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Simulated learning programs are an important component of allied health education. Although the role of simulation clinical educators has been highlighted as critical for student learning within simulation, their perceptions of their role have not yet been investigated. This study aimed to explore the experiences of simulation clinical educators. Participants were ten simulation clinical educators who had supported speech-language pathology students' learning during a 5-day simulation program focussed on speech-language pathology practice with adult clients in acute hospital and rehabilitation settings. Educators participated in individual semi-structured interviews exploring their role and their perceptions of the simulation-based learning program. Data were analysed using inductive thematic analysis. Three inter-related themes emerged from participants' views. The major theme of Unique teaching and learning environment incorporated five subthemes: focus on teaching; safe learning environment; authenticity and engagement; structure and intensity of learning, and; feedback opportunities. Two additional themes were identified: Clinical educator role same but different, and Simulation bridges the gap between theory and practice. This study offers new insights into simulation clinical educators' perceptions of their role when supporting students within simulation and highlight the importance of harnessing the unique benefits of simulation as a teaching pedagogy to maximize its impacts on student learning and justify its costs.

Background: Simulated learning activities are an effective tool for reducing speech-language therapy (SLT) students' anxiety and improving their confidence for clinical placements. Such activities include interacting with patients who are actors, clinical educators or peers and are known to decrease anxiety and increase confidence in SLT students. Screen-simulated patients using video are another alternative, which has not yet been fully evaluated in the education of SLT students. Aims: To compare the effectiveness of (1) modified simulated patient and (2) video simulated learning for increasing self-reported (a) confidence and (b) preparedness and (c) decreasing self-reported anxiety. Methods & Procedures: This study used a randomized crossover design with 127 first-year graduate-entry master's SLT student participants. Students participated in two activities related to a clinical interaction with a paediatric client's carer: (1) a 1-hr modified simulated patient experience with clinical staff as the simulated patient; and (2) a video-learning task, with two videos of a clinician-carer interaction and an accompanying worksheet. Students were randomly allocated to a group of four students and the groups randomly allocated to receive modified simulated patient or video-learning first. Students were not blinded to the activities. The students completed a 19-item questionnaire at three time points: before either activity, after the first activity and after the second activity, to evaluate their self-reported confidence, clinical preparedness and anxiety. Outcomes & Results: A total of 62 students completed modified simulated patient first and 63 completed video-learning first. After either single activity the students had significantly increased confidence and preparedness scores, while only the modified simulated patient significantly reduced student anxiety scores. As a second activity, modified simulated patient resulted in further significant improvements in confidence, preparedness and anxiety; however, adding video learning as a second activity resulted in no significant benefit. Conclusions & Implications: This study demonstrates the effectiveness of two low-resource clinical-learning activities for novice SLT students that can be applied in a range of settings. Of the two activities, modified simulated patient had greater effectiveness, as it was the only activity to decrease anxiety. An investigation of the pedagogical principles within the activities revealed that modified simulated patient activity had more opportunities for peer learning, supervisor feedback and verbal reflection in comparison with video learning that may explain the increased benefits.

Purpose: Clinical education is a key component of speech-language pathology university curriculum, whereby students have the opportunity to apply theoretical knowledge and practical skills learned in the classroom into a real workplace. However, more recently the availability of high quality, consistent clinical placements and learning experiences across the range of practice areas in the discipline is reducing. Therefore, alternative clinical learning opportunities that enable students to develop skills and competencies are being explored. Recently, replacing clinical time with a simulated learning program has been shown to achieve equivalent levels of clinical competency in speech pathology. However, it is unknown how simulation impacts on student learning in traditional clinical placements. Therefore, this research explored clinical educators' perceptions of students undertaking clinical placements in their workplace immediately following a five-day simulation-based learning program related to the same area of practice. Method: Thirty-five clinical educators who supervised students in the workplace immediately after they completed the simulation program participated in semi-structured interviews. All interviews were transcribed verbatim and analyzed using qualitative methods described by Graneheim and Lundman (2004). Result: The analysis identified four key themes related to the impact of students in the workplace, simulation priming students for learning, the importance of the transition from simulation-based learning to the workplace, and the role of simulation in clinical education programs. Conclusion: The use of simulation to support student learning and develop clinical skills and competencies in adult speech pathology practice is supported by workplace clinical educators. However, results of this study suggest that the simulation program needs to be embedded within the curriculum and clinical education program to enhance transition between learning experiences and maximize benefits of learning experiences in real workplace contexts.

