By: Marie R. Kerins, EdD, CCC-SLP, Loyola University Maryland
Editor of Child and Adolescent Communication Disorders: Organic and Neurogenic Bases
Interprofessional Education (IPE) is becoming a more recognized model for educating pre-professional students entering the healthcare or education workforce. It is quickly gaining momentum in institutions of higher education as a means of addressing some of the fragmentation observed in the healthcare industry and in the schools, both of which strive to produce positive and lasting outcomes for the individuals and communities they serve. Working collaboratively mends fragmentation, reduces duplicative efforts, and effectively addresses client/student needs. The World Health Organization (WHO) has endorsed IPE and defines it as a period when “two or more professions learn about, from, and with each other to enable effective collaboration and improve [health] outcomes” (WHO, 2010, p. 7). Formalizing IPE through published guidelines from organizations such as the Interprofessional Education Collaborative (IPEC) has helped renew interest in interdisciplinary and collaborative practices that have been around for quite some time but have not been systematically or formally taught in higher education settings. While the WHO and IPEC are geared more toward international health care practices, professionals working in schools have also joined in the conversation and are adopting the language of IPE. One goal of IPE is to develop a practice ready workforce where professionals can immediately implement knowledge and skills they have practiced while training in an integrated and interdisciplinary manner. Evidence is mounting to support interprofessional care (see Reeves, Perrier, Goldman, Freeth, & Zwarestein, 2013; WHO, 2010). IPE and collaborative practice will become an established manner of service delivery to improve patient/student care, if we can embrace interprofessional education as a shared vision with an understanding of the benefits of this new collaborative curriculum.
Collaborative Internship Experience: Speech-Language Pathologists and Reading Specialists
Because there is a strong evidence-base to support experiential learning or simulation based learning to promote skill development (Hum, 2015; Poore, Cullen & Schaar, 2014), building IPE goals into practicum experiences helps students achieve the competencies needed. During a summer 2014 internship experience at the Loyola Clinical Centers of Loyola University Maryland, master’s level students in Speech-Language Pathology (SLP) and master’s students in the Reading Specialist program came together to pilot an intensive four week program that met four mornings each week addressing emergent literacy skills for preschool and kindergarten aged children. SLPs and Reading Special students worked side by side. The objective of the summer ‘14 research project was twofold: (a) to improve emergent literacy skills in the identified population, and (b) to provide a model demonstrating how two related professions can collaborate to benefit children in the area of emergent literacy. Both goals were achieved.
Because language and literacy are intimately woven particularly at the emergent level both areas should be addressed in tandem by using the expertise of the speech-language pathologist and the reading specialist for maximal benefit. Both professionals are trained in the area of emergent literacy with slightly different areas of expertise. As professionals recognize the value of interdisciplinary training, institutions of higher education are beginning to recognize that they need to be part of the equation and design classrooms and training programs to train in an interprofessional/interdisciplinary manner. There have been calls across professions to collaborate by providing coordinated interdisciplinary services to support the acquisition of early reading skills (American Speech-Language Hearing Association [ASHA], 2010, International Reading Association [IRA], 2010, Paul, Blosser, & Jakubowitz, 2006, Sawyer, 2010). ASHA (2010) recommends that speech-language pathologists (SLPs) work closely with reading specialists, literacy coaches, and special education teachers. Similarly, the IRA (2010) explicitly calls upon reading specialists to work with other professionals that include but are not limited to special educators, and speech and language teachers. To promote this cooperative plan, successful models and intervention programs need to be developed and published to demonstrate the effects of a collaborative approach.
Steps in the IPE Process
- After pre-testing using traditional discipline specific assessments, (Pals- Pre K and Pals-K for Reading Specialists; CELF-2 Preschool and Narrative assessment for SLPs) the pairs met to discuss results, identified areas that corroborated findings and also identifyied areas more unique to discipline specific testing.
For example both identified phonological awareness weaknesses and vocabulary deficits, however areas of difference included, sound symbol deficits noted by the literacy students and poor oral output and syntax problems identified by the SLP students. All the identified areas are often part of a larger constellation of language-based learning deficits and should be addressed holistically as opposed to parceled out.
- A joint intervention plan was then identified capturing all of the parts of the diagnostic puzzle so a comprehensive program could be developed.
- Students modeled for each other best practices while observing how one another approached a particular aspect of the program.
