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Gupta S, Parekh U, Bhargava DC. Reflective writing an assessment strategy for post-mortem observational activity in medical students. J Forensic Leg Med 2024; 106:102733. [PMID: 39089137 DOI: 10.1016/j.jflm.2024.102733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/25/2024] [Accepted: 07/28/2024] [Indexed: 08/03/2024]
Affiliation(s)
- Sanjay Gupta
- Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, Rajkot, Gujarat, India.
| | - Utsav Parekh
- Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, Rajkot, Gujarat, India.
| | - Daideepya Chandra Bhargava
- Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
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Edelist T, Friesen F, Ng S, Fernandez N, Bélisle M, Lechasseur K, Rochette A, Vachon B, Caty MÈ. Critical reflection in team-based practice: A narrative review. MEDICAL EDUCATION 2024. [PMID: 38973068 DOI: 10.1111/medu.15462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/08/2024] [Accepted: 05/29/2024] [Indexed: 07/09/2024]
Abstract
INTRODUCTION Research on critical reflection (a process of recognising and challenging assumptions that frame health care practice) has demonstrated strong potential for making health care more collaborative and equitable, yet its enactment within team-based health care remains underexplored. We conducted a narrative review to advance understanding of how critical reflection develops, occurs in and impacts team-based practice and care. METHODS We searched three databases (Medline, CINAHL and Scopus) for articles related to the concepts of critical reflection and/or critically reflective practice in the context of team-based health care and examined how teams engage with those theoretical concepts, to inform ideas for a new approach to support critically reflective practice. FINDINGS The search identified 974 citations of which nine articles showed elements of critical reflection in team-based practice. However, since only one of the nine included articles explicitly used the term 'critical reflection' in their research, critical reflection as a theoretical concept was found to be largely missing from the current team-based health care literature. Instead, aspects of critical reflection were evident in terms of challenging power hierarchies and questioning practice assumptions through dialogue, with a goal of collaborative practice. This sharing of knowledge and skills allowed teams to push boundaries and innovate together in practice. The included articles also emphasised the importance of creating a purposeful environment for open dialogue and practice change to occur. CONCLUSION To support equitable care through collaborative practices, we suggest dialogue as and for critical reflection should be explicitly developed and researched within team-based health care.
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Affiliation(s)
- Tracey Edelist
- Département d'Orthophonie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Farah Friesen
- Centre for Advancing Collaborative Healthcare and Education (CACHE), University Health Network, Toronto, Canada
| | - Stella Ng
- Centre for Advancing Collaborative Healthcare and Education (CACHE), University Health Network, Toronto, Canada
| | - Nicolas Fernandez
- Département de Médecine de Famille et de Médecine d'Urgence, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Marilou Bélisle
- Faculté d'Éducation, Université de Sherbrooke, Sherbrooke, Canada
| | | | - Annie Rochette
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation de Montréal (CRIR), Montreal, Canada
| | - Brigitte Vachon
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Marie-Ève Caty
- Département d'Orthophonie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Nagle KF, Pilkington B. Professionalism in the context of providing elective services: reflecting on bias. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024:1-5. [PMID: 38426507 DOI: 10.1080/17538068.2024.2323852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
We examine the provision of elective pronunciation services, such as intelligibility enhancement, to non-native speakers by speech language pathologists (SLPs). Practices associated with the 'modification' of non-native accent raise significant professionalism questions about bias for SLPs and healthcare professionals. These questions arise partly due to the socio-cultural context in which SLPs practice and their clients live, and the relational nature of communication. We argue that due to the ambiguity inherent in accent modification practices, SLPs must weigh a variety of considerations before determining the circumstances in which such services are professionally acceptable. Our argument is rooted in consideration of the complex nature of professionalism related to communication. After surveying potentially relevant models from other healthcare professions and finding them wanting, we support our position in light of current literature on topics such as accounts of functionality. We conclude by generalizing our anti-bias recommendations to interprofessional healthcare professionalism.
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Affiliation(s)
- Kathleen F Nagle
- Department of Speech-Language Pathology, School of Health & Medical Sciences, Seton Hall University, Nutley, NJ, USA
| | - Bryan Pilkington
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, USA
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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.
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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
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Brittlebank S, Sowers DJ. Developing Augmentative and Alternative Communication Competence in Preservice Speech-Language Pathologists: A Collaborative Model for Clinical Educators. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1-15. [PMID: 37850831 DOI: 10.1044/2023_ajslp-23-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
PURPOSE Practicing speech-language pathologists (SLPs) reveal a perceived lack of preparedness to deliver augmentative and alternative communication (AAC) services. This is concerning because it is indicative of inadequate graduate training in AAC. The purpose of this clinical focus article was to present a collaborative model of clinical education for AAC preservice training. This clinical focus article will provide recommendations to support practicing SLPs in the provision of effective clinical instruction for preservice clinicians working with individuals with complex communication needs who require AAC. METHOD There is an urgent need for improved training for clinical educators providing instruction in AAC. In this clinical focus article, a literature review of the existing evidence regarding best practices in clinical education and AAC training for SLPs was completed to explore current theoretical and practical approaches. The evidence was utilized to create a collaborative model of recommended clinical education in AAC. RESULTS There is limited guidance for clinical educators when it comes to training preservice clinicians. This clinical focus article provides recommendations for AAC training of preservice SLPs by clinical educators in the field of speech-language pathology. CONCLUSIONS The collaborative model proposed in this clinical focus article delivers a roadmap to guide practicing SLPs in the development of AAC clinical competence of preservice clinicians. Future research is needed to evaluate the effectiveness of the model.
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Affiliation(s)
- Savanna Brittlebank
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | - Dawn J Sowers
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
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Beamish N, Footer C, Lowe R, Cunningham S. Rehabilitation professions' core competencies for entry-level professionals: a thematic analysis. J Interprof Care 2024; 38:32-41. [PMID: 37551889 DOI: 10.1080/13561820.2023.2241519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 06/26/2023] [Indexed: 08/09/2023]
Abstract
Rehabilitation services are essential interventions designed to optimize functioning and reduce disability in individuals with health conditions. Eight core professions offer rehabilitation services: audiology, occupational therapy, physical and rehabilitation medicine, physiotherapy, psychology, prosthetics and orthotics, rehabilitation nursing, and speech-language pathology. These professions often work together to provide patient-centered care. Each rehabilitation profession has developed its own international or national document to describe entry-level competencies. However, it is not evident in the literature whether rehabilitation professions share the same core competencies. Therefore, we explored the international standards for rehabilitation professions to identify commonalities and differences in entry-level professionals' required core competencies. A thematic analysis of current, published, international, or national entry-level competencies documents was conducted to determine commonalities and differences in the core competence requirements for the eight rehabilitation professions. The following four themes were evident across all professions: (a) evidence-based clinical practice knowledge and skills; (b) culturally competent communication and collaboration; (c) professional reasoning and behaviors; and (d) interprofessional collaboration. This thematic analysis highlighted the commonalities among rehabilitation professionals and may be used to provide a greater understanding of how rehabilitation professionals can support and work together on interprofessional teams.
