JCPSLP Vol 19 No 1 March 2017

community-controlled entity with governance from key Indigenous community members. The therapy service has weekly interaction with both the principal and board members to ensure its responsiveness to cultural and broader school needs. The service commenced as an OT clinic at an urban school for students from prep to year 12 and evolved into an interprofessional SLP/OT clinic from 2011. This sessional (half-day/week for 12 weeks during each university semester) student clinic provides school- based interventions and is linked to a broader service delivery model which comprises other allied health services and a school-employed OT and SLP. Context 2: Aboriginal and Torres Strait Islander Community Controlled Health Services (ATSICCHS) Funding was obtained from the Queensland Regional Training Network (QRTN) to trial a student service in four clinics across south-east Queensland (SEQ). These clinics were all members of a regional body tasked with coordination of service delivery and workforce development in SEQ ATSICCHS. Students attended sessional ATSICCHS clinics in four locations where there was no existing established allied health service and focused on developing skill development programs for children from 3 to 5 years. However, service delivery design aligned with the already established clinical and cultural governance of the existing allied health services across the regional network, including a governance model which was driven by Indigenous leadership. In both contexts, service delivery was designed using “strengths-based, action-oriented approaches to achieving cultural safety that can facilitate increased access to affordable, available, appropriate and acceptable health care” (IAHA, 2015, p. 8). Programs were designed with local Indigenous staff to incorporate activities with cultural meaning for children and families. Participants There were two groups of participants in this study. Students Students who completed sessional placements within these two interprofessional clinic contexts were invited to participate in this study. There were three subgroups of student participants, all of whom were undergraduate students in their third or final year or graduate entry masters students in their first or second year who attended a clinic in interprofessional teams: Group 1 included four SLP and four OT students attending a Murri School placement in 2013; Group 2 included 24 SLP and 24 OT students who had completed a placement at the Murri School between 2013 and 2015; Group 3 included 18 OT and six SLP students who attended an ATSICCHS clinic in 2014. Of all students approached to participate, the following consented: Group 1 – four SLP and four OT students; Group 2 – 13 SLP and four OT students; Group 3 – three SLP and eight OT (one of whom was Indigenous) students. Clinical educators All four clinical educators (CEs) who supervised the students, an OT and SLP CE in each context, agreed to participate in this study. All CEs were female and had a range of 2–35 years of experience in supervising students. Procedure Ethical approval to conduct the study was obtained from the relevant university ethics board. Students were invited

to participate in the study at the end of their placement. They were advised that their participation was independent of their clinical placement and would not impact in any way on their assessment grades. Students in group 1 completed semi-structured interviews as OT/SLP pairs (four pairs of two students). Students in all groups completed a post-placement survey. Clinical educators completed semi-structured interviews as OT/SLP pairs. One clinical educator team (OT CE 1 and SLP CE 1) participated in two interviews, one in 2013 and one in 2016. Data Collection Survey tool Student participants in all groups completed the 10-minute survey 1 week to 2 months following their placement. It involved 15 five-point Likert scale items asking questions about students’ experiences of the learning environment, clinical skills development, knowledge of working with Indigenous people, supervision and feedback, and overall experience of their placement. Questions were also asked about the impact of the student placement on knowledge, attitudes and skills, for example, “I am more likely to consider working in Indigenous contexts in the future as a result of this placement”. Two open-ended response items on the positive and negative aspects of the placement were also included. Interviews Interviews were conducted by an independent researcher not associated with the student clinic. A semi-structured CE and student interview guide was used. Questions focused on the placement structure, teaching processes and practices, how these developed over time in context 1, and how students responded to these processes. Data analysis Data collected from 2013 to 2016 were pooled and analysed together. Survey data Quantitative survey data was grouped and descriptively analysed to provide percentages of student responses. Open-ended questions were analysed using content analysis. Interview data Interview data were analysed using a qualitative description approach (Sandelowski, 2000). Transcripts were reviewed by two of the researchers and initial coding categories were independently generated, then adjusted after comparison and discussion. A proportion of the data (approximately 20%) was then coded by one researcher for each data set (student and CE). Further discussion with the research team occurred and refinements to the coding categories were made. One researcher then coded the remainder of the student data and another researcher coded the CE data. Results Findings from the qualitative data are used to structure the results, with quantitative data from the surveys integrated throughout. Four main themes emerged. These were: 1) Structures and processes supporting placements; 2) The importance of relationships; 3) Client-centred practice; and 4) Interprofessional leadership. Structures and processes Eighty-six per cent of students felt they were adequately prepared by the university for their placement. CE and

Jodie Copley (top), Teresa Quinlan (centre), and Rebekah White

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JCPSLP Volume 19, Number 1 2017

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