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Purpose: To explore student and tutor perspectives on the learning efficacy of virtual, compared to in-person, problem-based tutorial (PBT) in occupational therapy, physiotherapy, and speech-language pathology health professional programs., Materials and Methods: This was a quality improvement study using a cross sectional survey at a single institution. Separate student and tutor surveys were disseminated online. Students received the survey at two timepoints, tutors received the survey at one timepoint. Descriptive statistics summarized quantitative survey questions. Chi-squared or Fischer's Exact analyses explored differences between in-person and virtual PBT. Exploratory analyses determined if associations amongst programs and/or between cohorts existed on variables of interest. Open-ended survey questions were analyzed using content analysis., Results: A total of 241 students and 85 tutors completed the survey. Results demonstrate most students and tutors were satisfied with the use of virtual tutorials (77%; 89% respectively) and felt that they were effective in exploring content within the PBT course. However, students in the most recent cohort rated virtual tutorials more highly ( p  = 0.01)., Conclusions: Virtual modes of PBT were successful in achieving course objectives and led to high satisfaction in users. Health professional programs can use this information when designing virtual problem-based tutorial courses in the post-pandemic era.

Purpose: Reflection can be a valuable learning strategy for connecting theory with practice and illuminating insights and understandings from complex or messy experiences. This learning is critical for educators and health professionals who work or teach students in complex contexts. In anticipation of their future needs, speech-language pathology students, like many health profession students in Australia, are expected to demonstrate the ability to reflect on their practice as part of their professional practice or clinical education. It is challenging to support educators to facilitate reflection and students to learn when, why, and how to reflect for personally and professionally meaningful outcomes given the diversity in understandings and capabilities present in the literature. The purpose of this study was to investigate the feasibility of an evidence-based reflection intervention to clarify and support student reflective practice., Method: A convergent mixed methods design captured quantitative and qualitative results from 16 participants for a better understanding of the feasibility of a reflection intervention., Result: The diversity in the reflection literature also appears to be present in students' reflection approaches. This diversity can encourage student engagement and ownership of reflecting when considered within a rich learning environment., Conclusion: Findings are discussed for timely, intellectually and emotionally safe reflection interventions that develop students' reflective inquiry in the real-world.

Purpose: Clinically integrated teaching (CIT) is an effective approach for promoting evidence-based practice (EBP) competencies among medical students. Challenges towards the implementation of CIT in rehabilitation curricula include educators' different conceptualizations of EBP, the perceived complexity of EBP and the boundaries between the academic and the clinical setting. This study aimed to identify tailored strategies to implement in rehabilitation programs and their affiliated clinical sites to support the development of EBP competencies among students in occupational therapy (OT), physical therapy (PT) and speech-language pathology (S-LP)., Materials and Methods: Nominal group technique (NGT) with stakeholders from three rehabilitation programs in Canada, offering the professional master's in OT and PT ( n  = 35 participants) and in S-LP ( n  = 8)., Results: The top two strategies identified in the OT/PT NGT were: 1) Developing a flexible definition of EBP that recognizes its complexity; 2) Providing clinicians with more access to the teaching content by pairing faculty with preceptors. The top two strategies identified in the S-LP NGT were: 1) Providing students with opportunities for decision-making with experienced clinicians; 2) Increasing interactions between faculty and preceptors using formal group meetings., Conclusion: Findings laid foundations for future integrated knowledge translation projects to collaboratively implement, and test identified strategies.

Purpose: Communication partner training is a recommended intervention for partners of people with acquired brain injury. In this paper we explore the past, present, and future of communication partner training (CPT) based on our 2023 Speech Pathology Australia national conference address., Method: We focus on our research team's contributions, and highlight research knowledge across stroke, traumatic brain injury (TBI), and dementia. This work is anchored in the voice of people with communication disability. One partner in the CPT journey, Rosey Morrow, co-authors this paper., Result: The CPT evidence base for acquired neurological conditions is growing, including in the areas of technology, co-design, and translation. However, knowledge and implementation gaps remain., Conclusion: The future of CPT will require us to harness co-design and technology, whilst meeting the implementation challenges of complex systems to enable communication for all.

Purpose: This study explored the impact of an Australian regional university's Clients-as-Tutors Program (CTP) on speech-language pathology students' perception and understanding of client-centred practice., Method: Two focus group interviews comprising three final-year students and four newly graduated speech-language pathologists who had completed the CTP. An inductive thematic analysis was undertaken to identify salient themes., Result: Three themes were identified: (a) learning from theory, (b) learning from others, and (c) learning from yourself. These themes represented all participants' experiences in the CTP, yet there were unique, individual journeys that each participant experienced., Conclusion: Findings from this study have the capacity to affect change in how client-centred practice is taught at universities across speech-language pathology and other health courses, to disrupt the traditional power structure between client and clinician, and to provide an evidence base for the role of experiential learning in this area.

Purpose: Australian Early Development Census (AEDC) data for the Australian Capital Territory (ACT) indicates a concerning increase in the proportion of children who are at risk or developmentally vulnerable in the domains of communication and general knowledge, and language and cognitive skills. This study investigated the effectiveness of speech-language pathologist and educator collaboration to build educator capacity to promote oral language and emergent literacy skills in preschool children., Method: A quasi-experimental, pre-test post-test design was used to evaluate the effectiveness of interprofessional delivery of Read It Again - KindergartenQ! on (a) children's oral language and emergent literacy outcomes, (b) educators' oral language and emergent literacy instructional practices, and (c) quality of the classroom environment., Result: Children demonstrated improved print knowledge and narrative skills. One of the two educators demonstrated a significant increase in their use of oral language and emergent literacy promoting strategies in their day-to-day interactions with children. No significant changes were observed in the classroom environment., Conclusion: Interprofessional collaboration with a coaching component is an effective method of improving children's emergent literacy skills and educator instructional practices.

