Continuum of Care in Speech-Language Pathology Student Placements: Identifying Key Learning Themes
Keywords:continuum of care experiences, placement models, placements, speech-language pathology students
AbstractDespite growing evidence in favour of longitudinal integrated clerkships (LICs) for medical student placements, allied health student placements continue to address single caseload types, often representing one stage of the patient journey. This study explored perceptions of speech-language pathology (SLP) students in a continuum of care placement in Australia, following the patient journey of stroke survivors from acute admission to rehabilitation. Four pairs of students participated in 24-day continuum of care placements. Student clinical competence was assessed in the usual way using the COMPASS® tool to ascertain if students achieved required levels of competency and were not disadvantaged by the new placement structure. Student satisfaction was assessed with a 5-point Likert scale. Learning outcomes were explored in individual semi-structured interviews at conclusion of placement. Thematic analysis was undertaken on interview transcripts to identify key themes from interviews. All students achieved entry-level competency upon completion of their placement. Positive learning outcomes reported included improvement in understanding of the post-stroke journey, broadened clinical knowledge, improved adaptability to different clinical settings, and awareness of and ability to deliver patient-centred care. As a result of this placement model, students reported developing an increased sense of their professional role and responsibility in advocacy for the patient. It is recommended that continuum of care placements be considered as an alternative placement experience structure in hospital settings to enhance student learning of the patient journey.
Aurini, J., Heath, M., and Howells, S. (2016) The How To of Qualitative Research: Strategies for
Executing High Quality Projects. Thousand Oaks, CA: Sage.
Baldry Currens, J. (2003) ‘The 2:1 clinical placement model: Review’. Physiotherapy, 89 (9), 540-554 https://doi.org/10.1016/S0031-9406(05)60180-0
Bates, J., Konkin, J., Suddards, C., Dobson, S., and Pratt, D. (2013) ‘Student Perceptions of Assessment and Feedback in Longitudinal Integrated Clerkships’. Medical Education, 47 (4), 362-374 http://onlinelibrary.wiley.com/doi/10.1111/medu.12087/full
Bennett, S., Fancourt, N., Peters, D., and Wu, A. (2015) ‘Global Strategy on People-Centred and Integrated Health Services, Interim Report for the World Health Organization’. [online] available from http://apps.who.int/iris/bitstream/10665/155002/1/WHO_HIS_SDS_2015.6_eng.pdf?ua=1&ua=1 [4 July 2015]
Braun, V. and Clarke, V. (2006) ‘Using thematic analysis in psychology’. Qualitative Research in Psychology, 3 (2), 77-101 https://doi.org/10.1191/1478088706qp063oa
Canadian Interprofessional Health Collaborative (2010) A National Interprofessional Competency Framework. [online] available from http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf [20 December 2016]
Creswell, J. W. (2014) Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. 4th edn. Thousand Oaks, CA: Sage.
Dall’Alba, G. (2009) ‘Learning professional ways of being: Ambiguities of becoming’. Educational Philosophy and Theory, 41 (1), 34-45 http://dx.doi.org/10.1111/j.1469-5812.2008.00475.x
Feilzer, M.Y. (2010) ‘Doing mixed methods research pragmatically: Implications for the rediscovery of pragmatism as a research paradigm’. Journal of Mixed Methods Research, 4 (1), 6-16. https://doi.org/10.1177/1558689809349691
Gaufberg, E., Hirsh, D.A., Krupat, E., Ogur, B., Pelletier, S., Reiff, D., and Bor, D. (2014) ‘Into the future: Patient-centredness endures in longitudinal integrated clerkship graduates’. Medical Education, 48 (6), 572-582 https://doi.org/10.1111/medu.12413
Hirsh, D.A., Ogur, B., Thibault, G.E., and Cox, M. (2007) ‘“Continuity” as an organizing principle for clinical education reform’. The New England Journal of Medicine, 356 (8), 858-866
Hirsh, D.A., Walters, L., and Poncelet, A.N. (2012) ‘Better learning, better doctors, better delivery system: Possibilities from a case study of longitudinal integrated clerkships’. Medical Teacher, 34 (7), 548-554 http://dx.doi.org/10.3109/0142159X.2012.696745
Kogan, J.R., Conforti, L.N., Bernabeo, E.C., Durning, S.J., Hauer, K.E., and Holmboe, E.S. (2012) 'Faculty staff perceptions of feedback to residents after direct observation of clinical skills'. Medical Education, 46 (2), 201-215 https://doi.org/10.1111/j.1365-2923.2011.04137.x
Lave, J. and Wenger, E. (1991) Situated Learning: Legitimate Peripheral Participation. Cambridge, UK: Cambridge University Press https://doi.org/10.1017/CBO9780511815355
Lekkas, P., Larsen, T., Kumar, S., Grimmer, K., Nyland, L., Chipchase, L., Jull, G., Buttrum, P., Carr, L., and Finch, J. (2007) ‘No model of clinical education for physiotherapy students is superior to another: A systematic review’. Australian Journal of Physiotherapy, 53, 19-28 https://doi.org/10.1016/S0004-9514(07)70058-2
Mihalynuk, T., Bates, J., Page, G., and Fraser, J. (2008) ‘Student learning experiences in a longitudinal clerkship programme’. Medical Education, 42 (7), 729-732
Minichiello, V., Sullivan, G., Greenwood, K., and Axford, R. (eds.) (2004) Handbook of Research Methods in Nursing and Health Science. Sydney: Pearson Education.
