JCPSLP Vol 23 No 3

Telepractice delivery of stuttering treatment is effective and well documented throughout the literature (see Lowe et al., 2013; McGill et al., 2019), thus it is a relevant practice area for both simulated and client- based telehealth placements with speech pathology students. Previous studies demonstrate benefits for speech pathology students engaged in such telehealth placements (Bridgeman et al., 2018; Penman et al., 2020) as well as traditional face-to-face delivery of stuttering treatment (Block, et al., 2005; Cardell & Hill, 2013). With growing interest in innovative clinical placements and telesupervision, it is important to seek to understand the experiences and roles of clinical educators in this space. Research questions/aims This project addresses the accessibility of speech pathologists’ education by exploring clinical educators’ (CE) experiences of transitioning to online clinical education during a telepractice stuttering simulation placement. This study forms part of a larger study considering multiple perspectives (student and CE) using mixed research methodologies. This project received Charles Sturt University Human Research Ethics Committee approval, protocol number: H20363. Method A qualitative research design was adopted to explore perspectives of speech pathology CEs after completing a telepractice simulation placement. A research assistant (not from the speech-language pathology discipline) invited six CEs to participate in semi-structured interviews and conducted, de-identified and transcribed the interviews for analysis. Four CEs completed an interview. While telesupervision was new for the participating CEs, all had previous experience supervising speech pathology students in face-to-face settings. Among the four participants, two CEs had experience using telehealth for clinical practice, two CEs had experience providing online learning, and one had prior experience delivering the Camperdown program. Interview transcripts were read and annotated separately by the research assistant, and two authors (CS, MN). Initial annotations were coded into concise phrases that reflected what was said during the interviews. The initial analysis process was completed on each individual transcript before reviewing other participant transcripts. A content analysis of the interview transcripts was then conducted by two authors (CS, MN), who were not involved with delivering the placement. Following Erlingsson and Brysiewicz (2017), initial codes were then grouped into organising phrases or key ideas with similar meanings which were cross- referenced between researchers for agreeance. These were then grouped into unique themes, before being discussed with the wider research team. A second round of analysis was completed with the researchers consciously reflecting on the research questions to build an understanding of the most important parts of the transcripts. The final step of the analysis involved identifying connections, similarities and differences between participants, to highlight individual and collective perceptions of experiences. The context of this project is a specialist stuttering telepractice simulation placement undertaken by final year undergraduate and postgraduate speech pathology students through a regional Australian university. Students participated in this placement one day per week for five weeks, using simulated client profiles. During

each telepractice session, groups of three students alternated the roles of client, clinician, and observer, providing students with the opportunity to implement the Camperdown program (O’Brien et al., 2018), and the opportunity to take on the role of simulated client. Being the client in peer simulation can afford students the opportunity to develop unique and valuable insights into patients’ experiences of and feelings about health issues and health care interactions (Dalwood et al., 2020). CEs provided telesupervision to between one and three groups of students simultaneously, with each student located separately (see Figure 1). The simulation placement had been implemented in face-to-face format during the preceding four years. This research is based on the first implementation via an online, telesupervision modality

Location A Clinical educator

Virtual Clinical education space

Location B Student clinician

Location D Student observer

Location C Simulated client

Melissa T. Nott (top), and Lisa Brown

Figure 1: The online simulated telepractice placement model

Results Four themes specific to CE transition to telesupervision for clinical education in a simulated environment emerged from the interviews: relationships with and between students; reflexive, collaborative learning; sustainability; and flexibility- enhanced learning opportunities. Relationships with and between students During telesupervision CEs worked to promote systems for bidirectional feedback and to build student confidence to request help, as these practices often required directed effort and action by all parties. Subtle visual, verbal, and other interpersonal cues that typically enable CEs to facilitate student learning and build a working relationship in face-to-face formats were noted as more difficult to discern in the online mode. To counter this, CEs described implementing specific techniques at the start of the placement to build rapport and foster buy-in from the students regarding the online and simulated modality. This included emphasising the utility of telesupervision and simulation techniques for professional practice as well as using the available technology to give a more personable insight into their set-up and practice: “I tried to show them my room, you know by turning my screen around and explain who I was and what my background was to give them a sense of who I was (CE4).” CEs identified that peer learning and support were more difficult than in face-to-face delivery for both CEs

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JCPSLP Volume 23, Number 3 2021

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