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1.
J Prosthet Dent ; 2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33218745

RESUMO

STATEMENT OF PROBLEM: How the loading rate might affect the mechanical properties of interim materials and interim fixed dental prostheses is unclear. PURPOSE: The purpose of this in vitro study was to compare the material stiffness, material strength, and structural strength of interim 3-unit fixed dental prostheses fabricated from 3 interim materials when stressed at different loading rates. MATERIAL AND METHODS: Bar-shaped specimens and anatomically correct interim 3-unit fixed dental prostheses with a modified-ridge lap pontic were fabricated from polyethyl methacrylate resin (Trim) and 2 bis-acrylic composite resins (TempSmart; Integrity) (n=10). Flexural modulus and strength of the bar specimens, representing material stiffness and strength, were determined with a 4-point bend test in a universal testing machine. The structural strength of the prosthesis was assessed from the failure load from a vertical force applied on the occlusal surface of the pontic. Three loading rates, 0.5, 5, or 10 mm/min, were evaluated. Results were statistically analyzed with 2-way analysis of variance and multiple comparisons (α=.05). RESULTS: Loading rate and material significantly affected flexural modulus, flexural strength, and structural strength (P<.05). Increasing loading rate significantly increased the flexural modulus of all materials (P<.05), but the effect of loading rate on the flexural strength of bis-acrylic composite resins was mostly insignificant. Polyethyl methacrylate specimens did not fracture when loaded at 0.5 or 5 mm/min, and the interim fixed dental prostheses made from polyethyl methacrylate did not fracture at the 0.5 mm/min loading rate. Dual-polymerizing bis-acrylic composite resin had significantly higher flexural modulus and strengths than autopolymerizing bis-acrylic composite resin. CONCLUSIONS: Polyethyl methacrylate resin had the lowest stiffness among the interim materials tested and did not fracture but excessively deformed at the low loading rate. Dual-polymerizing bis-acrylic composite resin consistently had higher stiffness and material strength and provided higher structural strength than the autopolymerizing bis-acrylic composite resin. Loading rate significantly affected the mechanical properties of polyethyl methacrylate resin (P<.05), but the effect was indistinct for the bis-acrylic materials.

2.
J Interprof Care ; : 1-8, 2020 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-32838601

RESUMO

Healthcare services are accountable to their clients, communities, governments and funding sources to clearly demonstrate the effectiveness of interventions. A First Australian children's therapy service delivering culturally responsive, interprofessional collaborative practice aimed to evaluate their service. However, this process was constrained by available outcome measures which lacked the flexibility necessary for meaningful use within the dynamic and relational nature of their service delivery. This paper outlines an action research process in three cycles which was used to develop the Australian Therapies Outcome Measure for Indigenous Clients (ATOMIC) with the aim of evaluating therapy outcomes for urban First Australian children engaged in culturally responsive interprofessional therapy. Interrater reliability values of 0.995 and 0.982 were established for ATOMIC pre- and post-therapy measures, respectively, during a pilot phase involving 16 participants. Participants in the main study were 80 First Australian children aged two to 16 years who attended between two and nine interprofessional therapy sessions with occupational therapists and speech pathologists. Pre- and post-therapy ATOMIC scores confirmed progress on pre-determined functional goals across a range of skill domains. Outcomes of this study demonstrated that real gains are being made in urban First Australian children's lives following interprofessional collaborative service provision.

