency when a mean of 20% of placement time was replaced with simulation compared to placements without a simulation component. METHOD This non-inferiority randomised controlled trial involved students from six Australian universities. Students were randomised to either a simulation + traditional placement group attending 5 days of simulation prior to their traditional placement, or a traditional only placement group. Their end-placement clinical competency was assessed using Competency Assessment in Speech Pathology (COMPASS®). RESULT Final data were available for 325 students: 150 students in traditional placements, 138 students in protocol-compliant simulation + traditional placements, and 37 students in non-protocol simulation + traditional placements. There were no statistically significant differences between groups (traditional vs protocol-compliant simulation + traditional Mann-Whitney-Wilcoxon z = 1.23, df = 286, p = 0.22; traditional vs intention-to-treat simulation + traditional Mann-Whitney-Wilcoxon z = 0.23, df = 323, p = 0.81). CONCLUSION This research contributes to the evidence base which suggests that simulation can partially replace traditional placement time for speech-language pathology students without loss of competency, substantiating its value as an alternative placement model in speech-language pathology programmes.
Collapse
Affiliation(s)
- Anne E Hill
- Discipline of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Elizabeth Ward
- Discipline of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Robert Heard
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Sue McAllister
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Patricia McCabe
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Adriana Penman
- Discipline of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Emma Caird
- Discipline of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Danielle Aldridge
- Discipline of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | | | - Elizabeth Cardell
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Rachel Davenport
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Bronwyn Davidson
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
| | - Sally Hewat
- School of Humanities and Social Science, The University of Newcastle, Callaghan, Australia
| | - Simone Howells
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Alison Purcell
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Joanne Walters
- School of Humanities and Social Science, The University of Newcastle, Callaghan, Australia
| |
Collapse
|
17
|
Muñoz-Montes MM, Villagrán-Gutiérrez I, Pozo-Tapia F, Tapia-Tapia P, Castro-Soares Y, Fuentes-López E. Speech and language therapy students' perception of learning through the incorporation of clinical simulation workshops: a mixed-methods study. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/202123311920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
18
|
Miles A, Hayden S, Carnell S, Halan S, Lok B. What do speech pathology students gain from virtual patient interviewing? A WHO International Classification of Functioning Disability and Health (ICF) analysis. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 7:239-245. [DOI: 10.1136/bmjstel-2020-000616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 11/03/2022]
Abstract
BackgroundVirtual patients have an established place in medical education but do virtual patient interviews train holistic clinicians or just diagnosticians? This study explored speech pathology students’ virtual patient interviews using WHO International Classification of Functioning Disability and Health (ICF).MethodsEighteen speech pathology students in their final year of training participated. Students interviewed virtual patients with dysphagia (swallowing difficulties) as part of their curriculum. Student questions and patient responses were coded using established ICF coding. Codes were tallied and compared under categories of body structures, body functions, activities/participation and environmental factors. Flesch Reading Ease was calculated as a measure of health literacy.ResultsConversational turns primarily focused on the ICF component—activity and participation in both student questions and virtual patient responses: 0.03% body structures, 30% body functions—swallowing, 7% body functions—associated, 43% activities/participation and 19% environmental factors. Personal factors such as gender, ethnicity, age or socio-economic situation were not mentioned by student or patient. Patients commented on social impact on self and/or family, sometimes in the absence of targeted student questions. Student and virtual patient Flesch Reading Ease scores were congruent.ConclusionSpeech pathology students naturally matched their virtual patient’s health-literacy level and asked a range of medical and daily living questions. Virtual patients readily offered social impact information to student questions. Computer science: healthcare teams should consider creating virtual patients who challenge students to practise asking sensitive questions and in doing so develop holistic thinkers with competent communication skills.
