JCPSLP - March 2018

Developmental Language Disorder

Attitudes and experiences of SLP students from a pilot telehealth stuttering clinic Kate Bridgman, Keisha Pallathil, Nicole Ford, Joanne Tran, Di-Luu Lam, Evelyn Wee, and Elaina Kefalianos

This pilot aimed to explore student speech- language pathology (SLP) experiences with telehealth service delivery during a clinical placement, and to capture attitudinal changes throughout the placement. Six speech pathology students completed their entry level placement at a university based clinic. Students delivered stuttering treatment to clients in-clinic and using telehealth. Students’ experiences and attitudes toward these service delivery modes were documented at the beginning, mid-point and end of their placement. Questionnaires contained Likert scale and open-ended questions. Overall, student SLP responses were positive. Five main themes emerged from student SLP responses: (a) challenges of working within a “virtual” environment; (b) student perspectives on self-management of anxiety; (c) different learning approaches; (d) ease of access to services; and (e) telehealth considerations. Outcomes from this pilot study support the implementation of various service delivery modes to enhance student SLPs’ competency in emerging areas of clinical practice. T he 2030 Speech Pathology Australia Futures Report (SPA, 2016) forecasts significant changes in service delivery. Advances in technology will require future speech language pathologists (SLPs) to be proficient in a range of service delivery models, including telepractice. Speech Pathology Australia (2014) defines telepractice (also known as “telehealth”) as “the application of telecommunications technology to deliver clinical services at a distance by linking clinician to client, caregiver, or any person(s) responsible for delivering care to the client, for the purposes of assessment, intervention, consultation and/or supervision” (p. 4). Services may be delivered via a range of methods including video conferencing, internet, store-and-forward devices, streaming media, and terrestrial and wireless communication (International Standardization Organisation, 2016).

Telehealth is considered an efficient and effective mode of service delivery (Lam et al., 2016) and is situated within the broader context of eHealth. According to the World Health Organization (WHO), eHealth embraces the use of information and communication technologies “in support of health and health-related fields, including health-care services, health surveillance, health literature, and health education, knowledge and research” (WHO, 2005) and is a growing mode of service provision designed to promote equity of access and efficiency of service delivery. In preparation for this, tertiary courses need to equip student SLPs with the required clinical skills for telehealth service models in addition to in-clinic (May & Erickson, 2014; Theodoros, 2014). Such direct and explicit training in service provision is also necessary to satisfy the requirements of Entry Level Competency-based Occupational Standards (CBOS) (SPA, 2011) in relation to planning, implementing and providing speech pathology services across a variety of service contexts and range of practice areas. To date, the utilisation of telehealth technology by medical and health science students has been largely assumed due to their frequent personal use of technological devices (Lam et al., 2016; Rienits, Teuss, & Bonney, 2015). However, there is some evidence to suggest that despite being referred to as the “net generation” or “digital natives”, students do not always naturally transfer social and personal use of technology into formal learning and professional environments (Margaryan, Littlejohn, & Vojt, 2011; Selwyn, 2009). Further, emerging evidence suggests that medical and health science students generally have little understanding of eHealth, and more specifically lack of experience of telehealth practices, due to limited professional exposure throughout their academic and clinical training (Lam et al., 2016; Rienits et al., 2015). Researchers have started to explore student perspectives and experiences of telehealth (Bull, Dewar, Malvey, & Szalma, 2016; Glinkowski, Pawłowska, & Kozłowska, 2013; Lam et al., 2016). A recent survey of 420 Australian health science students indicated that student familiarity with personal technology does not necessarily translate to confidence or application in clinical settings (Lam et al., 2016). To illustrate, 85% of students reported that they used synchronous videoconferencing for social use, yet only 52% felt they would be confident using the same technology professionally. Further, 75% of students indicated they would require explicit training in videoconferencing for

KEYWORDS CLINICAL EDUCATION EHEALTH STUTTERING TELEHEALTH

THIS ARTICLE HAS BEEN PEER- REVIEWED

Kate Bridgman (top), Keisha Pallathil (centre) and Nicole Ford

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JCPSLP Volume 20, Number 1 2018

Journal of Clinical Practice in Speech-Language Pathology