JCPSLP Vol 20 No 2 July 2018

Table 1. Critical appraisal of Flatley et al. (2014)

Flatley, D., Kenny, B., & Lincoln, M. (2014). Ethical dilemmas experienced by speech-language pathologists working in private practice. I nternational Journal of Speech-Language Pathology , 16 (3), 290–303.

Question

Y/N Comment

Y The researchers aimed to identify ethical dilemmas in the private practice setting where there is currently limited research. The researchers aimed to describe the nature of these dilemmas, understand the support needs unique to this setting and inform potential supports that may be beneficial. Y A qualitative, interview-based approach with thematic analysis was appropriate to the study aims. Y Purposeful sampling was conducted as the researchers required participants to have specific knowledge for research aims. The researchers acknowledged some limitations with the sampling, namely the lack of a range of practice locations, e.g., rural; limited role in private practice (owners only) and possible lack of clarity of definitions of “ethical issues” with participants. Y Methods are appropriate for a qualitative study. Data collected via semi-structured interview. Two interviewers performed different functions within the interview. Demographic information also elicited at interview. Questions were open-ended to encourage narrative response and probes to elicit specific examples were provided. The interview process is clearly outlined. Y Interviews were transcribed verbatim (excluding any identifying information). Two authors were involved, and consensus reached re themes identified. The Qualitative Content Analysis protocol (Graneheim and Lundham, 2004) which identifies, condenses and interprets meaning units to develop themes and subthemes was used. An audit trail was maintained – i.e., decisions made re identifying themes, condensing and interpreting text recorded. Participants were given opportunity to review the analysis after the interviews were transcribed and coded. Y The researchers clearly outlined current roles (e.g., undergraduate SLP student, researcher, academic and lecturer) and state that these backgrounds may have influenced interactions and interpretations Y The aim of the study, to identify and describe the nature of the ethical dilemmas experienced by speech-language pathologists working in private practice, was addressed. The authors outline the themes and subthemes and give numerous examples and direct quotes from the interviews. Y The authors conclude that speech pathologists in private practice experience ethical dilemmas around client management, business practices, accessing and distributing external funds, and personal and professional integrity of other speech-language pathologists. They highlight that, while some of these themes are similar to SPs working in the public domain, their manifestation is different in private practice settings. Issues surrounding business concerns were seen as unique to this setting Results have been compared with literature regarding ethical dilemmas in public health care settings. Y The information presented is plausible and credible.

1. Did the article describe an important clinical problem

addressed via a clearly formulated question?

2. Was a qualitative approach appropriate? 3. Was the sampling strategy clearly defined and justified?

4. What methods did the

researcher use for collecting data? Methods and data sources appropriate?

5. What methods did the

researcher use to analyse the data, and what quality control measures were implemented? Are the results credible?

6. Was the relationship between the researcher(s) and participant(s) explicit? 7. What are the results, and do they address the research question?

8. Are the results credible?

9. What conclusions were drawn, and are they justified by the results? In particular, have alternative explanations for the results been explored?

Unsure Questions exist regarding transferability of results to other clinical settings. Sampling was restricted to urban NSW and to practice owners. It is not clear whether the findings are transferable to other states, to rural and remote areas or to private practitioners who are not practice owners. These issues are raised by the authors.

10. To what extent are the findings of the study transferable to other clinical settings?

management) and the need to work through decisions efficiently and effectively in areas that he has high expertise. The paper also highlighted that there may be situations in which high ambiguity combined with Mark’s low degree of experience and expertise (e.g., in setting up a staff employment contract) would warrant either delegation to someone more qualified or mentoring through the process. Although the authors identified that the proposed decision- making framework required further research to validate and confirm generalisability, Mark recognises it as a tool for helping him to identify situations where he will need external consultation and/or collaboration in establishing and operating his business.

Libby highlights that within Australia in a changing landscape of government funding, particularly with the evolution of the National Disability Insurance Scheme (NDIS), being a resilient business owner will be essential. As such, Mark and Libby discuss the final paper by Ayala and Manzano (2014) which reports on the findings of a longitudinal study examining the resilience of the entrepreneur and how this influences success of a business. Resilience is defined by the Macquarie Dictionary as the ability to “spring back” or “rebound” or “return to original form or position after being bent, compressed or stretched” (p. 808). In the study, three dimensions of resilience were identified as important predictors of

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JCPSLP Volume 20, Number 2 2018

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