JCPSLP Vol 15 No 2 2013

Clinical education

Developing speech pathology clinical competency Are there predictors for success? Robyn Johnson, Alison Purcell and Emma Power

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. L 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

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 environment. 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

Keywords clinical education

failure speech-

language pathology success PREDICTORS

This article has been peer- reviewed

Robyn Johnson (top), Alison Purcell (centre) & Emma Power

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JCPSLP Volume 15, Number 2 2013

Journal of Clinical Practice in Speech-Language Pathology