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Affiliation(s)
- Nicole Beamish
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | | | | | - Shala Cunningham
- Physiopedia, London, UK
- Department of Physical Therapy, Radford University, Radford, Virginia, USA
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Cook KJ, Messick C, Baylor C, McAuliffe MJ. A qualitative study of reflective practice in the workplace. Speech-language pathologists have their say. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-15. [PMID: 38058000 DOI: 10.1080/17549507.2023.2267193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
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.
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Affiliation(s)
- Kate J Cook
- School of Psychology Speech & Hearing, Te Kura Mahi ā-Hirikapo, University of Canterbury, Aotearoa, New Zealand
| | - Cheryl Messick
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, DC, USA
| | - Megan J McAuliffe
- School of Psychology Speech & Hearing, Te Kura Mahi ā-Hirikapo, University of Canterbury, Aotearoa, New Zealand
- New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Aotearoa, New Zealand
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Neal JW, Greenwald M. Self-Awareness and therapeutic alliance in speech-language treatment of traumatic brain injury. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:757-767. [PMID: 36178155 DOI: 10.1080/17549507.2022.2123041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Purpose: To investigate the relationships among client self-awareness, client perception of the therapeutic alliance, and speech-language pathologist (SLP) communicative self-awareness in dyads of SLPs and traumatic brain injury (TBI) clients.Method: Nineteen SLP-TBI client dyads (N = 38) engaged in the same collaborative therapy task. At baseline, client self-awareness and client perception of the therapeutic alliance was assessed. SLP communicative self-awareness was measured by 1) a prediction/reflection questionnaire about their own communicative behaviour, administered pre- and post-treatment sessions, and 2) self-evaluation during a novel procedure using video review within three hours after the session.Result: Client self-awareness was not associated with client perceptions of the therapeutic alliance. Client perceptions of the therapeutic alliance were related to specific communicative intentions of the SLP. Regarding SLP communicative self-awareness, SLPs predicted their primary communication modality with 66% accuracy. The video review procedure yielded more detailed SLP communicative self-awareness ratings and was completed within real-world clinical settings.Conclusion: TBI client self-awareness may not impact the establishment of a strong therapeutic alliance between SLP and client. The finding that specific communicative intentions of the SLP were related to client perception of the therapeutic alliance should prompt further efforts to measure SLP communicative intentions and behaviours during TBI treatment sessions.
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Affiliation(s)
- J Whitney Neal
- Department of Communication Sciences and Disorders, Wayne State University, Detroit, MI, USA
| | - Margaret Greenwald
- Department of Communication Sciences and Disorders, Wayne State University, Detroit, MI, USA
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Nichols K, Ttofari Eecen K, Crosbie S. The exploration of speech-language pathology students' perceptions and attitudes towards written clinical reflection. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:697-709. [PMID: 35924686 DOI: 10.1080/17549507.2022.2100930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Purpose: Written clinical reflection is frequently used in speech-language pathology training programs to develop student clinical skills. The aim of this study was to explore speech-language pathology students' perceptions towards written clinical reflection.Method: Seventy-two undergraduate speech-language pathology students completed an online survey. An observational research design was undertaken. Descriptive statistics were used to analyse quantitative data. Inductive content analysis was used for qualitative data analysis.Result: Speech-language pathology students reported that written clinical reflections are useful but also wanted to explore alternative ways to reflect. Most students used written clinical reflection to focus on self-improvement of clinical skills and a small number of students used reflection to consider stakeholders' points of view. Students wanted more guidance and feedback on written clinical reflections.Conclusion: The results indicate that written clinical reflection is a useful learning tool. To facilitate the development of reflection skills in speech-language pathology students, it is important to explicitly teach clinical reflection in university curricula and to receive guidance from professional practice educators.
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Affiliation(s)
- Kiah Nichols
- School of Allied Health, Australian Catholic University, Melbourne, 3065, Australia
| | - Kerry Ttofari Eecen
- Speech Pathology, Australian Catholic University, Melbourne, 3065, Australia
| | - Sharon Crosbie
- Speech Pathology, Australian Catholic University, Brisbane Campus, Virginia, 4014, Australia
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Armstrong E, Gapany D, Maypilama Ḻ, Bukulatjpi Y, Fasoli L, Ireland S, Lowell A. Räl-manapanmirr ga dhä-manapanmirr - Collaborating and connecting: Creating an educational process and multimedia resources to facilitate intercultural communication. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 24:533-546. [PMID: 35633090 DOI: 10.1080/17549507.2022.2070670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Purpose: Yolŋu (First Nations Australians from North-East Arnhem Land, Northern Territory) and Balanda (non-Indigenous people) often encounter communication challenges at a cultural interface during the provision of health and education services. To address these challenges, our project co-created an educational process and resources to inform and facilitate intercultural communication. During interactive workshops, participants and researchers from different cultural backgrounds reflected on their communication practice together in small groups. Reflection and discussion during the workshops were supported by multi-media resources designed to be accessible and resonant for both Yolŋu and Balanda partners. Participants explored and implemented strategies during intercultural engagement within and beyond the workshop. In this article we explain our processes of co-creating intercultural communication education and share features of our educational process and resources that resonated with participants from both cultural groups.Method: Our intercultural team of researchers used a culturally-responsive approach to Participatory Action Research (PAR) to co-create an intercultural communication workshop and multi-media resources collaboratively with 52 Yolŋu and Balanda end-users.Result: Collaborating (the power and value of genuine collaboration and engagement throughout the process) and connecting (the meeting and valuing of multiple knowledges, languages and modes of expression) were key elements of both our methods and findings. Our processes co-created accessible, inclusive, collaborative spaces in which researchers and participants were actively supported to implement intercultural communication processes as they learned about them.Conclusion: Our work may have relevance for others who are developing educational processes and resources for facilitating intercultural communication in ways that honour participants' voices, challenge inaccessible systems, resonate with diverse audiences and create opportunities for research translation.Explanation of terms• Yolŋu are First Nations Australians from North-East Arnhem Land in the Northern Territory of Australia.• Balanda is a term used by speakers of Yolŋu languages to refer to non-Indigenous people.• First Nations Australians is used to include diverse Aboriginal and Torres Strait Islander peoples in Australia. This term recognises the identities of First Nations peoples who hold unceded sovereignty over their lands and waters.• The pronouns we, us and our are used to refer to the intercultural research team who are also authors (i.e. Emily, Gapany, Ḻäwurrpa, Yuŋgirrŋa and supervisors Anne, Lyn and Sarah). When sharing other people's perspectives, or the voices of individual researchers, the text will specify whose voice is being shared.
