Jennifer Lethlean

Narrative discourse in multiple sclerosis: An investigation of conceptual structure

Abstract The aim of the present study was to determine whether multiple sclerosis (MS) affects a persons ability to formulate message content in narrative discourse. Discourse samples were elicited from 47 persons with MS and 47 matched controls in response to computer-generated, animated sequences. Within the conceptual level of discourse processing, data were analysed for story schema and informative content. The two groups, MS and control, could not be distinguished by measures of the quantity of information conveyed. However, results revealed a difference in the nature of the information produced by the two groups. The persons with MS produced less essential story information than control subjects, while a tendency for the persons with MS to produce more incorrect and ambiguous information than controls was also noted. A number of factors were considered in an attempt to explain the underlying source of these differences. It was postulated that both pragmatic and cognitive skills impact on performanc...

Does communication partner training improve the conversation skills of speech-language pathology students when interacting with people with aphasia?

BACKGROUND Aphasia is a common consequence of stroke. Despite receiving specialised training in communication, speech-language pathology students may lack confidence when communicating with People with Aphasia (PWA). This paper reports data from secondary outcome measures from a randomised controlled trial. OBJECTIVE The aim of the current study was to examine the effects of communication partner training on the communication skills of speech-language pathology students during conversations with PWA. METHOD Thirty-eight speech-language pathology students were randomly allocated to trained and untrained groups. The first group received a lecture about communication strategies for communicating with PWA then participated in a conversation with PWA (Trained group), while the second group of students participated in a conversation with the PWA without receiving the lecture (Untrained group). The conversations between the groups were analysed according to the Measure of skill in Supported Conversation (MSC) scales, Measure of Participation in Conversation (MPC) scales, types of strategies used in conversation, and the occurrence and repair of conversation breakdowns. RESULTS The trained group received significantly higher MSC Revealing Competence scores, used significantly more props, and introduced significantly more new ideas into the conversation than the untrained group. The trained group also used more gesture and writing to facilitate the conversation, however, the difference was not significant. There was no significant difference between the groups according to MSC Acknowledging Competence scores, MPC Interaction or Transaction scores, or in the number of interruptions, minor or major conversation breakdowns, or in the success of strategies initiated to repair the conversation breakdowns. CONCLUSION Speech-language pathology students may benefit from participation in communication partner training programs.

A pre–post intervention study investigating the confidence and knowledge of health professionals communicating with people with aphasia in a metropolitan hospital

ABSTRACT Background: Communication partner training (CPT) is a social intervention approach that can be used to educate and train volunteers, family members, significant others and professionals, in addition to providing skills and strategies for people with aphasia (PWA). This body of CPT research extends the current research in the area by implementing CPT with health professionals (HPs) in using PWA as trainers in a sub-acute care setting, but some previous research in acute care setting has primarily focused on caregivers and volunteers in a community setting. Aims: The aim of this study was to investigate implementing a CPT programme in an Australian metropolitan hospital by training professionals and utilising PWA as a key component of the training to facilitate “real-time” practical skill acquisition. Method & Procedures: Fifty-two HPs from multidisciplinary teams (allied health assistants, audiology, dietetics, occupational therapy, pharmacy, physiotherapy, social work and nursing staff in a rehabilitation unit) participated in a pre–post intervention study. HPs completed a questionnaire to collect demographic information, identify current knowledge of aphasia-related communication strategies and ascertain their confidence levels (using a 100-mm visual analogue scale) related to interacting with people with communication impairments and list any strategies/resources that could be used as an adjunct to facilitate exchanges with PWA. These open-ended responses were categorised into four main groups using content analysis. The CPT component, adapted from two programmes run by “Connect—Communication Disability Network” in the United Kingdom, consisted of an educational lecture on communicating with PWA given by a speech-language pathologist and a practical conversation with a person with aphasia. The PWA provided “expert” practical feedback to the professionals participating in the training. Outcomes & Results: HPs reported mean confidence levels of 46.56 mm (SD = 15.71) prior to training and 75.81 mm (SD = 12.16) post-training, t(51) = 12.479 (p < .001). More HPs were able to identify relevant strategies to assist with communication following the training (median total responses = 52, interquartile range [IQR] = 50–52), than prior to the training (median total responses = 15, IQR = 9–38). Conclusions: The results provide preliminary evidence to suggest that a CPT programme may be an effective method to increase the confidence and knowledge of communication strategies of HPs, in an acute care setting, when interacting with PWA.