Technological and therapeutic advances have allowed many children who are born hard-of-hearing (HoH) to start school with age-appropriate spoken language skills, yet many of these children continue to find everyday conversations challenging. This scoping review maps the evidence related to development of conversation and pragmatic skills in children who are HoH and learning spoken language. The review followed Arksey and O'Malley's methodological framework and the PRISMA Extension for Scoping Reviews guidelines. Quality appraisal, data extraction, and thematic analysis were used to describe the data. Systematic searches identified 36 articles for inclusion. Sample sizes were small and heterogenous. Most studies focused on school-aged children with severe hearing loss or greater. Methodological rigor varied. Thematic analysis revealed two global themes. First, children who are HoH continue to find conversation and pragmatics difficult to master, and second, there are a set of audiological, communication, environmental, and demographic characteristics that are associated with better conversation and pragmatic outcomes, some of which are fixed, whereas others are malleable. Focused attention on designing valid and reliable assessments for conversation and pragmatic skills, and on developing therapeutic approaches targeting early conversation and pragmatic skill development, is needed to reduce the impact conversation and pragmatic differences across the lifespan. [ABSTRACT FROM AUTHOR]

Background: Simulation-based learning provides students with a safe learning environment, guaranteed exposure to specific clinical scenarios and patients, time for reflection and repetition of tasks, and an opportunity to receive feedback from multiple sources. Research including studies specific to allied health training programmes have demonstrated that simulation-based learning also helps increase learners' confidence and reduces anxiety related to clinical environments, activities and skills. Such evidence, together with increasing challenges in provision of workplace clinical education, has supported an expansion of integrating simulation-based learning into university curricula. Aims: To provide detailed information about the processes and considerations involved in the development of a simulation-based learning programme for speech-language pathology. Methods & Procedures: Through reflection on the development process of a 5-day simulation-based learning programme, and in light of existing research in simulation, this paper outlines the important steps and considerations required for the development of a simulation-based learning programme to support student competency development in adult speech pathology range of practice areas. Main Contribution: A proposed framework for the development of future simulation-based learning programmes in speech-language pathology. Conclusions & Implications: The framework can be applied to simulation-based learning for university programmes and/or workplace training in speech-language pathology and across several other health disciplines.

This study explored the feasibility of training school teaching assistants to provide the treatment, Dynamic Temporal and Tactile Cueing to treat childhood apraxia of speech (CAS, also known as developmental verbal dyspraxia). The study used a single case experimental design across behaviours and a qualitative evaluation of teaching assistant experiences using interviews. Two student-teaching assistant dyads participated. One child was aged 6;2 (6 years 2 months) and the other 5;6 at the time of the study. Both participants had speech characteristics consistent with the features outlined in the 2007 Technical Report on CAS from the American Speech and Language Hearing Association (ASHA). These included lengthened and disrupted coarticulatory transitions between sounds and syllables, inappropriate prosody and inconsistent errors on consonants and vowels. Treatment outcomes were measured using visual analysis and calculations of total-change improvement rate difference (TC-IRD) and composite IRD (C-IRD) based on percent of phonemes correct. Fidelity to the treatment protocol was measured using a Fidelity Score. Visual analysis of both child participant's data showed an upward trend for all treatment and similar words and a flatter trajectory for control words. Both child participants had a TC-IRD score of 100% for all treatment words. One child also had a TC-IRD score of 100% for their similar words and a TC-score of 25% for their control words. The second child had a TC-score of 67% for similar and control words. Both teaching assistants had a Fidelity Score of over 90%. Both teaching assistants reported positive experiences in conducting the program. Training teaching assistants may be an effective means of providing treatment to children with CAS while they are at school. Training teaching assistants also helps to improve their capacity which may have positive implications in their interactions with other children with speech sound disorders.

