Speech and Language Therapy Society

Recently at the University of Essex I have been trying to start a SLT Society to bring together both the year 1 and year 2 students, as well as to promote SLT to the undergraduates on campus that may have an interest in language, the sciences and communication.  We wanted to be able to get a budget and invite members so that we could fund external speakers, training days and SIGs as well as develop journal clubs and a safe area to discuss issues between peers.  Having pushed and pushed for this since December 2012, we were finally offered the opportunity to be ratified today!

 

I had to prepare a 2 minute speech and was informed prior to today that I would give this 2 minute speech about why we wanted to be a society, then there would be an anonymous vote.  I had assumed this would be a select few members of the Student's Union and was then surprised when I walked into a big lecture theatre to find committee members from all societies on campus! I had managed to drag another committee member with me from the SLT Society and so when 'societies to be ratified' were called to the front of the lecture theatre I dragged her with me (luckily she was willing!).

 

Another hopeful society went before us, and she spoke for 2 minutes, was then bombarded with questions and was then told the voting would commence.  Suddenly arms were flying in the air to the words "not in favour of this society" and hardly any movement during "in favour".  She unfortunately didn't get ratified.  Well, it was fair to say I was nervous following this as I had not been mentally prepared for questions, nor had I been prepared for a non-anonymous vote - now I was faced with watching people say that they were for or against us. 

 

In the essence of being a therapist though I remained swan-like and despite my desperate nervous paddle, I looked graceful on the surface and took to the stage with my accomplice.  I spoke of how it was imperative that the 2 year groups merged more over the course of the 2 years on the MSc programme and how we longed to draw in members from linguistics, sciences and psychology degree programmes to share knowledge and work together.  I spoke of recent news that SLT is "least preferred" profession for teenagers, highlighting the lack of awareness of SLT and how we really wanted to bring this to light, who we are and what we do. In my flustered state my accomplice took over and really reiterated that we wanted to promote awareness and inclusion, before I then went on to outline that we hoped to have social events as well as academic events in the form of external speakers and journal clubs. 

 

Then it was doomsday time. The floor was opened to questions.  Not a single person had a single question. We paused a second to enjoy the moment of relishing in the fact we had made our points clear and concise to the audience.  Only to then return to doomsday feelings of vote time.  I could have jumped for joy and screamed when "those in favour" was said and the whole room shot their hands in the sky! Of course, there was the cynical man in the front row who put his hand to "not in favour", but besides him, we were on the full stretch home.  The VP of activities then said the sweet word "congratulations"! We were officially a society!!!

 

Hard work, persistence and dedication to the cause paid off, all whilst looking calm and collected - all features of the SLT profession from my experiences so far!

 

It was an even lovelier moment when a girl from the crowd came up to us at the end of the meeting to tell us she desperately wanted to be a SLT and that she was so glad we had decided to start up, asking for our email addresses and more info.  We had our first member!!

 

It's safe to say that from now till I leave in August, there will be much awareness raising, many academic events and a much better sense of community between year 1 and year 2 students.

 

I am so looking forward to this journey!

Clinical Reasoning Models: Applying these to supervision

Today I had a lecture on clinical reasoning and clinical supervision.  It was really eye-opening to see that my feelings that I had reflected on in my previous 2 blogs on clinical supervision were mirrored by my peers.  I was able to reflect more on the issue of supervision being a 2 way process, of which is reciprocal from both supervisor and supervisee. 

 

What was interesting to then draw on was the notion of clinical supervision as a space for the supervisee to draw out their thoughts and really become more self-aware whilst engaging in offline reflection - a process of clinical reasoning.  It was interesting to then be aware of how to apply the Higgs and Titchen's model of knowledge alongside a newer model of evidence based practice to clinical supervision in order to become effective at clinically reasoning whilst drawing out personal strengths and areas to develop. 

 

Higgs and Titchen Model

 

By reflecting offline with a supervisor, you were able to see more clearly how you clincally reasoned derived at that thought, by drawing on research/literature/theory from propositional knowledge, vs. personal knowledge from own experience and from client centred personal knowledge vs. drawing on clinical skill craft knowledge.  It was interesting to be aware that as we grow as student SLTs that the way in which we apply these different domains can alter and this can be a growing process in itself.  

 

Only through reflection and supervision can we become more aware of our skills and expertise, as well as our areas to develop.

