JCPSLP Vol 14 No 2 2012

Table 3. Common characteristics of peer-group consultation compared with mentoring and/or supervision Peer-group consultation Mentoring/Supervision • Non-hierarchical • Hierarchical • Suitable for experienced clinicians • Suitable for new graduates • Power shared (even balance of power) • Power over (uneven balance of power) • Participants equal colleagues • Participants mentored or supervised • Shared/rotating leadership and responsibilities • Appointed/dominant leader • Participant volunteers/willing to be consultant colleague • Participation often required/mandatory to be mentored/supervised • Different expertise shared by multiple consultants and equally valued • Expertise considered mastered by sole/dominant practitioner • Collective reflection and breadth of resolutions/possibilities to • Supervisor’s and participant’s reflection and resolutions/possibilities solve issues to solve issues • Focus upon developing/considering new professional • Focus upon operating within and conforming to organisational status techniques/strategies quo/culture • Increases professional socialisation and outcomes • Increases organisational socialisation and organisational outcomes • Outward looking to numerous colleagues and external resources • Predominantly inward looking to supervisor/mentor to solve/deal and support with issues • Provides and encourages wider professional interaction and • Provides and encourages more personal emotional/psychological networking support

1985). They identified quite rigid and structured boundaries for establishing a peer consultation group. They suggested that a regular time, place, and membership is necessary for the group to be successful. Shields et al. suggested groups hold between three and ten members who meet regularly (possibly monthly) in a consistent setting which suggests a business-like meeting but with sharing of drinks and food to create a feeling of informality before and after the meeting. Wallerstein and Bernstein (1988) proposed a five- step plan to move group discussion from a personal or social encounter to a critical analysis and action outcome for clinical staff. Initially (Step 1) participants are invited to describe an incident from their clinical experience. Then all group members are involved in exploring the complexities of the problem (Step 2). Step 3 involves sharing of similar experiences. The group then identifies dynamics such as biophysical, psychosocial, cultural, religious-spiritual, economic, and political factors which contribute to the problem (Step 4). Collectively a care plan develops to address the problem (Step 5). Through the group experience, clinical reasoning skills are affirmed, and necessary changes to the individual’s knowledge base or reasoning process are identified and encouraged. Table 4. Summary of recommendations for establishing a PGC • Recruit 8–10 members for a start-up group • Decide on where and when to meet, length of meeting • Plan a rotation of hosts and destinations for the year • Decide who will provide refreshments • Decide about social time: how much time before the meeting • Discuss norms regarding attendance, commitment, absence • Discuss group rules/expectations (e.g., confidentiality) • Review phases of consultation

For those who would like to consider commencing a PGC, Hart (2010) made several useful recommendations for establishing a peer-group consultation model that can serve as a guide for speech pathologists (summarised in Table 4). Fundamentally, a PGC agenda is set with a different consultee each week who will present for approximately 45 minutes (or less) about a topic of their choice. Other members act as consultants providing feedback and suggestions for the consultee. Discussion may follow for 1 to 1.5 hours after the consultee’s presentation. Hart-Smith (1985) noted a number of skills required of participants in a peer group relative to their role (consultant, consultee, attending member; see Table 5). Gavrin (1985) suggested that consultees need to address three areas of preparation, presentation , and perpetuation of the consultation process. Suggested components for each area are noted in Table 6. Table 5. Summary of skills required of participants in a peer group 1. For a consultee: • an awareness of personal strengths and weaknesses (self- awareness) • an ability to state the problem/present case study/topic/issue • and ability to tolerate feedback (positive and critical) • an ability to structure the meeting (the presentation and discussion) 2. For a consultant/s: • an ability to listen carefully • an ability to ask questions that stimulate problem solving (insight oriented questions) • a style of communicating suggestions that leads to acceptance and mutual respect • an understanding of the theory of consultation and of group dynamics • an ability to let go of your suggestions, allowing consultees to proceed as they wish 3. For all members:

• Review roles of consultees • Review roles of consultation • Review roles of host, timekeeper, taskmaster

• an ability to make a commitment to the group. • an ability to make the peer group a priority • an ability to share responsibility and achievement • a willingness to be proactive to assist each other Source: Hart-Smith, 1985

• Discuss a dinner meeting at the beginning and end of the year • Discuss the idea of a retreat/professional development day. Source: Hart, 2010

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JCPSLP Volume 14, Number 2 2012

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