Simulation-based Learning Experiences in Stuttering Management Delivered Online: What Do Students, Clinical Educators and Simulated Patients Think?


  • Adriana Penman The University of Queensland
  • Monique Waite The University of Queensland
  • Anne E. Hill The University of Queensland
  • Taliesha-jayne Leslie The University of Queensland
  • Brooke-Mai Whelan The University of Queensland
  • Andrea Whitehead The University of Queensland



Speech pathology students are required to demonstrate competency across a range of practice areas. There are, however, limited opportunities for students to access clinical placements in the area of stuttering. Simulation-based learning (SBL) activities have proven to be effective in increasing students’ clinical experience in this area. Due to the COVID-19 pandemic, the delivery of in-person SBL programs was not feasible, resulting in a shift to online provision. The aim of this study was to investigate the perceptions of students, clinical educators and simulated patients who participated in an online adult stuttering SBL experience. Ten first-year graduate entry Masters program speech pathology students participated in the study alongside four clinical educators and four simulated patients. The experience involved two online SBL sessions and one online tutorial via videoconferencing from separate locations. Each participant group engaged in focus group interviews exploring their perceptions of the online SBL activity. Thematic network analysis of the focus group interview data was conducted. Overall interpretation of the data from the perspectives of students, clinical educators and simulated patients revealed an overarching global theme that online SBL offers a positive, comfortable and comparable experience to enable students to build client-centred, clinical and telepractice skills. The positive outcomes of this study suggest that together with in-person clinical experiences, online SBL has an important role in the education of speech pathology students. 


Attride-Stirling, J. (2001). Thematic networks: an analytic tool for qualitative research. Qualitative Research: QR, 1(3), 385–405.

Barrows, H. S. (1993). An overview of the uses of standardized patients for teaching and evaluating clinical skills. Academic Medicine, 68(6), 443–451.

Bridgman, K., Pallathil, K., Ford, N., Tran, J., Lam, D., Wee, E., & Kefalianos, E. (2018). Attitudes and experiences of SLP students from a pilot telehealth stuttering clinic. Journal of Clinical Practice in Speech-Language Pathology, 20(1), 14–20. Retrieved from

Cardell, E., & Hill, A. E. (2013). Student-delivered intensive smooth speech programs for adolescents and adults who stutter: A preliminary exploration of student confidence, anxiety, and interest. Journal of Clinical Practice in Speech-Language Pathology, 15(2), 54–59. Retrieved from

Cleland, J., McKimm, J., Fuller, R., Taylor, D., Janczukowicz, J., & Gibbs, T. (2020). Adapting to the impact of COVID-19: Sharing stories, sharing practice. Medical Teacher, 42(7), 772–775.

Contreas, M., Curran, E., Ross, M., Moran, P., Sheehan, A., Brennan, A. M., Cosgrave, D., McElwain, J., Lavelle, C., & Lynch, B. (2020). Rapid development of interprofessional in situ simulation-based training in response to the COVID-19 outbreak in a tertiary-level hospital in Ireland: Initial response and lessons for future disaster preparation. BMJ Simulation & Technology Enhanced Learning, 7(3), 159-162.

Creswell, J. W. (2014). Research design: Qualitative, quantitative and mixed methods approaches (4th ed.). Sage.

Furman, G. E. (2008). The role of standardized patient and trainer training in quality assurance for a high-stakes clinical skills examination. Kaohsiung Journal of Medical Sciences, 24(12), 651–655.

Hewat, S., Penman, A., Davidson, B., Baldac, S., Howells, S., Walters, J., Purcell, A., Cardell, E., McCabe, P., Caird, E., Ward, E., & Hill, A. E. (2020). A framework to support development of quality simulation-based learning programs in speech-language pathology. International Journal of Language and Communication Disorders, 55(2), 287–300.

Hill, A. E., Ward, E., Heard, R., McAllister, S., McCabe, P., Penman, A., Caird, E., Aldridge, D., Baldac, S., Cardell, E., Davenport, R., Davidson, B., Hewat, S., Howells, S., Purcell, A., & Walters, J. (2020). Simulation can replace part of speech-language pathology placement time: A randomised controlled trial. International Journal of Speech Language Pathology, 23(1), 92–102.

Hmelo-Silver, C. E. (2004). Problem-based learning: What and how do students learn? Educational Psychology Review, 16(3), 235–266.

Howells, S., Cardell, E. A., Waite, M. C., Bialocerkowski, A., & Tuttle, N. (2019). A simulation-based learning experience in augmentative and alternative communication using telepractice: speech pathology students’ confidence and perceptions. Advances in Simulation, 4(S1), 23.