 

 

Evidence Based Practice Model

 

I am very excited about starting my block placement in a month and hope to go into this being open and honest about how I prefer supervision to be, having been able to reflect on the things that I have valued in a supervisor previously, but also in the hope that I can become more aware of my own clinical reasoning skills through applying both the Higgs and Titchen model and the EBP model that I have now come to know.

 

Does anyone have experiences of this as a student supervisee or as a supervisor? How do you apply these models to your practice? How do you develop your reflection skills? I would appreciate any comments or tweets on this topic :)

 

My first SIG: Intensive Interaction & PODD

On Monday I attended my first SIG.  The London Autism SIG.  I had no clue what to expect and was going alone, so armed with my Kindle and my diary I prepared to be sat alone not being able to network with anyone.  How wrong was I! I met a lovely NQP to start with and she told me all about her past 6 months working and how autism was a new area to her so she thought she’d join the SIG.  Then a lady she knew arrived and I got talking to her, followed by another lady who sat to my left who also joined in.  It was lovely.  The SIG hadn’t even started and I was beginning to feel like a real SLT, able to discuss clients and other SLTs I knew. 





Graham Firth

The first presenter of the day was Graham Firth.  He has a lot of experience in Intensive Interaction and is the current project leader for it in the Leeds Partnership Trust.  He also has a book out about it and has developed the Framework for Recognising Attainment in Intensive Interaction.  The FRA is a tool I’ve been using recently with my Communication Partner as it is really easy to use and shows clearly where my client is at.  But on Monday, Graham talked about how to use it most effectively and boy oh boy is there ways for me to improve my recording of intensive interaction! I was also surprised as there were activities to watch a videoclip of II and then map it to the framework, I was surprised that so many of us had different opinions about which level the client was at.  This made me realise that best practice for II, may in fact be video recording the interaction and gathering a colleague or two to discuss where you may place them on the FRA.  This way you will get to hear peoples clinical reasoning out loud and develop your own.  It was a packed hour with lots to learn about the framework and great opportunities to practise it, but by then I was bursting for a drink and a stretch and before I knew it, it was break time. 

After the tea break Hayley Parfett, an Australian SLT now currently working in the UK.  She came to talk about a method of AAC called PODD (Pragmatic Organisation Dynamic Display).  Now I had never heard of this before and upon showing us a big hefty book chocker full of symbols I began to doubt this method.  Would a child with autism who was reluctant to engage in communication actually use a book of symbols so big? Then Hayley said “How often do you provide a system with just the words that you know they are able to achieve?” “How are you pushing your clients to learn and to grow?” – Well, she certainly had my attention! She stated that we need to widen our expectations of our clients and not be masked by what we have seen them achieve.  And that is exactly what PODD does, whilst a child may not know the symbols or words to start with, when adults, staff, family are facilitating their speech/communication with the symbols within the book, the adult is facilitating the child to learn that they can use these too.  She then went on to ask us, if we had the option to leave the SIG right now, and be free in London, with no responsibilities, what would we like to do with our afternoons? Then she produced two pictures, one of the big ben and one of tower bridge.  Then she said “which one do you want to do?” “you choose”. 

 

Well, it was fair to say nobody in the room had even had these two options in mind, and in fact we didn’t want to choose either of those 2 pictures.  Hayley then detailed that often this happens, we give our clients a choice of 2, in a situation where there could be endless choices and then we view our client as being incapable of making a choice if they don’t make one out of the two limited ones presented.  That, she stated, was what PODD also tried to achieve, to give a range of possibilities to the child to support them to be able to communicate.  I am hoping to learn more about PODD and read up on the evidence base, but I wonder how much these display communication books are currently being used? I haven't come across PODD before, have you?

Overall, it was a very interesting thought provoking day, which not only supported my skills using the FRA for II, but also began to change my views on communication and how we work with people with autism.  I will definitely be going to the full day SIG in June that is for sure!

Clinical Supervisiors: The response!

Following on from my blog the other day on Clinical Supervisors, I had an overwhelming response. Many of my followers on Twitter sent me messages saying they had felt the same, and that supervision had been variable between placements. It struck a chord with others more than I realised it would, both with students and supervisors themselves.

 

Many students or practitioners reflecting on their days as a student stated that they always appreciated their supervisor giving feedback on strengths/areas for development. They stated that having the opportunity as a student to have room to grow on placement, and being supported in having the opportunity to experience flying solo in practice. One person even reflected that a supervisors compliments were much more appreciated when they were rarities, when the student had truly exceeded expectations.