3.
Int J Lang Commun Disord ; 55(5): 690-701, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32654424

RESUMO

BACKGROUND: It has long been recognized that tracheoesophageal speech (TES) rehabilitation after laryngectomy is a specialized area of practice for speech and language therapist (SLTs) due to the complex nature of patient presentation and the invasive components of the SLT's role in this area. Therefore, postgraduate experience and training is required to work competently and safely in this clinical area. However, it is generally acknowledged that the steps and processes followed by individual clinicians to achieve this training and clinical skill development are inconsistent and vary widely across services. There is a need to identify critical elements deemed most beneficial to clinical skill development in order to inform future training models. AIMS: To explore clinicians' perceptions of factors that contribute to training and clinical skills development in the area of TES rehabilitation post-laryngectomy. METHODS & PROCEDURES: All participants were SLTs working in an Australian clinical service, with a current or recent clinical caseload that included patients using TES. A total of 36 SLTs were recruited and then grouped by level of experience (novice n = 15, intermediate n = 7, experienced n = 14). Each participant took part in one small focus group with other participants of similar experience level. Ten focus groups were conducted, each of approximately 60 min in duration. A semi-structured interview guide was used to facilitate the discussion of issues relating to training in this area. Thematic analysis was used to analyse transcripts and identify themes. OUTCOMES & RESULTS: Interviews identified six key themes, including: Learning with and from others; Formal programmes; Hands-on learning; Processes that influence training; and Individual influences. SLTs reported both positive issues and elements that were challenging across all five themes. The final (sixth) theme was identified regarding clinician perceptions of how this area differed to specialized training in other areas of the profession. The majority of themes were discussed equally by clinicians across all three experience levels. CONCLUSIONS & IMPLICATIONS: Participants across all experience levels identified that multiple factors contributed to clinicians successfully gaining skills, understanding and competency when working in TES rehabilitation post-laryngectomy. These factors, when fully considered and incorporated into future SLTs training pathways and opportunities, have the potential to optimize competency, skill acquisition and maintenance in this area. What this paper adds What is already known on this subject While studies have considered the training, preparation and knowledge base of SLTs working in the clinical area of TES, the focus has predominantly been at the immediate postgraduate level or assessment of university course work. No studies have used a qualitative methodology to consider the reflections and perceptions of clinicians' training pathways and training needs across all levels of experience for this clinical area. What this paper adds to existing knowledge The results of this study build upon the existing body of literature regarding education and training in this area, determining factors SLTs feel are required to successfully gain skills, understanding and competency when working in TES rehabilitation. The findings highlight that training pathways and methods in this clinical area are an ongoing consideration for SLTs regardless of experience level and have the ability to impact on future competency programmes, training opportunities and delivery methods in this area. What are the potential or actual clinical implications of this work? Effective and ongoing postgraduate training programmes and professional development opportunities have the potential to positively impact on professional competence and confidence, patient safety and overall service delivery. Hence, the themes generated from this research highlight essential factors to include within training and professional development programmes for SLTs in TES rehabilitation. This information can be used to help optimize current training pathways for all experience levels.

4.
Gen Dent ; 68(3): 51-56, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348244

RESUMO

Low-viscosity polymer resins, or surface sealants (SSs), have been utilized as a means of finalizing the polishing step following the placement of composite resin restorations. The aim of this study was to measure the surface roughness (Ra) of composite resins treated with different SSs before and after exposure to an accelerated artificial aging protocol. The study included 5 experimental groups of composite resin discs (TPH Spectra ST) treated with different SSs (PermaSeal, Embrace WetBond Seal-n-Shine, OptiGuard, BisCover LV, and DuraFinish) and a control group consisting of untreated discs (n = 6 per group). The discs were prepared by inserting composite resin in 10 × 1-mm rings, covering the ring and material with a transparent strip, compressing the assembly between glass slides, and polymerizing through the slides on each side for 40 seconds with an LED curing light. Each disc except for the control specimens received a coating of the selected SS followed by application of a transparent matrix strip and then light polymerization for 20 seconds using an LED light source. Surface roughness measurements were obtained with a digital contact profilometer at baseline (immediately after polymerization) and following exposure to a thermocycling regimen to simulate aging. The data were analyzed using 2-way analysis of variance and post hoc Student-Newman-Keuls test with significance set at P < 0.05. There were no statistically significant differences among the groups at baseline. There were no statistically significant differences between the baseline and post-thermocycling Ra measurements except among the DuraFinish specimens, which were significantly rougher than all other groups after accelerated artificial aging. The use of SSs for the initial insertion and possibly for the long-term maintenance of composite resins could be minimally beneficial for restoration maintenance if a transparent covering medium is utilized during polymerization. However, due to the effects caused by formation of an oxygen-inhibited layer of unpolymerized monomers if a covering medium is not used, the results suggest the benefits do not offset the costs considering both gloss and Ra surface-testing parameters.


