JCPSLP Vol 23 No 3

Student perspective The student voices highlighted the invaluable role patients can play in SLP education. The development of student knowledge and key competencies was enhanced by the active involvement of patients as teachers, consistent with previous research (Wykurz and Kelly, 2002). Of particular benefit to the students was receiving feedback from the expert teachers. Students gained confidence and insight into their competencies through immediate, positive and constructive feedback. These findings are similar to Speers and Lathlean’s (2015) results where nursing students experienced deep and transformative learning following verbal and written feedback from service users. Hearing expert teachers disclose emotional experiences supports research which recognises that hearing patients’ stories (Jha et al., 2009; Spencer et al., 2011) can be emotionally taxing for students. Students in this study experienced this, alongside a sense of attachment, having developed a relationship with the expert teachers. Emotional challenges are recognised in research about patient involvement in health professional education (Morgan & Jones, 2009), yet these findings have not been explicitly documented. In combination, these findings highlight a need to provide appropriate support to students to help them manage their own emotional responses to patient self-disclosure. Shared perspectives There was coherence between the views of expert teachers and students that emphasises elements of the model that were meaningful to both groups. These include: the authenticity of the clinical experience (McKinlay et al., 2009; Purves et al., 2013; Towle et al., 2010), the nature of the relationship between expert teachers and students, the safe learning environment (Henriksen & Ringstead, 2011), and the giving/receiving of feedback. Research (Henriksen & Ringstead, 2011) has found that patients in a teaching role can create a safe learning environment for students. The similarity in experiences has implications for planning and further developing the expert teacher model of clinical education. The main implication of this study for the SLP profession is that involving clients in student education enhances student learning, and provides a foundation for how to form therapeutic relationships. This in turn will guide early-career SLPs in the development of truly client-centred practice. Limitations This study is limited in that it was small. It involved one clinical group from one educational institution, which limits the applicability of results to other contexts. Additionally, the first author was a student in a previous expert teacher clinic, which may have introduced bias. However, this prior experience provided valuable insights in the formation of the interview and focus group questions. Conclusion This creative program has identified key teaching and learning experiences of PWP and students in an “expert teacher” education model. Programs involving patients need to ensure that patients and students receive support and training. Further exploration of the perceptions of different patient groups or students with different levels of competency is needed to advance understanding about the impact of patients as teachers in SLP student education.

The relationship was trusting and respectful in several ways. One student mentioned the reciprocal trust and others discussed developing a greater empathy for the lived experiences of people with Parkinson’s disease. knowing that they’re prepared to be quite vulnerable, you know in our hands…and them having to provide feedback afterwards…it builds a different level of respect… I don’t know but for me I sort of felt there was a deeper level of empathy with what they were going through just because we had this kind of teacher-student relationship. (MY) Students commented on feeling attached to the expert teachers, because they were volunteering their time to support student learning. I think being in this type of clinic it did bring in a little bit more um emotion ‘cause you sort of really felt like you knew them and you knew that they were doing something for you… (SE) Having a safety net The clinic created a safe learning environment. Several factors contributed to a sense of safety. Students perceived that receiving feedback on performance and having a clinical educator modelling a session provided a safe learning environment. One mentioned that watching the clinical educator demonstrate the steps involved in the therapeutic activities eased them into the process. I think that was what made it a nice safety net that you had already seen it the week before… You saw it one week, did it the next week; so it was still relevant and then yeah even if you did a mistake or mucked it up, you know that it wasn’t a big deal. (AC) Discussion These findings highlight the valuable role patients play as teachers in SLP student clinical education. This has not been reported in previous literature. The “expert teacher” model met the needs of the patients while providing positive While the expert teachers experienced some challenges during their involvement in this clinic, they reported several benefits that met personal health needs and contributed to teaching experiences. The expert teachers had opportunities to work on their communication, similar to Swart and Horton’s (2015) study where trainers with aphasia could develop and practise communication skills. Echoing research about patient involvement in health care education (Lauckner et al., 2012; Stacy & Spencer, 1999), the expert teachers benefitted from learning more about their condition in the learning encounter. That expert teachers profited from therapy for real difficulties highlights the importance of involving patients with chronic conditions as teachers in SLP education. All expert teachers felt they contributed to student development and that their experiential knowledge of Parkinson’s disease was valuable to SLP education, consistent with previous research on patient-as-teacher initiatives (Lauckner et al., 2012; Morgan and Jones, 2009). Involving patients in SLP education recognises the importance of their unique contribution to student education. One expert teacher perceived ambiguity around what the expert teachers were “experts” in. When considering the ongoing planning and development of this as a model for SLP education, patients would benefit from further support and training to develop their identity as an “expert”. learning experiences for students. Expert teacher perspective

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JCPSLP Volume 23, Number 3 2021

Journal of Clinical Practice in Speech-Language Pathology