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Affiliation(s)
- Emily Armstrong
- Northern Institute, College of Indigenous Futures, Education and the Arts, Charles Darwin University, Darwin, NT, Australia
| | - Dorothy Gapany
- Northern Institute, College of Indigenous Futures, Education and the Arts, Charles Darwin University, Darwin, NT, Australia
| | - Ḻäwurrpa Maypilama
- Molly Wardaguga Research Centre, Charles Darwin University, Darwin, NT, Australia
| | | | - Lyn Fasoli
- Northern Institute, College of Indigenous Futures, Education and the Arts, Charles Darwin University, Darwin, NT, Australia
| | - Sarah Ireland
- Molly Wardaguga Research Centre, Charles Darwin University, Darwin, NT, Australia
| | - Anne Lowell
- Northern Institute, College of Indigenous Futures, Education and the Arts, Charles Darwin University, Darwin, NT, Australia
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Schaepkens SPC, Veen M, de la Croix A. Is reflection like soap? a critical narrative umbrella review of approaches to reflection in medical education research. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:537-551. [PMID: 34767115 PMCID: PMC9117338 DOI: 10.1007/s10459-021-10082-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 10/31/2021] [Indexed: 05/21/2023]
Abstract
Reflection is a complex concept in medical education research. No consensus exists on what reflection exactly entails; thus far, cross-comparing empirical findings has not resulted in definite evidence on how to foster reflection. The concept is as slippery as soap. This leaves the research field with the question, 'how can research approach the conceptual indeterminacy of reflection to produce knowledge?'. The authors conducted a critical narrative umbrella review of research on reflection in medical education. Forty-seven review studies on reflection research from 2000 onwards were reviewed. The authors used the foundational literature on reflection from Dewey and Schön as an analytical lens to identify and critically juxtapose common approaches in reflection research that tackle the conceptual complexity. Research on reflection must deal with the paradox that every conceptualization of reflection is either too sharp or too broad because it is entrenched in practice. The key to conceptualizing reflection lies in its use and purpose, which can be provided by in situ research of reflective practices.
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Affiliation(s)
- Sven P C Schaepkens
- Department of General Practice, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands.
| | - M Veen
- Department of General Practice, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - A de la Croix
- Faculty of Medicine, Vrije Universiteit Amsterdam, Postbus 7057, 1007 MB, Amsterdam, The Netherlands
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12
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McCluskey J, Gallagher AL, Murphy CA. Reflective practice across speech and language therapy and education: a protocol for an integrative review. HRB Open Res 2022; 4:29. [PMID: 34853822 PMCID: PMC8591512 DOI: 10.12688/hrbopenres.13234.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 12/23/2022] Open
Abstract
Effective co-practice is considered a linchpin of inclusive education. Speech and language therapists (SLT), in collaboration with teachers, are amongst the professionals who have a role in ensuring inclusion for students. The challenges of collaboration are well documented, with communication considered a potential antidote. Proposals for how collaborative communication can take place often align with models of reflection. Uncertainty around a shared language for reflection within and across the professions of teaching and SLT may pose a barrier to it occurring. Reflection has long been documented as a strategy used by effective clinicians to improve practice. Hence, teachers and SLTs reflecting together could be considered 'a port of entry' for effective collaborative practice. This study aims to synthesise literature and knowledge on the phenomenon of reflective practice across the professions to facilitate collaboration for inclusive education. The method of qualitative evidence synthesis will be an integrative review. A systematic search will be conducted to extract empirical studies, reviews and theoretical papers on the topic of reflection across both professions. An adapted version of the PRISMA reporting guidelines will be used in the development, design and reporting of this review. Four databases will be searched: CINAHL, SCOPUS, Education Source and ERIC. A web-based search will also be conducted to retrieve relevant policy documents. Included literature will be appraised using the M-MAT and an adapted checklist from the Joanna Briggs Institute. Deductive content analysis will endeavour to determine if a shared language exists about reflection, across the professions of teaching and speech and language therapy. Establishing a shared language represents a first step towards the development of a framework for collaborative reflection between teachers and SLTs. This is turn serves to inform future research, policy and practice regarding how speech and language therapist can work collaboratively with teachers in schools.
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Affiliation(s)
- Jessica McCluskey
- School of Allied Health, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland,
| | - Aoife L. Gallagher
- School of Allied Health, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland,Health Implementation Science and Technology Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Carol-Anne Murphy
- School of Allied Health, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland,Health Implementation Science and Technology Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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13
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McCluskey J, Gallagher AL, Murphy CA. Reflective practice across speech and language therapy and education: a protocol for an integrative review. HRB Open Res 2021; 4:29. [PMID: 34853822 DOI: 10.12688/hrbopenres.13234.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 11/20/2022] Open
Abstract
Effective co-practice is considered a linchpin of inclusive education. Speech and language therapists (SLT), in collaboration with teachers, are amongst the professionals who have a role in ensuring inclusion for students. The challenges of collaboration are well documented, with communication considered a potential antidote. Proposals for how collaborative communication can take place often align with models of reflection. Uncertainty around a shared language for reflection within and across the professions of teaching and SLT may pose a barrier to it occurring. Reflection has long been documented as a strategy used by effective clinicians to improve practice. Hence, teachers and SLTs reflecting together could be considered 'a port of entry' for effective collaborative practice. This study aims to synthesise literature and knowledge on the phenomenon of reflective practice across the professions to facilitate collaboration for inclusive education. The method of qualitative evidence synthesis will be an integrative review. A systematic search will be conducted to extract empirical studies, reviews and theoretical papers on the topic of reflection across both professions. An adapted version of the PRISMA reporting guidelines will be used in the development, design and reporting of this review. Four databases will be searched: CINAHL, SCOPUS, Education Source and ERIC. A web-based search will also be conducted to retrieve relevant policy documents. Included literature will be appraised using the M-MAT and an adapted checklist from the Joanna Briggs Institute. Deductive content analysis will endeavour to determine if a shared language exists about reflection, across the professions of teaching and speech and language therapy. Establishing a shared language represents a first step towards the development of a framework for collaborative reflection between teachers and SLTs. This is turn serves to inform future research, policy and practice regarding how speech and language therapist can work collaboratively with teachers in schools.