Purpose: To investigate the use of two versions of a simulation-based learning experience (SBLE) to decrease speech-language pathology (SLP) students' anxiety and increase their confidence and sense of preparedness for clinical placements., Method: Two cohorts of third-year SLP students ( n  = 33) participated in a mixed-methods study with each cohort completing one version of the SBLE. Participants completed pre- and post-program quantitative ratings of anxiety, confidence, and preparedness for clinical placements and participated in focus groups. Three clinical educators also provided qualitative data in debriefs and interviews., Result: Significant decreases in student ratings of anxiety, and increases in confidence and sense of preparedness, were found for participants from both versions of the SBLE. No significant differences were found between changes in each measure between the two groups. Qualitative data from the student focus groups and clinical educator interviews described affective changes in the students, which concurred with the quantitative results., Conclusion: Results suggest this SBLE can be used to improve SLP students' self-perceptions of readiness for clinical placements. Comparable outcomes can be achieved for students using the shorter, less resource intensive version of the SBLE program, with reduced costs, to overcome barriers to its implementation.

Facilitated communication (FC) has been a heavily debated and documented topic across multiple disciplines, including sociology, education, psychology, pediatrics, speech-language pathology, and disability studies. Although many professionals from various disciplines and advocates have offered opinions, suggestions, and research on the topic, there has been minimal input from the occupational therapy (OT) profession. The lack of OT input is noteworthy as OTs are experts in enabling upper extremity performance and independence through a variety of training, adaptation and modification strategies, and use of external supports. Because of their professional code of ethics and a specific knowledge base, OTs are uniquely positioned to provide a host of ethical and evidence-based strategies that enable independent access to communication technology. The consideration of multiple access options is contrary to the typical facilitated encounter where facilitators exclusively choose to manipulate an upper extremity in order for letters to be selected on a display or keyboard. The purpose of this paper is threefold: (a) To offer insight into the standard of care by OTs including their ethical standards; (b) to identify varied accommodations that enable access using a feature-matching standard of care that eliminates the need for a facilitator; and (c) to highlight how to increase independent assistive technology/augmentative and alternative communication access, thus dissuading the need or use of facilitated access to letters.

Graduate programs have made strides to improve augmentative and alternative communication (AAC) learning opportunities for pre-service speech-language pathologists (SLPs). In addition, a number of continuing education opportunities are available to practicing SLPs; however, many still report feeling underprepared to serve clients with AAC needs. The purpose of this study was to describe school-based SLPs' perspectives regarding their graduate training, on-the-job experience, and ongoing professional development needs related to AAC. Semi-structured interviews were completed with 17 school-based SLPs. Interviews were recorded and transcribed verbatim. Using a phenomenological approach, key themes emerged related to AAC knowledge and skills including a need for SLPs to rely on a framework for decision making, the importance of interprofessional training, and difficulties with staying abreast of new technology. The researchers present recommendations of principles and concepts for instructors to include in graduate AAC courses, as well as professional development considerations.

Purpose: Written clinical reflection is frequently used in speech-language pathology training programs to develop student clinical skills. The aim of this study was to explore speech-language pathology students' perceptions towards written clinical reflection. Method: Seventy-two undergraduate speech-language pathology students completed an online survey. An observational research design was undertaken. Descriptive statistics were used to analyse quantitative data. Inductive content analysis was used for qualitative data analysis. Result: Speech-language pathology students reported that written clinical reflections are useful but also wanted to explore alternative ways to reflect. Most students used written clinical reflection to focus on self-improvement of clinical skills and a small number of students used reflection to consider stakeholders' points of view. Students wanted more guidance and feedback on written clinical reflections. Conclusion: The results indicate that written clinical reflection is a useful learning tool. To facilitate the development of reflection skills in speech-language pathology students, it is important to explicitly teach clinical reflection in university curricula and to receive guidance from professional practice educators.

Purpose: Developmental Language Disorder (DLD) remains prevalent for secondary school students and continues to compromise educational, social and vocational outcomes within and beyond school. Community-based approaches to service provision are needed to use speech-language pathology resources effectively in realising benefits for this student population. Our article focusses on educator experiences of a whole-school project facilitated by a speech-language pathologist (SLP) to address DLD in secondary school settings., Method: Twenty-one educators were interviewed across three schools to understand their perceptions and experiences of the project and their view(s) of what assisted or compromised early implementation. Data were analysed inductively to develop key themes., Result: Educators reported gaining increased knowledge and awareness of DLD, which supported a reframing of their perceptions of student behaviour and learning issues. They identified the project provided them with ready skills and tools to change their practice, realised learning benefits for all the students they taught, aligned with broader school initiatives, and overcame potential challenges to supporting project implementation., Conclusion: Overall, the educators found the project and implementation of strategies doable, acceptable, important, and sustainable. We explore the features of project design that appeared to contribute to educators' positive experience of the project. This knowledge will be helpful for SLPs using innovative service approaches in classroom settings.

Purpose: Transcription of speech sounds is a fundamental skill used by speech-language pathologists. Little is known about the impact of professional development courses on transcription accuracy and confidence. This study explored speech-language pathologists' use and perceptions of transcription and the effect of a professional development course on their transcription accuracy and confidence. Method: A quasi-experimental, one-group pretest-posttest design was used. Twenty-two Australian speech-language pathologists working with children with speech sound disorders participated in the course. Participants transcribed single words and completed a survey about confidence, perceptions, and the use of transcription at both time points. Result: The number of participants who reported feeling confident about using transcription significantly increased from 36.84% pre-training to 68.42% post-training. Transcription accuracy of phonemes based on point-to-point accuracy was high pre-training (88.97%) and did not significantly improve. Participants identified strategies to maintain their transcription skills. Conclusion: This study suggests speech-language pathologists transcribe single words in typical speech with high accuracy using broad transcription, and that participating in a transcription professional development course increases their transcription confidence. Further research is needed to explore different delivery methods of professional development, the impact of professional development on transcription accuracy of disordered speech, and the long-term impacts of professional development on transcription accuracy and confidence.

Purpose: To explore speech-language pathologists' (SLP) practice in literacy prior to, and during, COVID-19 to understand the practicalities, feasibility and sustainability of telepractice literacy services., Method: This exploratory study employed a cross-sectional survey comprising 46 questions covering participants' caseload profile and service delivery models, their assessment and intervention practices and telepractice delivery of literacy services., Result: Participants were 44 SLPs working primarily in private practice and education with children and adolescents. Students with literacy difficulties comprised a significant proportion of SLPs' caseloads. Individual and group sessions were the most common format of delivery prior to COVID-19. In a telepractice model during COVID-19, SLPs saw fewer students overall. Most provided individual sessions only and reported cancellation of group sessions. SLPs described their practice in literacy as being aligned with evidence-based principles. A range of resources were used for literacy assessment and intervention. For most, their usual practice changed for telepractice. Many felt underprepared to use telepractice and experienced numerous challenges mostly relating to technology and family engagement., Conclusion: Literacy has become a core area of practice for SLPs; however, continued advocacy towards consultative and collaborative services is needed within onsite and telepractice models. Telepractice required SLPs to develop additional skills and modify usual practice. Despite experiencing challenges, many indicated they would continue with telepractice given its perceived benefits.

