Student Reflections in Simulated Speech and Language Therapy Placements Using Telehealth and In-Person Formats: A Qualitative Study.

backgroundSimulated placements, including those within a telehealth setting, are increasingly being relied upon as an alternative to traditional placements within health professions degrees. Existing research is focused around evaluating the learning outcomes generated by simulation programs and advocates the comparable quality of traditional and simulated placements in some contexts. However, there is limited understanding of the nature of student reflections within speech and language therapy simulated placements, and no studies have explored student experiences in both in-person and online simulation formats. Understanding salient student learning experiences will allow university educators to better tailor simulated placements towards students' learning needs in either format and encourage effective reflection on critical practice skills.

aimsThis study explores speech and language therapy student perceptions of their learning experiences following participation in a simulation placement in either telehealth or in-person formats. It focuses on two research questions, (1) what aspects of their learning experience do students reflect on after one day in a simulated speech and language therapy placement? And (2) how are student reflections following simulation similar or different in telehealth and in-person formats? METHODS AND PROCEDURES: This study adopted an Exploratory- Descriptive-Qualitative design. Two cohorts of mid-program speech and language therapy students from one Australian university completed a simulation placement. Students interacted with the same learning activities, including the same standardised patient scenarios with roles played by actors, in either an online telehealth or in-person format. Online discussion posts following the first day of a simulated placement from students in each format were analysed separately using Reflexive Thematic Analysis and then compared. OUTCOMES AND

resultsIn the telehealth format, 23 students consented to participate and in the in-person format, 16 students consented to participate. In both simulation formats, students' reflections were similar, with the same themes of (1) client-centred communication, (2) emotions, (3) working collaboratively, (4) learning from and with others and (5) therapeutic approaches, being constructed. Each theme had two to four subthemes. Student reflections differed between the telehealth and in-person simulation formats in four subthemes, two within client- centred communication and one each within working collaboratively and therapeutic approaches. CONCLUSION AND IMPLICATIONS: Findings suggest that speech and language therapy students reflect upon similar areas of learning whether their simulation is in telehealth or in-person formats. Further investigation across different professions and simulation programs is recommended to extend understanding of student reflection and better build learning opportunities for student reflection in simulation. WHAT THIS PAPER ADDS: What is already known on this subject Simulated placements are being used as alternatives to traditional placements in health professions degrees including speech and language therapy (SLT). Comparable learning outcomes have been shown for health professions students either for in-person or online telehealth formats, but no studies have explored experiences in both formats. What this study adds to existing knowledge By exploring student reflections on their learning, this paper suggests that what is salient for SLT students on their first day of a simulated placement is in the areas of (1) communication, (2) emotions, (3) working collaboratively, (4) learning from and with others and (5) therapeutic approaches. The paper suggests that students' reflections on their learning experiences are similar whether the simulation is in an in-person or telehealth format. What are the potential or actual clinical implications of this study? This paper guides universities in designing learning experiences for SLT students to develop key competencies for practice within health services, whether they use in-person or online telehealth contexts to provide effective care.