Purpose: A Phase I pilot study was designed to collect preliminary evidence on the use of the Kaufman Speech to Language Protocol (K-SLP; Kaufman, 2014) to treat children with childhood apraxia of speech. We hypothesized that the K-SLP approach would result in more accurate speech production in targeted words, whereas untrained (control) words and speech sounds would remain unchanged. Method: A single-case multiple-baseline across behaviors experimental design was used to see if experimental feasibility could be demonstrated. Two children each received a total of 12 1-hr treatment sessions over 3 weeks. The children's response to treatment and experimental control was measured by administering baseline, treatment, and post-treatment probes. Results: Both children showed some response to treatment, as measured by percent phonemes correct; however, the response to treatment varied. In general, for the treated words that improved with therapy, accuracy was maintained above baseline level during the maintenance phase. Minimal generalization was observed for this study, with only 1 participant generalizing treatment gains to 2 sets of untrained (similar) words. Conclusion: This Phase I pilot study provides limited preliminary evidence for the effectiveness of the K-SLP approach in treating childhood apraxia of speech in some children under the conditions specified in this study. Replication of these results in well-controlled studies is needed before this structured and operationalized version of the K-SLP approach can be recommended for clinical use.

Purpose: This study assesses the impact of patient clinical history on audiologists' performance when interpreting auditory brainstem response (ABR) results. Method: Fourteen audiologists' accuracy in estimating hearing threshold for 16 infants through interpretation of ABR traces was compared on 2 occasions at least 5 months apart. On the 1st occasion, ABR traces were presented to the audiologists with no clinical information except for the age of the child. On the 2nd occasion, audiologists were given a full clinical history for the ABR cases. Results: The addition of clinical history information had no statistically significant impact on sensitivity, specificity, or accuracy of diagnosis. Although the mean numbers of true-negative and true-positive diagnoses were higher when audiologists were given clinical information, the difference was again not statistically significant. Conclusion: This study suggests that if there are circumstances in which case material is incomplete or unavailable, audiologists have no cause for concern regarding the accuracy of their interpretation of ABR traces. In a clinical manner, this may help audiologists with large caseloads or audiologists who need to provide a diagnosis of hearing loss in a short time by allowing them to focus on conducting ABR without the need for case history information.

Long-term variability of bioassessments has not been well evaluated. We analyzed a 20-year data set (1984–2003) from four sites in two northern California streams to examine the variability of bioassessment indices (two multivariate RIVPACS-type O/E scores and one multimetric index of biotic integrity, IBI), as well as eight metrics. All sites were sampled in spring; one site was also sampled in summer. Variability among years was high for most metrics (coefficients of variation, CVs ranging from 16% to 246% in spring) but lower for indices (CVs of 22–26% for the IBI and 21–32% for O/E scores in spring), which resulted in inconsistent assessments of biological condition. Variance components analysis showed that the time component explained variability in all metrics and indices, ranging from 5% to 35% of total variance explained. The site component was large (i.e., >40%) for some metrics (e.g., EPT richness), but nearly absent from others (e.g., Diptera richness). Seasonal analysis at one site showed that variability among seasons was small for some metrics or indices (e.g., Coleoptera richness), but large for others (e.g., EPT richness, O/E scores). Climatic variables did not show consistent trends across all metrics, although several were related to the El Niño Southern Oscillation Index at some sites. Bioassessments should incorporate temporal variability during index calibration or include climatic variability as predictive variables to improve accuracy and precision. In addition, these approaches may help managers anticipate alterations in reference streams caused by global climate change and high climatic variability.