Collapse
|
19
|
Buchholz AC, Vanderleest K, MacMartin C, Prescod A, Wilson A. Patient Simulations Improve Dietetics Students' and Interns' Communication and Nutrition-Care Competence. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:377-384. [PMID: 31699616 DOI: 10.1016/j.jneb.2019.09.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/11/2019] [Accepted: 09/29/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate the impact of simulated patients on dietetics students' and interns' communication and nutrition-care competence. DESIGN Pre-post observational study in which students' communication and nutrition-care competence was evaluated during the first and final clinical nutrition simulations in winter, 2017. SETTING University of Guelph, Canada. PARTICIPANTS Seventeen undergraduate students enrolled in Applied Clinical Skills (NUTR*4120) and 15 graduate students/interns enrolled in Practicum in Applied Nutrition II (FRAN*6720). VARIABLES MEASURED Selected communication and nutrition-care performance indicators (PI) (undergraduates = 18; graduate = 33) included in the Canadian Integrated Competencies for Dietetic Education and Practice, each measured out of a maximum of 3 points. ANALYSIS Grand means of communication and nutrition-care PI scores were compared across 2 time points using paired t tests, at a significance level of .05. RESULTS Undergraduates' (n = 15) communication and nutrition-care PI scores increased by 0.9 ± 0.35 (49.7%) and 0.8 ± 0.22 (45.8%) points, respectively (both P < .001). Graduate students' communication and nutrition-care PI scores increased by 0.4 ± 0.45 (18.5%) and 0.7 ± 0.59 (37.9%) points, respectively (both P < .01). CONCLUSIONS AND IMPLICATIONS Simulated patients incorporated into clinical nutrition courses increase dietetics students' and interns' communication and nutrition-care competence. More research using comprehensive practice-based competency assessment tools is needed in larger samples of students and interns.
Collapse
Affiliation(s)
- Andrea C Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
| | - Kaitlyn Vanderleest
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Clare MacMartin
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Alexia Prescod
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Ann Wilson
- School of English and Theatre Studies, University of Guelph, Guelph, Ontario, Canada
| |
Collapse
|
20
|
O'Shea MC, Palermo C, Rogers GD, Williams LT. Simulation-Based Learning Experiences in Dietetics Programs: A Systematic Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:429-438. [PMID: 31345676 DOI: 10.1016/j.jneb.2019.06.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/29/2019] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Simulation-based learning experiences (SBLEs) are widely used in education for health professionals, but this literature has not yet been synthesized for dietetics. The aim of this study was to describe presupervised practice SBLEs using simulated patients within programs credentialing dietitians. METHODS A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 8 databases were searched (MEDLINE by EBSCO HOST, CINAHL Plus with Full Text, Web of Science, PsycINFO, Scopus, ERIC ProQuest, Embase, and ProQuest Education) for studies published up to November 2, 2018 with the terms "dietitian," "standardized patient," "student," and their synonyms. RESULTS Fourteen out of 740 studies were identified. Most focused on development/assessment of communication and counseling skills. Learning outcomes were measured in 12 studies with 8 different tools. CONCLUSIONS AND IMPLICATIONS The dietetics profession needs robust and consistent reporting methods to enable the development of a high-quality body of evidence on SBLEs. The quality and quantity of SBLE research need to improve to ensure that simulations are pedagogically sound and are accompanied by measures of quality and impact on learning.
Collapse
Affiliation(s)
- Marie-Claire O'Shea
- Department of Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Gary D Rogers
- School of Medicine, Griffith University Gold Coast Campus, Queensland, Australia
| | - Lauren T Williams
- Department of Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Queensland, Australia
| |
Collapse
|
21
|
Hewat S, Penman A, Davidson B, Baldac S, Howells S, Walters J, Purcell A, Cardell E, McCabe P, Caird E, Ward E, Hill AE. A framework to support the development of quality simulation-based learning programmes in speech-language pathology. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:287-300. [PMID: 32020763 DOI: 10.1111/1460-6984.12515] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 10/24/2019] [Accepted: 10/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Simulation-based learning provides students with a safe learning environment, guaranteed exposure to specific clinical scenarios and patients, time for reflection and repetition of tasks, and an opportunity to receive feedback from multiple sources. Research including studies specific to allied health training programmes have demonstrated that simulation-based learning also helps increase learners' confidence and reduces anxiety related to clinical environments, activities and skills. Such evidence, together with increasing challenges in provision of workplace clinical education, has supported an expansion of integrating simulation-based learning into university curricula. AIMS To provide detailed information about the processes and considerations involved in the development of a simulation-based learning programme for speech-language pathology. METHODS & PROCEDURES Through reflection on the development process of a 5-day simulation-based learning programme, and in light of existing research in simulation, this paper outlines the important steps and considerations required for the development of a simulation-based learning programme to support student competency development in adult speech pathology range of practice areas. MAIN CONTRIBUTION A proposed framework for the development of future simulation-based learning programmes in speech-language pathology. CONCLUSIONS & IMPLICATIONS The framework can be applied to simulation-based learning for university programmes and/or workplace training in speech-language pathology and across several other health disciplines.
