JCPSLP Vol 20 No 2 July 2018

and colleagues (2017) further explored the paradoxical nature of SLPs’ perceptions of working with assistants and found the importance of consumer focus in the formation of professional perceptions. These findings are consistent with the consumer focus within the professional code of ethics, which identifies the fundamental values of the profession as integrity, professionalism, respect and care, quality standards and continuing competence (The Speech Pathology Association of Australia Limited, 2010). Aims This paper aims to explore the role of professional identity shaping in SLPs’ perceptions of working with assistants. SLPs’ accounts of their perceptions of working with assistants are examined to explore how professional identity contributes to their assessment of this aspect of workforce redesign. The following questions are addressed: 1. How do SLPs perceive their professional identities? 2. How do SLPs describe the values of their profession? 3. What factors pertaining to the introduction of assistants potentially impact professional identity? Method Research design This current study is part of a larger research project investigating how SLPs perceive working with assistants prior to assistants being introduced by the health organisation. Given the exploratory nature of this research, an inductive qualitative methodology was used. Interviews were conducted with SLPs in remote, rural and metropolitan areas to ascertain their perceptions of a workforce redesign involving assistants. Ethical approval was sought and granted by a health-based lead ethics committee as well as the university’s human research ethics committee. Recruitment Given the primary researcher (Author A) is a practising SLP, recruitment was conducted by another party independent of the research to ensure perceived coercion was avoided. Details of the study were provided to a SLP colleague, who disseminated the information to senior SLPs across a public health organisation in New South Wales, Australia. Senior SLPs then distributed this information to their staff, who were invited to contact the researcher directly if interested in participating. Participants Twenty SLPs volunteered to be interviewed. Demographic data are presented in Table 1. Seventeen of the sample were women; three were men, and participants were from community, hospital, or mixed settings. The majority worked full-time and had more than 10 years’ clinical experience. Both adult and paediatric caseloads were represented. Fourteen of the 20 participants reported some experience of working with assistants in their careers;however, this was not part of the selection criteria for participation in this research. Data collection Semi-structured interviews were conducted by a SLP researcher (Author A) to explore perceptions of the introduction of assistants, and participants’ understanding of their role, boundaries, job security and satisfaction. Participants were encouraged to lead and direct the discussion about issues they perceived as most important (Smith, Flowers, & Larkin, 2009). A comprehensive list of

agreed standards of practice and behaviour which are encouraged by universities, professional associations (e.g., Speech Pathology Australia, 2011) and employers (e.g., employer’s code of conduct). Speech-language pathology can be considered a community of practice (Ferguson & Armstrong, 2004; Wenger, 1998), by way of its shared practices, goals and language. Wenger (1998) suggests that dynamic change in a community of practice occurs at the boundaries of the community (in this instance, the profession), and so it is suggested that by examining the activity occurring at these boundaries, the potential future scope of professional practice for speech-language pathology may be found – for example, by considering advanced scope of practice at the upper end of the professional boundary (e.g., Fibreoptic Endoscopic Evaluation of Swallow [FEES]). While reforms involving contested professional boundaries have been addressed in research into other professions (Nancarrow & Borthwick, 2005), past studies are scant in relation to changes in professional identity consequent to the introduction of new occupational groups that may be perceived as being on the lower end of the professional boundaryinto speech pathology. It is acknowledged that unclear definition of the assistant role, and subsequent uncertain delineation between that and the SLP role may contribute to threatened professional identity. This paper therefore aims to build awareness that perceptions of workforce redesign are not only informed by the sense of self as an individual, but also by the sense of belonging to a distinct professional group (Haslam, 2014). Speech-language pathologists’ perceptions of assistants Assistants are utilised by SLPs internationally. Aspects of these assistant roles include direct care of lower complexity patients as well as provision of administrative support, thus allowing professionals to concentrate on more complex clinical needs (Lizarondo et al., 2010). It has been shown that perceptions of working with assistants in allied health research are consistently ambivalent. Specific to speech- language pathology, McCartney and colleagues (2005) conducted a case study of speech-language therapists working with assistants in the United Kingdom and found both benefits and “disbenefits” to working with assistants. For example, participants in their study identified that working with an assistant contributed to ensuring that SLPs’ clinical reasoning and rationales were sound and well articulated, but also resulted in less time for the SLPs to plan their own caseload. The authors noted that the perceptions of SLPs in their study were similar to those reported in a study by Van der Gaag and Davies (1993) more than ten years previously. In this study SLPs were notably conservative in their willingness to share tasks with assistants, a finding that was attributed to the fact that members of the SLP profession had less experience and exposure to working with assistants at that time (Davies & Van der Gaag, 1992; Van der Gaag & Davies, 1993). O’Brien and colleagues (2013) explored the perceptions of SLPs in one local health district in Australia and found that SLPs with previous exposure to working with assistants were generally more positive towards working with assistants than those with no previous exposure (O’Brien et al., 2013). They suggested the need for positive perceptions to ensure the sustainability of such a workforce redesign and offered professional identity as a framework for understanding such perceptions. More recently, O’Brien

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JCPSLP Volume 20, Number 2 2018

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