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Volume 15, Number 2 2013

Journal of Clinical Practice in Speech-Language Pathology










This article

has been



Robyn Johnson

(top), Alison

Purcell (centre) &

Emma Power

Clinical education

Developing speech

pathology clinical


Are there predictors for success?

Robyn Johnson, Alison Purcell and Emma Power

that may influence or predict academic and clinical success

(Forrest & Naremore, 1998; Halberstam & Redstone, 2005;

Kjelgaard & Guarino, 2012; Shapiro, Ogletree, & Dale

Brotherton, 2002). For the most part, studies of clinical

education in SLP (and other fields) have examined variables

that are in the control of the universities themselves, i.e.,

the provision of academic and clinical education (including

the skills of the clinical educators). Further, this research

has predominantly concentrated on predictors of academic

success. Very few studies examine predictors of clinical

success, e.g., Shapiro et al. (2002) and Dowling (1985).

Surprisingly, there has been little research into the

thinking and learning skills health sciences students bring to

their tertiary education. This may be due in part to differing

priorities of university staff and students. The differences

were described by Alhaqwi, Molen, Magzoub, and Schmidt

(2010), who examined opinions on effective clinical learning

in medical students and educators in Saudi Arabia. They

found that students focused on opportunities for clinical

learning and “their own strengths and weaknesses as

learners” (p. 12), while educators focused on “creating

the learning environment” (p. 13). It may be that student

factors are less represented in the literature because the

researchers (who are mainly educators) have focused more

on understanding their own area of interest, the learning


SLP studies have recognised academic success

as a contributor to students successfully developing

competent clinical skills (McAllister, Lincoln, Ferguson,

& McAllister, 2011). Thus, providing additional academic

support may be one way to improve clinical competency

for struggling students. However, the success of

providing additional academic support may be limited if

the students’ clinical difficulties exist at least in part due

to issues with their clinical education placement and/or

their own characteristics. In Figure 1, we provide a simple

representation of the way features (broadly represented

in the literature) may contribute to development of a

competent entry-level clinician. These features include

tertiary academic education, clinical education and the

students’ characteristics. Further investigation of the impact

of these three features is necessary to ensure appropriate

assistance for SLP students experiencing difficulties in the

acquisition of clinical competency.

This paper presents a narrative summary of the

literature regarding the impact of clinical failure on SLP

students and the potential predictors of success or failure

in their development. The variables that may influence

Learning the necessary skills to become a

speech-language pathologist is a complex

task. It involves academic and clinical

learning as well as the students’ own

personal characteristics (e.g., learning,

health, thinking, gender, age). However, there

is little published research worldwide

regarding student skills that will predict

clinical success in speech language

pathology (SLP). We present a summary of

the literature regarding the impact of clinical

failure for SLP students and the potential

predictors to success or failure in this

development. Variables that may influence

student clinical performance are discussed

with specific emphasis on the student

characteristics. We conclude that further

research into early predictors of clinical

success is warranted.


earning the necessary skills to become a speech-

language pathologist is a complex task. Speech-

language pathology (SLP) students spend several

years acquiring the theoretical knowledge needed to

be competent across the areas of practice identified by

Speech Pathology Australia (Speech Pathology Australia,

2003). Graduating SLP students must also demonstrate

competency in both discipline-specific and more generic

clinical skills common to all health professionals (Clouten,

Homma, & Shimada, 2006). A proportion of students have

difficulty acquiring the required level of clinical competency

and identifying these students early in the first years of SLP

study is extremely challenging. Failing clinical placements

can have serious ramifications for these students. Early

identification of those at risk of clinical failure would allow

time for additional specific learning support to take place

before starting clinical placements. It would also allow

additional support to be provided over longer periods of

time. This support would aim to minimise the number of

students who experience clinical difficulties and failure.

There is little published research regarding predictors

of clinical success in SLP. Indeed, Ho and Whitehill (2009)

identified that SLP clinical education as a whole is under-

researched. A handful of studies have examined variables