INACSL Standards Committee. (2016). INACSL standards of best practice: SimulationSM Simulation design. Clinical Simulation in Nursing, 12(S), S5–S12.

Ker, J., & Bradley, P. (2014). Simulation in medical education. In T. Swanwick (Eds.), Understanding Medical Education (pp. 175–192). John Wiley & Sons, Ltd.

Jones, D., McAllister, L., & Lyle, D. (2015). Stepping out of the shadows: Allied health student and academic perceptions of the impact of a service-learning experience on student's work-readiness and employability. Journal of Teaching and Learning for Graduate Employability, 6(1), 66–87.

Larue, C., Pepin, J., & Allard, E. (2015). Simulation in preparation or substitution for clinical placement: A systematic review of the literature. Journal of Nursing Education and Practice, 5(9), 132–140.

Maidment, J. (2010). Getting ready for placement. In K. Stagnitti, A. Schoo, & D. Welch (Eds.), Clinical and fieldwork placement in the health professions (pp. 3–12). Oxford University Press. Retrieved from

Nyumba, T. O., Wilson, K., Derrick, C. J. & Mukherjee, N. (2018). The use of focus group methodology: Insights from two decades of application in conservation. Methods in Ecology and Evolution, 9(1), 20–32.

O’Shea, M-C., Reeves, N. E., Bialocerkowski, A., & Cardell, E. (2019). Using simulation-based learning to provide interprofessional education in diabetes to nutrition and dietetics and exercise physiology students through telehealth. Advances in Simulation, 4(S1), 28.

Overby, M. S., & Baft-Neff, A. (2017). Perceptions of telepractice pedagogy in speech-language pathology: A quantitative analysis. Journal of Telemedicine and Telecare, 23(5), 550–557.

Penman, A., Hill, A. E., Hewat, S., & Scarinci, N. (2020). "I felt more prepared and ready for clinic": Connections in student and clinical educator views about simulation-based learning. Australian Journal of Clinical Education, 7(1).

Penman, A., Hill, A.E., Hewat, S., & Scarinci, N. (2021). Does a simulation-based learning programme assist with the development of speech-language pathology students’ clinical skills in stuttering management? International Journal of Language and Communication Disorders, 56(6), 1334-1346.

Randall, K., Steinheider, B., Isaacson, M., Shortridge, A., Byrd, S., Ciro, C., Ross, H., & Loving, G. (2016). Measuring knowledge, acceptance, and perceptions of telehealth in an interprofessional curriculum for student nurse practitioners, occupational therapists and physical therapists. Journal of Interactive Learning Research, 27(4), 339–353. Retrieved from

Rose, S. (2020). Medical student education in the time of COVID-19. JAMA, 323(21), 2131–2132.

Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health, 23(4), 334–340.<334::AID-NUR9>3.0.CO;2-G

Shorland, J., Morris, C., & Stephens, D. (2018). Simulation speaks for itself: Building speech-language pathology students' confidence through high quality simulation within a workplace clinical placement. Focus on Health Professional Education, 19(2), 53–67.

Smith, C., Ferns, S., & Russell, L. (2014). The impact of work integrated learning on student work-readiness. Australian Government Office for Learning and Teaching.

Speech Pathology Australia [SPA]. (2014) Telepractice in Speech Pathology [Position Statement]. Retrieved from

Speech Pathology Australia [SPA]. (2018). Clinical Education in Australia: Building a profession for the future. Speech Pathology Australia. Retrieved January 15, 2021, from

Tabatabai, S. (2020). Simulations and virtual learning supporting clinical education during COVID 19 pandemic. Advances in Medical Education and Practice, 11, 513–516.

Tohidast, S. A., Mansuri, B., Bagheri, R., & Azimi, H. (2020). Provision of speech-language pathology services for the treatment of speech and language disorder in children during the COVID-19 pandemic. International Journal of Pediatric Otorhinolaryngology, 138, 110262.

World Health Organisation [WHO]. (2020). COVID-19: Physical distancing. Retrieved January 15, 2021, from

Yaruss, J. S., & Quesal, R. W. (2002). Academic and clinical education in fluency disorders: an update. Journal of Fluency Disorders, 27(1), 43–63.




How to Cite

Penman, A., Waite, M., Hill, A. E., Leslie, T.- jayne, Whelan, B.-M., & Whitehead, A. (2022). Simulation-based Learning Experiences in Stuttering Management Delivered Online: What Do Students, Clinical Educators and Simulated Patients Think? . International Journal of Practice-Based Learning in Health and Social Care, 10(1), 23–35.