Assuntos
Resinas Compostas , Polimento Dentário , Humanos , Teste de Materiais , Propriedades de Superfície
5.
Int J Speech Lang Pathol ; : 1-11, 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32168458

RESUMO

Purpose: This study aimed to explore factors, perceived by students themselves, that help or hinder development of competency in voice.Method: Focus group interviews were conducted with a convenience sample of 14 speech pathology students (93% female, mean age 22 years). Interviews were transcribed verbatim and analysed using template analysis.Result: Students' perceptions of influencing factors were grouped into two major themes: (1) personal factors, and (2) educational factors. A key finding was that many participants perceived a student's own voice to be a major factor impacting their development and attainment of clinical competency in voice, and that mindsets towards the (un)changeability of students' own voices varied across participants. Students with a performance background were considered to be at an advantage in terms of performing vocal tasks and suitability to work with specific populations. Key facilitatory educational factors included access to and experience of demonstrations (face-to-face and video), additional training workshops, peer learning, and simulation.Conclusion: This study identified a number of personal and educational factors that students perceive to impact the development of competency in voice. Consideration of these holistic factors may assist speech-language pathology educators to deliver optimally effective voice-related curricula.

6.
Int J Speech Lang Pathol ; : 1-11, 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-32098509

RESUMO

Purpose: Simulation is increasingly used within speech-language pathology education. Research has primarily explored students' perceptions of learning in simulation. The aim of this study was to determine if speech-language pathology students achieved a statistically-equivalent level of competency when a mean of 20% of placement time was replaced with simulation compared to placements without a simulation component.Method: This non-inferiority randomised controlled trial involved students from six Australian universities. Students were randomised to either a simulation + traditional placement group attending 5 days of simulation prior to their traditional placement, or a traditional only placement group. Their end-placement clinical competency was assessed using Competency Assessment in Speech Pathology (COMPASS®).Result: Final data were available for 325 students: 150 students in traditional placements, 138 students in protocol-compliant simulation + traditional placements, and 37 students in non-protocol simulation + traditional placements. There were no statistically significant differences between groups (traditional vs protocol-compliant simulation + traditional Mann-Whitney-Wilcoxon z = 1.23, df = 286, p = 0.22; traditional vs intention-to-treat simulation + traditional Mann-Whitney-Wilcoxon z = 0.23, df = 323, p = 0.81).Conclusion: This research contributes to the evidence base which suggests that simulation can partially replace traditional placement time for speech-language pathology students without loss of competency, substantiating its value as an alternative placement model in speech-language pathology programmes.

7.
Int J Lang Commun Disord ; 55(2): 287-300, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32020763

RESUMO

BACKGROUND: Simulation-based learning provides students with a safe learning environment, guaranteed exposure to specific clinical scenarios and patients, time for reflection and repetition of tasks, and an opportunity to receive feedback from multiple sources. Research including studies specific to allied health training programmes have demonstrated that simulation-based learning also helps increase learners' confidence and reduces anxiety related to clinical environments, activities and skills. Such evidence, together with increasing challenges in provision of workplace clinical education, has supported an expansion of integrating simulation-based learning into university curricula. AIMS: To provide detailed information about the processes and considerations involved in the development of a simulation-based learning programme for speech-language pathology. METHODS & PROCEDURES: Through reflection on the development process of a 5-day simulation-based learning programme, and in light of existing research in simulation, this paper outlines the important steps and considerations required for the development of a simulation-based learning programme to support student competency development in adult speech pathology range of practice areas. MAIN CONTRIBUTION: A proposed framework for the development of future simulation-based learning programmes in speech-language pathology. CONCLUSIONS & IMPLICATIONS: The framework can be applied to simulation-based learning for university programmes and/or workplace training in speech-language pathology and across several other health disciplines.