Most speech-language pathologists (SLPs) in Malaysia practice with an undergraduate degree, which provides them with limited knowledge about and training in augmentative and alternative communication (AAC). This limited knowledge and training may affect their confidence and competence when introducing and using AAC with individuals for whom it is required. This study aimed to obtain feedback, via semi-structured interviews, from a group of 11 Malaysian university students who participated in an AAC training program about their experiences participating in and the effectiveness of the training program. Three themes were derived from qualitative content analysis of the interviews: (a)Time Demands, (b) Generalizing the use of AAC, and (c) Learning Required When Introducing AAC. The participants reported that they obtained better insights into the role of SLPs and communication partners with regards to AAC, as well as the struggles they faced. Students also reported increased confidence when working with individuals who use AAC after participating in the training program, thus supporting the need for similar training programs in the future.

Purpose: The sociocultural and historical context and membership of the speech-language pathology (SLP) profession underpins our norms of practice and our discourses. This context also informs and defines the ways that we practice today, including who we legitimise to enter our profession and why. In this paper, we used theory as a tool to critically explore how this socioculturally constituted knowledge and practice influences how students experience learning in SLP practice placements. Method: We used the theory of Legitimate Peripheral Participation (1991) as a conceptual framework to interpret qualitative data from two separate programs of research that had explored the phenomena of student learning in SLP practice placements. Result: The analysis cast light on how our understanding and expectations of SLP students' learning and competency development in placements is recursive and strongly legitimised in our profession. Students adjust to accommodate the professional knowledges, practices and expectations they encounter in their placements. This facilitates the perpetuation of practices proffered by the majority culture. Conclusion: The use of theory allowed us to explore the phenomena of student learning in placements in a new light, which unmasked new understandings of the longstanding challenge to increase diversity in the SLP community.

Purpose: Legacies of colonialism continue to influence the profession of speech-language pathology (SLP) around the world. While there is some literature on ways in which we can decolonise the profession, there is little written on these issues in relation to research and practice in the field. In this paper, we discuss how qualitative approaches can be useful particularly in post-colonial contexts to transform research and practice in the profession. Method: Using a reflective framework, we draw on examples from several of our own research and teaching experiences that have embraced a variety of qualitative approaches, conducted across various contexts in the post-colonial South African context. Result: Qualitative approaches can play a central role in achieving transformation goals because they offer opportunities for highlighting the voices of marginalised communities and they are flexible and adaptable to the needs of particular contexts. We reflect on how qualitative approaches can be linked to SLP curricula, practice and research, and consider innovative ways in which such approaches can be embraced within the profession. Specifically focussing on research, we explore issues of access, representation and inclusion, the use of contextually relevant methods, and ethical considerations when working in post-colonial contexts. Conclusion: Many of the points raised in this article are important for all contexts. Embracing qualitative approaches offers opportunities for the SLP profession to transform and meet our mandate of providing culturally safe, appropriate, effective care.

Purpose: The use of dosimetric information to guide the management of dysphagia related to head and neck cancer (HNC) treatment is an emerging area of practice. In order to better meet the needs of people with dysphagia in HNC, it is important to explore how clinicians use this information to guide practice and also to identify factors that influence/discourage the use of dosimetric information. Method: A descriptive qualitative method was chosen and purposeful sampling with additional snowball sampling were used to recruit clinicians working within Australian cancer centres. To facilitate participation, clinicians were offered either a focus group or individual interview as a means to collect their perspectives. A total of 20 clinicians with varying years of clinical experience (range 2.5 - 29 years) were recruited. Eight participants took part in a focus group and 12 elected to participate in an individual interview. Content analysis was used to analyse transcripts. Result: Three main themes emerged from the transcripts: (1) clinician factors such as experience, confidence and knowledge and (2) clinical service factors such as staffing levels, clinical management pathways and system access influence use of dosimetric information; (3) patient factors such as demographics, surgical history and education needs influence dysphagia management plans. Conclusion: Speech-language pathologists' (SLPs') use of dosimetric information within HNC settings to direct patient management is emerging and varies between clinicians and workplaces. Given that dosimetric information potentially enables specialised dysphagia management planning for patients during their radiotherapy treatment, further education and training for speech-language pathologists in this area should be prioritised.

The aim of this study was to describe how professionals from multiple disciplines (e.g., speech-language pathologists, teachers, occupational therapists) in the United States reported challenges they face in delivering services to children with cortical visual impairment (CVI) who use augmentative and alternative communication (AAC). Three surveys were utilized to identify barriers to and priorities for improving educational and clinical services and in-service and preservice education from the perspectives of professionals in school, community, and university settings. Results suggest that current service delivery models may not be meeting the needs of either children with CVI who use AAC or the professionals whose job it is to provide them with services. Professionals in community-based settings appeared to encounter more barriers. Findings help to support a discussion about approaching AAC interventions for children with CVI who use AAC by adopting interprofessional collaborative practice (IPCP) and interprofessional education (IPE) models, which reflect long-standing best practice guidelines for AAC service delivery and are encouraged by multiple professional organizations.

Purpose : A lack of diversity in the speech-language pathology profession is widely recognised internationally. The role of speech-language pathology education in reproduction of this homogeneity and as a barrier to diversification is little understood. The potential of blended online education to increase access to education and diversify the speech-language pathology profession is yet to be explored. The purpose of the study was to investigate the profile of students engaging in the first blended online speech-language pathology course in Australia, including motivations for studying, experiences of studying via a blended online mode, and intentions for future practice. Method : Data were collected from 44 students in the first Australian blended online Master of Speech Pathology via an online survey. Quantitative data were analysed using descriptive statistics in SPSS and a content analysis of the qualitative data was conducted using NVivo. Result : With over 92% of participants choosing the course because it was offered online, flexible blended online study provided opportunity for those who would not have otherwise accessed speech-language pathology education, including rural students and those balancing work and home commitments. Participants found face to face elements of the course essential to their learning, but also the most challenging to manage and to fit around other commitments. Participants' ideal work scenarios revealed that 82.9% wished to practice within 50kms of their current location, indicating that provision of tertiary education to people in rural areas is contributing to establishing and retaining a rurally focussed speech-language pathology workforce. Conclusion : Blended online study provides an opportunity to diversify the speech-language profession by providing access to students such as rural students and those balancing work and home commitments with tertiary education. By reducing barriers to studying speech-language pathology, flexible learning is helping address issues of access and equity in service delivery across Australia.

