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Background: COVID‐19 necessitated emergency telepractice for student‐led speech‐language therapy clinical practicals in training institutions, with limited preparation and evidence‐based guidelines. Beyond the pandemic, practitioners and university training sites are likely to continue to offer telepractice necessitating thorough preparation for telepractice services underpinned by a comprehensive understanding of the complexities involved in online therapy. Aims: Adopting realist evaluation principles, our aim in this paper was to explore broadly what works and does not work in a set of student‐led telepractice sessions in a diverse, resource‐limited context. The broader goal of this project was to provide evidence‐based support to enhance the efficiency and success of telepractice sessions in student clinical training contexts. Methods & Procedures: We used qualitative observational methods with reflexive thematic analysis to analyse 28 video recordings and 61 observation notes of student‐led paediatric telepractice sessions from a South African university clinic as part of a pilot study. Outcomes & Results: We identified four overarching considerations for student‐led telepractice: (1) additional, specific preparation is required, (2) with greater management of technology and adaptation of tasks, especially during times of poor connectivity; (3) telepractice relies heavily on caregiver input and collaboration; and (4) promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical skills that are complicated by the lack of face‐to‐face contact. Conclusions & Implications: Our findings indicate that telepractice pedagogy needs to be explicitly taught and students require practical assistance as they learn how to use this service delivery approach effectively. There are some aspects peculiar to telepractice that require unique consideration and planning, especially in contexts where service providers and users may be unfamiliar with this form of service provision. The findings of this pilot study can be used by clinical educators and student clinicians to enhance clinical training opportunities involving telepractice. WHAT THIS PAPER ADDS: What is already known on this subject: Many speech‐language therapy (SLT) student clinicians had to transition quickly to telepractice service provision during COVID‐19 with limited existing guidelines and support, especially in contexts where teletherapy is typically non‐existent or difficult to access. Although there is some literature available on experiences of telepractice, there is very little evidence‐based research which explores the mechanics of such sessions in real‐time and which offers practical support to student clinicians and clinical educators engaging in this mode of service delivery. What this study adds: This pilot study examined video‐recorded, student‐led, paediatric, speech‐language teletherapy sessions to understand challenges and considerations involved in using telepractice as a clinical training tool. Findings show that additional preparation for telepractice sessions is required, particularly in contexts of poor digital literacy; students must learn to manage technology, especially when connectivity poses a challenge, and adapt therapy tasks for online work with clients; telepractice relies heavily on caregiver input and collaboration, more so than in in‐person consultations, and this relationship requires careful management; and promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical yet challenging skills in telepractice. What are the potential or actual clinical implications of this work?: Our findings highlight a need to teach telepractice pedagogy explicitly and support students practically in learning how to provide therapy effectively via this mode of service delivery. Observational methods for studying practices in recorded telepractice sessions can be used as part of a reflective approach to clinical training. Using already available data allowed us to unpack the 'messy reality' of clinical training using telepractice. [ABSTRACT FROM AUTHOR]

The terminology and jargon used in medical interactions can pose particular challenges to understanding for patients, healthcare providers, and mediators in cases where a language barrier is present. Common medical words used in the interactional space may mean different things to each party present. This study focuses on 79 mediated and nonmediated South African and Italian recorded healthcare interactions in which a language barrier was present. Using a hybrid sociolinguistic approach, we examined how patients, mediators, and healthcare providers orient to the use of medical terminology and how both parties demonstrate understanding of terminology used in the interactional space. Talk-extrinsic data in the form of interviews with South African patients revealed a frequent lack of understanding of key terminology, yet we found few displays of a lack of understanding in the interactional data nor explicit requests by patients for clarification of terminology not understood. In both data sets, patients made use of medical terminology infrequently and usually when describing their symptoms. Healthcare providers used medical terminology quite regularly. We found limited evidence of explicit verification of patients' understanding of medical terminology by healthcare providers or mediators. Given the additional communication complexities inherent in health interactions where a language barrier is present and patients' tendency not to request clarification, the healthcare provider has a special responsibility to ensure that all parties understand the terminology brought into the interactional space. Direct checks of patient understanding of terminology can provide an effective and efficient way of revealing comprehension and establishing shared membership. [ABSTRACT FROM AUTHOR]

COVID-19 necessitated a swift move of speech-language pathology clinical practicals to online platforms, without much preparation. Given that telepractice is likely here to stay, it is important to understand the challenges and special considerations required for teletherapy sessions so that students can be adequately prepared. We used qualitative observational Methods: with reflexive thematic analysis to analyse 29 video recordings and 61 observation notes of student-led speech-language pathology teletherapy sessions with paediatric clients, collected at a South African university clinic. Four overarching considerations for telepractice were identified across the data set. Additional preparation is required, with greater management of technology and adaptation of tasks especially during connectivity challenges. Telepractice relies heavily on caregiver input and collaboration, and students need to navigate this relationship carefully. Promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical and require a different approach online. Basic principles of therapy are relevant to both in-person and telepractice services, but teletherapy requires a significant amount of additional preparation, flexibility and problem solving by students to promote client engagement and motivation. We offer insights into aspects of teletherapy sessions that do and do not work, with implications for student training. [ABSTRACT FROM AUTHOR]

Background: Little is known about the experiences and impact of coronavirus disease 2019 (COVID-19) on the mental health and wellbeing of healthcare workers (HCWs), particularly in Global South contexts., Aim: The authors aimed to explore the experiences of HCWs at different points during the COVID-19 pandemic in South Africa., Setting: This study's sample included 621 HCWs from various professions and health sectors who completed the survey during the pandemic peaks of waves I, II and III in South Africa., Methods: The authors used a qualitative survey design exploring participants' general work, life, mental health and wellbeing experiences, and their support mechanisms or strategies. Data were analysed using thematic analysis., Results: The authors identified three overarching themes in the data, namely stress, adjustment to work during COVID-19, and support experiences and needs. These themes were common across all three survey waves, with some minor differences noted across the waves., Conclusion: An overarching thread of uncertainty seems central to HCWs' experiences of working during COVID-19, related to pressures in the South African healthcare system that have been aggravated by the pandemic., Contribution: These findings have the potential to inform the development of contextually relevant approaches to support the mental health and wellbeing needs of HCWs during and after a pandemic. In particular, workplaces need to actively offer psychological support to all HCWs, not just to workers traditionally defined as frontline., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2023. The Authors.)