8.
Int J Lang Commun Disord ; 55(1): 85-96, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31612612

RESUMO

BACKGROUND: The management of tracheoesophageal speech (TES) rehabilitation is an area of speech and language therapists' (SLTs) clinical practice where knowledge and skills are primarily developed through postgraduate workplace experience and training. Although recent research suggests clinicians in Australia perceive there is adequate access to workplace training, little is known about how clinicians develop and/or maintain clinical confidence when working in this specialist caseload. AIMS: To investigate factors that contribute to development of clinician confidence as well as the factors that impact on improving and maintaining confidence when working in the clinical area of TES rehabilitation. METHODS & PROCEDURES: SLTs working in an Australian clinical service and in a current or recent caseload including patients using TES were eligible to participate. A total of 36 SLTs were recruited and then grouped by level of experience (novice n = 15, intermediate n = 7, experienced n = 14). Ten focus groups of 60-min duration were conducted each with three to four participants from the same experience level. A semi-structured interview guide was used to facilitate the discussion of issues relating to training and confidence; however, only the content pertaining to clinical confidence is reported. Thematic analysis was used to analyse the transcripts. OUTCOMES & RESULTS: Four themes were identified as contributing to the development of confidence: training, exposure, accessing support and mentorship, and leadership opportunities. Three themes were identified as critical for improving or maintaining clinical confidence: ongoing management of a caseload, ongoing support and further learning. An additional overarching theme was the desire for SLTs to classify or quantify their level of confidence, typically using a numeric scale or in years of clinical experience. The impact of varying contexts and caseloads on confidence levels was highlighted by all participants, but particularly those in the novice focus groups. CONCLUSIONS & IMPLICATIONS: The findings highlight the fact that the acquisition and maintenance of confidence is an ongoing consideration for SLTs, both those starting out and those with years of clinical experience. With patient presentation increasing in complexity, the importance of understanding contributing factors for gaining and maintaining confidence should be considered alongside postgraduate training and the provision of ongoing support for SLTs working in this specialized clinical area, regardless of experience level.


Assuntos
Competência Clínica , Terapia da Linguagem/educação , Autoimagem , Fonoterapia/educação , Atitude do Pessoal de Saúde , Austrália , Grupos Focais , Humanos , Pesquisa Qualitativa , Traqueostomia/reabilitação
9.
Int J Speech Lang Pathol ; 21(3): 317-324, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31084263

RESUMO

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.


Assuntos
Saúde Global , Patologia da Fala e Linguagem , Humanos
10.
Dent Mater ; 34(1): 152-160, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29061285

RESUMO

OBJECTIVE: The relationship between post-gel shrinkage, total shrinkage, and cuspal flexure was examined. Cuspal flexure was measured on restored typodont teeth, which offered a standardized tooth shape for comparison of shrinkage stress effects among restorative composites. METHODS: Six restorative composites were compared (Filtek LS, Venus Flowable, Tetric EvoCeram, Filtek Flowable, Esthet-X, and Filtek Supreme). Total shrinkage was determined from changes in projected surface area before and after polymerization (n=10). Post-gel shrinkage was determined with a biaxial strain gauge that measured strain development during polymerization (n=10). Cuspal flexure was determined using typodont maxillary second premolars with standard MOD slot preparation (n=10). Flexure was determined by comparing the three-dimensionally scanned cuspal surfaces before and after restoration. Restoration bonding to the typodont cavity was achieved by sandblasting and adhesive application. Bond integrity was verified by measuring dye penetration. Results were analyzed using ANOVA and Student-Newman-Keuls post hoc test (significance level 0.05). Pearson was used for correlations. RESULTS: Total and post-gel shrinkage were significant different for all composites (t-test; P<0.001). Depending on the composite, only 9-41% of the total shrinkage was recorded as post-gel shrinkage. Bond integrity of restored typodont teeth was 96-99%. Cuspal flexure correlated strongly with post-gel shrinkage, but there was no correlation with total shrinkage. SIGNIFICANCE: Cuspal flexure of restored typodont teeth showed the effect of shrinkage stress caused by polymerizing composite restorations, ensuring standardization while maintaining the effects of tooth/cavity geometry. Post-gel shrinkage gave a good indication to screen composites for the stress they may generate; total shrinkage had no direct correlation with stress.


