How To Practice “Undefensively”

2010 ◽  
Vol 15 (2) ◽  
pp. 54-64 ◽  
Author(s):  
Paula Leslie ◽  
Kate Krival
Keyword(s):  
Decision Making ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Speech Language Pathologists ◽  
Internal Resources ◽  
Language Pathology ◽  
Decision Making Processes

Speech-language pathologists (SLPs) are increasingly challenged by the medical complexities our patients present and gripped by the fear of litigation, if patients decline physically under our care. One response to these pressures may be to practice defensive medical speech-language pathology. We propose that best practice is ethically achieved by deliberately using specific external and internal resources to practice undefensively. We suggest how consideration of these materials and processes will help SLPs ensure evaluation and clinical decision-making processes are as effective, evidence-based, and transparent to patients, caregivers, administrators, and payers as possible.

scholarly journals Moving Beyond Traditional Understandings of Evidence-Based Practice: A Total Evidence and Knowledge Approach (TEKA) to Treatment Evaluation and Clinical Decision Making in Speech-Language Pathology

2019 ◽  
Vol 40 (05) ◽  
pp. 370-393 ◽  
Author(s):  
Arlene McCurtin ◽  
Carol-Anne Murphy ◽  
Hazel Roddam
Keyword(s):  
Decision Making ◽  
Explicit Knowledge ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Total Evidence ◽  
Management Approach ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Language Pathology

AbstractEvidence-based practice (EBP) is a well-established framework for supporting clinical decision making in the discipline of speech-language pathology. The benefits of using evidence to inform clinical practice are acknowledged by clinicians and researchers alike. Even so, after over two decades of EBP advocacy, much clinical uncertainty remains and models supporting the evaluation of interventions require review and reconsideration. The EBP model, while promoting positive principles, can be argued to be conceptually flawed because it suffers from a lack of attention to and explicit valuing of other forms of knowledge crucial to the formation of realistic and judiciously informed decisions. We propose that the evaluation of interventions would be better supported by an explicit knowledge management approach reflecting a range of evidence and knowledge. One worked example is presented to demonstrate what using such an approach can produce in terms of intervention information.

The Influence of Linguistic Bias Upon Speech-Language Pathologists’ Attitudes Toward Clinical Scenarios Involving Nonstandard Dialects of English

2021 ◽  
pp. 1-17
Author(s):  
Catherine Easton ◽  
Sarah Verdon
Keyword(s):  
Decision Making ◽  
Service Provision ◽  
Clinical Decision Making ◽  
Linguistic Diversity ◽  
Clinical Decision ◽  
Assessment Tools ◽  
Speech Language Pathology ◽  
Speech Language Pathologists ◽  
Clinical Scenarios ◽  
Language Pathology

Purpose Variation within languages, including dialects, takes on an indexical function, marking belonging and connection. Meanwhile, attitudes toward these speech varieties become marked by linguistic bias. Within the speech-language pathology profession, research evidence, assessment tools, and intervention programs have largely been designed for and by the White, English-speaking middle class. As such, linguistic bias with a preference for standardized dialects is prevalent in the training and practice of the speech-language pathology profession, resulting in discriminatory and racialized practices. Method To investigate the influence of linguistic bias upon speech-language pathologists' (SLPs') clinical decision making, data were collected from 129 Australian SLPs via an online survey. Inferential statistics were used to investigate the relationship between clinical decision making and SLPs' attitudes toward nonstandard dialects as well as personal and professional factors. A content analysis of extended responses was conducted to identify themes in clinical decision making. Results SLPs with more years of experience and those who had received professional development were significantly more likely to seek out more information before making a diagnosis, while those with more negative attitudes toward linguistic diversity were significantly more likely to identify a disorder than a difference. SLPs provided a range of justifications for their clinical decision making, but few acknowledged the influence of their own attitudes and bias upon their decision making. Conclusions SLPs' linguistic bias towards speakers of nonstandard dialects has the potential to impact upon their clinical judgment of difference versus disorder and lead to inequality of service provision for speakers who do not express themselves in standardized forms. Before the profession can truly move toward an antiracist approach of equitable service provision for all, SLPs must engage in critical self-reflection to disrupt the adherence of the speech-language pathology profession to standardized “White” norms of communication.

scholarly journals Conscious Clinical Education: The Evidence-Based Education—Clinical Education Model

2020 ◽  
Vol 41 (04) ◽  
pp. 279-288
Author(s):  
Mark DeRuiter ◽  
Sarah M. Ginsberg
Keyword(s):  
Clinical Education ◽  
Teaching And Learning ◽  
Clinical Decision Making ◽  
Graduate Programs ◽  
Clinical Decision ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Clinical Educators ◽  
Language Pathology ◽  
Education Model

AbstractThe fields of speech-language pathology and audiology, collectively referred to as communication sciences and disorders, are driven by evidence-based practice (EBP). As accountability in clinical service delivery continues to increase, there are few who would argue that encouraging clinicians to engage in methods that have withstood the rigors of peer-review is the wrong approach. Graduate students are typically given many opportunities to learn about the evidence for their discipline, and graduate programs are required to provide these opportunities under accreditation standards. While EBP is critical to our discipline's clinical function, we assert that evidence-based education (EBE) is equally as important as EBP to our discipline's function in educating our students. This article discusses EBP and EBE with a focus on elements that may not have been considered in the past, particularly within the complex dynamic of the EBE and clinical education interface. We present current and proposed models, including a new model of EBE in clinical education. We share insights into how the new and proposed models fit within the broader context of clinical decision making and the scholarship of teaching and learning. We conclude by addressing future needs for the education of clinical educators.

Beyond the Big Screen: Avatars Prepare Graduate Students for Real-World Practice

2010 ◽  
Vol 11 (2) ◽  
pp. 50-55 ◽  
Author(s):  
Stacy Williams ◽  
Linda R. Schreiber
Keyword(s):  
Real World ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Virtual Simulation ◽  
Speech Language Pathology ◽  
Web Based ◽  
Client Data ◽  
Language Pathology ◽  
Virtual Simulations

Abstract This article explores the potential of virtual simulation technology in preparing university students for real-world experiences. SimuCase™, a Web-based virtual simulation application designed to support best practice in speech-language pathology, is described. The research base for learning via virtual simulations also is described. This type of simulation using case studies encourages the user to select and analyze client data to improve clinical decision-making skills in the area of assessment and supports Knowledge and Skills Assessment competencies of the American Speech-Language-Hearing Association.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

Benner’s Framework and Clinical Decision-Making in the Critical Care Environment

2016 ◽  
Vol 30 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Kristi J. Stinson
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Experience ◽  
Strong Correlation ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Decision Making Process ◽  
Clinical Experiences ◽  
Care Environment ◽  
Decision Making Processes

Completed as part of a larger dissertational study, the purpose of this portion of this descriptive correlational study was to examine the relationships among registered nurses’ clinical experiences and clinical decision-making processes in the critical care environment. The results indicated that there is no strong correlation between clinical experience in general and clinical experience in critical care and clinical decision-making. There were no differences found in any of the Benner stages of clinical experience in relation to the overall clinical decision-making process.

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