 

In discussing whether or not it was the student or the supervisor that adapted their ways on clinical placements, many people stated that both needed to be flexible. They stated that the clinical supervisor should be aware of clinical area and the amount the student was able to achieve in that setting due to specialism and department structure. They also stated that supervisors should be aware of student’s previous clinical experiences, the point at which the student was in their training and the resources available to them.

 

But though this has been focused on what students prefer and what supervisors need to consider about students, I became aware that I hadn’t considered what supervisors preferred or what the student should consider about the supervisor. As it was pointed out to me, supervisors themselves are also learning, both about the profession, but also about how to be a good supervisor. Having asked some peers, it became clear that many supervisors did not ask their students for feedback on their supervision style, therefore how can we expect supervisors to be flexible to our needs if we are not explicit in telling them what we need from them on the placement.

 

“It’s important to remember that supervisors are continually learning and improving as well as students” - @TstarrMarshall

 

In my own experience I have never been explicitly asked and been given the open opportunity to reflect openly to my supervisors about their supervision styles. I was once told that if I had any issues I could approach her, however this seemed to be for extreme cases where I was struggling to keep up, not just general comments on how I felt the student-practitioner supervision process was going. One suggestion was that universities could address the issue of students giving feedback to supervisors prior to clinical placement. At my University we are given booklets which supervisors fill in with sections being labeled “students strengths and areas to develop”, would a booklet that the supervisor has, filled in by the student support this gap? After all, we are all learning from the clinical placement process, a reason why many practitioners continue to take students on.

 

So to any clinical supervisors of students on clinical placements happen to read this, give it a try, ask your students to give you open honest feedback about how your supervision style fits with their learning style. I’d be interested to hear how successful it is and whether or not students have the insight to answer this, and whether they feel “brave enough” to reflect on your practice as well as their own.

Many thanks to all those who tweeted and contributed to the discussion!

Put yourself in their shoes

For many years I have had an interest in working with people with ASD (Autism Spectrum Disorder) and have spent many years working for both a disabled charity and a camp in america with a wide range of individuals all heterogenous to each other.  Having attended many CPD events such as the Autism Show and a conference day hosted by Autism Anglia I have had an opportunity to widen my understanding of Autism and gain more of an insight into the lifes of the people I have worked with.  However, can someone ever really have an insight of someone elses life, without having stepped into their shoes?

 

At the Autism Anglia day there were many obstacle courses set up.

 

The first one included un-wrapping a starburst sweet with a mitten on, no ability to grip it, no sensory input to feel the edges of the wrapper and general annoyance that the sweet you wanted was unobtainable to you. 

 

Next obstacle was manouvering around many objects, but whilst using binoculars.  You may think this sounds relatively easy, but when the binoculars are being used in the wrong way, everything diminished in size.  It became both tricky and frustrating to manouvere your way across a classroom.

For me, this was an eye opening experience to begin to make a step toward understanding of how my clients must feel on a daily basis. Then came the surpise of it all. 

 

I was sat in a lecture at university, when the lights began to flicker.  Not only did that come with an annoyance over light input and sight, it was accompanyed by a bleeping noise that persisted the whole lecture.  On top of this I became distinctly aware of the persons next to me heavily breathing through their mouth (a current round of head colds!) and the banging of doors in rooms above and below our classroom.  Having recently experienced some sensory difficulties at the Autism Anglia day, I was overly aware that all these sensory experiences in the lecture were both frustrating, removed my concentration and were out of my control. 

 

This morning I read on Twitter about a new game called "Auti-Sim", a simulation game that replicates sensory overload as a way for people to experience neurological difficulties. The 2 minute youtube clip is enough to throw anyone off and many people who have been diagnosed as having Autism or Aspergers have noted that it is accurate to their daily experiences.

 

This makes me wonder, how many people try to put themselves in the physical shoes of their clients? I know in stroke training hemianopia glasses are given to allow professionals to experience visionary loss.  So besides Autism and Stroke, are there ways to experience how your client feels day in and day out? Has anyone had any other experiences with these client groups that has supported their understanding of their client?

 

For me, I have widened my understanding of both those I have previously worked with and those I will in the hopeful furture work with. 

 

In the coming month myself and my peers hope to attend a special Autism Screening at the local Cinema to review this, and to get some feedback about how these specialist set ups not only help decrease sensory stimulation in those with autism, but also how they allow someone with autism to access society.

 

Reference:

"Auti-Sim" A review: http://arstechnica.com/gaming/2013/03/auti-sim-lets-you-experience-the-horror-of-sensory-overload/
Youtube Clip: "Auti-Sim" http://www.youtube.com/watch?v=DwS-qm8hUxc&feature=player_embedded

Clinical Supervisors..A Rose by any other name!