The confidence and knowledge of health practitioners when interacting with people with aphasia in a hospital setting

Abstract Purpose: The aim of the study was to describe and compare the confidence and knowledge of health professionals (HPs) with and without specialized speech-language training for communicating with people with aphasia (PWA) in a metropolitan hospital setting. Methods: Ninety HPs from multidisciplinary teams completed a customized survey to identify their demographic information, knowledge of aphasia, current use of supported conversation strategies and overall communication confidence when interacting with PWA using a 100 mm visual analogue scale (VAS) to rate open-ended questions. Conventional descriptive statistics were used to examine the demographic information. Descriptive statistics and the Mann–Whitney U test were used to analyse VAS confidence rating data. The responses to the open-ended survey questions were grouped into four previously identified key categories. Results: The HPs consisted of 22 (24.4%) participants who were speech-language pathologists and 68 (75.6%) participants from other disciplines (non-speech-language pathology HPs, non-SLP HPs). The non-SLP HPs reported significantly lower confidence levels (U = 159.0, p < 0.001, two-tailed) and identified fewer strategies for communicating effectively with PWA than the trained speech-language pathologists. The non-SLP HPs identified a median of two strategies identified [interquartile range (IQR) 1–3] in contrast to the speech-language pathologists who identified a median of eight strategies (IQR 7–12). Conclusion: These findings suggest that HPs, particularly those without specialized communication education, are likely to benefit from formal training to enhance their confidence, skills and ability to successfully communicate with PWA in their work environment. This may in turn increase the involvement of PWA in their health care decisions. Implications for Rehabilitation Interventions to remediate health professional’s (particularly non-speech-language pathology health professionals) lower levels of confidence and ability to communicate with PWA may ultimately help ensure equal access for PWA. Promote informed collaborative decision-making, and foster patient-centred care within the health care setting.

How does feedback from patients impact upon healthcare student clinical skill development and learning? A systematic review

Abstract Background: A key feature of health professionals’ training, irrespective of discipline, is the acquisition and application of clinical and communication skills. Despite this, little is known about the potential role of patient feedback on this process. This systematic review aimed to answer the question: How does feedback from patients impact upon healthcare student clinical skill development and learning? Design: Systematic review of published literature. Methods: Electronic databases were searched for studies that explored the effects of patient feedback on student learning and were published before March 2016. Eligible articles underwent methodological evaluation using the McMaster University Critical Evaluation Forms and data extraction. Results: A total of 237 articles were retrieved following searches of electronic databases and hand searches of reference lists. Twelve (7 quantitative, 2 qualitative, 3 mixed methods) studies met the inclusion criteria. Eleven studies reported that patient feedback improved students’ clinical skills. Conclusion: Minimal research has explored the impact of patient feedback on student learning. The research to date suggests that direct feedback from patients may be beneficial for the development of students’ communication and clinical skills; however, the wide variety of evaluation methods and the lack of validated tools for patients to provide feedback suggest that further exploration is warranted.

Is an educational lecture a critical component of communication partner training

Abstract 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.

Effects of communication partner training on people with aphasia

Annual Conference of the Asia Pacific Stroke Organization (APSO) Combined with Stroke Society of Australasia, Brisbane, Qld, Australia, July 14-17, 2016Annual Conference of the Asia Pacific Stroke Organization (APSO) Combined with Stroke Society of Australasia, Brisbane, Qld, Australia, July 14-17, 2016