Living in the transformative age is one of disruption, change, and infinite opportunity. However, living in a cloud-based world with self-driving cars, advanced robotics, artificial intelligence, e-health, 3-D printing, and COVID-19 can also be somewhat daunting, challenging, and even confronting. As speech-language pathologists, researchers, educators, and advocates, we need to be agile, more creative and connected to data, experiences, and people. Now more than ever, these connections will enable transformation and ensure the future of our profession.speech-language pathologists are now practising on a global scale, in multiple languages and unique contexts, and the education of our future workforce is critical. Over the past 10 years, there has been rapid growth in the number of speech-language pathology training programs delivered by universities in Australia, as well as a significant shift in the demand for services and changing employment opportunities. In Australia, the profession has been planning for the future; Making Futures Happen , Building a Future workforce , and re-developing our Professional Standards . But, are we really cognisant of the global challenges and opportunities for our profession? Do we really value global connectivity?In this discussion paper, authentic examples and plausible scenarios are being used to explore the global transformation of the speech-language pathology profession. Each will highlight some of the political, economic, societal, cultural, and technological influences on speech-language pathology research, teaching, and practices that are driving development, change, and innovation. Readers will be challenged to consider how thinking globally, with a focus on context, translation, and connection will enable them to rise to the challenges we face today and forge new paths for the future.

Purpose: This study explored experiences of bulbar (speech, voice and swallowing) symptoms in Australian adults with Myasthenia Gravis (MG), and the relationship between these symptoms and community participation and quality-of-life. Further, it examined access to and experiences with speech-language pathology (SLP) services, and awareness and perceptions of the SLP's role. Method : A cross-sectional mixed methods online survey collected data using researcher-designed questions and patient-reported outcome measures (PROMs) including the Dysarthria Impact Profile (DIP), Voice Handicap Index (VHI), Dysphagia Handicap Index (DHI), Community Integration Questionnaire-Revised (CIQ-R), and Myasthenia Gravis Quality of Life-Revised 15 (MG-QOL15r). Analyses included descriptive and non-parametric statistics, and content analysis. Result: Participants were 111 adults with MG living in Australia. 74% of respondents reported experiencing symptoms of speech difficulties but only 20% of those were referred to SLP services. Similarly, 85% of respondents reported experiencing swallowing difficulties, but only 26% were referred to SLP. Voice handicap (VHI) was strongly correlated with the psychosocial impact of dysarthria (DIP) and dysphagia handicap (DHI). Increased voice and dysphagia handicap were moderately correlated with worse quality-of-life. There was generally poor awareness of the SLP's role and many were reluctant to attend SLP appointments. Conclusion : These findings highlight unmet consumer needs for MG-related bulbar symptoms, and a lack of awareness of SLP services. It is suggested that, in addition to other strategies, consumer education and increased awareness are required to address these unmet needs.

Purpose: This study aimed to explore factors, perceived by students themselves, that help or hinder development of competency in voice., Method: Focus group interviews were conducted with a convenience sample of 14 speech pathology students (93% female, mean age 22 years). Interviews were transcribed verbatim and analysed using template analysis., Result: Students' perceptions of influencing factors were grouped into two major themes: (1) personal factors, and (2) educational factors. A key finding was that many participants perceived a student's own voice to be a major factor impacting their development and attainment of clinical competency in voice, and that mindsets towards the (un)changeability of students' own voices varied across participants. Students with a performance background were considered to be at an advantage in terms of performing vocal tasks and suitability to work with specific populations. Key facilitatory educational factors included access to and experience of demonstrations (face-to-face and video), additional training workshops, peer learning, and simulation., Conclusion: This study identified a number of personal and educational factors that students perceive to impact the development of competency in voice. Consideration of these holistic factors may assist speech-language pathology educators to deliver optimally effective voice-related curricula.

Purpose: Simulation is increasingly used within speech-language pathology education. Research has primarily explored students' perceptions of learning in simulation. The aim of this study was to determine if speech-language pathology students achieved a statistically-equivalent level of competency when a mean of 20% of placement time was replaced with simulation compared to placements without a simulation component., Method: This non-inferiority randomised controlled trial involved students from six Australian universities. Students were randomised to either a simulation + traditional placement group attending 5 days of simulation prior to their traditional placement, or a traditional only placement group. Their end-placement clinical competency was assessed using Competency Assessment in Speech Pathology (COMPASS ® )., Result: Final data were available for 325 students: 150 students in traditional placements, 138 students in protocol-compliant simulation + traditional placements, and 37 students in non-protocol simulation + traditional placements. There were no statistically significant differences between groups (traditional vs protocol-compliant simulation + traditional Mann-Whitney-Wilcoxon z  = 1.23, df  = 286, p  = 0.22; traditional vs intention-to-treat simulation + traditional Mann-Whitney-Wilcoxon z  = 0.23, df  = 323, p  = 0.81)., Conclusion: This research contributes to the evidence base which suggests that simulation can partially replace traditional placement time for speech-language pathology students without loss of competency, substantiating its value as an alternative placement model in speech-language pathology programmes.

Purpose: Conducting and interpreting videofluoroscopic swallow studies (VFSS) is a complex, multi-dimensional task, requiring post-qualification training to develop knowledge, skill and competence. Speech-language pathology (SLP) managers must continually ensure staffs are adequately trained to deliver safe and effective VFSS services. However, VFSS training is resource intensive, variable in content and not consistently accessed universally. This study examined managers' perceptions of a new VFSS eLearning programme and its impact on VFSS training and service delivery. The eLearning programme incorporated theoretical and procedural aspects of VFSS, accessed free of charge by speech-language pathologists working in a large public health service in Queensland, Australia., Method: Twenty-two SLP managers participated in semi-structured interviews, which were evaluated using inductive content analysis., Result: Four themes were identified relating to eLearning benefits: (1) design and content facilitated widespread uptake, (2) enhanced training opportunities, (3) increased clinical skill and workforce capacity and (4) benefits and efficiencies for SLP services. A fifth theme described contextual considerations for using the programme., Conclusion: This study contributes information about the benefits of eLearning for delivering consistent, accessible VFSS training, in a resource-efficient manner. Managers perceived the eLearning programme as a valuable resource to supplement practical VFSS training, to ultimately support VFSS service provision.