Last week I finished my 8 day placement and was able to on my final day reflect on me, my performance on the placement and my practice as a student SLT . However, having had my final appraisal with my practice educator (of which went very successfully) I realised that I could reflect on practice educators and styles of supervision over my past placements.
 

On my latest placement I had a supervisor who was really good at letting me take the lead in my clients journey, having told her that I wanted an opportunity to be autonomous and independent.  I was able to leave comprehensive clinical notes, email her and on occasion track her down and have face to face conversations when I initiated.  During this placement I really grew as a student SLT and even in some ways as a SLT.  However, I was surprised on my final assessment for her to be so fully aware of everything I had done and all my successes, including having gained feedback from staff I had been working with.  Whilst I did not feel I needed her around any more than she already was, I was pleasantly surprised to find out how active she had been behind the scenes following me through my placement.

 

Compared to this, my last block placement I had 4 therapists shadowing me (or me shadowing them in some instances) and of these 4, one was my practice educator.  I was with her 1 day a week for 5 weeks and conducted all therapy in front of her, as well as having her review all clinical case notes and reports with me.  Whilst she was a very hands on therapist, I felt the final assessment was not fully holistic of my performance with all the  therapists, as well as with her.  She gave me feedback that she had noted and whilst her feedback was very useful, I felt I lacked input from the other 3 therapists.  Despite this, I returned to University the following week to be greeted by my tutor who stated that my practice educator had rang the university to tell them how successful I had been on my placement and that they would not hestitate to have students from Essex again. 

 

If I compare this again with my very first SLT supervisor, she was very hands on, it was just the 2 of us in therapy every second of the day together.  She gave me brilliant points at my final assessment, but little indication of areas to develop despite having observed me hands on for 8 days. 

 

Overall, I have enjoyed experiencing many different supervisors, and many different ways of supervision and have grown through each of these.  I have been very lucky to have such wonderful placements, with such wonderful supervisors though each different in their own ways.

 

Therefore, this really got me questioning which style of placement supervisor/practice educator is most effective for students? It is all a very personal experience and I wonder if hands on works best for some, but not for others?

 

Do some students prefer more positive feedback, whilst others prefer more structural areas to develop?

 

Having done some reading for my research proposal in the area of clinical placements, I am aware that there are many ways for a supervisor to conduct their student placements.  Though I wonder, do supervisors change their ways of conduct dependent on the student? Or is it the student that is flexible to the supervisors ways?

 

Any comments/tweets about this are much appreciated, I would love to have an insight from students and clinical placement supervisors.

The last long run..

I am sure that I am not the only student SLT in this position, the position where the long stretch from now to qualifying means that the end is in sight, but that there is still a lot of hard work and time to put in over the next few months.

This unfortunately means that my Blog has taken a back seat, though I do want to thank all those that continue to visit my blog - I really do appreciate it!

So what is to come for me and my peers at the University of Essex over the next 5 months, 4 weeks and 1 day? (Thanks to my Countdown app I know exactly how long it is until my final University deadline).

Well I have 7 more weeks of University term, which includes 2 essays, 2 placements, and a Research Proposal to write, on top of 3 days a week of class.  Luckily for me, I just finished 1 of my 2 placements and have completed 1 of the 2 essays, so a little breathing space means more time for Research Proposal (Anyone else doing a MSc SLT degree? Hard hard work, but feels so so worth it!). 

Then in 7 weeks time I start my block placement.  And for anyone on the University of Essex degree programme, the block placement is the light at the end of the tunnel, its 5 whole weeks of doing what you are here to do, be a SLT! I am very excited to announce that my block placement is in Surrey, in the Community Adult LD team and I for one cannot wait to begin it!

And then it really is a whirlwind after block.  We luckily have TAPP - Transition to Autonomous Practitioner Placement, where we get an opportunity to work with paediatric client having not seen any littlies since May 2012! And then a VIVA to end the summer, and a CPD portfolio to bring it all together. 

So whilst it may seem like a long hard stretch, this really is my last long run as a Student SLT and I cannot wait for the day I can blog and work as a real SLT!

 

 

Any other student SLTs in the same position?

How are you coping with the last few months of being a Student SLT?

 How are your placements going?

I'd love to hear all about it!

 

As for me and the next few months, I have built up a long list of ideas that I want to blog about.  So look out for me and my blog over the next month or two and I hope to return back to the blogging scene on full form. 

As for today, research methodologies await me.