Assuntos
Resinas Compostas/química , Restauração Dentária Permanente/métodos , Dente Pré-Molar , Adaptação Marginal Dentária , Falha de Restauração Dentária , Imageamento Tridimensional , Técnicas In Vitro , Teste de Materiais , Maleabilidade , Polimerização , Propriedades de Superfície
11.
Int J Audiol ; 55(12): 758-764, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27686138

RESUMO

OBJECTIVE: To compare simulated patients (SP) versus seminars for training audiology students to take a case history and give feedback with adult patients. DESIGN: A randomized controlled trial with cross-over. STUDY SAMPLE: Twenty-four audiology students, five SPs, two clinical educators (CE) and three evaluators. Students were randomly allocated to Group 1 who completed SP then seminar training or Group 2 who completed seminar then SP training. The SP training saw each student work with an SP in a clinic room and receive individualized feedback. The seminar training saw the student group work with a single CE in a lecture room and receive group feedback. All students were assessed taking a case history and giving feedback to an SP before, between, and after the training blocks. RESULTS: Mixed model analyses of derived factors for case history and feedback showed significant (p < 0.05) effects for assessment occasion (i.e. student skills improved with more training) but not for training sequence (i.e. order of training did not affect skill improvements) or training type (i.e. type of training did not affect skill improvements). CONCLUSION: SP training provided no benefit over seminar training in audiology students learning case history and feedback skills with adult patients.


Assuntos
Audiologia/educação , Competência Clínica , Anamnese/métodos , Simulação de Paciente , Ensino , Adulto , Comunicação , Estudos Cross-Over , Avaliação Educacional , Análise Fatorial , Feminino , Humanos , Masculino , Relações Médico-Paciente , Adulto Jovem
12.
Int J Audiol ; 55(12): 765-774, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27696974

RESUMO

OBJECTIVE: To develop a tool for assessing audiology students taking a case history and giving feedback with simulated patients (SP). DESIGN: Single observation, single group design. STUDY SAMPLE: Twenty-four first-year audiology students, five simulated patients, two clinical educators, and three evaluators. RESULTS: The Audiology Simulated Patient Interview Rating Scale (ASPIRS) was developed consisting of six items assessing specific clinical skills, non-verbal communication, verbal communication, interpersonal skills, interviewing skills, and professional practice skills. These items are applied once for taking a case history and again for giving feedback. The ASPIRS showed very high internal consistency (α = 0.91-0.97; mean inter-item r = 0.64-0.85) and fair-to-moderate agreement between evaluators (29.2-54.2% exact and 79.2-100% near agreement; κweighted up to 0.60). It also showed fair-to-moderate absolute agreement amongst evaluators for single evaluator scores (intraclass correlation coefficient [ICC] r = 0.35-0.59) and substantial consistency of agreement amongst evaluators for three-evaluator averaged scores (ICC r = 0.62-0.81). Factor analysis showed the ASPIRS' 12 items fell into two components, one containing all feedback items and one containing all case history items. CONCLUSION: The ASPIRS shows promise as the first published tool for assessing audiology students taking a case history and giving feedback with an SP.


Assuntos
Audiologia/educação , Competência Clínica , Avaliação Educacional/métodos , Anamnese/métodos , Simulação de Paciente , Adulto , Comunicação , Feminino , Humanos , Masculino , Relações Médico-Paciente , Adulto Jovem
13.
Int J Speech Lang Pathol ; 17(3): 230-40, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25833074

RESUMO

PURPOSE: The use of simulated learning environments to develop clinical skills is gaining momentum in speech-language pathology training programs. The aim of the current study was to examine the benefits of adding Human Patient Simulation (HPS) into the university curriculum in the area of paediatric dysphagia. METHOD: University students enrolled in a mandatory dysphagia course (n = 29) completed two, 2-hour HPS scenarios: (a) performing a clinical feeding assessment with a medically complex infant; and (b) conducting a clinical swallow examination (CSE) with a child with a tracheostomy. Scenarios covered technical and non-technical skills in paediatric dysphagia management. Surveys relating to students' perceived knowledge, skills, confidence and levels of anxiety were conducted: (a) pre-lectures; (b) post-lectures, but pre-HPS; and (c) post-HPS. A fourth survey was completed following clinical placements with real clients. RESULT: Results demonstrate significant additive value in knowledge, skills and confidence obtained through HPS. Anxiety about working clinically reduced following HPS. Students rated simulation as very useful in preparing for clinical practice. Post-clinic, students indicated that HPS was an important component in their preparation to work as a clinician. CONCLUSION: This trial supports the benefits of incorporating HPS as part of clinical preparation for paediatric dysphagia management.


