JCPSLP Vol 23 No 3

and students. This was due to both time constraints and difficulties facilitating ad-hoc opportunities for collaborative learnings between groups. CEs identified an increased use of formalised feedback to support student learning to replace informal “corridor” conversations. I had to be more organised I had to have more, I suppose, tools for me to capture comments and give feedback to the students. […] I just made templates and things like that and then we had the opportunity to email, you know, in between as needed. Whereas I think most of the time we would just have a quick catch up at the end of every session face to face. (CE3) CEs also identified the need for intentional creation of opportunities for social connections between students. They noted how students used the online break-out rooms to catch-up between sessions and recognised students’ “social need” (CE2) particularly during the COVID-19 restrictions. Reflexive, collaborative learning Flexibility and problem-solving skills were viewed as fundamental for transitioning to the online telesupervision modality for all CEs, although this differed based on their prior levels of comfort and experience with telehealth delivery, online learning, and the simulation clinic. The new experience of telesupervision, however, meant all CEs described continuously reflecting on their practice during and after the placement, including how to best adapt their teaching and the student learning environment to the online mode. I found it was harder this time than face-to-face to demonstrate things to them… There were some elements of the program that weren’t as good online compared to face-to-face… I think I could do some of that stuff better because as we were going [along] I was figuring out how do I convert this to online. So, I think if I did it a second time I would be able to do it better. (CE2) Peer support between CEs was also important for enhancing the learning environment as the CEs adapted to the online mode. For instance, CE2 described “making videos of me pretending to be a client” for students and sending “those on to the other CEs with a bit of information about this is what I did with this, because they didn’t have it.” CEs recognised that additional time should be allocated to foster collaborative work between groups and for “debriefing” among CEs. “Maybe we need to work out ways of building a little bit of extra time so we can do some more pre-placement discussion and have a virtual tearoom or something (CE3)”. CEs described increasing their own telepractice and telesupervision skills through their transition. This included an opportunity for CEs to learn new telepractice practice techniques through the technological skills of students. “The students certainly came up with some really good ideas about doing telepractice that I wouldn’t have thought of” (CE1). Sustainability With the transition from face-to-face to online, issues regarding sustainability were identified. A key issue raised with the move to telesupervision was that CEs “can’t have an ear on multiple [student] groups at a time.” (CE1) This resulted in a smaller staff to student ratio, increasing the cost of the placement. Providing simultaneous

telesupervision to multiple groups was acknowledged by CE2 and CE3 as being more cost-effective and therefore a more sustainable model. However, CEs also identified opportunities to manage multiple student groups: “Maybe instead of having two groups starting simultaneously we could start them 15 minutes apart or something. You could do that sort of staggered watch… (CE3)”. Further, in this context, CEs described the role of simulation in facilitating student learning: “if I was concerned about a student’s ability to do a component of the prac and I missed it, I asked them, […] can you just rerun that bit. How did you do that? (CE4).” Preparation time to adapt to the online modality and associated ongoing problem-solving, including the development of online-friendly tools, was a recurring feature of the CEs’ experience. While additional time spent on preparation for the placement was viewed as largely owing to this being the first iteration of the online delivery, time stress during the placement was commonly referred to. CEs recognised the need for additional time to foster collaborative work between and within student groups, to provide students with additional or “discreet” feedback and/or to repeat competencies. However, CE1 identified that additional time spent online could add to the feeling of “online fatigue”. Flexibility-enhanced learning opportunities A key positive of the online modality was the opportunity to change a full-day, week-long, face-to-face clinical experience to one-day per week with some time flexibility in the afternoons. Previously, the student placement had been run over a weeklong intensive with students and CEs required to travel to campus. The new structure was perceived as beneficial in managing online fatigue and in the flexibility it provided CEs. The structure enabled CEs to maintain paid and unpaid work responsibilities when they would otherwise need to take a full week off work, travel, and meet associated expenses. “It was quick and efficient because there was no travel involved for me as an educator and I would end those meetings and then just carry on with my own zoom clinical practice (CE4).” The increased flexibility of online simulation combined with telesupervision created the opportunity to employ experienced CEs from a wider geographical catchment area compared to usual practice of employing locally based clinicians to support face-to-face clinics on campus. “[It] meant that we could increase our pool of good quality clinical educators to use. And that gave the students the opportunity to link in with people who are working as speech pathologists and their skills and resources (CE1).” Further, the modality of the experience was considered to offer increased learning opportunities for students. Even if you are in a metropolitan area and had the best access and transport and those barriers were removed, you still have a limited number of practitioners who do this type of therapy. It’s quite specialized. I think you would have difficulty getting everybody into a [student] placement to experience this. (CE4) Simulation of telepractice was also viewed as beneficial because the modality paralleled typical clinical service delivery for specialised clinical areas such as adult stuttering clients, particularly for those residing outside metropolitan areas, and was therefore important in preparing students for rural practice.

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JCPSLP Volume 23, Number 3 2021

Journal of Clinical Practice in Speech-Language Pathology