JCPSLP Vol 23 No 3

SLP students will continue to participate in telepractice literacy placements for the foreseeable future. It is therefore important that SLP students leave university with the requisite knowledge and skills to work not only in the literacy domain, but in telepractice, as a continuing model of service delivery. Scope of practice documents and clinical guidelines from speech pathology organisations outline the competencies that are required to work both in literacy and telepractice; however, we need to understand the perspectives of students engaged in placements involving both literacy and telepractice to understand what is important to students and to help inform the best pedagogical strategies to support them in delivering a successful service. The findings of this study have contributed to filling this gap in knowledge, and to the set out below recommendations. Recommendations 1. Support access to appropriate online assessment tools for literacy (e.g., resources from MOTIf) and intervention resources (e.g., subscription-based resources and online platforms). SLP students could be supported to develop the skills required to create and adapt assessment and intervention resources. It is important to be mindful that selecting and creating resources for intervention can be time-consuming, and this should be considered alongside SLP students’ usual caseload requirements. Copyright also needs to be considered. Some standardised assessment tools are now available in online versions and where these are available, it is important that universities invest in these resources. Where resources have not been converted to online versions by the authors or publishers, it is important for permission to be sought before adapting these resources. 2. Provide explicit teaching and opportunities for practice around communication skills in a telepractice environment, including how these differ to onsite contexts. Teaching and practice opportunities could focus on the antecedent and feedback components of the teaching moment with clients, and considerations for clients with sensory needs (e.g., vision impairment, hearing impairment). 3. Provide SLP students with practical learning opportunities in telepractice literacy services. The most effective telepractice pedagogy, from the perspective of SLP students, may include simulated learning environments, role-playing with peers and supervisors, and observation of peers and supervisors delivering telepractice literacy services. 4. Support students to determine which clients are best suited to telepractice and to reflect on the evidence base, particularly for literacy where research evidence is limited. Encourage students to explain the limitations and benefits of telepractice to clients and families, so that they can make informed decisions. 5. Ensure that all speech pathology courses adequately prepare students to work in the literacy domain. Limitations The sample size for this study was small; however, the richness of participants’ responses was adequate to address the research questions and allow for meaningful analysis. The lack of data from New South Wales may be a limitation given the number of well-established speech pathology courses run in this state. It is a limitation of the study that no third-year speech pathology students participated in the survey.

consideration. Furthermore, SLP students need support to understand how to tailor intervention approaches, resources, and activities for literacy to meet individual client needs in a telepractice context. Our respondents reported a heightened focus on their own communication skills in a telepractice environment. This included attempting to be more animated, and providing timely, specific, and clearly articulated instructions and feedback to clients. In Overby’s study (2018), interpersonal engagement was identified by all stakeholders (SLP faculty, graduate students, and telehealth clinicians) as important for telepractice services, with SLP students identifying this as the most important telepractice clinical skill. In a telepractice placement context, differences compared to face-to-face service delivery have been reported by allied health students relating to observation and interpretation of clients’ non-verbal communication (Bridgman et al., 2018; O’Hara & Jackson, 2017) with some recommending this as an area for explicit teaching within academic training programs (Overby & Baft-Neff, 2017). For our respondents, the importance of presenting clear and concise instructions and information to clients may have been heightened due to these perceived challenges in an online context relating to non-verbal communication. Despite this, the real-time visual feedback afforded by telepractice, and the ability to view session recordings means that telepractice can provide an opportunity for SLP students to reflect on their own performance, including their interpersonal skills, and adjust their performance accordingly (Bridgman et al., 2018). Like the perspectives of stakeholders in Overby’s study (2018), our respondents indicated that practical learning experiences with peers and supervisors were most beneficial for preparing them to deliver telepractice literacy services. These experiences included observation of supervisors or peers delivering telepractice literacy services, role-playing and participation in simulation clinics. It is thought that practical experiences such as these provide familiarity with technology and its capabilities, examples of the types of difficulties that might be encountered and an opportunity to analyse the strategies used by other clinicians in telepractice (Overby, 2018). Interestingly, our respondents reported feeling more confident with the technological aspect of their telepractice placement rather than the literacy aspect. This is consistent with the findings of Overby (2018), where fear and anxiety about technology failure did not emerge as a theme from their SLP student data. In the current COVID-19 climate, many tertiary institutions have rapidly transitioned to online learning and therefore, our respondents’ own experiences of learning online may have contributed to their confidence with the technological aspect of telepractice. Half of our respondents commented on their lack of confidence working in the literacy domain as being a barrier to delivering a successful telepractice literacy service, despite literacy being recognised as within SLPs’ scope of practice (Serry et al., 2021; Speech Pathology Australia, 2011). Some SLP students reported an intention to seek additional professional development in literacy following graduation, consistent with the findings of Serry and Levickis (2020) who reported that much of the knowledge and skills SLPs gain for working in the literacy domain are obtained through post-university training. Given the expected long-lasting effects of the COVID-19 pandemic, along with an appreciation of the benefits offered by telepractice relating to cost and service access, many

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JCPSLP Volume 23, Number 3 2021

Journal of Clinical Practice in Speech-Language Pathology