Assuntos
Transtornos de Deglutição/terapia , Deglutição , Esôfago/fisiopatologia , Treinamento por Simulação , Patologia da Fala e Linguagem/educação , Ensino/métodos , Fatores Etários , Competência Clínica , Currículo , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/fisiopatologia , Avaliação Educacional , Escolaridade , Métodos de Alimentação , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Manequins , Apoio Nutricional , Exame Físico , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Inquéritos e Questionários , Traqueostomia/educação , Resultado do Tratamento
14.
Int J Speech Lang Pathol ; 16(5): 464-75, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23992225

RESUMO

Clinical education programs in speech-language pathology enable the transition of students' knowledge and skills from the classroom to the workplace. Simulated clinical learning experiences provide an opportunity to address the competency development of novice students. This study reports on the validation of an assessment tool designed to evaluate speech-language pathology students' performance in a simulated clinical placement. The Assessment of Foundation Clinical Skills (AFCS) was designed to link to concepts and content of COMPASS(®): Competency Assessment in Speech Pathology, a validated assessment of performance in the workplace. It incorporates units and elements of competency relevant to the placement. The validity of the AFCS was statistically investigated using Rasch analysis. Participants were 18 clinical educators and 130 speech-language pathology students undertaking the placement. Preliminary results support the validity of the AFCS as an assessment of foundation clinical skills of students in this simulated clinical placement. All units of competency and the majority of elements were relevant and representative of these skills. The use of a visual analogue scale which included a pre-Novice level to rate students' performance on units of competency was supported. This research provides guidance for development of quality assessments of performance in simulated placements.


Assuntos
Avaliação Educacional/métodos , Patologia da Fala e Linguagem/educação , Adolescente , Adulto , Competência Clínica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudantes , Adulto Jovem
15.
Int J Lang Commun Disord ; 48(6): 613-24, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24119132

RESUMO

BACKGROUND: Standardized patients (SPs) are frequently included in the clinical preparation of students in the health sciences. An acknowledged benefit of using SPs is the opportunity to provide a standardized method by which students can demonstrate and develop their competency. Relatively little is known, however, about the capacity of SPs to offer an accurate and standardized performance across a speech-language therapy student cohort. AIMS: To investigate the accuracy, reproducibility (consistent performance of each SP across student interviews) and replicability (consistent performance of a number of SPs across each scenario) of SPs portraying three scenarios, each as a parent of a child presenting with a speech disorder. METHODS & PROCEDURES: Forty-four speech-language therapy students interviewed four SPs to gain a case history. All interviews were videotaped. The accuracy of SP portrayal of key features of each scenario was scored by an expert rater and two other raters. Data were analysed to determine levels of accuracy, reproducibility and replicability, and inter-rater reliability was evaluated. OUTCOMES & RESULTS: SPs were found to have moderate to high levels of accuracy across the three scenarios. There were no significant differences in the performances of each individual SP across interviews or between all SPs on each scenario, indicating that reproducibility and replicability were achieved. Overall inter-rater reliability between raters across all scenarios was greater than 80%. CONCLUSIONS & IMPLICATIONS: The results would seem to indicate that SPs can present in a standardized manner within a speech-language therapy context, confirming the value of their inclusion in clinical education programmes. Suggestions for improving the training of SPs in order to maintain accuracy are highlighted.


