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

The Use of Simulation in Communication Sciences and Disorders: A Follow-Up Survey

PURPOSE

This study investigates changes in the prevalence and practice of simulation in communication sciences and disorders (CSD) education. It is a follow-up to a 2015 survey on the same topic. Given the changes in program certification standards and the impact of the COVID-19 pandemic on clinical education programs across the United States, re-examination of simulation in CSD is warranted.

METHOD

An online questionnaire was developed to survey university programs accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association. University program directors and clinical directors received recruitment e-mails using QuestionPro, an online survey platform. The recruitment e-mail contained the purpose of the study and a link to the online questionnaire along with instructions to forward the survey to the appropriate designee. The consent form was then embedded in the questionnaire.

RESULTS

The results of this survey indicated changes in patterns and the use of simulation in clinical education for CSD. Results indicated an overall increase in the use of simulations, specifically in computer-based simulations. Distance simulation as a hybrid technology proved a major addition to clinical education programs during the COVID-19 pandemic. External and internal factors affecting the use of simulations in CSD were identified.

CONCLUSIONS

The use of simulation to supplement clinical education in CSD has evolved in recent years. These changes are likely due in part to changes in certification standards in the profession, an increase in awareness and training, and reliance on distance simulation during the COVID-19 pandemic.

How Are Alternative Clinical Placements Performed Compared to Traditional Clinical Placements During the COVID-19 Pandemic? Sought Through a Systematic Review and Meta-Analysis

Clinical placement is the essential method of learning in health professions education, but it has been the most disrupted by the COVID-19 pandemic. Institutions of higher education resorted to alternative learning such as telehealth, simulations, and blended-learning for clinical placement to ensure that educational activities continue without delay. However, this raises questions about student competency and necessitates making up for missed in-person hours. A thorough investigation of the effectiveness of alternative clinical placement learning is required. A systematic searching was conducted on ten electronic databases, and the quality of the included articles was assessed using the Medical Education Research Study Quality Instrument (MERSQI). A meta-analysis was conducted by pooling studies with examination mark outcomes. Twenty-four articles were included in the systematic review and nine were included in the meta-analysis. The average MERSQI score for included studies is 11.15. Outcomes on student performance favor alternative placement, whereas perceived-based outcomes have mixed results and are slightly prone to traditional clinical placement. Meta-analysis indicates that alternative learning is either more effective than traditional clinical placement or at least on par with it. There is a discrepancy between perceived outcome and performance assessment regarding the utility of alternative learning to conventional clinical placement. Nonetheless, objective measurement outcomes and the meta-analysis support alternative learning as a reliable learning strategy for clinical education. Alternative learning for clinical placement experience can be improved further by adding more synchronous sessions, and implementing various learning methods, learning activities based on strong instructional design, and at least a short real-setting attachment.

Lessons From an Exploratory Qualitative Survey on Simulation Opportunities for Clinical Education in Speech-Language Pathology and Audiology in South Africa

Phenomenon: This study explored experiences of simulation-based clinical education in the Speech-Language Pathology and Audiology professions in South Africa, a Global South context where research on this topic is limited. In this context, the COVID-19 pandemic brought simulation to the forefront of clinical education as a training solution when in-person encounters were impossible. As these simulation-based training approaches gain traction, with continued use post-pandemic, it is important to understand how they are currently being used so that appropriate support can be offered to ensure their efficiency and success in the future. Approach: We distributed a survey to South African university departments offering Speech-Language Pathology and Audiology training, inviting participation from students across years of study and clinical educators. Data were collected between October 2022 and February 2023. Twelve responses were received: three from clinical educators and nine from students. We analyzed the responses using descriptive statistics and a domain summary approach. Findings: Simulated activities were implemented as options for clinical education in South African Speech-Language Pathology and Audiology (SLP/A) programs during the pandemic, albeit in a somewhat haphazard way depending on available resources, often with limited preparation or guidance. Some universities have continued using aspects of simulation training post-pandemic. Insights: Our findings, although preliminary, are somewhat consistent with Global North literature, particularly regarding barriers and challenges to implementing these approaches in clinical education. We offer suggestions for enhancing the support of simulation-based clinical education in our context.

The impact of COVID-19 on speech-language and hearing professions in low- and middle-income countries: Challenges and opportunities explored

BACKGROUND

 Since the advent of the coronavirus disease 2019 (COVID-19), the speech-language and hearing (SLH) professions globally have been confronted with novel and unexpected challenges.

OBJECTIVE

 The aim of this article was to explore the impact of COVID-19 on SLH professions in low- and middle-income countries (LMICs) as presented in the Special Issue of the South African Journal of Communication Disorders in the year 2022.

METHOD

 Divergent from the standard editorial writing style, this editorial adopted a research approach where a qualitative, descriptive scoping review design was conducted to meet the objectives of the study. Three specific objectives were targeted: (1) exploring the challenges to SLH research, teaching and practice; (2) establishing evidence-based solutions available for these challenges that can be used to improve the professions' response in the post-pandemic era; and (3) determining the areas that require further investigation, alternative solutions and innovation for improved readiness for future pandemics. A total of 21 manuscripts were reviewed that covered three predetermined themes - research, teaching and practice - that were constructed through a deductive approach as part of the call for papers for the special issue. These manuscripts were from academics, researchers and clinicians from various institutions in LMICs. The review is presented using thematic analysis.

RESULTS

 The review raised important challenges, presented under various subthemes, to the three key themes. These challenges reflect on the impact of COVID-19 on the SLH professions in terms of research, teaching, service provision and ethical challenges, as well as its impact on speech language, hearing, swallowing and balance functions. The review also advanced solutions and future directions during and beyond COVID-19.

CONCLUSION

 These findings raise global implications for research, teaching and practice that are not only relevant to the SLH professions.

Application of machine learning approaches to analyse student success for contact learning and emergency remote teaching and learning during the COVID-19 era in speech-language pathology and audiology

BACKGROUND

 The onset of the COVID-19 pandemic across the globe resulted in countries taking several measures to curb the spread of the disease. One of the measures taken was the locking down of countries, which entailed restriction of movement both locally and internationally. To ensure continuation of the academic year, emergency remote teaching and learning (ERTL) was launched by several institutions of higher learning in South Africa, where the norm was previously face-to-face or contact teaching and learning. The impact of this change is not known for the speech-language pathology and audiology (SLPA) students. This motivated this study.

OBJECTIVES

 This study aimed to evaluate the impact of the COVID-19 pandemic on SLPA undergraduate students during face-to-face teaching and learning, ERTL and transitioning towards hybrid teaching and learning.

METHOD

 Using course marks for SLPA undergraduate students, K means clustering and Random Forest classification were used to analyse students' performance and to detect patterns between students' performance and the attributes that impact student performance.

RESULTS

 Analysis of the data set indicated that funding is one of the main attributes that contributed significantly to students' performance; thus, it became one of the priority features in 2020 and 2021 during COVID-19.

CONCLUSION

 The clusters of students obtained during the analysis and their attributes can be used in identification of students that are at risk of not completing their studies in the minimum required time and early interventions can be provided to the students.