Speak Out June 2020

Clinical placements in the COVID-19 pandemic

by Andrea Whitehead and Kelly Beak UQ Health and Rehabilitation Clinics School of Health and Rehabilitation Sciences The University of Queensland

pathologist, Rebecca Gillogly and others in her area are making the most of video conferencing technology. “Smaller teams meet on a daily basis to ensure professionals remain connected, both professionally and socially during this time. The area team looks forward to establishing further WebEx meetings for the duration of the period of working from home and further adapting services as needed.” Volunteer Committees have also seized opportunities to use technology to support mental health and motivation for staff in the remote workplace, organising scavenger hunts and trivia competitions via teleconferencing. And what of the lighter side to all of this? Social media’s awash with teleconferencing gaffes, some true, other artificial, all hilarious. One of Kirsty Lay’s clinicians conducted a paediatric telehealth session with a client in his jocks; “His mum couldn’t convince him to put trousers on!” Another of Kirsty’s clinicians held a session while the client sat in a trolley and his parents shopped for groceries. Littlies at Chrystal Symons and Associates have also embraced their technology-driven therapy. “It’s funny when the clients realise that they can see themselves on the screen. I’ve had clients open their mouths extra wide or admire their smiles from different angles. One client opened their mouth so wide I got a good view of their tonsils.”— a strategy Chrystal thinks she just might use in her post-pandemic practice. Now the curve has flattened, many of us are reflecting on the tumult. Royal Melbourne Hospital are learning to live with the current environment in the long haul, with a possible low peak of COVID-19 presentations. But there’s positives that have come from the chaos, as Maddie Gwynn points out, “We’ve demonstrated we can adapt to a rapidly evolving environment. This has really challenged us to think laterally and highlighted our under utilisation of technology.” Maddie and the speech pathology staff at Royal Melbourne Hospital are also hopeful that the adaptations made during this period that have led to positive change and innovations continue into the future. We’re also left questioning our new practices, some of us falling into the old, well-laid traps of self-doubt, but there’s been some healthy reflection. Although overwhelmed initially, Chrystal Symons is optimistic. “I’ve learnt a whole lot of new skills and, along with my clients, have had to increase my ability to be flexible and resilient”. And there’s comfort we can also take from our shared experience, our stories of successes, obstacles and anxieties. “Sometimes families will ask to say ‘hi’ to my kids and so I bring them on for a brief meet-and-greet. I was initially worried that this made me look unprofessional, however I now think it makes me look human.”

T he COVID-19 situation resulted in considerable unforeseen changes to the clinical placements of students in the School of Health and Rehabilitation Sciences of the University of Queensland (UQ). Across all disciplines, large numbers of clinical placements were cancelled or disrupted as a consequence of COVID-19, including social distancing restrictions, client cancellation; redeployment of clinicians to other roles, and student and/ or staff absence. Consequently, an urgent and immediate expansion of tele rehabilitation services to clients and exploration of alternative models of clinical supervision was commenced. Evidence-base Telerehabilitation in speech pathology (SP) is well established, with evidence across a multitude of clinical areas that its use is at least equivalent to standard clinical care (Speech Pathology Australia (SPA),2014). Although there is evidence regarding synchronous remote supervision of early career professionals, no such studies have been identified which describe a model when the student, clinical educator (CE), and client are all in separate locations, and the student’s only mode of clinical supervision and support is provided via remote supervision (Laughran & Sackett, 2015; Martin, Lizaronda, & Kumar, 2018; McAllister & Nagarajan, 2015; Nagarajan et al., 2015, 2016, 2018; Chipchase et al.,2014). SPA references remote supervision in an example for consideration with final year students (SPA,2018). Background UQ established the Tele rehabilitation Clinic in 2015 with a focus on student-delivered services in specifically developed clinics. Clinical supervision of SP students at UQ is traditionally provided in a model whereby the student, CE, and client are in one location. In existing tele rehabilitation clinics, the student and CE are co-located while the client is off-site. UQ has two speech pathology programs, including an undergraduate (UG) degree, and a graduate entry masters (GEM)program.

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June 2020 www.speechpathologyaustralia.org.au

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