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Affiliation(s)
- Jessica McCluskey
- School of Allied Health, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland
| | - Aoife L Gallagher
- School of Allied Health, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland.,Health Implementation Science and Technology Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Carol-Anne Murphy
- School of Allied Health, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland.,Health Implementation Science and Technology Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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14
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McCarthy B, Bessell N, Murphy S, Hartigan I. "Nursing and speech and language students' perspectives of reflection as a clinical learning strategy in undergraduate healthcare education: A qualitative study". Nurse Educ Pract 2021; 57:103251. [PMID: 34775226 DOI: 10.1016/j.nepr.2021.103251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/19/2021] [Accepted: 10/29/2021] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to explore nursing and speech and language students' perspectives of reflection as a clinical learning strategy during years three and four of their undergraduate education programmes. BACKGROUND Reflection is recognised as a core student learning activity which is widely used in undergraduate healthcare education for clinical practice. Studies indicate that structured models and frameworks do help novice students to develop the process of reflection-on-practice particularly in years one and two. However, there is limited research on healthcare students' perspectives of reflection as a clinical learning strategy in the latter years of their undergraduate healthcare education (years 3 and 4). DESIGN A qualitative descriptive design was used. METHODS Using a self-reporting method whereby students respond to a series of questions posed by the researchers, data were collected from nursing (n = 20) and speech and language students (n = 26) in one university in Ireland and analysed using thematic analysis. RESULTS The findings from both nursing and speech and language students were similar. Three themes identified included: description of reflection, undertaking reflection and contribution to clinical learning. Most students expressed beneficial effects of reflection for personal and professional clinical learning. Some students reported negativities to the written reflections, expressing a preference for more diverse and less structured strategies and more face-to-face reflective discussions with clinical educators. CONCLUSIONS Whilst the benefits of reflection for clinical practice are well versed in this study, the authors suggest that academic and clinical educators employ more diverse and innovative reflective tools for healthcare students who are at a more competent level of their undergraduate education programme. Further interprofessional research in relation to different clinical reflective strategies for healthcare students in years three and four of their undergraduate education programmes is warranted.
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Affiliation(s)
- Bridie McCarthy
- School of Nursing & Midwifery, University College Cork, Cork, Ireland.
| | - Nicola Bessell
- School of Clinical Therapies, University College Cork, Cork, Ireland.
| | - Siobhan Murphy
- School of Nursing and Midwifery, University College Cork, Ireland.
| | - Irene Hartigan
- School of Nursing and Midwifery, University College Cork, Ireland.
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15
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Moorcroft A, Allum J, Scarinci N. Speech language pathologists' responses to the rejection or abandonment of AAC systems. Disabil Rehabil 2021; 44:4257-4265. [PMID: 33745410 DOI: 10.1080/09638288.2021.1900412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: This study aimed to explore the reported responses of speech-language pathologists (SLPs) to the rejection or abandonment of AAC systems for children with complex communication needs.Methods: Semi-structured in-depth interviews were conducted with 16 SLPs who worked with children with complex communication needs. Interviews were transcribed and coded using thematic analysis.Results: Four themes describing SLPs' responses were identified: (1) SLPs work with families; (2) SLPs respect families' wishes; (3) SLPs "push ahead" with AAC irrespective of families' wishes; and (4) SLPs reflect and acknowledge emotions.Conclusions: SLPs varied in the degree to which they remained family-centred and utilised clinical reflection following the rejection or abandonment of AAC systems for the children they worked with. SLPs also described experiencing a range of negative emotions following the rejection or abandonment of an AAC system, which could impact upon ongoing client care.Implications for RehabilitationIn this research SLPs reported variability in the degree to which they remained family-centred following the rejection or abandonment of an AAC system for the children they worked with.SLPs should reflect on their emotional responses to the rejection or abandonment of AAC systems by their clients.This research suggests that SLP services should consider monitoring the reflective practices of their clinicians to ensure ongoing clinical development and optimisation of client care.
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Affiliation(s)
- Alison Moorcroft
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Jennifer Allum
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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16
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Chahda L, Carey LB, Mathisen BA, Threats T. Speech-language pathologists and adult palliative care in Australia. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:57-69. [PMID: 32182437 DOI: 10.1080/17549507.2020.1730966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE This research explored the role of Australian Speech-Language Pathologists (SLPs) to identify SLP experiences and practices regarding adult palliative care (PC) management. METHOD Utilising mixed methods, phase one comprised a literature scoping review of SLP practices in PC. Phase two involved a survey compiling demographic data of Australian SLPs working in adult PC. Phase three involved in-depth interviews exploring SLP experiences in PC. RESULT It was found that minimal resources or published literature existed regarding SLPs in PC, however the available literature indicated SLPs can be valuable and influential members of a PC team. Interviewed SLPs acknowledged their proficiency in end-of-life communication and swallowing, nevertheless initially they felt ill-prepared given insufficient knowledge or skills to manage palliative cases based upon their tertiary education and were poorly supported once in the field given a lack of clinical practice guidelines (CPGs). Participants also noted a lack of knowledge among medical, nursing and allied health clinicians about a SLP's contribution to PC, causing barriers for SLPs being professionally accepted within palliative environments. CONCLUSION Recommendations included the development of improved resources specifically about SLP practice in end-of-life care, the need for greater exposure at the tertiary level of SLP palliative care practices, and CPGs for SLPs working in adult palliative care.
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Affiliation(s)
- Laura Chahda
- Department of Audiology and Speech Pathology, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Lindsay B Carey
- Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Bernice A Mathisen
- Discipline of Speech Pathology, School of Health and Human Sciences, Southern Cross University, Gold Coast, Australia, and
| | - Travis Threats
- Department of Communication Sciences and Disorders, University of St. Louis, St. Louis, MI, USA
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17
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Alary Gauvreau C, Le Dorze G. Participant reported outcomes of a community of practice about social participation for speech-language pathologists in aphasia rehabilitation. Disabil Rehabil 2020; 44:231-242. [PMID: 32441986 DOI: 10.1080/09638288.2020.1764116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose: Because of their communication difficulties, persons with aphasia are at risk of not fully participating in significant activities after rehabilitation. Speech-language pathologists can contribute to support optimal social participation in rehabilitation. A community of practice (CoP) was designed to provide motivated clinicians with opportunities to acquire knowledge and reflect on social participation within aphasia rehabilitation. The aim of this study was to describe the outcomes of this CoP according to the perspectives of speech-language pathologist participants.Methods: Semi-structured individual interviews were conducted 4 to 10 weeks after the end of the CoP with 13 speech-language pathologist participants. Analyses were guided by grounded theory.Results: Participants perceived that the CoP experience contributed to a better alignment of their practice with the ideal end purpose of optimizing social participation. A sense of community emerged among CoP members, who collectively reflected on their practice. Participants stated feeling equipped to adopt new practices, adopting new practices for optimizing social participation, and/or advocating for better services for persons with aphasia. They felt increased confidence, motivation, well-being, and/or energy towards their practice.Conclusions: CoPs can help speech-language pathologists to more confidently practice with the goal of optimizing the social participation of persons with aphasia.Implications for rehabilitationSpeech-language pathologists in aphasia rehabilitation, as a result of being involved in a community of practice (CoP) about social participation, may offer more evidence-based services aiming at optimizing the social participation of persons with aphasia.Markers of a successful CoP may include participants' increased feelings of confidence, motivation, well-being, and/or energy towards their practice.CoPs can be used for continuing education purposes and support the development of clinical expertise among professionals, such as speech-language pathologists in aphasia rehabilitation.
