Simulation speaks for itself: Building speech-language pathology students’ confidence through high quality simulation within a workplace clinical placement

Joanna Shorland, Clare Morris, Dr. Delwyne Stephens


Introduction: This study investigated student perceptions of a brief standardised patient programme within a speech-language pathology workplace clinical placement. The simulation programme was designed to allow practise of communication and interpersonal skills with standardised patients before working with real patients in the healthcare environment. 

Methods: Speech-language pathology students (n = 30) completing their final-year placement at an Australian metropolitan healthcare provider participated in this programme between 2014 and 2016. Students routinely completed anonymous pre-post experience surveys as part of the programme. A retrospective pre-post study design was used to determine the programme’s impact on perceived anxiety and perceived confidence for communication and interpersonal skills. A qualitative analysis of written feedback was also utilised to further understand student perceptions of the programme. 

Results: Reported levels of anxiety, when anticipating interaction with real patients, significantly reduced (p < 0.05). Further, confidence across all communication and interpersonal skills increased significantly (p < 0.05) post programme. Thematic analysis of written feedback showed three themes related to student perceptions and learning preferences.

Conclusions: Although actual learning outcomes were not investigated, it appears that the utilisation of a brief standardised patient learning programme, embedded within a speech-language pathology workplace placement, is a promising way to target student competencies, such as communication and interpersonal skills.


speech-language pathology; standardised patients; clinical education

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Barrows, H. S. (1993). An overview of the uses of standardized patients for teaching and evaluating clinical skills. Academic Medicine, 68(6), 443–451.

Barrows, H., & Abrahamson, S. (1964). The programmed patient: A technique for appraising student performance in clinical neurology. Journal of Medical Education, 39, 802–805.

Beattie, B. E., Kinney, J., Fitzgerald, M., Murdoch-Kinch, C. A., Guenther, M. K., Ridley, K., . . . Ramaswamy, V. (2014). Dental and dental hygiene students’ perceptions of a standardized patient instructor conflict resolution program. Journal of Dental Education, 78(10), 1397–1404.

Bornais, J. A. K., Raiger, J. E., Krahn, R. E., & El-Masri, M. M. (2012). Evaluating undergraduate nursing students' learning using standardized patients. Journal of Professional Nursing, 28(5), 291–296.

Bressmann, T., & Eriks-Brophy, A. (2012). Use of simulated patients for a student learning experience on managing difficult patient behaviour in speech-language pathology contexts. International Journal of Speech-Language Pathology, 14(2), 165–173.

Brumfitt, S., & Freeman, M. (2007). Speech and language therapy students’ perceptions of learning in a university clinical setting. Learning in Health and Social Care, 6(4), 231–244.

Chan, J. B., Carter, S., & McAllister, L. L. (1994). Sources of anxiety related to clinical education in undergraduate speech-language pathology students. Australian Journal of Human Communication Disorders, 22(1), 57–73.

Corbin, J., & Stauss, A. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory (3rd ed.). Thousand Oaks, CA: Sage.

Dennis, D., Ng, L., & Furness, A. (2017). First-year physiotherapy students who elect to participate in simulation-based learning activities benefit from the experience. Focus on Health Professional Education: A Multi-disciplinary Journal, 18(2), 89–101.

Gibbons, C., Dempster, M., & Moutray, M. (2011). Stress, coping and satisfaction in nursing students. Journal of Advanced Nursing, 67(3), 621–632.

Gore, T., & Thomson, W. (2016). Use of simulation in undergraduate and graduate education. AACN Advanced Critical Care, 27(1), 86–95.

Halkett, G. K. B., McKay, J., & Shaw, T. (2011). Improving students’ confidence levels in communicating with patients and introducing students to the importance of history taking. Radiography, 17(1), 55–60.

Herge, E. A., Lorch, A., DeAngelis, T., Vause-Earland, T., Mollo, K., & Zapletal, A. (2013). The standardized patient encounter: A dynamic educational approach to enhance students’ clinical healthcare skills. Journal of Allied Health, 42(4), 229–235.

Hill, A. E., Davidson, B. J., & Theodoros, D. G. (2010). A review of standardized patients in clinical education: Implications for speech-language pathology programs. International Journal of Speech-Language Pathology, 12(3), 259–270.