Collapse
Affiliation(s)
- Sally Hewat
- Speech Pathology Department, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW, Australia
| | - Adriana Penman
- School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia
| | - Bronwyn Davidson
- Melbourne School of Health Sciences, The University of Melbourne, VIC, Australia
| | | | - Simone Howells
- School of Allied Health Sciences, Griffith University, QLD, Australia
| | - Joanne Walters
- Speech Pathology Department, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW, Australia
| | - Alison Purcell
- Sydney School of Health Sciences, The University of Sydney, NSW, Australia
| | - Elizabeth Cardell
- School of Allied Health Sciences, Griffith University, QLD, Australia
| | - Patricia McCabe
- Sydney School of Health Sciences, The University of Sydney, NSW, Australia
| | - Emma Caird
- School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia
| | - Elizabeth Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia
- Centre for Functioning and Health Research, QLD, Australia
| | - Anne E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia
| |
Collapse
|
22
|
Giroux I, Pauzé E, Rosa M. [Apprentissage par simulation : activité novatrice de formation interprofessionnelle sur la gestion de la dysphagie]. CAN J DIET PRACT RES 2020; 81:44-48. [PMID: 31081679 DOI: 10.3148/cjdpr-2019-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Interprofessional patient simulations are an emerging pedagogical approach that is increasingly being used in the education of health professionals. Although the benefits of patient simulations have been widely documented in the fields of medicine and nursing, few studies have explored the potential of this approach in educating future dietitians. This article describes 4 patient simulations, including 2 interprofessional simulations, focused on the management of dysphagia, which were carried out as part of an Honours Bachelor in Nutrition Sciences program and discusses the potential merits of this teaching method in educating future dietitians.
Collapse
Affiliation(s)
- Isabelle Giroux
- Écoles des sciences de la nutrition, Université d'Ottawa, Ottawa, ON
| | - Elise Pauzé
- Écoles des sciences de la nutrition, Université d'Ottawa, Ottawa, ON
| | - Mylène Rosa
- Faculté d'éducation, Université d'Ottawa, Ottawa, ON
| |
Collapse
|
23
|
Miles A, Greig L, Jackson B, Keesing M. Evaluation of a tracheostomy education programme for speech-language therapists. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:70-84. [PMID: 31566861 DOI: 10.1111/1460-6984.12504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/28/2019] [Accepted: 09/11/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Tracheostomy management is considered an area of advanced practice for speech-language therapists (SLTs) internationally. Infrequent exposure and limited access to specialist SLTs are barriers to competency development. AIMS To evaluate the benefits of postgraduate tracheostomy education programme for SLTs working with children and adults. METHODS & PROCEDURES A total of 35 SLTs participated in the programme, which included a 1-day tracheostomy simulation-based workshop. Before the workshop, SLTs took an online knowledge quiz and then completed a theory package. The workshop consisted of part-task skill learning and simulated scenarios. Scenarios were video recorded for delayed independent appraisal of participant performance. Manual skills were judged as (1) completed successfully, (2) completed inadequately/needed assistance or (3) lost opportunity. Core non-medical skills required when managing a crisis situation and overall performance were scored using an adapted Ottawa Global Rating Scale (GRS). Feedback from participants was collected and self-perceived confidence rated prior, immediately post and 4 months post-workshop. OUTCOMES & RESULTS SLTs successfully performed 94% of manual tasks. Most SLTs (29 of 35) scored > 5 of 7 on all elements of the adapted Ottawa GRS. Workshop feedback was positive with significant increases in confidence ratings post-workshop and maintained at 4 months. CONCLUSIONS & IMPLICATIONS Postgraduate tracheostomy education, using a flipped-classroom approach and low- and high-fidelity simulation, is an effective way to increase knowledge, confidence and manual skill performance in SLTs across patient populations. Simulation is a well-received method of learning.
