The confidence of speech-language pathology students regarding communicating with people with aphasia

BMC Medical Education

Steven M McPhail²  Ashley Cameron¹  Jennifer Lethlean¹  Kyla Brown³  Jennifer Fleming⁵  Emma Finch⁴ 

[1] Speech Pathology Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia;School of Public Health & Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia;NHMRC Centre for Clinical Research Excellence, Aphasia Rehabilitation, Brisbane, Queensland, Australia;Centre for Functioning and Health Research, Queensland Health, Brisbane, Australia;Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia

关键词: Training needs;    Communication;    Confidence;    Students;    Speech pathology;    Aphasia;   

Others  :  1138872
DOI  :  10.1186/1472-6920-13-92

 received in 2012-09-06, accepted in 2013-03-20,  发布年份 2013

【 摘 要 】

Background

Aphasia is an acquired language disorder that can present a significant barrier to patient involvement in healthcare decisions. Speech-language pathologists (SLPs) are viewed as experts in the field of communication. However, many SLP students do not receive practical training in techniques to communicate with people with aphasia (PWA) until they encounter PWA during clinical education placements.

Methods

This study investigated the confidence and knowledge of SLP students in communicating with PWA prior to clinical placements using a customised questionnaire. Confidence in communicating with people with aphasia was assessed using a 100-point visual analogue scale. Linear, and logistic, regressions were used to examine the association between confidence and age, as well as confidence and course type (graduate-entry masters or undergraduate), respectively. Knowledge of strategies to assist communication with PWA was examined by asking respondents to list specific strategies that could assist communication with PWA.

Results

SLP students were not confident with the prospect of communicating with PWA; reporting a median 29-points (inter-quartile range 17–47) on the visual analogue confidence scale. Only, four (8.2%) of respondents rated their confidence greater than 55 (out of 100). Regression analyses indicated no relationship existed between confidence and students‘ age (p = 0.31, r-squared = 0.02), or confidence and course type (p = 0.22, pseudo r-squared = 0.03). Students displayed limited knowledge about communication strategies. Thematic analysis of strategies revealed four overarching themes; Physical, Verbal Communication, Visual Information and Environmental Changes. While most students identified potential use of resources (such as images and written information), fewer students identified strategies to alter their verbal communication (such as reduced speech rate).

Conclusions

SLP students who had received aphasia related theoretical coursework, but not commenced clinical placements with PWA, were not confident in their ability to communicate with PWA. Students may benefit from an educational intervention or curriculum modification to incorporate practical training in effective strategies to communicate with PWA, before they encounter PWA in clinical settings. Ensuring students have confidence and knowledge of potential communication strategies to assist communication with PWA may allow them to focus their learning experiences in more specific clinical domains, such as clinical reasoning, rather than building foundation interpersonal communication skills.