Hill, A. E., Davidson, B. J., & Theodoros, D. G. (2013). Speech-language pathology students’ perceptions of a standardised patient clinic. Journal of Allied Health, 42(2), 84–91.

Kneebone, R. L., Scott, W., Darzi A., & Horrocks, M. (2004). Simulation and clinical practice: Strengthening the relationship. Medical Education, 38(10), 1095–1102.

Levett-Jones, T., Pitt, V., Courtney-Pratt, H., Harbrow, G., & Rossiter, R. (2015). What are the primary concerns of nursing students as they prepare for and contemplate their first clinical placement experience? Nurse Education in Practice, 15(4), 304–309.

Lincoln, Y., & Guba, E. (1985). Naturalistic inquiry. Thousand Oaks, CA: Sage.

Livsey, K., & Lavender-Stott, E. (2015). Impact of vicarious learning through peer observation during simulation on student behavioural measures. Focus on Health Professional Education: A Multi-disciplinary Journal, 16(4), 64–73.

Macbean, N., Theodoros, D., Davidson, B., & Hill, A. E. (2013). Simulated learning environments in speech-language pathology: An Australian response. International Journal of Speech-Language Pathology, 15(3), 345–357.

Mann, K., Gordon, J., & MacLeod, A. (2009). Reflection and reflective practice in health professions education: A systematic review. Advances in Health Sciences Education, 14(4), 595–621.

McGaghie, W. C., Issenberg, S. B., Petrusa, E. R., & Scalese, R. J. (2010). A critical review of simulation-based medical education research: 2003–2009. Medical Education, 44(1), 50–63.

McKenna, L., Innes, K., French, J., Streitberg, S., & Gilmour, C. (2011). Is history taking a dying skill? An exploration using a simulated learning environment. Nurse Education in Practice, 11(4), 234–238.

Parikh, P. P., Brown, R., White, M., Markert, R. J., Eustace, R., & Tchorz, K. (2015). Simulation-based end-of-life care training during surgical clerkship: Assessment of skills and perceptions. Journal of Surgical Research, 196(2), 258–263.

Pasupathy, R., & Bogschutz, R. J. (2013). An investigation of graduate speech-language pathology students’ SLP clinical self-efficacy. Contemporary Issues in Communication Science and Disorders, 40, 151–159.

Ross, A., Anderson, J., Kodate, N., Thomas, L., Thompson, K., Thomas, B., . . . Jaye, P. (2013). Simulation training for improving the quality of care for older people: An independent evaluation of an innovative programme for inter-professional education. BMJ Quality & Safety, 22(6), 495–505.

Schwartz, V. S., Rothpletz-Puglia, P., Denmark, R., & Byham-Gray, L. (2015). Comparison of standardized patients and real patients as an experiential teaching strategy in a nutrition counseling course for dietetic students. Patient Education and Counseling, 98(2), 168–173.

SPSS Inc. (2007). Statistical package for the social sciences: SPSS for Windows (Version 16.0) [Computer software]. Chicago, IL: Author.

Syder, D. (1996). The use of simulated clients to develop the clinical skills of speech and language therapy students. European Journal of Disorders of Communication, 31(2), 181–192.

Ward, E. C., Hill, A. E., Nund, R. L., Rumbach, A. F., Walker-Smith, K., Wright, S. E., . . . Dodrill, P. (2015). Developing clinical skills in paediatric dysphagia management using human patient simulation (HPS). International Journal of Speech-Language Pathology, 17(3), 230–240.

Watson, K., Wright, A., Morris, N., McMeeken, J., Rivett, D., Blackstock, F., . . . Jull, G. (2012). Can simulation replace part of clinical time? Two parallel randomised controlled trials. Medical Education, 46(7), 657–667.

Zraick, R. (2012). Review of the use of standardized patients in speech-language pathology clinical education. International Journal of Therapy and Rehabilitation, 19(2), 112–118.

Zraick, R. I., Allen, R. M., & Johnson, S. B. (2003). The use of standardized patients to teach and test interpersonal and communication skills with students in speech- language pathology. Advances in Health Sciences Education, 8(3), 237–248.



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