JCPSLP Vol 23 No 3

Creative clinical education

Patients as teachers in speech-language pathology Expert teacher and student perceptions Alice Darragh, Philippa Friary, and Clare M. McCann

Patients are increasingly active as teachers in health professional education, but less so within speech language pathology (SLP). This study explored how SLP students and people with Parkinson’s disease (PWP) experienced their involvement in a patient-as-teacher program. Semi-structured interviews with four PWP and a focus group with six students were conducted. Responses were analysed using inductive thematic analysis. Five themes arose from the semi-structured interviews: working on a real thing; helping the next generation; expert teacher-student relationship; safe environment; and challenges you’ve got to overcome. Four themes were generated from the focus group, namely: developing skills; getting feedback from the client; teacher-student relationship; and having a safety net. The expert teacher program is an innovation in SLP student education. The findings show that involving clients in student education enhances student learning and provides a foundation for how to form therapeutic relationships. P atients have a long history of being actively involved as teachers in health professional education including medicine (Dijk et al., 2020), nursing (Towle et al., 2010) and nutrition and dietetics (Porter et al., 2019). As experts in the lived experience of their own health condition, using patient voices is invaluable in the education of students (O’Neill et al., 2006). This study uses the term expert teacher to refer to the people with Parkinson’s disease (PWP) involved as teachers of speech-language pathology (SLP) students. To date, there has been limited research about expert teachers in SLP education, and even less documenting PWP as expert teachers. One early study emphasised the important role of patients as teachers to promote equitable clinical relationships in SLP education (Beecham, 2005). Two further studies (Purves et al., 2013; Swart & Horton, 2015) considered the perspectives of people with aphasia in this role. Within medical education, patients have occupied roles in teaching clinical skills, assessment, evaluating student performance

and in developing curricular (Morgan and Jones, 2009; Towle et al., 2010). Much less is known about patients’ active involvement in providing feedback, despite feedback to students being identified as a positive and powerful factor in learning (Speers & Lathlean, 2015). More research is needed to understand how this can enhance student learning especially in SLP. Clinical education programs need to consider effective patient involvement (Robert et al., 2014) and ensure quality student learning (Spencer et al., 2011). Research indicates that learners and patients value initiatives involving patients as teachers (Jha et al., 2009; Stacy & Spencer, 1999). Students have reported gaining insight into the experience of disease (Morgan and Jones, 2009), acquiring communication skills, increasing confidence and reducing anxiety (Wykurz & Kelly, 2002). Patients have experienced elevated self-esteem (Lauckner et al., 2012), opportunities for personal learning (Spencer et al., 2011) and improved quality of life (Towle et al., 2010). However, given the limited literature on patient involvement in SLP education, the benefits and challenges for students and patients in SLP educatios are unknown. The aim of this pilot study was to explore the experiences and perceptions of PWP and students involved in the expert teacher model of clinical education in SLP. Methods The study was conducted within the first clinical practicum of SLP students completing a graduate-entry qualifying degree at a New Zealand university (prior to any specific teaching on Parkinson’s disease). PWP occupied the expert teacher role in SLP students’ education and in doing so provided verbal feedback based on their experiences of living with Parkinson’s disease. Over eight weeks, six students (in pairs) observed the clinical educator and then independently completed SLP tasks including taking a case history, assessing communication and/or swallowing, discussing assessment results and formulating goals with the PWP. Appendix 1 outlines the 8-week program. After each 40–45 minute session, students debriefed (15–20 minutes) with the expert teacher and the clinical educator (identified as “Maree” in the quotes below) to develop their clinical competencies. Before commencing the clinical practicum, the expert teachers completed a two-hour training session with the clinical educator which outlined their role, the program, and ways to give feedback. Throughout the program, the clinical educator supported the expert teachers in providing feedback to the students (see Appendix 2 for the written advice).

KEYWORDS CLINICAL PRACTICUM EXPERT TEACHER FEEDBACK

THIS ARTICLE HAS BEEN PEER- REVIEWED

Alice Darragh (top), Philippa Friary (centre) and Clare M. McCann

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JCPSLP Volume 23, Number 3 2021

www.speechpathologyaustralia.org.au