Collapse
Affiliation(s)
- Anna Miles
- Speech Science, The University of Auckland, Auckland, New Zealand
| | - Lucy Greig
- The University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
| | - Bianca Jackson
- Speech Science, The University of Auckland, Auckland, New Zealand
| | - Melissa Keesing
- Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
| |
Collapse
|
24
|
Jackson BN, Brady A, Friary P, Braakhuis A, Sekula J, Miles A. Educator–student talk during interprofessional simulation-based teaching. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2019; 6:206-213. [DOI: 10.1136/bmjstel-2019-000455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/08/2019] [Indexed: 01/24/2023]
Abstract
BackgroundSimulated learning environments are increasingly common in interprofessional education (IPE). While reflection is key to simulated learning, little is known about the nature of these conversations during simulation. The aim of this exploratory paper was to quantify communicative features of conversations during interprofessional simulation scenarios between dietetics students, speech-language therapy students and their educators.MethodsConversations between students and educators during the pauses between simulated scenario phases were recorded and transcribed. Student and educator utterances were quantitatively analysed for speech acts, question types and elements of IPE (clinical reasoning, roles and responsibilities, client and family centred care, interprofessional collaboration, clinical procedural tasks).ResultsAcross 1340 utterances from six scenarios, analyses of conversational speech acts and question types highlighted similar patterns of usage between two educators despite different clinical scenarios and professional backgrounds. Educators used a minimally higher proportion of open compared with closed questions, and higher-level problem-solving questions predominated in comparison to simple factual questioning. Educators used more requests for action and attention and students displayed more performative and responsive acts (p<0.05). Students were exposed to all elements of IPE through conversations in all scenarios.ConclusionsConversations during pauses in immersive simulated scenarios between educators and students enable rich IPE opportunities and higher-level problem-solving. Educators encouraged students to problem solve within and across disciplines with open questions. Educators provided few factual responses to questions themselves rather diverting questions back to the students. This approach to the analysis of conversation can support educators to evaluate their own communication during interprofessional simulations.
Collapse
|
25
|
Carter MD. The effects of computer-based simulations on speech-language pathology student performance. JOURNAL OF COMMUNICATION DISORDERS 2019; 77:44-55. [PMID: 30597345 DOI: 10.1016/j.jcomdis.2018.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 12/12/2018] [Accepted: 12/18/2018] [Indexed: 05/13/2023]
Abstract
PURPOSE The purpose of this study was to assess the efficacy of a computer-based simulated learning environment on student learning in speech-language pathology. Despite a growing trend in the implementation of computer-based simulated learning environments, no research yet supports its efficacy. In addition, although over half of the United States' speech-language pathologists work in school systems, no studies have investigated simulated learning environments that focus on pediatric developmental language disorders as the disorder to be exemplified by the simulations. METHOD Four different cohorts of students (103 total students) received either a traditional learning experience or a computer-based simulation experience in a graduate level school-aged language disorders course. Groups were equivalent in academic performance and pre-experimental knowledge. Pre- and post-experimental measures of learning were obtained. RESULTS Findings demonstrated that the group that was involved with the simulated learning environment outperformed the traditional instruction group in several key areas associated with clinically-based educational outcomes. CONCLUSIONS Simulated learning environments continue to be a positive innovation in the clinical education of speech-language pathology students. Implications potentially affect educational models of speech-language pathology.