Students commence university with many hopes and dreams for their future and for most, these are realised. Health professional students must succeed in both their academic and clinical experiences. Excellent communication with their patients and colleagues on placement is necessary and particularly so for speech pathology students. This qualitative, descriptive study investigates how first- and final- year students view the screening of their communication skills in which they participate. The focus groups took place within the speech pathology department of a major Australian metropolitan university. Data were transcribed and analysed thematically. Three main themes arose: professional development, students' cognitive and emotional responses, and the organisation of the screener. Both groups of students felt the screener was both an important part of their professional development and a way of identifying and supporting speech pathology students with communication difficulties. They valued the student-led nature of the process. Implications for the value of using a student-led communication screener to identify students with weaker communication skills early in their program and for the support of such students are discussed. [ABSTRACT FROM AUTHOR]

Post-project evaluation and monitoring of stream restoration projects are rarely conducted, and long-term evaluations are even less common but are needed in order to gage the success of a project and to determine the time scale of biological recovery in the system. This study is a 5-year comparison to an initial post-project assessment completed in 1999 that evaluated an urban stream restoration project in Poinsett Park (El Cerrito, California). The results of this study found that habitat quality differed spatially between reaches, but was temporally similar in 1999 and 2004 with slight improvements at the restored reach in 2004. The biological assessment in 2004 found no improvements in ecological condition of the biotic assemblage compared to 1999. This lack of improvement may be attributed to the detrimental and limiting effects of a highly urbanized watershed. It is also possible that the aquatic communities successfully colonized the restored reach within the 2 years following the completion of the restoration project in 1997. A survey of the neighborhood residents indicated that, overall, they were pleased with the restored creek site 7 years after the completion of the project. Approximately half of the residents that moved to the neighborhood after the restoration project was completed were unaware that this segment of creek was previously underground. Long-term evaluations of restoration projects can help managers and designers of future projects determine the timeline of the success of a project.

Stream alterations and human disturbances over time have reduced salmonid fish populations in Redwood Creek (Marin County, California). A restoration project in fall 2003 sought to increase the number of juvenile fish rearing pools along an 1800-foot reach of Redwood Creek. To evaluate the success of this project, we characterized changes in channel morphology through feature and facies mapping and photo-documentation in a 432-foot sub-reach of the restoration site. Our post-project evaluation found that the installation of large woody debris weir structures was successful in creating pools and increasing the overall habitat complexity of this sub-reach. Our detailed survey map provides a basis for future monitoring at the Redwood Creek restoration site or other sites in need of evaluation.

Purpose: There is poor reporting of the cost of simulation and greater transparency is needed. The primary study aim was to conduct a financial analysis of the university/training institution costs associated with a 5-day simulation-based learning program for speech–language pathology students. The secondary aim was to consider the economic costs of the model. Method: Costs associated with the delivery of a 5-day simulation-based learning program for speech–language pathology students from six Australian universities were collected regarding: (a) pre-program training, (b) personnel, (c) room hire, (d) equipment, and (e) consumables. Both financial costs and economic costs (Australian dollar, at June 2017) were calculated per university site, and per student. Result: The simulation program was run 21 times involving 176 students. Average total financial cost per program ranged from $4717 to $11 425, with cost variation primarily attributed to local labour costs and various use of in-kind support. Average financial cost per student was $859 (range $683–$1087), however this was almost double ($1461 per student, range $857–$2019) in the economic cost calculation. Personnel was the largest contributing cost component accounting for 76.6% of financial costs. Personnel was also the highest contributing cost in the economic analysis, followed by room hire. Conclusion: This study provides clarity regarding financial and economic costing for a 5-day simulation-based learning program. These data can help universities consider potential up-front financial costs, and well as strategies for financial cost minimisation, when implementing simulation-based learning within the university context. [ABSTRACT FROM AUTHOR]

Purpose: Improving language and literacy skills in preschoolers can lead to better life outcomes. One way speech-language pathologists (SLPs) can improve these skills in preschoolers is by supporting educators through professional development (PD). However, PD in early childhood education and care (ECEC) settings is a complex intervention. To improve preschoolers' language and literacy skills using PD, SLPs must first work with educators to change or increase educators' language and literacy-promoting behaviours. This paper aimed to describe educator behaviours and preschooler skills following a real-world language and literacy PD intervention facilitated by two community SLPs. Method: Two pragmatic studies were conducted across four ECEC centres: (1) an observation study of 13 educators' self-reported language and literacy promoting behaviours, and (2) a non-randomised controlled trial investigating the language and literacy skills of 82 preschoolers as reported by their educators and parents/carers. Result: After the intervention, educators rated themselves as performing language and literacy-promoting behaviours more frequently. Educators also rated the early reading skills of preschoolers more highly after the PD intervention, but not preschoolers' oral language or early writing skills. Parents/carers did not report any significant improvements in preschoolers' skills. Conclusion: PD as an SLP intervention, whilst promising, showed mixed outcomes. Educator outcomes improved; however, preschooler outcomes were varied. [ABSTRACT FROM AUTHOR]

