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support programs across years within a SP program at the university, across a range of university programs with lower male participation rates (e.g., occupational therapy, nursing), or even SP programs across universities. Linking male SP students to a male clinical educator for a clinical placement or with a male speech pathologist/allied health mentor (McKinson, 2007) may also help to reduce identified feelings of isolation (Byrne, 2007) and marginalisation. Support of males during the SP program may assist completion of the SP program and the ongoing contribution to the SP profession. Addressing Indigenous Australian participation rates A lack of Indigenous Australians in the SP workforce is consistent with low numbers reported across all health professions (Hindmarsh, 2003; Pink & Allbon, 2008); similar participation rates occur in health care for Indigenous Canadians (Dafoe, 2000; Downey & Sweetwater, 2003). Researchers have identified the training of Indigenous Australians to deliver health care services (Australian Health Ministers’ Advisory Council [AHMAC], 2011; Downey & Sweetwater, 2003; Murray & Wronski, 2006; NSW Ministry of Health, 2012) is a crucial step towards addressing the discrepancies between the life expectancies and health- related diseases between Indigenous and non-Indigenous Australians. The presence of Indigenous Australian staff has been reported as a facilitator to Indigenous Australians accessing mainstream health services (Martin & DiRienzo, 2012). While there are positive signs that the number of Indigenous Australian speech pathologists will increase in the future, the support and encouragement required to achieve this increase will need to occur at multiple levels. A range of currently utilised strategies can be applied to SP, for example university programs need to ensure programs are culturally appropriate and Indigenous Australian students (and staff) are culturally safe. Such practice includes supporting students to be both comfortable with, and understand the importance of, identifying as Indigenous Australians. Indigenous Australian cultural awareness training can help staff to understand the disadvantage experienced by Indigenous Australians (AHMAC, 2011; Martin & DiRienzo, 2012), and program content should be considered in relation to Indigenous Australians (Downey & Sweetwater, 2003). Given the small number of Indigenous Australian speech pathologists, it will be unlikely to be able to link an Indigenous Australian SP student with an Indigenous Australian SP clinical educator. However, when allocating clinical placements for Indigenous Australian SP students, universities should consider the general clinical environment of the practice that the student will attend. For example, they might seek a clinical placement with a SP service that has other Indigenous Australian mentors available (NSW Ministry of Health, 2012) or services present on-site (e.g., Indigenous Australian liaison officers), or that provides services to Indigenous Australian clients or demonstrates a commitment to providing culturally appropriate SP services (Martin & DiRienzo, 2012), including: displaying Indigenous Australian artwork, utilising Indigenous Australian SP resources and articulating service values related to commitment to culturally appropriate service delivery. Ensuring careers advisors are aware of SP as a career and “target” student groups may be essential to addressing

services has identified the following: there is clear evidence that CALD health professionals are more likely to work with CALD/underrepresented clients and these clients benefit via communication and increased interpersonal care and attendance at appointments. Further, it was reported that increasing the proportion of CALD health professionals would improve the quality of care that CALD clients receive, including increasing likelihood of attendance and compliance with health care services (US DHHS, 2006). Professional exposure to a speech pathologist has been identified as a key factor in influencing the decision to enter SP as a career (Byrne, 2008a), highlighting a paradox where reduced access to SP services by Indigenous Australians and people from CALD groups will likely impact on the ability to influence minority groups to enter a SP program. Implications Addressing male participation rates There has been some discussion over the years in regards to the sex imbalance in SP in Australia (Byrne, 2008b; McAllister & Neve, 2005; Nickless, 2004) and while recommendations have been made there has been little co-ordinated effort to address the issue. SPA has taken steps to promote the profession to males – see, for example, the webpage titled: Real Men Do Speech Pathology (Speech Pathology Australia, 2014b). This webpage is accessed by selecting the “Information for the community” then the “Education & Career opportunities” option. There are three videos of male speech pathologists and the content of these videos focuses on adult, acute care technology (e.g., FEES, AAC). While that portion of the SPA website aims to address this imbalance, it is not clear if the strategy has been effective or sufficient on its own, and further whether it may be counteracted by other aspects of the website. For example, the front page of the SPA website has a video which identifies a number of work areas for speech pathologists (Speech Pathology Australia, 2014c), and while there is a male voice over, it shows pictures only of female speech pathologists. Byrne (2007) highlighted the low number of male SP students was potentially isolating. For example, male SP students report “It is a bit of a social adjustment.…I don’t like to be considered as ‘one of the girls’” (p. 149) and female SP students report: “there only two guys here and I don’t think they’re going to last long” and “I’d say that males actually enrolled initially, are deterred by the fact that there are a lot of females” (p. 148). Male SP interest/ support groups (e.g., SPA Blokes in SP) and Internet websites targeting male speech pathologists (e.g., The Speech Dudes, 2014) are available, although it is not again clear what role these may play in attracting males to SP, facilitating completion rates or retention in the profession. A co-ordinated and high level approach (e.g., professional associations, universities) in consultation with male speech pathologists/ students is needed to implement strategies aimed at increasing male SP participation rates. Further, any identified strategies that are implemented need to be evaluated for effectiveness. For example, consideration needs to be given to promotional marketing of SP (e.g., career presentations, SPA website; McKinson, 2007) to include males, working in various settings, with various client groups and tapping into specific interest areas identified by males (e.g., Byrne, 2008b). SP university programs need to consider how males are supported in the program. This support could include offering male peer-

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JCPSLP Volume 17, Number 1 2015

Journal of Clinical Practice in Speech-Language Pathology