Collapse
Affiliation(s)
- Matthew D Carter
- Valdosta State University, 1500 N. Patterson St., Valdosta, GA 31698, United States.
| |
Collapse
|
26
|
|
27
|
Gummesson C, Sundén A, Fex A. Clinical reasoning as a conceptual framework for interprofessional learning: a literature review and a case study. PHYSICAL THERAPY REVIEWS 2018. [DOI: 10.1080/10833196.2018.1450327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Christina Gummesson
- Center for Teaching and Learning at the Faculty of Medicine, Lund University, Lund, Sweden
| | - Anne Sundén
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Angelika Fex
- Department of Health Sciences, Lund University, Lund, Sweden
| |
Collapse
|
28
|
Rech RS, Baumgarten A, Colvara BC, Brochier CW, de Goulart B, Hugo FN, Hilgert JB. Association between oropharyngeal dysphagia, oral functionality, and oral sensorimotor alteration. Oral Dis 2018; 24:664-672. [PMID: 29164750 DOI: 10.1111/odi.12809] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/25/2017] [Accepted: 11/16/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate whether the oral functionality and the oral sensorimotor alterations are associated with oropharyngeal dysphagia in community-dwelling older persons and long-term care older residents. METHODS An exploratory study with 265 independent older persons of the southern state of Brazil. The diagnosis of dysphagia, as well as the condition of the oral sensorimotor system, was assessed by a speech-language therapist and the oral health status by a dentist. Poisson Regression with robust variance was used to calculate the crude and adjusted Prevalence Ratios (PR) and their respective confidence intervals of 95%. RESULTS The mean age was 73.5 (±8.9) years, women represented 59.2% of the sample. The frequency of dysphagia in the studied population was 45.3% (n = 120), being more frequent in the long-term care older residents (62.5%; n = 75) than in the community-dwelling older persons (37.5%; n = 45). Individuals with four or more oral sensorimotor alterations (PR = 2.01; 95% CI 1.27-3.18), as well as those who presented a non-functional oral status (PR = 1.61; 95% CI 1.02-2.54) presented a higher frequency of dysphagia. Subgroup analysis indicates the same trend of results, when stratified by community-dwelling older persons and long-term older residents. CONCLUSION A non-functional oral health status and oral sensorimotor alterations are associated with a higher prevalence of oropharyngeal dysphagia.
Collapse
Affiliation(s)
- R S Rech
- Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - A Baumgarten
- Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - B C Colvara
- Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - C W Brochier
- Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bng de Goulart
- Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Health and Human Communication, Institute of Psychology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - F N Hugo
- Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Center of Community Dental Health Research, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - J B Hilgert
- Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
29
|
Baylor C, Burns MI, Struijk J, Herron L, Mach H, Yorkston K. Assessing the Believability of Standardized Patients Trained to Portray Communication Disorders. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:791-805. [PMID: 28595263 PMCID: PMC5829793 DOI: 10.1044/2017_ajslp-16-0068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 10/24/2016] [Accepted: 12/27/2016] [Indexed: 05/19/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the believability of standardized patients portraying individuals with communication disorders as part of a larger study in which standardized patients help train medical and allied health students about communication disorders. METHOD Two women portrayed persons with aphasia, and 2 men depicted persons with dysarthria associated with Parkinson's disease. Two stakeholder groups rated believability. Speech-language pathologists rated believability of videos online. Persons with aphasia rated aphasia videos during in-person sessions with the researchers. RESULTS Targeted believability was 80 or higher (0-100 scale; 0 = not at all believable, 100 = very believable). For speech-language pathologist raters, average ratings met the target for the portrayals of the aphasia characteristics of word-finding problems, agrammaticism, nonverbal communication, and overall portrayal but not for auditory comprehension problems. Targets for the portrayals were met for the dysarthria characteristics of reduced speech movements, reduced loudness, reduced intonation, flat affect, and overall portrayal but not for speech rate. Ratings for different standardized patients portraying the same case were not significantly different from each other on most characteristics. Ratings from persons with aphasia were highly variable. CONCLUSION Standardized patients who do not have communication disorders can portray disorder characteristics in a believable manner.
Collapse
Affiliation(s)
- Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Michael I. Burns
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Jennie Struijk
- Department of Health Sciences Academic Services, University of Washington, Seattle
| | - Lindsay Herron
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Helen Mach
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle
| |
Collapse
|