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JCPSLP
Volume 19, Number 1 2017
Journal of Clinical Practice in Speech-Language Pathology
practices with Aboriginal and Torres Strait Islander children.
In context 1, students engaged in a weekly journal club
as part of their clinic day. “In our journal club, we had a lot
of focus on issues they needed to consider working with
children from Indigenous backgrounds” (SLP CE 1). “I think
people felt safe to share their feelings and their observations
[in debriefing sessions]” (OT CE 1).
Students also reported positive outcomes from the
journal club. “A lot of it was on cultural and community
aspects that speech and OT can contribute … it was quite
good to bring that to awareness” (SLP student, group 1).
In context 2, some students met for tutorials and
debriefing at the host Institute where they were able to
interact with Indigenous staff: “the lunches and morning
teas with the Institute gave a really positive feel for working
in an Aboriginal and Torres Strait Islander Health service”
(OT Student, group 3).
Another student commented: “I never felt uncomfortable
to ask questions and was always given feedback when
needed” (OT Student, group 3). However, in one clinic,
students had difficulty attending the tutorials because of
their university timetable and this restricted their learning of
culturally responsive practice.
[The tutorials and debriefing] helped students to be
more in tune with expectations, have more opportunity
to discuss their clinical reasoning, so they were just
more immersed in the organisation’s style of practice.
The students [in the other clinic] did not have this
experience because they couldn’t fit [the tutorials] into
their schedule. The SLP students had to rush off to
get to a uni lecture before the [client] session had even
ended. (OT CE 2)
Overall, 93% of students indicated that their appreciation
and knowledge of Indigenous cultures and their awareness
of the health issues faced by Indigenous people had
increased as a result of their placement.
The importance of relationships
Responses from students and CEs reflected the importance
of relationships with a variety of stakeholders involved in
service delivery. It was important to ensure that clinical
educators had developed a relationship with staff in the
practice context over a period of time. This provided a solid
basis for the clinical educators to introduce students into
the context.
We’ve gradually built our own relationships with the
principal, with the prep teacher and the year one
teacher…we’ve spent quite a lot of time trying to
cement those relationships within the environment.
[Now] we’re accepted there and feel more comfortable
and we’ve established those bonds. (OT CE 1)
Developing relationships was more difficult in context 2
where the service was new. CEs in this context commented
that they had not had time to form connections with other
health staff at the clinics before running the programs.
Students were encouraged to spend time building
relationships with the staff in the practice contexts and it
was made clear that this was an important use of their time.
As a student, they would probably not do that without
our encouraging and nurturing because they’d be
on the product, you know, “I’ve got to complete this
assessment…” We did give them a lot of reassurance
that it was OK [to spend the time]. (OT CE 1)
Student responses reflected that they had learnt these skills
over time, with 89% of students indicating they felt they had
student participants agreed that it was important to receive
a comprehensive orientation for the placement. In context
1, this orientation had evolved over time to include a
cultural and community orientation from Indigenous board
members in the school and 100% of students felt they
received an adequate orientation for the placement.
Students from context 2 also received a cultural and
placement-specific orientation and they generally agreed
that the orientation was adequate but 10.5% indicated they
were either unsure or did not feel they had an adequate
orientation. One student commented: “I feel that the
orientation to this placement gave little speech related
information and unfortunately the speech CE was not able
to attend the orientation” (SLP student, group 3).
The need for clear expectations for interprofessional
contact was expressed by both student and CE
participants. CE responses indicated the importance of
students having face-to-face time with each other outside
of the clinic. In context 1, students were given a structured
schedule on their first day that detailed their interactions
with the clients as well as each other, including preparation
and debriefing meetings. Students were expected to
commit to a weekly two-hour meeting outside the clinic
day.
We will negotiate it until everybody agrees before we
leave…it’s too easy to go, when one says that time
doesn’t suit me, “Well OK, maybe you can catch up
later on”, and then that student doesn’t have the IP
experience that we’re after, so we keep going until we
get a good compromise. (OT CE 1)
In contrast, a CE in context 2 commented:
We strongly encouraged this [the students to meet
outside clinic time] but did not make it compulsory. We
did reiterate the importance of checking with the team
before sending session plans through, although we
could tell that this hadn’t always been done. (OT CE 2)
The process of establishing teams between OT and SLP
students was also conducted in an explicit manner with the
importance of being physically together highlighted so that
each pair of students began to consider themselves as a
team from the beginning. “Within the first hours they are put
into their pairs, I mean physically put into their pairs, sitting
together, so from the get-go when they are getting their
caseloads they are already thinking as one” (SLP CE 1).
Students came to appreciate the importance of these
meetings: “Initially I was resentful of attending so many
feedback and planning sessions, however throughout I
really appreciated the feedback and planning sessions as I
believe this really enhanced my learning and collaboration
with other students” (OT student, group 3).
In terms of more formal communication, students were
given the clear expectation that all their interactions with
the clinical educators and professional development
needed to happen as a team. “So if you want to talk to
us about a client, you come as a pair” (SLP CE 1). In
context 2, students in one location had made an effort
to communicate outside the clinic and this resulted in
them being more prepared and organised, knowing
their allocated roles, and working more effectively with
the children. In the other location, where this student
communication had been limited, students struggled with
working as a team.
It was also seen as important to incorporate structures
and processes which facilitated a safe learning
environment, particularly in exploring students’ roles and