JCPSLP Vol 15 No 2 2013

a student’s clinical performance, as shown in Figure 1, will be discussed with specific emphasis on student characteristics.

Figure 1: Variables in clinical skills development

Figure 2: Consequences of failure

Literature search method To conduct this narrative review, the initial search strategy was developed by identifying relevant keywords and searching Ovid, ProQUEST and Google Scholar. Search terms included: student learning, clinical success, clinical education, allied health, SLP, physiotherapy, occupational therapy, health, students, medicine and nursing. The articles were scan-read by the first author and excluded if they did not address SLP clinical education or predictors of clinical success in any of the health sciences fields noted. In addition, further articles were identified through review of reference lists. Impact of clinical failure on students Failing a clinical placement may have a number of consequences for students. These consequences have not been widely explored in the literature. However, our team has observed that failure may impact on students in a variety of ways (outlined in Figure 2). Failing a placement is usually distressing for the student and may lead to personal consequences, such as loss of confidence or family censure. Students may experience negative financial consequences from this failure. For example, they may be required to pay for the subject again if it is repeated or may risk losing a scholarship if its continuance is dependent on both academic and clinical success. It some cases, students may need to extend the length of their studies or even to consider an alternative career. There may also be intense family pressure to succeed or maintain high standards of success. Failing a final-year clinical placement when the student “should be better” or are “nearly there” is observed to be particularly difficult, and leaves little time for improvement. Dowling (1985) also observed “the agony experienced by clinicians who have had successive clinical failures and then have to select an alternate career late in their academic and clinical programs” (p. 54). Despite this range of negative consequences, SLP students have differing responses to clinical failure (Nemeth & McAllister, 2010). Nemeth and McAllister (2010) observed that some students are ready to learn from failure and go on to do so with the support of their clinical educator (CE).

In contrast, other students lack awareness or insight into their difficulties, may be angry at their failure and are not ready to use it as a learning experience. It is likely that the personal characteristics and skills students bring to each placement influence whether they are ready or not to learn, whether from failure or success. Minimising the number of students failing clinical placements, particularly in their final year, would help reduce the number of students who suffer these negative consequences. As noted by Dowling (1985), one way to achieve this goal is the early identification of students at risk The development and assessment of clinical skills of SLP students on clinical placements have been more widely researched (McAllister, Lincoln, Ferguson, & McAllister, 2010; McAllister et al., 2011) than the impact of clinical failure on the students. Ideally, we need to assist students as early as possible to allow time for development. However, to do this we need a greater understanding of predictors of success or failure to develop clinical skills. Presently there is little research in this area available in the field of SLP. There are some broader studies in medicine, nursing and allied health fields that may provide some guidance on important factors for success and failure. of clinical failure. Predictors

Figure 3: Themes among predictors of success

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JCPSLP Volume 15, Number 2 2013

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