A cross-sectional survey study was undertaken to describe the perceived competence, pre- and post-professional training, and practice of Filipino speech-language pathologists (SLPs) in augmentative and alternative communication (AAC). Printed and electronic questionnaires were distributed to all SLPs in the Philippines with at least 1 year of practice experience. A total of 152 (47%) questionnaires were returned. Based on these data, 108 respondents (71%) practiced AAC, but most (range = 59-89%) did not perceive themselves to be competent in working with various client populations with complex communication needs. A majority (range = 70-93%) of the respondents reported limited pre-professional training in all AAC content areas, and at least 82% strongly desired continuing education in almost all areas of AAC. Almost 90% of respondents only occasionally (53%) or rarely (36%) recommended AAC, and 82% considered it as a last resort. Major practice challenges reported were families' negative attitudes toward AAC and lack of AAC-specific interdisciplinary collaboration. Infrequent use of high-tech AAC was also reported. The findings suggest various ways through which AAC education and services in the Philippines may be enhanced. They also imply the need for further research on alternative service delivery models, as well as additional members of the AAC team.

Speech Pathology Australia, through its landmark project for the profession, "Speech Pathology 2030 - making futures happen" (SP 2030), calls for speech-language pathologists to "respond (to presenting clients) in ways that respect each person's culture, language, life experiences, and preferences" (Speech Pathology Australia, 2016, p. viii). Such engagement, it holds, is central to successful practice. Meeting the needs of Aboriginal and/or Torres Strait Islander (Indigenous) clients and communities, however, requires a skilled response to client wholeness, to their indissoluble, and unique, immersion in their: indigeneity; lived cultural experience; and the social, geographical, economic and political realities that surround them. Equally, the achievement of a truly-effective engagement, one able to engender desired outcomes, is also dependent on the challenging achievement of culturally-safe practice. Given that the relevant literature is, historically, based on a privileging of western purviews, this article asserts the validity of incorporating (pan-)Indigenous epistemologies and perspectives. As well as the Indigenous health and cultural safety literature, then, this article draws on particular Indigenous professional experience as a locus of good-practice evidence, one capable of contributing additional insights to best address the question: "How might Non-Indigenous speech-language pathologists really engage, effectively, with Indigenous Australia?". It introduces a guiding rubric, "Meet People in their Own Reality", as a tool with which to examine how engagement, in the service of more-effective practice, can be optimised in four exemplar domains of SP 2030.

Aim: The aims of this study were to determine the self-efficacy of speech pathology students in conducting evidence-based practice before and after a comprehensive evidence-based practice course, and the impact of timing of the course (Semester 1/2)., Method: Students attended a 13-week course in their final year of study. The evidence-based practice confidence scale (EPIC) was used to measure the students' self-efficacy pre- and post-training., Results: Ninety-two percent of students enrolled over six semesters participated. Students began the evidence-based practice course with high confidence in asking patients their preferences but low confidence in interpreting and analysing statistics. A significant improvement in confidence in all evidence-based practice areas was found, with greatest improvement occurring in the critical appraisal of research. Overall, the teaching had greatest effect on a group of skills for finding valid EBP information. There were significant differences between semester one and two students in only 18% of responses. Semester two students were more confident in half of these responses., Conclusions: An evidence-based practice course made a significant difference to student self-efficacy across all aspects, with few differences related to timing of the course. Implications are discussed. Implications for Rehabilitation Health professionals must be confident implementing evidence-based practice throughout the course of their careers, as best practice changes over time. A capstone unit of study/course for undergraduate speech pathology students significantly improved their self-efficacy in implementing evidence-based practice. This has positive implications for evidence-based practice across a wide range of clinical settings including rehabilitation and disability as the graduate entry level students enter the workforce. For on-going success, graduate entry level students must continue to implement evidence-based practice as clinicians if they are to maintain their confidence and further develop their skill set.

Purpose: This study profiled the demographic characteristics and practice patterns of speech-language pathologists working with older Australians to inform future workforce planning and service development in response to an ageing population and aged care sector reform., Method: Data were collected through snowball distribution of an online survey comprising six sections: demographic details; caseload and service delivery practices, degree of inter-professional practice; engagement with professional development and support; and assessment and management of swallowing, mealtime and communication difficulties. All data were analysed using descriptive statistics and chi-square to determine the independence of key variables., Result: Data from 145 speech-language pathologists highlight the need for increased numbers of clinicians working outside of metropolitan areas and greater workforce diversity, along with increased incentive, supervision and inter-professional support for new graduate and early career clinicians considering working outside of hospital settings. To ensure evidence-based practice, further research into the validity of current assessment and intervention methods used across aged care settings is needed., Conclusion: The findings highlight the need for an extended scope of practice and improved models of support for speech-language pathologists working with older people to better respond to the needs of an ageing population and on-going aged care sector reform.

Purpose: This prospective study investigated the impact of supervising students on public health speech-language pathologists' (SLPs) time and patient activity levels in order to broaden evidence in the profession., Method: Thirty-four SLPs supervising students collected data profiling their time use and activity during the first, middle and penultimate placement week. They also collected data for a week when not supervising students. Pre- and post-placement surveys were used to supplement quantitative data with additional information such as clinician and student experience levels., Result: Overall clinical time (face-to-face and indirect) and the number of patients seen neither increased nor decreased during student placements. However, clinicians' use of time altered across placement periods. For example, SLP time delivering clinical services decreased but time observing students providing clinical services increased as the placement progressed. Some differences in time spent in non-clinical activities (e.g. student teaching and SLP administration) were found. Comparing data from placements with varying supervision models or student competence level showed few significant differences in time use, activity or productivity., Conclusion: There was no significant difference in overall clinical time used, nor patient activity or productivity whether clinicians were supervising students or not. Further research is required within SLP services.