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Affiliation(s)
- Christine Alary Gauvreau
- School of Speech-Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada.,Jewish Rehabilitation Hospital, Centre intégré de santé et de services sociaux de Laval, Laval, Canada
| | - Guylaine Le Dorze
- School of Speech-Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
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18
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Dunn K, Rumbach A, Finch E. Dysphagia in non-traumatic subarachnoid haemorrhage: a scoping review. Neurosurg Rev 2019; 43:1079-1087. [PMID: 31377942 DOI: 10.1007/s10143-019-01155-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/11/2019] [Accepted: 07/29/2019] [Indexed: 10/26/2022]
Abstract
There is currently limited information regarding dysphagia following non-traumatic subarachnoid haemorrhage (SAH), which impacts upon speech-language pathologists' (SLP) decisions when providing clinical care for this patient cohort. This scoping review aims to summarise the available evidence on the topic and identify gaps in the literature. The scoping review framework as described by Arskey and O'Malley (Soc Res Methodol 8(1):19-32, 2005) was used. Searches were undertaken in six databases. Inclusion criteria included that participants were adults (18+ years), with a primary diagnosis of non-traumatic SAH, and dysphagia occurred as a result of non-traumatic SAH. Data was extracted by the primary author independently and cross-checked by the second author. Data extracted included year of publication, study location, population, aims of the study, study design, method used to identify dysphagia, who completed the assessment, dysphagia incidence, dysphagia type and severity, risk factors, characteristics, and intervention details. Ten studies were included. Dysphagia was diagnosed based on staff reports, screening, clinical swallowing examination, and/or instrumental swallowing assessment with considerable variability identified across studies with regard to incidence (range 0.9-100%). Studies were highly heterogeneous with regard to dysphagia assessment practice, risk factors, characteristics, provision of intervention, and outcomes. The current evidence regarding dysphagia following non-traumatic SAH is insufficient to provide best practice guidelines for assessment and management recommendations. Emerging evidence will inform healthcare professionals managing dysphagia in individuals following non-traumatic SAH. Future research with more rigorous study designs will promote evidence-based clinical care standards for this population.
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Affiliation(s)
- Katrina Dunn
- Speech Pathology Department, West Moreton Health, Queensland Health, Ipswich, Queensland, Australia. .,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Anna Rumbach
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Emma Finch
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.,Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Australia.,Speech Pathology Department, Princess Alexandra Hospital, Metro South Hospital and Health Service, Queensland Health, Brisbane, Queensland, Australia
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19
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Ziebart C, MacDermid JC. Reflective Practice in Physical Therapy: A Scoping Review. Phys Ther 2019; 99:1056-1068. [PMID: 30921467 PMCID: PMC6665949 DOI: 10.1093/ptj/pzz049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 11/12/2018] [Indexed: 11/13/2022]
Abstract
BACKGROUND Many practitioners experience complex, uncertain, and unique clinical practice situations that can be navigated with reflection. Little is known about the theoretical and pragmatic perspectives of reflection in physical therapy. PURPOSE The purpose of this paper was to examine the literature on reflection in physical therapy and identify gaps in the literature. DATA SOURCE The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, EMBASE, Scopus, and PsycINFO were used to identify articles. STUDY SELECTION Studies were selected to describe: (1) theoretical concepts related to reflection, (2) examples of reflection, and (3) the use of reflection in clinical or educational contexts. DATA EXTRACTION Authors, year of publication, country of origin, publication type or source, methodology, conceptual approach (including terminology used, definition of terminology used), and practical approach (including theoretical underpinning, context of reflection/reflective practice, and target group) guided the data extraction. DATA SYNTHESIS A total of 46 articles were reviewed spanning from 1992 to 2017, which included research studies, field articles, editorials, and a review article. Theoretical underpinnings of reflection were based on the thoughts of Donald Schön. Written approaches to reflection were most common, and reflection was used to inform education, clinical practice, and professional growth. LIMITATIONS As with any review paper, there is a certain level of interpretation required when collating and interpreting data. CONCLUSIONS Reflection in physical therapy could be advanced by a thorough conceptualization of reflective practice, a broader and deeper pool of research to inform optimal implementation of reflection across the career span from learners to experts, and a clear definition and linkage of reflection to epistemologies of physical therapy practice.
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Affiliation(s)
- Christina Ziebart
- Health and Rehabilitation Sciences, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada,Address all correspondence to Ms Ziebart at:
| | - Joy C MacDermid
- Physical Therapy and Surgery, Western University; Clinical Research Lab, Hand, and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario, Canada; and Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
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20
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Alary Gauvreau C, Le Dorze G, Kairy D, Croteau C. Evaluation of a community of practice for speech-language pathologists in aphasia rehabilitation: a logic analysis. BMC Health Serv Res 2019; 19:530. [PMID: 31358002 PMCID: PMC6664764 DOI: 10.1186/s12913-019-4338-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 07/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aphasia is a communication disorder affecting participation. Although there are evidence-based practice recommendations about participation and aphasia rehabilitation, it may be challenging for speech-language pathologists to ensure that rehabilitation activities have an impact on the person's participation, in part due to time limitations. Participation remains limited after rehabilitation for persons who have aphasia. Communities of practice (CoPs) are a collaborative knowledge transfer strategy that can be used for evidence-based practice implementation. The aim of this study was to describe the components and evaluate a CoP for speech-language pathologists about participation and aphasia rehabilitation. METHODS Logic analysis was used to determine the adequacy between resources, implemented activities, outputs and short-term outcomes of the CoP. Qualitative and quantitative descriptive data were collected through observation and participants' logbooks. Outputs and outcomes of the CoP were revealed through thematic analysis and interpretation of descriptive statistics. RESULTS Resources including CoP design and educational aims, human and material resources were combined to create various web-based, online and offline activities. Participants invested more time per week than expected in the CoP, shared and created clinical tools and appreciated the array of suggested activities. Participant engagement allowed them to reflect, interact and collaborate with each other. All 13 participants reported they acquired knowledge about clinical tools and 12 mentioned they reflected on their practice. While the CoP was ongoing, six participants noticed evidence-practice gaps, seven prepared to change their practice, and three changed their practice towards including more participation-based considerations. CONCLUSIONS This study showed that speech-language pathologists can include more participation-based approaches in aphasia rehabilitation as a result of participating in a time-bound, web-based CoP.
