JCPSLP Vol 15 No 2 2013

level of clinical performance and competencies for each block of clinical education reflected those of the Speech Pathology Australia Competency-based Occupational Standards (CBOS; Speech Pathology Australia, 2001). Clinical competence was targeted in the key speech therapy domains of speech, language, fluency, voice, and swallowing. However, during the clinical education blocks students were not expected to demonstrate clinical competence in all of the components of these key domains. This was because the unique working arrangements of the students (having to continue practising in their jobs as physiotherapists, nurses or doctors), and difficulty accessing clinical education opportunities outside their individual workplaces limited students’ ability to access clients reflecting all the key speech pathology domains. Competency in those domains not assessed during the clinical education blocks was assessed via completion of a clinical portfolio, assignments, clinical case studies, and viva exams. Further, students were expected to demonstrate their ability to access relevant literature via various means to develop their understanding of less familiar client groups, and be able to identify colleagues and experts to whom they may refer or from whom they may seek further information. Many challenges emerged during the establishment of the speech therapy course, foremost of which was managing cultural differences. Whether it be identifying and working with key stakeholders both internal and external to PNTU when negotiating course design and subject content, when assisting local lecturers to develop their understanding of speech therapy, or when working with members of the PNTU IT Department to establish reliable IT services, the subtleties and nuances of culture interacted and on many occasions collided. It was of the utmost importance to build meaningful relationships that would enable an understanding of different perspectives, culturally, linguistically, personally and professionally, and the ability to acknowledge and then discard preconceptions and assumptions. Being aware of the potential to “impose” rather than collaborate, and working actively against this was critical to developing relationships that fostered collegiality and forged successful partnerships. Flexibility and learning to accept what could and could not be controlled was important. The knowledge of PNTU staff and other key stakeholders as to what speech therapy was and could offer the people of Viet Nam was limited, so significant time was devoted to educating stakeholders, and developing culturally relevant subject content and teaching materials. Sourcing Vietnamese lecturers for subjects such as linguistics, psychology, anatomy and physiology was important in ensuring cultural relevance and sustainability of the course, but these staff required briefing about speech therapy in order for their content to be appropriate and support for their teaching approaches to be congruent with the educational approach of the course. From its inception, emphasis within the speech therapy program was upon students as “active learners”. However, observation of students undertaking classes with local lecturers at PNTU revealed a more didactic approach to teaching. To introduce an interactive style of teaching, opportunities were created for local lecturers to observe the teaching of visiting lecturers and to participate in joint teaching sessions. Students reported this interactive learning to be an aspect of the program they particularly enjoyed.

Vietnamese staff also commented on the novelty and value of this educational approach. The provision of clinical education was particularly challenging. In addition to the typical problems of preparing students and sites for placements, managing timetables and learning goals, clinical educators needed to be sourced from abroad. They required orientation and support to understand students’ prior knowledge and experiences and match these to the available patients and learning opportunities. Further, the students had to juggle their paid work roles in their hospitals with their student roles while on placement in the same site. The future of speech therapy in Viet Nam The future of speech therapy in Viet Nam will require ongoing collaboration between all stakeholders, and the graduates of the course. Identified needs in the short-term include refinement of the speech therapy course, capacity building of the host university to manage the curriculum and the course, and ongoing professional support of the 2012 graduates to lead the emerging profession through establishment of a professional association and development of a continuing professional development program, and acquire the academic skills and qualifications needed to lead the course in the future. Course changes for the second cohort of students A comprehensive program of evaluation has indicated the need for revisions to the course in its second offering which commenced in September 2012. Revisions include moving foundational knowledge to term 1, threading Multimodel Communication (as the sixth area of competency for entry-level clinicians in the revised CBOS; Speech Pathology Australia, 2011) throughout the course, and creating opportunities for more interprofessional interaction for the speech therapy students. As students had been practising in health-related fields for varying periods of time, it was anticipated that they would possess therapeutic skills that reflected this experience. However, observation of students in clinical practice during term 2 revealed the level of basic therapeutic skills (such as session planning, goal setting and treatment evaluation) generally to be that of novice clinicians as defined in the most recent CBOS (Speech Pathology Australia, 2011). Further, students’ ability to utilise theoretical knowledge to inform their clinical practice, to plan, problem-solve and to undertake reflection so as to facilitate changes to clinical practice was limited. Consequently, clinical education will begin earlier in the 2012–14 course and the amount will be significantly increased. Further, the last two weeks of every on-campus term will be spent in tutorials applying the term’s theory to clinical scenarios to assist the development of clinical reasoning. Clinical educators will be better prepared to build on coursework and previous clinical blocks to maximise learning outcomes in the clinical education sessions. Capacity building the future leaders of the profession TFA and former course director Marie Atherton assisted two future leaders – Mrs Xuan (see below) and Mr Dien (see below) – to successfully apply for scholarships from the Hoc Mai Foundation, an Australian organisation providing

Le Thi Thanh Xuan (top) and Le Khanh Dien

77

JCPSLP Volume 15, Number 2 2013

www.speechpathologyaustralia.org.au