Assuntos
Terapia da Linguagem/educação , Terapia da Linguagem/normas , Simulação de Paciente , Fonoterapia/educação , Fonoterapia/normas , Adolescente , Adulto , Criança , Pré-Escolar , Competência Clínica , Avaliação Educacional , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Gravação de Videoteipe , Adulto Jovem
16.
J Allied Health ; 42(2): 84-91, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23752235

RESUMO

UNLABELLED: This study aimed to investigate speech-language pathology students' perceptions of a foundation clinical skills simulation program incorporating standardised patients (SPs) by determining if experiences with SPs decreased students' anxiety about interaction with real clients and increased confidence in clinical skills. In addition, it aimed to identify students' overall perceptions of the SP experience. METHODS: The study used a pre-post design. Students who were enrolled in undergraduate and graduate speech-language pathology programs (n=175) completed a survey prior to and following the SP clinic. The survey asked questions related to levels of anxiety and confidence for clinical skills. The post-clinic survey also included questions about the use of SPs and program administration. RESULTS: All participants reported decreased anxiety levels following clinic, with those of the undergraduate students at a significant level. Participants also reported significantly increased confidence in a range of clinical skills and evaluated the program positively. CONCLUSIONS: The results of this study suggest that inclusion of SPs into a foundation clinical skills program is perceived by students to be valuable. Further investigation is required to determine the relationship between students' perceived increase in confidence and their clinical competencies. These results will inform future simulation program development.


Assuntos
Competência Clínica/normas , Avaliação Educacional/métodos , Simulação de Paciente , Patologia da Fala e Linguagem/educação , Adolescente , Adulto , Ansiedade/prevenção & controle , Austrália , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Inquéritos e Questionários
17.
Int J Speech Lang Pathol ; 15(3): 345-57, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23586581

RESUMO

The rising demand for health professionals to service the Australian population is placing pressure on traditional approaches to clinical education in the allied health professions. Existing research suggests that simulated learning environments (SLEs) have the potential to increase student placement capacity while providing quality learning experiences with comparable or superior outcomes to traditional methods. This project investigated the current use of SLEs in Australian speech-language pathology curricula, and the potential future applications of SLEs to the clinical education curricula through an extensive consultative process with stakeholders (all 10 Australian universities offering speech-language pathology programs in 2010, Speech Pathology Australia, members of the speech-language pathology profession, and current student body). Current use of SLEs in speech-language pathology education was found to be limited, with additional resources required to further develop SLEs and maintain their use within the curriculum. Perceived benefits included: students' increased clinical skills prior to workforce placement, additional exposure to specialized areas of speech-language pathology practice, inter-professional learning, and richer observational experiences for novice students. Stakeholders perceived SLEs to have considerable potential for clinical learning. A nationally endorsed recommendation for SLE development and curricula integration was prepared.


Assuntos
Aprendizagem , Patologia da Fala e Linguagem/educação , Austrália , Currículo , Humanos , Estudantes
18.
Int J Speech Lang Pathol ; 15(1): 69-74, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23134085

RESUMO

The timely release of the World Report on Disability serves as a challenge to members of the health professions to review and renew their response to inequity of access and provision of services to children and adults with a disability. This paper responds to the lead article by Wylie, McAllister, Davidson, and Marshall, and provides commentary on two of the recommendations of the World Report on Disability in the context of a novel inter-professional service for Aboriginal and Torres Strait Islander children with communication and learning needs. Speech-language pathology and occupational therapy students reported on their learning within a model of service delivery based on partnership with an Aboriginal and Torres Strait Islander school community and inter-professional collaboration. Lessons learned have the potential to inform future services for under-served populations and to impact on capacity building through health professionals gaining experiential knowledge and understanding of an urban Aboriginal and Torres Strait Islander community.