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Affiliation(s)
- Christine Alary Gauvreau
- School of Speech-Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. .,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada. .,Jewish Rehabilitation Hospital, Centre intégré de santé et de services sociaux de Laval, Laval, Quebec, Canada.
| | - Guylaine Le Dorze
- School of Speech-Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Claire Croteau
- School of Speech-Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
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21
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Millar C, Carey LB, Fortune T, Mathisen BA, Hill AE, Dukhno J, McKenzie B. Global citizenship: Defining capabilities for speech-language pathology. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 21:317-324. [PMID: 31084263 DOI: 10.1080/17549507.2019.1607902] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 03/25/2019] [Accepted: 04/11/2019] [Indexed: 06/09/2023]
Abstract
Purpose: This paper outlines the findings of a scoping review of the literature relating to global citizenship. The purpose of the review was to develop a working definition and associated capabilities for assessing global citizenship among speech-language pathologists (SLPs), which may also prove helpful to other health professionals and for educating tertiary students. Method: Using Arksey and O'Malley's scoping review framework, key databases were searched, namely Medline, CINAHL, PsycINFO, the Cochrane Library and Google Scholar. Subsequently the Medical Subject Heading (MeSH) terms were applied for coding and categorising initial research findings. Articles were individually appraised using the Critical Appraisal Skills Programme tool (CASP). Result: Of the 2126 articles identified, 21 articles were determined to satisfy the search criteria. The literature revealed nine capabilities associated with global citizenship appropriate for health professionals including SLPs. Conclusion: Based on the findings, a working definition is determined for assessing professional global citizenship capabilities, which will prove useful for improving occupational standards, for charting competencies, and ultimately enhancing professional capability.
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Affiliation(s)
- CaraJane Millar
- a Department of Education and Training , Victoria Government , Melbourne , Australia
- b Department of Public Health School of Psychology and Public Health , La Trobe University , Melbourne , Australia
| | - Lindsay B Carey
- b Department of Public Health School of Psychology and Public Health , La Trobe University , Melbourne , Australia
| | - Tracy Fortune
- c Department of Community and Clinical Allied Health, School of Allied Health , La Trobe University , Melbourne , Australia
| | - Bernice A Mathisen
- d Speech Pathology, School of Health and Human Sciences , Southern Cross University , Queensland , Australia
| | - Anne E Hill
- e School of Health and Rehabilitation Sciences , The University of Queensland , Queensland , Australia
| | - Julia Dukhno
- f Department of Speech Pathology, Health Sciences , University of Sydney , Sydney , Australia , and
| | - Bridie McKenzie
- g Department of Medicine School of Health , University of Wollongong , Wollongong , Australia
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22
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Pace AE, Krings K, Dunlap J, Nehilla L. Service and Learning at a Residential Parenting Program for Incarcerated Mothers: Speech-Language Pathology Student Outcomes and Maternal Perspectives. Lang Speech Hear Serv Sch 2019; 50:308-323. [DOI: 10.1044/2018_lshss-ccjs-18-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
This article reports preliminary outcomes from a service-learning (SL) experience for graduate students in the Speech-Language Pathology program with incarcerated mothers who reside with their infants at a residential parenting program. We present an ecological model to serve as a framework for interpreting the impact of the experience on student learning and maternal perceptions.
Method
Graduate speech-language pathology students (total
n
= 30) participated in an SL project, called the
Partnership for Healthy Parenting
. With faculty guidance, students implemented parent education and child development workshops designed to foster secure attachment relationships, enhance the quality of mother–child interactions, and promote communication and language development. Students completed self-report scales measuring civic attitudes and self-efficacy before participating; they also provided written reflections about their experience that were analyzed qualitatively. Mothers completed voluntary feedback surveys after each workshop.
Results
Student reflections revealed a variety of perceived positive learning outcomes related to personal attitudes and beliefs about their role as a clinician, family-centered practices in early intervention, and knowledge about the population of interest. Feedback surveys administered to mothers who attended the workshops indicated satisfaction relating to the value of the services provided.
Conclusions
SL programs may benefit students, faculty, communities, higher education institutions, and the relationships among all these stakeholders. Results, limitations, and implications for strengthening university–community collaborations in the field of communication disorders are discussed.
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Affiliation(s)
- Amy E. Pace
- Department of Speech & Hearing Sciences, University of Washington, Seattle
| | - Kate Krings
- Department of Speech & Hearing Sciences, University of Washington, Seattle
| | - Julie Dunlap
- Department of Speech & Hearing Sciences, University of Washington, Seattle
| | - Lauren Nehilla
- Department of Speech & Hearing Sciences, University of Washington, Seattle
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Rogers SL, Priddis LE, Michels N, Tieman M, Van Winkle LJ. Applications of the reflective practice questionnaire in medical education. BMC MEDICAL EDUCATION 2019; 19:47. [PMID: 30732611 PMCID: PMC6367754 DOI: 10.1186/s12909-019-1481-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 01/30/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND We sought to determine whether the Reflective Practice Questionnaire (RPQ) is a reliable measure of reflective capacity and related characteristics in medical students. We also planned to learn how the RPQ could be used in medical education. METHODS The RPQ is a 40 item self-report questionnaire that includes a multi-faceted approach to measuring reflective capacity. It also includes sub-scales on several other theoretically relevant constructs such as desire for improvement, confidence, stress, and job satisfaction. The reliabilities of reflective capacity and other sub-scales were determined by calculating their Cronbach alpha reliability values. In the present study, the RPQ was answered by 98 graduating fourth-year medical students from an American University, and these RPQ scores were compared with general public and mental health practitioner samples from a prior study using ANOVA and Bonferroni adjusted comparisons. RESULTS Medical students reported a higher reflective capacity than the general public sample, but students were statistically indistinguishable from the mental health practitioner sample. For medical students, reflective capacity was associated with features of confidence, stress, and desire for improvement. Job satisfaction was positively associated with confidence in communication with patients, and negatively associated with stress when interacting with patients. A cluster analysis revealed that around 19% of the medical students exhibited a relatively high level of anxiety interacting with patients, 23% were less engaged, 5% were dissatisfied, and 7% expressed a level of over-confidence in their knowledge and skills that was concerning. CONCLUSIONS The RPQ is a reliable measure of reflective capacity (Chronbach's alpha value = 0.84) and related characteristics (Cronbach's alpha values from 0.75 to 0.83) in medical students. The RPQ can be used as part of pre-post evaluations of medical education initiatives, to complement student self-reflection activities in the curriculum, and to identify students who might benefit from targeted intervention.