For example, during the storybook reading activity the graduate literacy student identified simple word patterns and site words while the SLP modeled how to expand an utterance in response to a comprehension question.
- Weekly meetings were held to evaluate the child’s progress and to determine what skills should be emphasized for the following week.
Below are several excerpts from the participating graduate students:
“The interprofessional experience allowed me to figure out what my role as an SLP is in a literacy program, as compared to a reading specialist, since we work on the same skills in different ways. The knowledge and skills I took away from the experience are invaluable and continue to benefit me in my clinical placements.”
“While I came with background that includes a repertoire of songs, chants, letter-sound activities and classroom management my [partner] brought more of a scientific background that included how oral language has a significant role in early childhood education.”
“At times, I used language that was unfamiliar to my partner, which forced me to take a step back and explain the term and its importance in less “field-specific” language. … [this] gave me practice communicating to a professional outside my field.”
“I have taught many students who received speech services, but never really knew what they did or communicated with the SLP on how we could make better connections to the classroom.”
“We didn’t divide the session into speech and literacy sections, but instead tried to incorporate both skills into each activity.”
While these reflective and anecdotal remarks are very positive, as the program expands to a second summer, more formal measures will be embedded to measure both the student’s perceptions of one another’s discipline as well as their concrete knowledge of how one might use each other’s skills assisting them to become “work-force ready.” One such instrument is the Interprofessional Collaborator Assessment Rubric ([ICAR](Curran, et al.,) intended for use in the assessment of interprofessional collaboration. The rubric assesses six areas ranging from communication to team functioning. Integrating a formal assessment to more accurately measure progress toward interprofessional education goals will be the next step in determining which models yield better collaborative results.
American Speech-Language-Hearing Association. (2010). Roles and responsibilities of speech-language pathologists in school [Professional issues statement]. Available from www.asha.org/policy
Curran, V., Casimiro, L., Banfield, V., Hall, P., Gierman, T., Lackie, K., Oandasan, I., Simmons, B., & Wagner, S.( n.d.) Interprofessional Collaborator Assessment Rubric, Academic Health Council. Retrieved from http://www.med.mun.ca/getdoc/b78eb859-6c13-4f2f-9712-f50f1c67c863/ICAR.aspx
Hum, G. (2015). Workplace learning during the science doctorate: What influences research learning experiences and outcomes? Innovations in Education and Teaching International 52,1, 29-40. doi:10.1080/14703297.2014.981838
International Reading Association. (2010). Standards for reading professionals: A reference for the preparation of educators in the United States. Newark, DE: Author.
Paul, D., Blosser, J., & Jakubowitz, M. (2006). Principles and challenges for forming successful literacy partnerships. Topics in Language Disorders. Partnerships for Literacy: Principles and Practices, 26(1), 5-23.
Poore, J., Cullen, D., Schaar, G. (2014). Simulation Based interprofessional Education guided by Kolb’s experiential learning theory. Clinical Simulation in Nursing 10 (5), e241-e247. doi: http://dx.doi.org/10.1016/j.ecns.2014.01.004
Reeves, S., Perrier, L., Goldman, J., Freeth, D., & Zwarenstein, M. (2013). Interprofessional education: Effects on professional practice and healthcare outcomes (update). Cochrane Database of Systematic Reviews, (3)
Sawyer, D.J. (2010). Improving reading instruction: A call for interdisciplinary collaboration. Topics in Language Disorders, 50 (1), 28-38.
World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. Retrieved from http://whqlibdoc.who.int.ezp.lndlibrary.org/hq/2010/WHO_HRH_HPN_10.3_eng.pdf.
About the Author
Marie R. Kerins, EdD, CCC-SLP, has been a licensed and certified speech-language pathologist since 1981. After earning her doctorate in 1998, she began teaching speech-language pathology to graduate and undergraduate students at Loyola University Maryland. Dr. Kerins has published numerous articles and has presented nationally and internationally on language-based learning disabilities as well as the learning styles of the millennial student. She is currently the associate vice president for research and graduate affairs at Loyola. Dr. Kerins recently published Child and Adolescent Communication Disorders: Organic and Neurogenic Bases, a comprehensive undergraduate textbook for courses related to the organic and neurogenic bases of child and adolescent language disorders. It is a must-have text for anyone in the field of communication sciences and disorders who works with children and adolescent populations.