【 授权许可】

   
2013 Finch et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Berthier ML: Poststroke aphasia: Epidemiology, pathophysiology and treatment. Drugs Aging 2005, 22(2):163-182.
• [2]Dickey L, Kagan A, Lindsay MP, Fang J, Rowland A, Black S: Incidence and profile of inpatient stroke-induced aphasia in Ontario, Canada. Arch Phys Med Rehabil 2010, 91:196-202.
• [3]Lalor E, Cranfield E: Aphasia: A description of the incidence and management in the acute hospital setting. Asia Pacific Journal of Speech, Language and Hearing 2004, 9:129-136.
• [4]Pedersen PM, Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS: Aphasia in acute stroke: Incidence, determinants, and recovery. Ann Neurol 1995, 38(4):659-666.
• [5]Parr S: Living with severe aphasia: Tracking social exclusion. Aphasiology 2007, 21:98-123.
• [6]Ross A, Winslow I, Marchant P, Brumfitt S: Evaluation of communication, life participation and psychological well-being in chronic aphasia: The influence of group intervention. Aphasiology 2006, 20(5):427-448.
• [7]Simmons-Mackie N: Thinking beyond language: Intervention for severe aphasia. Perspectives on Neurophysiology & Neurogenic Speech & Language Disorders 2009, 19(1):15-22.
• [8]Simmons-Mackie N, Damico J: Access and social inclusion in aphasia: Interactional principles and applications. Aphasiology 2007, 21:81-97.
• [9]McPhail S, Beller E, Haines T: Two perspectives of proxy reporting of health-related quality of life using the Euroqol-5D, an investigation of agreement. Medical care 2008, 46(11):1140-1148.
• [10]Code C, Simmons-Mackie N, Armstrong E, Stiegler L, Armstrong J, Bushby E, Carew-Price P, Curtis H, Haynes P, McLeod E, Muhleisen V, Neate J, Nikolas A, Rolfe D, Rubly C, Simpson R, Webber A: The public awareness of aphasia: An international survey. Int J Language and Commun Disord 2001, 36(suppl):1-6.
• [11]Kagan A: Supported conversation for adults with aphasia: Methods and resources for training conversation partners. Aphasiology 1998, 12:816-830.
• [12]McVicker S, Parr S, Pound C, Duchan J: The communication partner scheme: A project to develop long-term, low-cost access to conversation for people living with aphasia. Aphasiology 2009, 23(1):52-71.
• [13]O’Halloran R, Hickson L, Worrall L: Environmental factors that influence communication between people with communication disability and their healthcare providers in hospital: A review of the literature within the International Classification of Functioning, Disability and Health (ICF) framework. Int J Language and Commun Disord 2007, 43(6):601-632.
• [14]Leach E, Cornwell P, Fleming J, Haines T: Patient centered goal-setting in a subacute rehabilitation setting. Disabil Rehabil 2010, 32(2):159-172.
• [15]O’Halloran R, Worrall L, Hickson L: Environmental factors that influence communication between patients and their healthcare providers in acute hospital stroke units: An observational study. Int J Language and Commun Disord 2011, 46(1):30-47.
• [16]Knight K, Worrall L, Rose T: The provision of health information to stroke patients within an acute hospital setting: What actually happens and how do patients feel about it? Top Stroke Rehabil 2006, 13(1):78-97.
• [17]Hill AE, Davidson B, Theodoros D: A review of standardized patients in clinical education: Implications for speech-language pathology programs. Int J Speech Lang Pathol 2010, 12(3):259-270.
• [18]Jagoe C, Roseingrave R: “If this is what I’m meant to be…“: The journeys of students participating in a conversation partner scheme for people with aphasia. Journal of Academic Ethics 2011, 9(2):127-148.
• [19]Andrighetti TP, Knestrick JM, Marowitz A, Martin C, Engstrom JL: Shoulder dystocia and postpartum hemorrhage simulations: Student confidence in managing these complications. J Midwifery Womens Health 2011, 57:55-60.
• [20]Lupu AM, Stewart AL, O’Neil C: Comparison of active-learning strategies for motivational interviewing skills, knowledge, and confidence in first-year pharmacy students. Am J Pharm Educ 2012, 76(2):1-28.
• [21]Speech Pathology Australia: Competency-based Occupational Standards for Speech Pathologists Entry Level (CBOS). The Speech Pathology Association of Australia Limited; 2011.
• [22]American Speech-Language-Hearing Association: Standards and Implementation Procedures for the Certificate of Clinical Competence in Speech-Language Pathology. [http://www.asha.org/certification/slp_standards/ webcite]
• [23]World Health Organisation: International Classification of Functioning, Disability, and Health. World Health Organisation; 2001.
• [24]Braun V, Clarke V: Using thematic analysis in psychology. Qualitative Research in Psychology 2006, 3:77-101.
• [25]Marks D, Yardley L: Research methods for clinical and health psychology. London: SAGE; 2004.
• [26]Maykut P, Maykut PS, Morehouse RE, Morehouse R: Beginning qualitative research: A philosophic and practical guide, Volume 6. London, UK: Routledge; 1994.
• [27]Patton MQ: Qualitative research and evaluation methods. Inc, London, UK: Sage Publications; 2002.
• [28]Passier L, McPhail S: Work related musculoskeletal disorders amongst therapists in physically demanding roles: qualitative analysis of risk factors and strategies for prevention. BMC Musculoskelet Disord 2011, 12(1):24. BioMed Central Full Text
• [29]Dalemans R, Wade DT, Van Den Heuvel WJA, de Witte LP: Facilitating the participation of people with aphasia in research: A description of strategies. Clin Rehabil 2009, 23:948-959.
• [30]Howe T, Worrall LE, Hickson L: Interviews with people with aphasia: Environmental factors that influence their community participation. Aphasiology 2008, 22(10):1092-1120.
• [31]Kagan A, Black SE, Duchan JF, Simmons-Mackie N, Square P: Training volunteers as conversation partners using “Supported Conversation with Adults with Aphasia”: A controlled trial. J Speech Lang Hear Res 2001, 44:624-638.
• [32]Kagan A, Winckel J, Black S, Duchan JF, Simmons-Mackie N, Square P: A set of observational measures for rating support and participation in conversation between adults with aphasia and their conversation partners. Top Stroke Rehabil 2004, 11:67-83.
• [33]Shelton C, Shryock M: Effectiveness of communication/interaction strategies with patients who have neurological injuries in a rehabilitation setting. Brain Inj 2007, 21(12):1259-1266.
• [34]Simmons-Mackie N, Raymer A, Armstrong E, Holland A, Cherney LR: Communication partner training in aphasia: a systematic review. Arch Phys Med Rehabil 2010, 91(12):1814.