Purpose: Written reflective practice aims to support critical thinking and problem solving skills in speech-language pathology (SLP) clinical education programmes. Yet, there has been limited investigation of students' development of written reflective practice skills over time and during a real-time clinical experience. The purpose of this study was to investigate students' development of breadth and depth of written reflective practice across a six-week clinical experience., Method: Participants were 59 undergraduate and 14 postgraduate SLP students. Participants wrote critical reflections describing an interaction with a client/s at the conclusion of weeks two, four and six of their clinical experience. Formative feedback was provided after each submission. Breadth and depth of reflection were coded using a modification of Plack et al.'s coding schema., Result: There was a statistically significant association between time and likelihood of development of breadth of reflection for the elements process and content. Depth of reflection improved significantly across time. The majority of participants were classified as "reflectors" or critical reflector at the conclusion of the study., Conclusion: SLP students can make significant improvements in both breadth and depth of written reflective practice over a six-week period. Implications for clinical teaching are discussed.

Purpose: Little is known about the critical ingredients of successful Communication Partner Training (CPT) programmes. The aim of this randomised controlled trial was to investigate the effects of including an educational component before a conversation with a person with aphasia compared to a conversation only., Method: Thirty-eight speech-language pathology students were randomly allocated to either the Full programme or Conversation only groups. The Full programme group received a lecture about communication strategies then participated in a conversation with a person with aphasia, while the other group participated in the conversation only. Both groups received feedback on performance from the people with aphasia. Students completed a customised mixed-methods questionnaire at study commencement and following the conversation., Result: Generalised linear models indicated confidence ratings improved after receiving either the Full programme or Conversation only (p < 0.001), however, greater improvements were observed following the Full programme (p < 0.001). More communication strategies were identified after the interventions (p = 0.001) with greater improvement occurring among the Full programme group (p < 0.01)., Conclusion: An educational lecture before a conversation with a person with aphasia is a critical component of CPT programmes, enhancing their knowledge base and increasing their confidence levels compared to only a conversation.

Although Article 19 of the Universal Declaration of Human Rights states that "everyone has a right to freedom of opinion and expression", for people with communication disability this may not be a reality. This commentary shares a practical example of how people with communication disabilities together with speech-language pathology (SLP) students, academics and clinical staff co-designed and co-implemented a Communication Awareness Training Programme for catering staff to enable communication access in coffee shops and restaurants. This is an example of how SLPs can embrace their social responsibility to break down barriers for people with communication disabilities. This commentary shares the reflections of those involved and how they felt empowered because they had learned new skills and made a difference. This commentary highlights the need for co-design and co-delivery of programs to raise awareness of communication disability among catering staff and how the stories of people with communication disabilities served as a catalyst for change. It also highlights the need to SLPs to move intervention to a social and community space.

Forty percent of Syrian refugees are younger than 12, and many have not attended school for up to five years, disadvantaging them academically, emotionally, and psychosocially. Article 19 of the Universal Declaration of Human Rights dictates "the right to freedom of opinion and expression…and to seek, receive and impart information and ideas…)". Resettled refugee children face the challenge of integration into majority-English school systems with limited ability to express themselves or linguistic means to access education. However, Syrian adults possess high rates of literacy and funds of knowledge that can promote an environment of learning in the home language. With incomplete language and literacy skills in their native Arabic, learning English for academics proves challenging. Without language and literacy instruction, refugee children experience a lower likelihood of class participation and a greater likelihood of social isolation or drop out. To inform speech-language pathologists and other educators, this literature review aims: (1) to apply second language learning concepts relevant to refugees, (2) to inform pedagogy specific to reading by highlighting cross-linguistic differences between Arabic and English, and (3) to illuminate strategies that families and educators of Arabic-speaking refugee students may employ to resume and promote language and literacy development.

Purpose: Videofluoroscopic swallowing study (VFSS) has been widely used in clinical settings and in research for evaluating swallowing functions. The interpretation of such studies requires subjective judgment by the raters, which may be affected by clinical experience and definitions of the rating parameters. Two methods have been proposed to improve the reliability: training and use of a coordinate mapping (CM) protocol. This study aimed at investigating the effect of training on improving the intra-and inter-rater reliabilities of VFSS analysis; and comparing the intra- and inter-rater reliabilities of a clinical evaluation (CE) protocol and a CM protocol for analysing VFSS., Method: Forty inexperienced judges were randomly assigned to one of two groups: a CE group or a CM group. Each group received training to perform VFSS judgments using the relevant analysis protocol. All participants were tested individually before and after training., Result: Results showed that training significantly improved the intra- and inter-rater reliabilities of both protocols. In addition, the CE group achieved significantly higher intra- and inter-rater reliabilities than the CM group after training., Conclusion: It is recommended that standard training protocols be implemented during clinical training to improve the reliability in VFSS analysis.

Purpose: Increasing the proportion of culturally and linguistically diverse (CALD) students and providing intercultural learning opportunities for all students are two strategies identified to facilitate greater access to culturally responsive speech-language pathology services. To enact these strategies, more information is needed about student diversity. This study collected descriptive information about CALD speech-language pathology students in Australia., Method: Cultural and linguistic background information was collected through surveying 854 domestic and international speech-language pathology students from three Australian universities. Students were categorised according to defined or perceived CALD status, international student status, speaking English as an Additional Language (EAL), or speaking a Language Other than English at Home (LOTEH)., Result: Overall, 32.1% of students were either defined or perceived CALD. A total of 14.9% spoke EAL and 25.7% identified speaking a LOTEH. CALD students were more likely to speak EAL or a LOTEH than non-CALD students, were prominently from Southern and South-Eastern Asian backgrounds and spoke related languages., Conclusion: Many students reported direct or indirect connections with their cultural heritage and/or contributed linguistic diversity. These students may represent broader acculturative experiences in communities. The sociocultural knowledge and experience of these students may provide intercultural learning opportunities for all students and promote culturally responsive practices.

