A rise in the number of speech-language pathology graduate programs, as well as workload issues make it difficult for speech-language pathologists (SLPs) to supervise students in the field (Hill, Davidson, & Theodoros, 2010); graduate programs are finding it increasingly difficult to secure clinical practicum placements for their students. It is particularly challenging to find clinical internships in areas of low incidence practice, such as voice, fluency, and swallowing. While some practicum sites offer hands-on clinical experience, they do not all offer sufficient training or opportunities for the development of important professional skills, including building rapport, collecting case histories, and refining clinical interviewing skills.
Allied health science programs in universities, such as nursing programs, are regularly using simulation to provide rich learning opportunities as part of their clinical education for students. Simulation experiences have been shown to be superior to problem-based learning as an instructional method and can help to develop skills such as critical-thinking, clinical decisionmaking, and effective communication with patients and colleagues (Steadman et al., 2006). Speech-language pathology programs are beginning to use simulation experiences as an effective and valuable alternative method for bridging the gap between academic knowledge and clinical skills (Sheepway, Lincoln, & Togher, 2011), though more research is needed to determine the efficacy of these experiences. Although limited, there are studies in the field of speech-language pathology (Hill et al., 2010; Zraick, 2012) supporting the use of simulation for increasing confidence levels and preparedness in clinical placements, managing stress levels, and teaching clinical interviewing skills (Chipchase et al., 2012; Hill, Davidson, & Theodoros, 2015; Miles, Donaldson, & Friary, 2015).
This investigation employed a single subject A-B research design with four participants and hypothesized that the use of simulation with a standardized patient would increase the percentage of open-ended questions used by students in a clinical interview and improve overall clinical interviewing skills. Clinical interviewing skills were rated using the Standardized Patient Interview Rating Scale (SPIRS). A celeration trend line, descriptive statistics, percentage of nonoverlapping data, and the two standard deviation band method (Portney & Watkins, 2009) were used to analyze the data by slope, trend and variability (Gast & Ledford, 2014). An improvement of clinical interviewing skills was demonstrated by all participants; however, three of the four participants demonstrated only a slight change in level in a positive or therapeutic direction during the treatment phase. Three of the four participants exhibited an immediate increase in the use of open-ended questions during a clinical interview with a standardized patient. Though the findings of this investigation showed a correlation between simulation with a standardized patient and increasing open-ended questions and overall improvement of clinical interviewing skills, these results are preliminary and should not be used to make causal deductions.