Purpose: This study assesses the impact of patient clinical history on audiologists' performance when interpreting auditory brainstem response (ABR) results. Method: Fourteen audiologists' accuracy in estimating hearing threshold for 16 infants through interpretation of ABR traces was compared on 2 occasions at least 5 months apart. On the 1st occasion, ABR traces were presented to the audiologists with no clinical information except for the age of the child. On the 2nd occasion, audiologists were given a full clinical history for the ABR cases. Results: The addition of clinical history information had no statistically significant impact on sensitivity, specificity, or accuracy of diagnosis. Although the mean numbers of true-negative and true-positive diagnoses were higher when audiologists were given clinical information, the difference was again not statistically significant. Conclusion: This study suggests that if there are circumstances in which case material is incomplete or unavailable, audiologists have no cause for concern regarding the accuracy of their interpretation of ABR traces. In a clinical manner, this may help audiologists with large caseloads or audiologists who need to provide a diagnosis of hearing loss in a short time by allowing them to focus on conducting ABR without the need for case history information., The auditory brainstem response (ABR) is one of the auditory evoked potentials that is used by audiologists to assess the function of the auditory pathway from the auditory nerve to [...]

While many examples of speech pathology intervention approaches for children with speech sound disorders (SSDs) exist in English and some other European languages, approaches with children in other languages are largely unknown. The aim was to determine current speech-language pathologists (SLPs) intervention practices with children with SSDs in the ME, and to then compare these with international practices. Data were collected by online questionnaire using Qualtrics. One hundred and eighty-nine SLPs completed the survey. Participants were required to be Arabic first language speaking SLPs practicing in the ME (e.g. Kuwait, Saudi Arabia, UAE, and Egypt), working with children with SSDs. The respondents reported a frequent use of phonological awareness, traditional articulation therapy, auditory discrimination, minimal pairs, and whole language therapy approaches in the treatment of children with SSDs, like their counterparts in Australia, the USA, UK, and Portugal. Gaps between research recommendations for evidence-based practice and actual clinical practice are identified, and discussed. Future research should investigate the efficacy of speech-therapy approaches to improve service delivery for Arabic-speaking children with SSDs in the ME. [ABSTRACT FROM AUTHOR]

Achieving better hypertension control for patients requires thinking outside of typical clinic visits. [ABSTRACT FROM AUTHOR]

Purpose: Research shows that monolingual children with cleft lip and/or palate (CLP) have a higher incidence of cognitive-linguistic deficits, but it is not clear whether bilingual preschool children with CLP are especially vulnerable because they need to acquire 2 languages. We tested the hypothesis that bilingual children with CLP score lower than bilingual children with typical development (TD) on receptive vocabulary, verbal memory, and visuospatial memory. Method: Participants were 86 bilingual CLP children and 100 TD children 3-6 years of age, dominant in English or Mandarin. Each child completed assessments of English and Mandarin vocabulary, verbal and visuospatial short-term and working memory, hearing, and articulation. Results: With analysis of covariance controlling for age and dominant language, no group differences were found between the CLP and TD bilingual children, although a correlational analysis indicated discrepancies in the relationship between variables. Conclusions: The findings do not support the hypothesis that preschool children with CLP score lower than preschool children with TD on receptive vocabulary and memory measures. Longitudinal research examining literacy skill development is needed to establish whether the deficits reported for school-age monolingual children with CLP become more obvious in bilingual children in later years, especially when the medium of instruction is the child's nondominant language.