Assuntos
Transtornos da Comunicação/terapia , Saúde Global , Acesso aos Serviços de Saúde/tendências , Populações Vulneráveis , Humanos
19.
BMC Med Educ ; 12: 112, 2012 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-23145840

RESUMO

BACKGROUND: During clinical placements, clinical educators facilitate student learning. Previous research has defined the skills, attitudes and practices that pertain to an ideal clinical educator. However, less attention has been paid to the role of student readiness in terms of foundational knowledge and attitudes at the commencement of practice education. Therefore, the aim of this study was to ascertain clinical educators' views on the characteristics that they perceive demonstrate that a student is well prepared for clinical learning. METHODS: A two round on-line Delphi study was conducted. The first questionnaire was emailed to a total of 636 expert clinical educators from the disciplines of occupational therapy, physiotherapy and speech pathology. Expert clinical educators were asked to describe the key characteristics that indicate a student is prepared for a clinical placement and ready to learn. Open-ended responses received from the first round were subject to a thematic analysis and resulted in six themes with 62 characteristics. In the second round, participants were asked to rate each characteristic on a 7 point Likert Scale. RESULTS: A total of 258 (40.56%) responded to the first round of the Delphi survey while 161 clinical educators completed the second (62.40% retention rate). Consensus was reached on 57 characteristics (six themes) using a cut off of greater than 70% positive respondents and an interquartile deviation IQD of equal or less than 1. CONCLUSIONS: This study identified 57 characteristics (six themes) perceived by clinical educators as indicators of a student who is prepared and ready for clinical learning. A list of characteristics relating to behaviours has been compiled and could be provided to students to aid their preparation for clinical learning and to universities to incorporate within curricula. In addition, the list provides a platform for discussions by professional bodies about the role of placement education.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Técnica Delfos , Docentes , Aprendizagem , Motivação , Terapia Ocupacional/educação , Fisioterapeutas/educação , Critérios de Admissão Escolar , Patologia da Fala e Linguagem/educação , Estudantes de Ciências da Saúde/psicologia , Adulto , Currículo , Retroalimentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistemas On-Line , Queensland , Inquéritos e Questionários
20.
Int J Lang Commun Disord ; 47(4): 413-26, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22788227

RESUMO

BACKGROUND: Reflective practice is reported to enhance clinical reasoning and therefore to maximize client outcomes. The inclusion of targeted reflective practice in academic programmes in speech-language therapy has not been consistent, although providing opportunities for speech-language therapy students to reflect during their clinical practice has been reported. Indeed, there has been limited investigation of the nature of speech-language therapy students' reflections. AIMS: (1) To describe the breadth and depth of reflection skills of novice speech-language therapy students by utilizing structured reflective learning journals. (2) To evaluate the use of a coding system to determine its reliability and relevance in identifying reflection skills. METHODS & PROCEDURES: Participants were 52 students in their second year of a 4-year undergraduate speech-language therapy programme. Mean participant age was 20.5 years; all students were female. Participants completed guided written reflections following three interviews with a standardized patient (an actor portraying a parent of a child with delayed speech development). Reflections were coded by two raters. Nine participants' reflections were recoded by raters A and B to establish intra-rater reliability. Inter-rater reliability between these two raters was calculated and a third rater completed coding of 20% of students' reflections to further establish inter-rater reliability. OUTCOMES & RESULTS: Results indicated that the majority of students were categorized as 'reflectors'. All students demonstrated at least one element of reflection. Their reflective writing primarily focused on a discussion of the content of and strategies used within the interviews, and reflection on and for action. Results also indicated that the coding system used within the study was reliable in determining both the breadth and depth of student reflections. CONCLUSIONS & IMPLICATIONS: This study found that novice speech-language therapy students can reflect on their clinical learning experiences within a structured clinical environment involving standardized patients. Only a small number of novice students were found to be critical reflectors who were able to analyse the content of clinical interviews, view the interaction from the perspective of the patient, and record changes to their own perspective which occurred as a result. The coding system was established as reliable and thus relevant for use in furthering research on reflective practice within speech-language therapy and other disciplines. Further investigation of reflective skills within other clinical environments and with additional clinical experience is recommended.


Assuntos
Terapia da Linguagem/educação , Aprendizagem , Fonoterapia/educação , Estudantes/psicologia , Pensamento , Adolescente , Competência Clínica , Avaliação Educacional/normas , Emoções , Retroalimentação Psicológica , Feminino , Humanos , Terapia da Linguagem/normas , Relações Profissional-Paciente , Reprodutibilidade dos Testes , Fonoterapia/normas , Adulto Jovem
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