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Affiliation(s)
| | | | - Nicole Michels
- Department of Medical Humanities, Rocky Vista University, 8401 S. Chambers Road, Parker, CO 80134 USA
| | - Michael Tieman
- Department of Medical Humanities, Rocky Vista University, 8401 S. Chambers Road, Parker, CO 80134 USA
| | - Lon J. Van Winkle
- Department of Medical Humanities, Rocky Vista University, 8401 S. Chambers Road, Parker, CO 80134 USA
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Cook K, Tillard G, Wyles C, Gerhard D, Ormond T, McAuliffe M. Assessing and developing the written reflective practice skills of speech-language pathology students. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 21:46-55. [PMID: 28925287 DOI: 10.1080/17549507.2017.1374463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 08/21/2017] [Accepted: 08/25/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Written reflective practice aims to support critical thinking and problem solving skills in speech-language pathology (SLP) clinical education programmes. Yet, there has been limited investigation of students' development of written reflective practice skills over time and during a real-time clinical experience. The purpose of this study was to investigate students' development of breadth and depth of written reflective practice across a six-week clinical experience. METHOD Participants were 59 undergraduate and 14 postgraduate SLP students. Participants wrote critical reflections describing an interaction with a client/s at the conclusion of weeks two, four and six of their clinical experience. Formative feedback was provided after each submission. Breadth and depth of reflection were coded using a modification of Plack et al.'s coding schema. RESULT There was a statistically significant association between time and likelihood of development of breadth of reflection for the elements process and content. Depth of reflection improved significantly across time. The majority of participants were classified as "reflectors" or critical reflector at the conclusion of the study. CONCLUSION SLP students can make significant improvements in both breadth and depth of written reflective practice over a six-week period. Implications for clinical teaching are discussed.
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Affiliation(s)
- Kate Cook
- a Department of Communication Disorders , University of Canterbury , Christchurch , New Zealand and
| | - Gina Tillard
- a Department of Communication Disorders , University of Canterbury , Christchurch , New Zealand and
| | - Christine Wyles
- a Department of Communication Disorders , University of Canterbury , Christchurch , New Zealand and
| | - Daniel Gerhard
- b Department of Mathematics and Statistics , University of Canterbury , Christchurch , New Zealand
| | - Tika Ormond
- a Department of Communication Disorders , University of Canterbury , Christchurch , New Zealand and
| | - Megan McAuliffe
- a Department of Communication Disorders , University of Canterbury , Christchurch , New Zealand and
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Richard A, Gagnon M, Careau E. Using reflective practice in interprofessional education and practice: a realist review of its characteristics and effectiveness. J Interprof Care 2018; 33:424-436. [PMID: 30513235 DOI: 10.1080/13561820.2018.1551867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This article presents the results of a realist review of the use of reflective practice interventions aimed at improving interprofessional education and collaborative practice (IPECP). Reflective practice is recognized as one of the determining factors in health and social service professionals' skills development and maintenance, as well as in the establishment of good collaboration practices. In this respect, it is a key element of interprofessional education (IPE) and its relevance in this field is being asserted more and more strongly. However, few studies have been conducted to document its effectiveness. The purpose of this article is therefore to advance knowledge in this field. Searches in health and social services electronic databases identified six studies presenting reflective practice interventions in IPECP aimed at enhancing collaboration among students or practicing professionals. Analysis provided preliminary answers as to the effectiveness of reflective practice interventions in IPECP, as well as pertinent information on the best methods for achieving effectiveness. It concludes by proposing recommendations designed to change reflective practice interventions in IPECP and by stressing the importance of further research in order to document more fully the effectiveness of reflective practice in IPECP and to identify the most promising intervention methods in this regard.
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Affiliation(s)
- Amélie Richard
- Centre for interdisciplinary research in rehabilitation and social integration (CIRRIS) , Quebec City , Canada
| | - Mathieu Gagnon
- Education Faculty, Université de Sherbrooke , Sherbrooke , Canada.,Centre de recherche interuniversitaire sur la formation et la profession enseignante-CRIFPE (Centre for interuniversity research in teacher training and the teaching profession) , Sherbrooke , Canada
| | - Emmanuelle Careau
- Centre for interdisciplinary research in rehabilitation and social integration (CIRRIS) , Quebec City , Canada.,Rehabilitation department, Faculty of medicine, Université Laval , Quebec City , Canada.,Centre de recherche sur les soins et les services de première ligne de l'Université Laval- CERSSPL-UL (Centre for research on primary care of Université Laval) , Quebec City , Canada
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Krikheli L, Mathisen BA, Carey LB. Speech-language pathology in paediatric palliative care: A scoping review of role and practice. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:541-553. [PMID: 28665209 DOI: 10.1080/17549507.2017.1337225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/17/2017] [Accepted: 05/25/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Attempts have been made within the literature to clarify the role and scope of speech-language pathologists (SLPs) within paediatric palliative care (PPC). As SLP literature regarding adult/geriatric populations is gaining traction, it is fitting to investigate the role of SLPs in the management of infants and children in end-of-life care. METHOD Arksey and O'Malley's ( 2005 ) scoping review method was utilised for searching multiple databases. Two database searches were undertaken. The first located literature in which SLP PPC intervention is specifically addressed. The second search utilised internationally recognised SLP scope of practice areas. Manual searching of reference lists was also utilised. RESULT Themes identified included management of communication, feeding, upper-airway and oral health as well as the role of SLPs within a multidisciplinary PPC team. CONCLUSION There is acknowledgement that SLPs have a role in PPC. However, there is little information identifying SLP involvement in the diagnosis and management of swallowing, cognition/communication, oral hygiene and upper airway issues. The available literature predominantly relies on limited adult palliative care research and does not address age-specific management approaches across the paediatric life-stage. Given an absence of SLP PPC guidelines, further research is warranted to explicitly define SLP scope of practice within this population.
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Affiliation(s)
- Lillian Krikheli
- a Palliative Care Unit, School of Psychology and Public Health , La Trobe University , Melbourne , Australia
- b Cabrini Health , Victoria , Australia , and
| | - Bernice A Mathisen
- c Department of Community and Allied Health , La Trobe Rural Health School, La Trobe University , Bendigo , Australia
| | - Lindsay B Carey
- a Palliative Care Unit, School of Psychology and Public Health , La Trobe University , Melbourne , Australia
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Abstract
The purpose of this paper is to evaluate the concept reflection as a process using a principle-based method of analysis that acknowledges the philosophical premises of formal cognitive operations (experiencing, understanding, judging, and deciding) espoused by Bernard Lonergan. The aim is to understand how we think and process cognitively in reflection while developing consciousness in knowing. Using Lonergan's formal cognitive operations adds a philosophical perspective and structure to the concept. Fostering the enactment of reflection is a complex process, but it is vital for nursing science and disciplinary advancement.