Poncelet, A., Bokser, S., Calton, B., Hauer, K.E., Kirsch, H., Jones, T., … and Robertson, P. (2011) ‘Development of a longitudinal integrated clerkship at an academic medical centre’. Medical Education Online, 16, 5939. available from https://doi.org/10.3402/meo.v16i0.5939
Poncelet, A.N., Wamsley, M., Hauer, K.E., Lai, C., Becker, T., and O’Brien, B. (2013) ‘Patient views of continuity relationships with medical students’. Medical Teacher, 35 (6), 465-471 https://doi.org/10.3109/0142159X.2013.774335
Puvanendran, R., Vasanwala, F.F., Kamei, R.K., Hock, L.K., and Lie, D.A. (2012) ‘What do medical students learn when they follow patients from hospital to community? A longitudinal qualitative study’. Medical Education Online, 17, 18899. available from https://doi.org/10.3402/meo.v17i0.18899
Sheepway, L., Lincoln, M., and McAllister, S. (2014) ‘Impact of placement type on the development of clinical competency in speech–language pathology students’. International Journal of Language and Communication Disorders, 49 (2), 189-203 https://doi.org/10.1111/1460-6984.12059
Sheepway, L., Lincoln, M., and Togher, L. (2011) ‘An international study of clinical education practices in speech-language pathology’. International Journal of Speech-Language Pathology, 13 (2) 174-185 https://doi.org/10.3109/17549507.2011.491129
Speech Pathology Australia (2011) COMPASS®: Competency Assessment in Speech Pathology. Melbourne, Australia: The Speech Pathology Association of Australia Ltd.
Stat Trek (n.d.) Convenience Sampling. [online] available from http://stattrek.com/statistics/dictionary.aspx?definition=convenience_sample [1 July 2015]
Sturmberg, J.P., Reid, S., and Khadra, M.H. (2002) ‘A longitudinal, patient-centred, integrated curriculum: Facilitating community-based education in a rural clinical school’. Education for Health, 15 (3), 294-304 doi: 10.1080/1357628021000012787
Teherani, A., Irby, D.M., Loeser, H. (2013) ‘Outcomes of different clerkship models: longitudinal integrated, hybrid, and block’. Academic Medicine, 88 (1), 35-43
Thistlethwaite, J.E., Bartle, E., Chong, A.A.L, Dick, M., King, D., Mahoney, S., … and Tucker, G. (2013) ‘A review of longitudinal community and hospital placements in medical education: BEME Guide No. 26’. Medical Teacher, 35 (8), e1340-e1364 https://doi.org/10.3109/0142159X.2013.806981
Walters, L., Greenhill, J., Richards, J., Ward, H., Campbell, N., Ash, J., and Schuwirth, L.W.T. (2012) ‘Outcomes of longitudinal integrated clinical placements for students, clinicians, and society’. Medical Education, 46 (11), https://doi.org/10.1111/j.1365-2923.2012.04331.x
World Health Organization (2010) Framework for Action on Interprofessional Education & Collaborative Practice. [online] available from http://www.who.int/hrh/resources/framework_action/en/ [20 December 2016]
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