Purpose: This study aims to explore the effects of an interactive workshop involving speech-language pathology students on medical students' knowledge about communication in relation to speech-language disorders., Method: Fifty-nine medical students received a lecture about speech-language disorders. Twenty-six of them also participated in a workshop on communication with patients with speech-language disorders. All students completed a 12-item questionnaire exploring knowledge and attitudes towards communication before and after the lecture or the workshop. The results from the two groups' self-ratings of confidence in knowledge were compared with expert-ratings of their ability to choose suitable communicative strategies., Result: Both the lecture and the workshop increased the students' confidence in knowledge about speech-language disorders and how to support communication. Only the workshop group also displayed a statistically significant increase in expert-rated ability and changed their attitude regarding responsibility for the communication in cases of speech-language disorders. There were no statistically significant correlations between the student's own confidence ratings and the experts' ratings of ability., Conclusion: Increased confidence in knowledge from learning is not always reflected in actual knowledge in how to communicate. However, an interactive workshop proved to increase medical students' expert-rated ability and attitudes related to communication in cases of speech-language disorders.

Purpose: The majority of individuals with disabilities live in low- and middle-income (LAMI) countries; typically these individuals receive limited, if any, communication rehabilitation services. The present study investigated the experiences of eight augmentative and alternative communication (AAC) professionals who had provided instructional support for AAC service delivery in LAMI countries., Method: An online focus group was used to explore the training experiences of eight AAC professionals., Result: A thematic analysis of the focus group discussion resulted in four major recommendations when providing training for AAC service delivery in LAMI countries: (a) investigate learner needs, (b) provide contextually relevant instructional content, (c) use engaging instructional activities and (d) assess the impacts of instructional activities., Conclusion: The instructional recommendations of the focus group participants are discussed within a theoretical framework of recommended best practices in supporting adult learning. The information shared by the focus group participants will benefit others providing instructional support for AAC service delivery in LAMI countries.

Purpose: Speech-language pathology programs globally need to prepare graduates to work with culturally and linguistically diverse populations. This study explored the knowledge, perceptions and experiences related to development of cultural awareness of graduate-entry Master of Speech Pathology students at an Australian university., Method: Sixty students across both year-levels completed a cultural awareness survey at the beginning of the semester. To explore how clinical placement influenced students' knowledge and perceptions, year-2 students completed written reflections pre- and post-placement (n = 7) and participated in focus groups post-placement (n = 6)., Result: Survey results showed student interest in working with culturally and linguistically diverse populations was high (over 80%) and confidence was moderate (over 50%). More than 80% of students reported awareness of their own cultural identities, stereotypes and prejudices. Content analysis of focus group and written reflection data identified key concepts comprising of: (1) context-university, and clinical placement site; (2) competencies-professional and individual; and (3) cultural implications-clients' and students' cultural backgrounds., Conclusion: Findings suggest clinical placement may positively influence cultural awareness development and students' own cultural backgrounds may influence this more. Further exploration of how students move along a continuum of cultural development is warranted.

Purpose: This qualitative study investigated the learning process for speech-language pathology (SLP) students engaging in a problem-based learning (PBL) curriculum and compared the perspectives of students from two pathways., Method: Sixteen final-year SLP students participated in one of four focus groups. Half the participants entered the course directly via an undergraduate pathway and the other half entered via a graduate entry pathway. Each focus group comprised two students from each pathway. Data were generated via a semi-structured interview and analysed thematically., Result: Regardless of participants' pathway, many similar themes about factors that influenced their expectations prior to PBL commencing as well as their actual PBL experiences were raised. Participants believed that PBL was a productive way to learn and to develop clinical competencies. Many were critical of variations in PBL facilitation styles and were sensitive to changes in facilitators. The majority of participants viewed experiential opportunities to engage in PBL prior to commencement of semester as advantageous., Conclusion: Combining students with different backgrounds has many advantages to the PBL learning process. Regardless of prior experiences, all students must be sufficiently prepared. Furthermore, the facilitator has a crucial role with the potential to optimise or detract from the learning experience.

Purpose: The use of simulated learning environments to develop clinical skills is gaining momentum in speech-language pathology training programs. The aim of the current study was to examine the benefits of adding Human Patient Simulation (HPS) into the university curriculum in the area of paediatric dysphagia., Method: University students enrolled in a mandatory dysphagia course (n = 29) completed two, 2-hour HPS scenarios: (a) performing a clinical feeding assessment with a medically complex infant; and (b) conducting a clinical swallow examination (CSE) with a child with a tracheostomy. Scenarios covered technical and non-technical skills in paediatric dysphagia management. Surveys relating to students' perceived knowledge, skills, confidence and levels of anxiety were conducted: (a) pre-lectures; (b) post-lectures, but pre-HPS; and (c) post-HPS. A fourth survey was completed following clinical placements with real clients., Result: Results demonstrate significant additive value in knowledge, skills and confidence obtained through HPS. Anxiety about working clinically reduced following HPS. Students rated simulation as very useful in preparing for clinical practice. Post-clinic, students indicated that HPS was an important component in their preparation to work as a clinician., Conclusion: This trial supports the benefits of incorporating HPS as part of clinical preparation for paediatric dysphagia management.

Purpose: This study aimed to describe perceptions of clinical placement experiences and competency development for international speech-language pathology students and to determine if these perceptions were different for domestic students., Method: Domestic and international students at two Australian universities participated in nine focus group interviews. Thematic analysis led to the identification of two themes shared by international and domestic students and several separate themes., Result: Shared themes identified the important influence of students' relationships with clinical educators, unique opportunities and learning that occurs on placement. International student themes included concerns about their communication skills and the impact of these skills on client progress. They also explored their adjustment to unfamiliar placement settings and relationships, preferring structured placements to assist this adjustment. Domestic student themes explored the critical nature of competency attainment and assessment on placement, valuing placements that enabled them to achieve their goals., Conclusion: The findings of this study suggest that international students experience additional communication, cultural and contextual demands on clinical placement, which may increase their learning requirements. Clinical education practices must be responsive to the learning needs of diverse student populations. Strategies are suggested to assist all students to adjust to the professional and learning expectations of clinical education placements.

Clinical education programs in speech-language pathology enable the transition of students' knowledge and skills from the classroom to the workplace. Simulated clinical learning experiences provide an opportunity to address the competency development of novice students. This study reports on the validation of an assessment tool designed to evaluate speech-language pathology students' performance in a simulated clinical placement. The Assessment of Foundation Clinical Skills (AFCS) was designed to link to concepts and content of COMPASS(®): Competency Assessment in Speech Pathology, a validated assessment of performance in the workplace. It incorporates units and elements of competency relevant to the placement. The validity of the AFCS was statistically investigated using Rasch analysis. Participants were 18 clinical educators and 130 speech-language pathology students undertaking the placement. Preliminary results support the validity of the AFCS as an assessment of foundation clinical skills of students in this simulated clinical placement. All units of competency and the majority of elements were relevant and representative of these skills. The use of a visual analogue scale which included a pre-Novice level to rate students' performance on units of competency was supported. This research provides guidance for development of quality assessments of performance in simulated placements.

