JCPSLP Vol 17 No 2 2015_web

100 90 80 70 60 50 40 30 20 10 0 % of participants K1

Confidence in clinical skills following a placement in an adult service. Confident, can do it independently Confident, but will need support Not confident, but have a good idea of what is required Not confident, unsure of what is required

Post-placement knowledge (n=52)

100 90 80 70 60 50 40 30 20 10 0 % of participants

I know a lot I know quite a lot

I only know a little I know nothing

K2

K3

K4

Note. K1 Age related and acquired communication changes and disorders in older people. K2 Communication changes associated with dementia. K3 Age related and acquired swallowing disorders in older people. K4 Swallowing changes associated with dementia.

people who are medically well and medically complex, as well as those with dementia) occurred, with an evident shift towards feeling confident to complete tasks independently or with some support. As indicated in Table 2, a positive change in students’ attitudes was noted, as measured on the UCLA-GAS; however, the change was not statistically significant. Following an adult placement, future employment within a residential setting was rated more favourably than at pre-placement based on group weighted preference scores (refer to Figure 3). Working with people with dementia in hospital (pre-post preference scores: 3.2; 4.3) or residential setting (pre-post preference scores: 4.5; 4.9) increased. Working with people aged 65–85 was rated more favourably (group weighted pre-post scores: 8.4; 8.8), however working with people older than 85 declined in overall preference ranking (pre-post preference scores: C1 C2 C3 C4 C5 C6 C7 Note. Assessment and management of: C1 communication changes arising as a normal part of ageing, C2 acquired motor speech disorders in older people, C3 language disorders in older people, C4 cognitive-communication disorders, C5 swallowing disorders in medically well older people, C6 swallowing disorders in medically complex older people, and C7 swallowing in people with dementia. Figure 5. Students’ reported confidence post-placement (n = 52)

Figure 4. Students’ reported knowledge post-placement

based rehabilitation setting. Twenty-nine participants (39%) ranked a paediatric caseload as their first employment preference, and 13 participants (17.5%) ranked a paediatric caseload as the least desirable option. Working with people on a palliative pathway or those with dementia, irrespective of setting, was rated least favourably.

Change in knowledge, confidence, attitudes, and employment interest following a clinical placement

Matched pre-post-placement surveys (n = 52) were analysed and revealed that participants demonstrated a statistically significant increase ( p < 0.05) in their aggregate scores for knowledge and confidence in clinical skills across all items (refer to figures 3 and 4, and Table 2) following completion of a clinical placement in an adult service. Increased knowledge of, and confidence in, management of both communication (i.e., motor speech, cognitive- communication, and language impairments) and swallowing changes and disorders in an older population (i.e., in older

Table1: Pre- and post-placement responses of students on geriatric attitude scale

Agree or strongly agree

Neutral

Disagree or strongly disagree

Pre (%¹)

Post (%)

Pre (%)

Post (%)

Pre (%)

Post (%)

UCLA Geriatric Attitude Scale items

n = 74

n = 52

n = 74 n = 52

n = 74

n = 52

79.7 ² 59

92.0 48 19.2 10

16.3 12 35.1 26 10.8 8 44.5 33 13.5 10

6.0 3

4.0 3

2.0 1

Most old people are pleasant to be with.

33.8 25 85.1 63 42.0 31 83.8 62

40.4 21 90.4 47 64.0 35 90.4 47

If I have the choice, I would rather see younger patients than elderly ones. Medical care for old people uses up too much human and material resources. Taking a medical history from elderly patients is frequently an ordeal. Treatment of chronically ill old patients is hopeless. It is interesting listening to old people’s accounts of their past experiences.

31.1 23

40.4 21

4.0 3

3.8 2 6.0 3 2.0 1

6.0 3

13.5 10

27.0 14

2.7 2

7.6 4 6.0 3

91.9 68

92.0 48

6.7 5

1.4 1

2.0 1

¹ Percentage of students whose responses were in this category 2 Items in italics reflect the % of participants with a positive attitude

78

JCPSLP Volume 17, Number 2 2015

Journal of Clinical Practice in Speech-Language Pathology