Purpose: Two disparate models drive American speech-language pathologists' views of evidence-based practice (EBP): the American Speech-Language-Hearing Association's (2004a, 2004b) and Dollaghan's (2007). These models discuss evidence derived from clinical practice but differ in the terms used, the definitions, and discussions of its role. These concepts, which we unify as clinical evidence , are an important part of EBP but lack consistent terminology and clear definitions in the literature. Our objective was to identify how clinical evidence is described in the field. Method: We conducted a scoping review to identify terms ascribed to clinical evidence and their descriptions. We searched the peer-reviewed, accessible, speech-language pathology intervention literature from 2005 to 2020. We extracted the terms and descriptions, from which three types of clinical evidence arose. We then used an open-coding framework to categorize positive and negative descriptions of clinical expertise and summarize the role of clinical evidence in decision making. Results: Seventy-eight articles included a description of clinical evidence. Across publications, a single term was used to describe disparate concepts, and the same concept was given different terms, yet the concepts that authors described clustered into three categories: clinical opinion, clinical expertise, and practice-based evidence, with each described as distinct from research evidence, and separate from the process of clinical decision making. Clinical opinion and clinical expertise were intrinsic to the clinician. Clinical opinion was insufficient and biased, whereas clinical expertise was a positive multidimensional construct. Practice-based evidence was extrinsic to the clinician—the local clinical data that clinicians generated. Good clinical decisions integrated multiple sources of evidence. Conclusions: These results outline a shared language for SLPs to discuss their clinical evidence with researchers, families, allied professionals, and each other. Clarification of the terminology, associated definitions, and the contributions of clinical evidence to good clinical decision-making informs EBP models in speech-language pathology. Supplemental Material: https://doi.org/10.23641/asha.21498546
Purpose: The purpose of this article is to describe the speech-language pathology master's program experience for two groups of students: students with former speech-language pathology assistant (SLPA) experience (fSLPA) and students without SLPA experience (nSLPA). Results are relevant to current SLPAs who are considering attending graduate school and university faculty members involved in program design. Method: A survey was distributed electronically to students nationwide. The survey included both Likert-style questions and open-ended responses. A total of 85 student responses were included in data, 43 fSLPAs and 42 nSLPAs. Qualitative and quantitative results were analyzed separately and then synthesized together in a mixed-methods analysis. Results: Although the study was not designed to directly measure stressors, bottom-up qualitative analysis resulted in a framework of internal and external stressors, internal and external supports, and learning and growing. Stressors and supports were described by participants as intertwined, and a given event (e.g., the start of clinical rotations) did not map neatly to stressors or supports for all participants. fSLPAs reported higher perceptions of clinical success, feeling different than their peers, and the perception that fSLPAs were more successful in graduate school. Taken together, these results converged to develop seven findings. For instance, one finding was that, although both groups reported external and internal stressors, the specific stressors somewhat varied by group. Conclusions: Findings are discussed in relation to transformational learning theory and prior works on stress within the field. Implications for program development and prospective speech-language pathology graduate students are discussed.
Purpose: To describe what researchers are investigating and how they are measuring the constructs of their investigations within the speech-language pathology (SLP) clinical education literature. Method: A scoping review methodology (Arksey & O’Malley, 2005) was employed to develop a picture of clinical education articles which reported a measured outcome. Articles that met criteria were categorized by the purpose of the investigation and the outcome measures reported. Result: 124 articles met inclusion criteria. Analysis of study purposes revealed a wide breadth of foci that were grouped into four broad clusters: Outcome Measures, Student Perspectives, Educational Contexts, and Teaching Methods. Most of the studies in the corpus relied only on student self-report measures. In addition, any specific outcome measure was typically used only once and not found in subsequent studies. Trends indicate a variety of constructs are being studied at an exploratory level with limited in-depth investigation. Conclusion: Given the inconsistency of outcome measures and reliance on self-report measures, more research is needed to validate recommendations of best practices in clinical education. Areas of need include developing and implementing validated outcomes, more frequent investigation of clinical education using measures other than student self-reports, and testing theories found in other fields.
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