It’s the second Tuesday of the month – which means it’s time for Blogging About Research. Today’s research will follow a similar format (I think) to last month; although, to be fair, I reserve the right to make [side excursions] as I often think out loud while typing. Don’t forget to read the compilation of all the article reviews from participating bloggers here.
Today’s research article comes from The ASHA journal of Language, Speech, and Hearing Services in Schools and …
is titled: Evidence-Based Speech-Language Pathology Practices in Schools: Findings From a National Survey by LaVae M. Hoffman, Marie Ireland, Shannon Hall-Mills, and Perry Flynn. You can retrieve the article here if you are an ASHA member.
Background: Practitioners across service platforms are required to use
evidence-based practice ( EBP ). SLPs in the school system are not
exempt from this requirement.
Purpose: This study looked at what school-based SLPs were doing in regards to EBP .
The purpose of this study was to see if school-based SLP’s were
implementing EBP and, if so, how effective was it.
Question: The study had four questions:
- What formal training was provided in undergrad/grad/work?
- What resources were available?
- How often do you engage in EBP?
- What training needs exist?
What they did: A survey was sent out to SLPs across the nation to answer these
questions. Of those surveyed, 2762 individuals responded to the survey
invitation. Of those who responded, 2394 participants completed the
survey.
Results: In a nutshell, the respondents answering the training question indicated the majority of formal training came from attending state conferences… (do you hear this state associations??? Great job!). While the most common informal training happened through reading ASHA journals and accessing online resources. Only 12% of the respondents indicated accessing a SIG (which is really unfortunate) and another 12% reported no informal training at all.
For the resources available question, 11% indicated their school district had formal EBP procedures, while 28% reported there were informal procedures in place. Unfortunately 40% of respondents indicated their schools had no EBP procedure in place at all while another 22% indicated they were uncertain what protocols existed.
Unfortunately, although 87% of the respondents indicated they knew ASHA journals were available on-line and 67% knew that ASHA members could sign up for alerts about the journals as they are published, only 47% have chosen to receive the alerts. (This is unfortunate. For those of you who didn’t know – the table of contents for ALL of the ASHA journals can be emailed to you. That way you’re able to see at a glance which articles may be pertinent or interesting to you. It truly is a great benefit and one I highly recommend signing up for…your ASHA Dues are helping pay for it – utilize what you’re paying for people!)
For intangible resources (things that can’t be printed or purchased) available to help with EBP, only 9% indicated they have the time set aside each week for EBP activities. An astounding 91% indicated they had no time to conduct EBP activities. Those that do have EBP time set aside, indicated less than one hour of time usually even though best practice indicated 6-7 hours per question was optimal.
For the question regarding how often do we engage in EBP as part of their job, 79% of respondents indicated they researched two or fewer EBP questions independently with almost half reporting they researched ZERO EBP questions. More than 85% indicated they researched two or fewer EBP questions with a colleague and more than 65% of those selected the zero option.
The survey asked how many SLPs read ASHA journal articles and 84% of the respondents indicated they had read four or fewer articles on evaluation or assessment with nearly 25% indicating they have read NO assessment articles. (This can’t be good…again…people, come on! I know time is precious but you’re already paying for these!!) When asked about treatment or intervention targets, 71% of people said they had read zero to four articles.
The final question was basically, what training is needed. For this the respondents were asked to consider three potential resources (besides more time). Of those who responded, 70% reported a need for additional training., clearer policies at the state, school, or district level was a popular vote with 62% selecting it, and 54% thought having a study group would be beneficial.
The question went on to ask which topics would be most beneficial for additional training. Four options were the most widely chosen: treatment, making EBP decisions in the schools, collecting data to support EBP, and assessment strategies to support EBP.
Discussion: Truly…this isn’t telling us anything we don’t know. School-based SLPs, particularly those that are drowning in insane caseloads (which is a whole different rant that I’ve sworn off of for a while), don’t have time to study EBP. The study recognizes that fact, and discusses it toward the end of the article. There is a lot of information in the article that I’ve opted to leave out or just briefly touch on. In the article, the questions are expanded (and so are the resulting data). However, we as school-based SLPs, really can’t let lack of time be the reason we are not engaging in more EBP. We have resources available if we chose to use them.
One area the article mentioned is the need for universities to engage students in an authentic learning experience. By that, I have to say, they probably don’t mean the requisite 20 journal article reviews per semester I’ve heard about. Just as worksheets (a pet peeve of mine) do not necessarily stimulate learning, Article reviews for the sake of article reviews do not stimulate EBP. (Yes, I know…The university professors are preparing to smite me now, but come on, you have to know by now that articles are usually picked not for their content but by their length and ease of reporting).
What I’d love to see are more article reviews (yes, now the students are smiting me)…but based on actual questions. Pose a question – then let the students find the research and the evidence base to support it. Require both assessment and treatment EBP. Hands down the articles I remember writing reviews for and really delving deep enough to understand in graduate school, were the ones I based my research on. I remember writing the others, I may remember (vaguely) what they were about…but not really. But, when I had to pose the question and find the answers…those articles…those I read and learned and continue to use.
So..to wrap this up. I’d love to hear how you are accessing EBP. Do you use the ASHA Journals? Do you have the TOC sent to your email? Does your school or place of employment have someone to help with EBP questions? Let me know…
Until then…Adventure on!
Speech Adventures 
Of course I think this is wonderful! This is exactly why I was inspired to start blogging about research once a month. We really need to increase awareness of how easy it can be to expose ourselves to research in the field, and how important it is to read the research (or at least reviews like this of the research). Thanks Mary!
Mary, what you describe fits perfectly with an educational initiative to engage in “problem-based learning.” As in, pose a question or case study to the students, then let them research what the problem is, how to treat it, what controversies there are about the problem and/or the treatment, etc. The younger clinicians I have worked with who went through programs using such a model are fun to work with because they are trained to think about not just what they are doing, but WHY and to go right away to a lit search if confronted with something they are not sure they understand. Having had a chance to be a guest lecturer for a semester or portion of a semester, I found that it took a lot of prep time to scaffold the students’ efforts and they were a little intimidated by the “learn something for yourself, share it, and we’ll discuss it” approach vs the “I’ll tell you what you need to know and then ask you to regurgitate it on an exam” approach. But, I think, overall a positive experience.
Thank you for the comment. I really dislike the common binge and purge methodology many students are exposed to (and I mean elementary, HS, and university level students).
Knowing how to find an answer is so much more worthwhile than just being able to regurgitate a spoon-fed answer. Even if the answer isn’t exactly 100% right – at least they went through the work and figured something out.
Great review Mary! I’m really enjoying this series and it’s encouraging me to try and spend more time reading my ASHA journals! 🙂
Me too Rachel!
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Your blog reminded me of an experience I had when I deliberately designed a multidisciplinary practicum program to encourage evidence-based decision making. The students were supposed to pose a clinical question based on the rather difficult patients they were treating and then construct an answer after consulting the literature and integrating their findings with their (admittedly limited) clinical experience. One student posed an excellent question, went into the literature, failed to find a perfect RCT that answered the question, did find an RCT that answered another question, so she changed her question and presented a completely different report! She couldn’t understand why I was so unhappy with her! This was the student’s final internship too. Students persist in behaving as if EPB assignments are some kind of game: the goal is to get an A in class and then you can forget all about an exercise perceived to have no clinical relevance. That’s the first problem. The second problem is the incorrect assumption that EPB is all about “levels of evidence” and RCTs: it is not.
It is frustrating when people believe the purpose is to “get an A.”
Grt job