Reflective processes of practitioners in head and neck cancer rehabilitation: a grounded theory study

Caty, Marie-Ève; Kinsella, Elizabeth Anne; Doyle, Philip C.

doi:10.3109/17549507.2016.1143974

Cited by 11 publications

(6 citation statements)

References 28 publications

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“…Expert clinical opinions and guidance, including from bodies such as the CDC and WHO, likely will constitute the bulk of what SLPs can seek out until more time elapses to allow both bench and clinical data to be generated. As a very first step, we encourage SLPs to engage in a reflective practice exercise, either individually or with others (e.g., SLP peers, multidisciplinary HNC team), in which they assess how they sought out and vetted information about TL care during the COVID-19 pandemic early on and how they are doing so now (Caty et al, 2016). Based on our experiences and communications with SLP colleagues, there are likely three sources of information that might be available.…”

Section: Considerations For Tl Care Moving Forwardmentioning

confidence: 99%

Clinical Experiences of People With a Laryngectomy During the SARS COVID-19 Pandemic

Searl

Kearney

Genoa

et al. 2021

Am J Speech Lang Pathol

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Purpose This study described the clinical experiences of patients with a total laryngectomy (TL) during the COVID-19 pandemic and identified changes in communication, tracheostoma care, and heat–moisture exchange (HME) use that were recommended or self-implemented. Method An online survey addressing the study aims was completed by 173 people with a TL who live in the United States. The survey was open from July 5 to August 10, 2020. Results In-person clinic visits, appointment cancellations, and contact from their speech-language pathologists (SLPs) were reported by 42%, 19%, and 54% of the TL respondents, respectively. At clinic visits, 78% were required to wear a mask over their nose/mouth, and 73% were required to wear a mask over their tracheostoma. Masks, gloves, and face shields worn by the SLP at these visits were reported by 84%, 82%, and 70% of the TL patients, respectively. Alaryngeal communication changes were recommended by the SLP for 7%–18% of TL patients, depending on their method of communication, whereas 43%–45% implemented changes on their own. Changes in tracheostoma care and HME use were recommended by the SLP for 27% and 21% of the TL respondents, respectively, whereas 54% and 47% made changes on their own. Conclusions Individuals with a TL will require in-person care even during a pandemic, as reflected in this study. Many had not been contacted by their SLP or otolaryngologist about TL guidelines that were becoming available. Notably, larger percentages of TL patients reported self-initiated changes to their communication, tracheostoma care, and HME use because of the pandemic than their SLP had advised. The types of communication changes varied in part, depending on the method of alaryngeal speech a respondent used. Supplemental Material https://doi.org/10.23641/asha.16807270

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Section: Considerations For Tl Care Moving Forwardmentioning

confidence: 99%

Clinical Experiences of People With a Laryngectomy During the SARS COVID-19 Pandemic

Searl

Kearney

Genoa

et al. 2021

Am J Speech Lang Pathol

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“…The role of colleagues and their impact on training success has been considered by other authors in similar clinical areas (Caty et al . 2016, Burns et al . 2017, Aryasomayajula et al .…”

Section: Discussionmentioning

confidence: 99%

“…Caty et al . (2016) described a model for reflective practice in which consulting with colleagues (both SLTs and ENT) was a critical component not just for reflection but also for learning. Increasing telepractice has been shown to be an effective method through which clinical observations, consultation for complex trouble‐shooting, and specific case‐mentoring can be offered between professionals and between clinical centres (Burns et al .…”

Section: Discussionmentioning

confidence: 99%

Factors contributing to clinician training and development in the clinical area of laryngectomy and tracheoesophageal voice