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Chahda L, Mathisen BA, Carey LB. The role of speech-language pathologists in adult palliative care. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:58-68. [PMID: 27762632 DOI: 10.1080/17549507.2016.1241301] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 09/20/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Given minimal studies describing the role and practice of speech-language pathologists (SLPs) in adult palliative care, the aim of this review was to compile a database of research literature, examine the potential research gaps and to consider material that specifically discussed the need for and/or use of procedures and protocols for SLPs working in palliative care that would support the development of SLP palliative care guidelines. METHOD A scoping review was conducted utilising Arksey and O'Malley's framework with the goal of exploring any key concepts and approaches utilised by SLPs in adult palliative care, plus any literature and/or recommendations regarding SLP practice in adult palliative care settings. RESULT Over 1200 articles were initially identified. Of the 1200 articles, 13 academic papers were considered relevant as they recommended, or at least suggested, the need for speech-language pathology therapy guidelines to be implemented within adult palliative care settings. CONCLUSION The main focus of these articles was on ethical considerations and clinical recommendations for SLPs. Recommendations arising from this scoping review include providing goals to support current practising SLP clinicians and developing clinical guidelines to manage swallowing and/or communication needs of people receiving palliative care.
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Affiliation(s)
- Laura Chahda
- a Palliative Care Unit, School of Psychology and Public Health , La Trobe University , Melbourne , Victoria , Australia and
| | - Bernice A Mathisen
- b Discipline of Speech Pathology, Department of Community and Allied Health , La Trobe Rural Health School La Trobe University , Bendigo , Victoria , Australia
| | - Lindsay B Carey
- a Palliative Care Unit, School of Psychology and Public Health , La Trobe University , Melbourne , Victoria , Australia and
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Caty MÈ, Kinsella EA, Doyle PC. Reflective processes of practitioners in head and neck cancer rehabilitation: a grounded theory study. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 18:580-591. [PMID: 27063686 DOI: 10.3109/17549507.2016.1143974] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE This study systematically examined how experienced Speech-Language Pathologists (SLPs) use the processes of reflection to develop knowledge relevant for practice in the context of head and neck cancer (HNC) rehabilitation. METHOD In-depth, semi-structured interviews were conducted with 12 SLPs working in HNC rehabilitation in North America. Grounded theory methodology was adopted for data collection and analysis. RESULT The findings inform a preliminary reflective practice model that depicts the processes of reflection used by practitioners interviewed. Nine categories of reflective processes were identified by participant SLPs in terms of the processes of reflection: ongoing questioning, experimenting through trial and error, integrating knowledge from past cases, embracing surprise, thinking out of the box, being in the moment, consulting with colleagues, putting oneself in the patients' shoes, and discerning ethical issues. These findings provide empirical evidence that supports Schön's theory of reflective practice and contribute to knowledge about the ways in which SLPs use processes of reflection in the context of HNC rehabilitation. CONCLUSION The findings of this study have implications for how SLPs perceive and consider their role as knowledge-users and knowledge producers in their day-to-day clinical work, as well as for building capacity for reflective practice.
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Affiliation(s)
- Marie-Ève Caty
- a Health and Rehabilitation Sciences Graduate Program, Faculty of Health Sciences, Western University , London , Ontario
| | - Elizabeth Anne Kinsella
- b School of Occupational Therapy , Faculty of Health Sciences, Western University , London , Ontario , and
| | - Philip C Doyle
- c School of Communication Sciences and Disorders , Faculty of Health Sciences, Western University , London , Ontario
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Searching for wisdom in oncology care: A scoping review. Palliat Support Care 2016; 15:384-400. [PMID: 27666083 DOI: 10.1017/s1478951516000675] [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: 11/07/2022]
Abstract
OBJECTIVE The concept of "wisdom" is beginning to emerge in the oncology literature, raising questions concerning: (1) how the concept of wisdom is used in oncology literature; (2) the ways in which wisdom has been a focus of inquiry within oncology care; and (3) how wisdom is characterized when the term is used. METHOD A scoping review, using Arksey and O'Malley's five-step framework, was undertaken to address these questions. In consultation with oncology reference librarians, "wisdom"- and "oncology"-related search terms were identified, and four electronic databases were searched: CINAHL, SocINDEX, PubMed, and PsychINFO. After removal of duplicates and application of inclusion and exclusion criteria, 58 records were identified and included for analysis. RESULTS The concept of wisdom was employed with a breadth of meanings, and 58 records were schematized into 7 genres, including: (1) empirical research with wisdom foregrounded as a study focus (n = 2); (2) empirical research articles where "wisdom" appears in the findings (n = 16); (3) a quality-improvement project where wisdom is an embedded concept (n = 1); (4) essays where wisdom is an aspect of the discussion (n = 5); (5) commentary/opinion pieces where wisdom is an aspect of its focus (n = 6); (6) personal stories describing wisdom as something gleaned from lived experience with cancer (n = 2); and (7) everyday/taken-for-granted uses of wisdom (n = 26). SIGNIFICANCE OF RESULTS The notion of wisdom has a taken-for-granted presence in the published oncology literature and holds promise for future research into patient and clinician wisdom in oncology care. Nonetheless, the terminology is varied and unclear. A scholarly focus on wisdom has not been brought to bear in cancer care to the degree it has in other fields, and research is in the early stages. Various characterizations of wisdom are present. If such a resource as "wisdom" exists, dwelling in human experiences and practices, there may be benefit in recognizing wisdom as informing the epistemologies of practice in oncology care.
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Howells S, Barton G, Westerveld M. Exploring the development of cultural awareness amongst post-graduate speech-language pathology students. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 18:259-271. [PMID: 27142251 DOI: 10.3109/17549507.2016.1154982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 06/05/2023]
Abstract
PURPOSE Speech-language pathology programs globally need to prepare graduates to work with culturally and linguistically diverse populations. This study explored the knowledge, perceptions and experiences related to development of cultural awareness of graduate-entry Master of Speech Pathology students at an Australian university. METHOD Sixty students across both year-levels completed a cultural awareness survey at the beginning of the semester. To explore how clinical placement influenced students' knowledge and perceptions, year-2 students completed written reflections pre- and post-placement (n = 7) and participated in focus groups post-placement (n = 6). RESULT Survey results showed student interest in working with culturally and linguistically diverse populations was high (over 80%) and confidence was moderate (over 50%). More than 80% of students reported awareness of their own cultural identities, stereotypes and prejudices. Content analysis of focus group and written reflection data identified key concepts comprising of: (1) context-university, and clinical placement site; (2) competencies-professional and individual; and (3) cultural implications-clients' and students' cultural backgrounds. CONCLUSION Findings suggest clinical placement may positively influence cultural awareness development and students' own cultural backgrounds may influence this more. Further exploration of how students move along a continuum of cultural development is warranted.
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Affiliation(s)
- Simone Howells
- a School of Allied Health Sciences, Griffith University , Gold Coast , Queensland , Australia
| | - Georgina Barton
- b School of Education and Professional Studies, Griffith University , Brisbane , Queensland , Australia
| | - Marleen Westerveld
- c Rehabilitation Sciences, Griffith University , Gold Coast , Queensland , Australia
- d College of Education, University of Canterbury , Christchurch , New Zealand
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