JCPSLP November 2016

Creating sustainable services: Minority world SLPs in majority world contexts

Building speech-language pathology capacity and colleagues across continents Abbie Olszewski and Erica Frank

There is a lack of qualified speech-language pathology service providers to serve persons with communication difficulties globally. This paper discusses current speech-language pathology training models in countries across continents and the limitations of these models. We propose a new training model called the Democratically Open, Outstanding Hybrid of Internet-aided, Computer-aided, and Human-aided Education (DOOHICHE), which can be implemented in any country. The pros and cons of the DOOHICHE model are critically examined. Lastly, the future direction of the DOOHICHE model is discussed. T here is a documented and substantial shortage of speech-language pathologists (SLPs) globally, including countries as diverse as Australia (Lowell, 2013), Fiji (Hopf, 2014), Ghana (Wylie, McAllister, Davidson, & Marshall, 2013), Malaysia (Ahmad, Ibrahim, Othman, & Vong, 2013), and South Africa (Weddington, 2002). Training future SLPs who can diagnose and treat persons with communication difficulties (PWCD) is widely recognised as important, given the ability to communicate effectively is a human right (Global Campaign for Free Expression, 2003; International Communication Project, n.d.; NJCCNPSD, 1992). However, building SLP capacity is difficult because it necessitates training in both content knowledge and clinical skills, often requiring skilled mentors to work individually or in small groups with SLPs who are in training. Current solutions Experts across the globe have begun to address the challenges of knowledge transfer and exchange to better serve PWCD (e.g., Ahmad et al., 2013; Cheng, 2013; Crowley et al., 2013). Cheng (2013) identified three models used in China: networking in close proximity, collaborating among different regions, and the use of technology. Working in Ghana, Crowley and colleagues (2013) used a biopsychosocial model, utilising interpreters to gather and share information to assess needs and make recommendations, delivering professional development, and collaborating with specialised teams. In Malaysia, Ahmad and colleagues (2013) developed local professional

capacity and increased focus on improving knowledge, local evidence, and research. Although these models have built local speech-language pathology capacity in their respective countries, current models are limited in their ability to scale up, be accessible to a wide range of individuals, be affordable, be accessible, be sustainable, and to provide a wide scope of course offerings. New solution At NextGenU, we have developed an innovative clinical speech-language pathology training program model grounded in the workforce capacity-building framework to address current model limitations (Goldberg & Bryant, 2012; Somerville et al., 2015). This model is called a Democratically Open, Outstanding Hybrid of Internet-aided, Computer-aided, and Human-aided Education (DOOHICHE, pronounced “doohickey”). NextGenU offers these courses to any organisation (e.g., universities, hospitals, ministries) requiring access to content training in speech-language pathology (Goldberg & Bryant, 2012) through the DOOHICHE model, which allows training of groups (e.g., in a flipped classroom) or of individuals. Individual training is important, as individuals are foundational to building capacity in an organisation (Goldberg & Bryant, 2012). Once proficient, these well- trained individuals can function as local mentors and train additional students in their communities – the “human- aided” component. The goal of the NextGenU speech-language pathology program is to give interested learners around the world practical and intellectual competencies to serve PWCD, and to empower these students to understand how these issues are addressed in their country, while interacting with a local and global community of peers and mentors to build a community of professionals who work with individuals with communicative disorders. Pros and cons The DOOHICHE model has the potential to be accessible and affordable to a larger number of students than current training models. The training courses are offered in 103 languages through Google Translate; hence, it is conceivable that it will reach a sizable number of students throughout the world. Although the courses are offered in a multitude of languages, translation of the content of the website through Google Translate may not be accurate. Because the courses are offered through the Internet,

KEYWORDS DOOHICHE GLOBAL INTERNATIONAL PEOPLE WITH COMMUNICA- TION DIFFICULTY SPEECH-

LANGUAGE PATHOLOGY

THIS ARTICLE HAS BEEN PEER- REVIEWED

Abbie Olszewski (top) and Erica Frank

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JCPSLP Volume 18, Number 3 2016

www.speechpathologyaustralia.org.au