Hancock

Ward

Hill

2020

Intl J Lang & Comm Disor

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Background It has long been recognized that tracheoesophageal speech (TES) rehabilitation after laryngectomy is a specialized area of practice for speech and language therapist (SLTs) due to the complex nature of patient presentation and the invasive components of the SLT's role in this area. Therefore, postgraduate experience and training is required to work competently and safely in this clinical area. However, it is generally acknowledged that the steps and processes followed by individual clinicians to achieve this training and clinical skill development are inconsistent and vary widely across services. There is a need to identify critical elements deemed most beneficial to clinical skill development in order to inform future training models. Aims To explore clinicians’ perceptions of factors that contribute to training and clinical skills development in the area of TES rehabilitation post‐laryngectomy. Methods & Procedures All participants were SLTs working in an Australian clinical service, with a current or recent clinical caseload that included patients using TES. A total of 36 SLTs were recruited and then grouped by level of experience (novice n = 15, intermediate n = 7, experienced n = 14). Each participant took part in one small focus group with other participants of similar experience level. Ten focus groups were conducted, each of approximately 60 min in duration. A semi‐structured interview guide was used to facilitate the discussion of issues relating to training in this area. Thematic analysis was used to analyse transcripts and identify themes. Outcomes & Results Interviews identified six key themes, including: Learning with and from others; Formal programmes; Hands‐on learning; Processes that influence training; and Individual influences. SLTs reported both positive issues and elements that were challenging across all five themes. The final (sixth) theme was identified regarding clinician perceptions of how this area differed to specialized training in other areas of the profession. The majority of themes were discussed equally by clinicians across all three experience levels. Conclusions & Implications Participants across all experience levels identified that multiple factors contributed to clinicians successfully gaining skills, understanding and competency when working in TES rehabilitation post‐laryngectomy. These factors, when fully considered and incorporated into future SLTs training pathways and opportunities, have the potential to optimize competency, skill acquisition and maintenance in this area.

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“…Une étude récente a examiné de manière inductive comment les cliniciens experts utilisent la réflexivité pour gérer les incidents critiques dans le domaine de la réadaptation du cancer de la tête et du cou [14]. Au coeur du modèle de réflexivité issu de cette étude, se situe un processus de questionnement continu et itératif des cliniciens.…”

Section: Se Préoccuper Des Aléas : Les Incidents Critiques Comme Sour...unclassified

Se réapproprier l’incertitude du marais : réintroduire la réflexivité dans l’enseignement du raisonnement clinique

Kinsella

2018

Pédagogie Médicale

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Contexte et problématique : L’auteure défend le point de vue selon lequel, paradoxalement, certains usages pédagogiques des typologies formelles développées à propos du raisonnement clinique pourraient limiter le développement des capacités de raisonnement clinique que les enseignants espèrent justement encourager. Exégèse : L’auteure rappelle les dimensions de complexité et d’incertitude du raisonnement clinique, en soulignant la nature foncièrement interprétative des processus en jeu. Elle suggère quelques moyens par lesquels il serait possible de se réapproprier la dimension de réflexivité dans le cadre de l’enseignement du raisonnement clinique. Conclusion : Dans une perspective éducationnelle, les théories de la réflexivité devraient désormais être mieux articulées avec les théories du raisonnement clinique. Les initiatives pédagogiques visant à favoriser le développement du raisonnement clinique pourraient bénéficier de la réintroduction de la réflexivité comme point de départ.

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Reflective processes of practitioners in head and neck cancer rehabilitation: a grounded theory study

Abstract: The findings of this study have implications for how SLPs perceive and consider their role as knowledge-users and knowledge producers in their day-to-day clinical work, as well as for building capacity for reflective practice.

Cited by 11 publications

References 28 publications

Clinical Experiences of People With a Laryngectomy During the SARS COVID-19 Pandemic

Clinical Experiences of People With a Laryngectomy During the SARS COVID-19 Pandemic

Factors contributing to clinician training and development in the clinical area of laryngectomy and tracheoesophageal voice

Se réapproprier l’incertitude du marais : réintroduire la réflexivité dans l’enseignement du raisonnement clinique

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