Question 3

How can we prepare the ideal speech-language pathologist of the future?

What current educational elements and practices should continue?

When identifying current educational elements and practices to continue, participants supported the delivery of an essential theoretical base with emphasis on practice. To that end, programs should retain both didactic/academic course work and experiential/clinical activities in the preparation of the entry-level professional. These academic and clinical elements must be aligned in a manner that maximizes learning in both arenas and include bridges between classroom and clinic. Further, many participants believed that the ideal entry-level professional remains the "master's level generalist" with support for continued learning postgraduation.

According to group input, the best (or good) practices of today's programs, as well as those in the future, should support the 5 Cs:

Coherence

Express a clear sense of educational priorities and communicate these priorities with students and others (e.g., academic community, supervisors, employers).

Continuity

Carefully conceive the relationship between baccalaureate and master's level study.

Common learning

Ensure that students with different backgrounds will address comparable issues.

Competence-based

Emphasize documented knowledge and abilities, not the accrual of "hours."

Community consciousness

Build on the ethics of community engagement.

To reinforce these goals, programs should consider including the following:

• Development of integrated program content to address:
  • Basic sciences (e.g., anatomy and physiology, neurology, speech science/phonetics), multicultural issues, use of technology, and evidence-based practices
  • Critical thinking, problem solving, and the ability to have diverse perspectives
  • Personal qualities, such as the ability to work as part of a team, to collaborate, to negotiate, and to resolve conflict
• Case study, observation, and problem-based learning approaches that offer practical, experiential, lasting learning
• Continued development of the "common floor" as evidence accumulates to support practices— but avoidance of pushing policy ahead of the evidence base
• Clinical teaching that provides "learning by doing with guidance"

What reforms should be considered?

As educational reforms were discussed, group participants raised numerous questions that merit consideration, including the following:

Outcomes of Professional Preparation

How should educational outcomes be defined and by whom? How will "professional creep" and a discipline that seems to be evolving by accretion affect these outcomes? Should a growing scope of practice prompt critical scrutiny of further opportunities for expansion? Is it possible to or practical for one program to prepare students for every employment setting? Should all programs have the same preparation outcomes?

Program Contents

Does a compartmentalized framework that offers disorder-based courses (one course addressing each of the areas in the "Big 9") support integrated learning? Are there more efficient and integrative models that would allow students to make connections and generalize knowledge? Should we focus on the science course work, infuse the disorders, and teach the "basics" that will enable students to generalize across disorders? Would a systemsbased curriculum (e.g., centered on neurological, cognitive, physiological, linguistic, motor, and acoustic aspects) result in such a focus?

Program Sequences

What is the appropriate sequence for course work and clinic? Are learning sequences matching current student learning styles? Should undergraduate preparation have a more interdisciplinary focus?

Role of Faculty in Reforms

Are faculty members willing and able to drive and support reforms? Are they able to shift from the "I train as I was trained, teach as I was taught" mentality? What is the role of academic freedom in course content, and does this lead to idiosyncratic content in some courses?

In addition to these questions, a number of current educational elements were scrutinized, including the "disorder courses" offered to both undergraduate and graduate students, the continuation of the clinical fellowship (CF) in its current form, the value of 400 hours of practicum, and the continued use of the Knowledge and Skills Acquisition (KASA) forms.

Remembering that reform need not be—and should not be—judgmental, the following pedagogical reforms dealing with delivery and content were considered by the group participants:

Pedagogical Reforms Dealing with Delivery

• Modify SLP preparation at the bachelor's level to emphasize linguistics, sciences, second language acquisition, and other liberal education values (e.g., "The bachelor's program should create critical, curious learners.")
• Demonstrate greater sensitivity to different styles of learning both in curricular structure and in teaching approaches
• Continue movement from "get your hoursc to "develop your competencies"
• Make better use of academic resources in allied disciplines
• Promote sharing of resources among communication sciences and disorders (CSD) programs
• Expand use of distance learning
• Create two tiers of certification to address pressing needs, especially in schools
• Introduce students earlier to clinical experience
• Instead of "silo approach," integrate the Big 9 across the curriculum, making learning expectations (scientific inquiry, creativity, etc.) transparent to students
• Be more intentional about teaching dispositions and attitudes by infusing such teaching within academic and clinical elements of program
• Increase use of facilitated grand rounds across disciplines
• Incorporate preceptor models with a greater focus on mentoring and modeling
• Increase student and faculty diversity
• Prepare and support clinical teachers
• Incorporate practices that support the evidence-based academic outcomes

Pedagogical Reforms Dealing with Content

Increase knowledge and skills in the following:

• Cognitive sciences
• Gerontology
• Pharmacology
• Language literacy connection
• Genetics
• Brain imaging
• Systems engineering and policy formulation
• Bilingualism
• Communication effectiveness
• Business practices
• Risk management
• Regulations/reimbursement issues
• Advocacy
• Lifelong learning

In what ways might a program of the future differ from a typical current program?

Participants suggested that the program of the future may be characterized by the following:

• Longer in duration (e.g., students obtaining basic entry-level competencies plus a selected specialty)
• Broader with a more interdisciplinary focus
• Addresses different clinical populations
• Incorporates new technologies and procedures requiring new therapeutic approaches
• May lead to a clinical doctorate
• More flexible and dynamic to address both student needs and the evolving profession
• Greater reliance on technology, especially simulators/simulations
• Less didactic
• Teaches students financial bases of service delivery (value of services, cost of providing service) including regulations/ reimbursement issues
• Includes admissions and recruitment processes that are more flexible and dynamic to increase diverse student pool, including international students
• Conducts educational outcome assessment in a variety of means
• Students, faculty, and practitioners that embrace diversity knowledgably and appreciatively