Model for rural and remote speech pathology student placements: Using non‐traditional sites and partnerships

Abstract

The Broken Hill University Department of Rural Health (BH UDRH) operates a successful multidisciplinary rural clinical placement program in far western New South Wales. 1 However, until recently, the development of allied health programs had been constrained by the region's limited access to allied health services and their capacity to support students. There are few placement opportunities nationally across the UDRH network for allied health disciplines such as speech pathology (22 students in 2008/2009 J. Ramsay, pers. comm., 2010).In Broken Hill, local primary school teachers and parents had raised concerns about the lack of paediatric speech pathology services and the impact this was having on educational attainment. We proposed a novel solution using a clinical education model 2 structured around student-run clinics 3 in the primary schools. The development relied on non-traditional partnerships with school education, a commitment by speech pathologists from the Area Health Service to allocate time for clinical supervision and work by BH UDRH staff to engage academic partners from a feeder university, recruit students and manage the placements. Participants, methods and resultsThe program was piloted in 2009 and three groups of final year students (17 students) completed a fieldwork placement during 2010. The six-week placements were scheduled for school terms 1, 2 and 3, and each included orientation and three days of structured teaching on cross cultural education, primary health care principles, preparation for fieldwork and professional resilience.Students worked in pairs running clinics at local primary schools supervised by local speech pathologists. Clinical activity varied with each placement. The first group of the year focused on screening kindergarten children while subsequent rotations screened other children referred by parents or teachers. The students delivered speech pathology interventions for children with straightforward problems, assisted speech pathologists in complex cases and referred to associated services if required. They also provided teacher and parent education. Each consultation was documented on a standard form, reviewed by the speech pathologist and filed in school records. The supervising speech pathologist referred children for ongoing treatment or further assessment to the speech pathology service as required.Individual student needs were closely monitored and tailored levels of clinical and non-clinical supervision/ support developed to enhance participant experiences. Students also participated in the local inter-professional learning program.The curriculum requirements for the placement were determined and monitored by academic staff from the Faculty of Health Sciences, University of Sydney and delivered collaboratively on-site.A total of 231 primary school aged children, including 167 from kindergarten (93% of enrolments) were assessed in 2010. Fifty-eight per cent of kindergarten children had a speech pathology intervention. Furthermore, the number of new referrals on...

Speech pathology and occupational therapy students participating in placements where their supervisor works in a dual role

“…Using non‐traditional placements can assist with addressing this . There are numerous examples of successful non‐traditional placements; a number of these have been provided in regional or rural settings …”

Securing a rural health workforce for the next generation of rural Australians

“…In some university departments of rural health and rural clinical schools, there are opportunities for students to contribute to service delivery to underserved rural communities through service learning. In this educational approach, students deliver clinical care under supervision to patients with high health need and poor access to services, in student‐led clinics or in an assisting role 2 . Progressively, academic teams have also formed to undertake research, evaluation and development work on the rural health agenda, including carrying out studies on the effectiveness of rural training in delivering rural health workforce outcomes and health service redesign for rural and remote communities.…”

Design and delivery of an innovative speech pathology service-learning program for primary school children in Far West NSW, Australia

“…12 The reported prevalence of communication delays in Broken Hill primary schools ranges between 13% and 28.6%. 6 If unresolved, speech, language and communication delays can lead to difficulties in learning, literacy, writing and socialisation. These challenges can have long-term implications for the life outcomes of children.…”

“…In contrast, in more traditional clinical placements, students work with health professionals and learn by 'shadowing' them during practice. 6,7 Broken Hill is a socio-economically disadvantaged community in Far West New South Wales (NSW) 8 , Australia. Australian 2016 census data show that the proportion of Aboriginal people living in Broken Hill is 8.5% compared with 5.2% across NSW.…”

“…11,17,18 In 2009, the Broken Hill University Department of Rural Health (BHUDRH) established a student-led speech pathology clinic in local primary schools in partnership with school education, the local health service and a metropolitan-based faculty of health sciences. The service was developed in response to concerns expressed by primary school principals about the high proportion of children entering school with communication impairments 6,10,19,20 and the lack of access to allied health services, in this case qualified speech pathologists. 9 The service-learning program aimed to: 1) support early identification and treatment of speech, language and communication delays in young children; 2) improve the educational, social and health outcomes of children experiencing these delays; 3) facilitate communityengaged learning experiences and work-readiness for speech pathology students; and 4) promote rural and remote practice and primary health care approaches to service provision.…”