Finding practical dysphagia opportunities for students pre-qualification is challenging. Discussions with clinicians led to the development of a new placement model. The placement was just five days and had an accompanying workbook. The current study aimed to evaluate the benefits of the placement. Data were analysed from 40 students who attended an adult dysphagia placement and 13 who attended a paediatric dysphagia placement. Measures included a pre and post self-rating questionnaire, qualitative feedback from clinical educators and students and a pre and post measure of knowledge using concept maps. Student self-rating data indicated gains in experience, awareness, knowledge, clinical skills, competence, confidence and interest in dysphagia. Clinical educators and students also reported a range of benefits from this placement. Students who undertook a placement that focused on adult dysphagia significantly increased their knowledge of adult dysphagia, but this did not generalize to paediatric dysphagia. Despite reporting that they felt they had gained in knowledge of dysphagia, the students who did a paediatric dysphagia placement did not significantly increase their knowledge of dysphagia. The study raises a number of important considerations when designing placements including length, timing, intensity, how best to encourage generalization of knowledge, and how best to measure learning.

Speech-language pathologists' scope of practice is currently unclear in relation to their contribution to the multi-disciplinary assessment of decision-making capacity for clients with aphasia and related neurogenic communication disorders. The primary aim of the current research study was to investigate the common practices of speech-language pathologists involved in assessments of decision-making capacity. The study was completed through the use of an online survey. There were 51 of 59 respondents who indicated involvement in evaluations of decision-making. Involvement in this kind of assessment was most commonly reported by speech-language pathologists working in inpatient acute and rehabilitation settings. Respondents reported using a variety of formal and informal assessment methods in their contributions to capacity assessment. Discussion with multidisciplinary team members was reported to have the greatest influence on their recommendations. Speech-language pathologists reported that they were dissatisfied with current protocols for capacity assessments in their workplace and indicated they would benefit from further education and training in this area. The findings of this study are discussed in light of their implications for speech-language pathology practice.

A shortage of clinical education placements for allied health students internationally has led to the need to explore innovative models of clinical education. The collaborative model where one clinical educator supervises two or more students completing a clinical placement concurrently is one model enabling expansion of student placements. The aims of this review were to investigate advantages and disadvantages of the collaborative model and to explore its implementation across allied health. A systematic search of the literature was conducted using three electronic databases (CINAHL, Medline, and Embase). Two independent reviewers evaluated studies for methodological quality. Seventeen studies met inclusion/exclusion criteria. Advantages and disadvantages identified were consistent across disciplines. A key advantage of the model was the opportunity afforded for peer learning, whilst a frequently reported disadvantage was reduced time for individual supervision of students. The methodological quality of many included studies was poor, impacting on interpretation of the evidence base. Insufficient data were provided on how the model was implemented across studies. There is a need for high quality research to guide implementation of this model across a wider range of allied health disciplines and to determine educational outcomes using reliable and validated measures.

The rising demand for health professionals to service the Australian population is placing pressure on traditional approaches to clinical education in the allied health professions. Existing research suggests that simulated learning environments (SLEs) have the potential to increase student placement capacity while providing quality learning experiences with comparable or superior outcomes to traditional methods. This project investigated the current use of SLEs in Australian speech-language pathology curricula, and the potential future applications of SLEs to the clinical education curricula through an extensive consultative process with stakeholders (all 10 Australian universities offering speech-language pathology programs in 2010, Speech Pathology Australia, members of the speech-language pathology profession, and current student body). Current use of SLEs in speech-language pathology education was found to be limited, with additional resources required to further develop SLEs and maintain their use within the curriculum. Perceived benefits included: students' increased clinical skills prior to workforce placement, additional exposure to specialized areas of speech-language pathology practice, inter-professional learning, and richer observational experiences for novice students. Stakeholders perceived SLEs to have considerable potential for clinical learning. A nationally endorsed recommendation for SLE development and curricula integration was prepared.

This study investigated the inter-rater and intra-rater reliability of subjective judgements of cough in patients following inhalation of citric acid. Eleven speech-language pathologists (SLPs) currently using cough reflex testing in their clinical practice (experienced raters) and 34 SLPs with no experience using cough reflex testing (inexperienced raters) were recruited to the study. Participants provided a rating of strong, weak, or absent to 10 video segments of cough responses elicited by inhalation of nebulized citric acid. The same video segments presented in a different sequence were re-evaluated by the same clinicians following a 15-minute break. Inter-rater reliability for experienced raters was calculated with a Fleiss' generalized kappa of .487; intra-rater reliability was higher with a kappa of .700. Inexperienced raters showed similar reliability, with kappa values for inter-rater and intra-rater reliability of .363 and .618, respectively. In conclusion, SLPs demonstrate only fair-to-moderate reliability in subjectively judging a patient's cough response to citric acid. Experience in making cough judgements does not improve inter-rater reliability significantly. Further validity and reliability research, including an evaluation of the effect of training on judgement reliability, would be beneficial for guiding clinical policies.

There are competency standards available in countries with established speech-language pathology services to guide basic dysphagia training with ongoing workplace mentoring for advanced skills development. Such training processes, however, are not as well established in countries where speech-language pathology training and practice is relatively new, such as Malaysia. The current study examines the extent of dysphagia training and workplace support available to speech-language pathologists (SLPs) in Malaysia and Queensland, Australia, and explores clinicians' perceptions of the training and support provided, and of their knowledge, skills, and confidence. Using a matched cohort cross-sectional design, a purpose-built survey was administered to 30 SLPs working in Malaysian government hospitals and 30 SLPs working in Queensland Health settings in Australia. Malaysian clinicians were found to have received significantly less university training, less mentoring in the workplace, and were lacking key infrastructure needed to support professional development in dysphagia management. Over 90% of Queensland clinicians were confident and felt they had adequate skills in dysphagia management; in contrast, significantly lower levels of knowledge, skills, and confidence were observed in the Malaysian cohort. The findings identify a need for improved university training and increased opportunities for workplace mentoring, training, and support for Malaysian SLPs.