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JCPSLP
Volume 17, Supplement 1, 2015 – Ethical practice in speech pathology
Journal of Clinical Practice in Speech-Language Pathology
Conclusion
This ethical conversation has raised a number of issues
regarding the translation of knowledge to practice. We
argue speech pathologists have professional and ethical
obligations to contribute to knowledge creation, in a variety
of ways and to continue to engage in knowledge
development throughout their professional careers. This
engagement can take many forms and SPA facilitates this
through the PSR program. Knowledge of the Code of
Ethics will support ethical decision-making when new
knowledge is implemented or changes made to existing
practice. Careful consideration of potential benefits and
harms and issues of justice may ensure knowledge
development within our profession brings positive,
empowering change for people with communication and
swallowing disorders. This in turn should enhance the
well-being and quality of working life for speech
pathologists.
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During selection, tailoring and implementation
of interventions
, knowledge must be responsibly
communicated to health care providers and the
community. Responsible communication avoids inflating
potential benefits and identifies potential risks in any new
intervention. Importantly, competing interests are disclosed
and contributions from each member of the research team
are appropriately acknowledged during dissemination.
Knowledge use is monitored
and opportunities identified
for responding to values, priorities, preferences and cultural
needs of knowledge consumers. Ethical practice means
that rather than adopting a “BUT that research won’t
work for me, my clients, or this setting” stance, we are
challenged to explore the strategies that will facilitate all
people with communication or swallowing impairments
to receive best practice interventions. For example,
opportunities for change in indigenous communities rest
upon mutual respect, willingness to work with existing
services and flexible timeframes for service delivery (Webb,
2012).
Outcome evaluation
may incorporate the broad spectrum
of social, economic and environmental effects including
potential positive and adverse effects of changes to
assessment, intervention or models of service delivery.
Outcomes must certainly provide quantitative data
regarding number of clients, hours of service, and waiting
list numbers impacted by change. However, it is equally
important not to overlook impacts upon an individual client
or family. Qualitative measures may provide meaningful
outcome data especially when applying knowledge to
clients and families from culturally and linguistically diverse
backgrounds (Hand, 2011; Kovarsky & Curran, 2007).
Access and appraisal of intervention research in speech
pathology is available through www.speechbite.com
Finally,
sustainability of knowledge use
is addressed
by making resources available to facilitate change
and assist consumers adapting to and maintaining
change. The “What Works” database (https://www.
thecommunicationtrust.org.uk/whatworks) is one example
of an educational resource that addresses sustainability
of knowledge. The Communication Trust collaborated
with the Better Communication Programme to develop
this evidenced-based resource providing intervention
resources to support children’s speech, language and
communication development. Free registration and
clinician-friendly language facilitates access to research.
Sustainability is further addressed by a year-long roll-out
process incorporating consultation with practitioners to
ensure the database is fit for purpose. Plans to add new
research interventions, in response to identified gaps, may
successfully maintain the engagement of the professional
community.
Facilitating sustainability of knowledge as well as KT,
within an ethical framework, is one of our major challenges.
Clearly clinical care gaps between high-quality evidence
and practice have major implications for quality of life
(Buchan, 2004). Carey-Sargeant and Carey (2012) propose
group peer consultation as one means of professional
development. This model has many benefits as it can be
workplace based, geographically based, topic based or
related to whatever individuals feel most meets their needs.
Interprofessional education and collaboration may also
provide a strong platform from which to advocate and
implement evidence based practice (Zwarenstein & Reeves,
2006).