CRITICAL THINKING IN CLINICAL PRACTICE – CURRICULUM INNOVATIONS

Julie Scherz, Anthony DiLollo, and Kathy Strattman

Department of Communication Sciences and Disorders

Wichita State University

Curriculum changes made to bridge the disconnect

  • Between clinical practicum and academic coursework
  • Between academic content areas

Critical thinking becomes the bridge to integrate what is being learned in multiple contexts

OLD COURSE SEQUENCE

Fall / Spring / Summer
1 / 800: Research Methods / 3 / 705: Counseling in CSD / 3 / 822: General Clinic Practicum / 2
809: Language/Literacy for Young Children / 3 / 710: Autism Spectrum Disorders / 3
814: Applied Phonology / 3 / 812: Aphasia, RHDDementia / 3 / Research –
895 (option 2) / 1
818: Fluency Disorders / 3 / 816: Language/Literacy School-Age / 3
822: General Clinic Practicum / 4 / 822: General Clinic Practicum / 4
831: Auditory Assessment Practicum / 2 / Research – 891(option 1) / 895(option 2) / 1
Total Credit Hours / 18 / Total / 17 / Total / 2+
2 / 810: Motor Speech Disorders / 2 / 817: Voice Disorders / 3 / 823: Medical Practicum / 6
811: Dysphagia / 3 / 819: Traumatic Brain Injury / 2
815: AAC / 3 / 821: Educational Practicum / 6
822: General Clinic Practicum / 4 / Research – 892 (option 1) / 899 (option 2) / 1
Research – 891 (option 1) / 899(option 2) / 1
PHS 804: Principles of Statistics in Health Sci / 3
Total Credit Hours / 13+ / Total / 12 / Total / 6

NEW COURSE SEQUENCE

Fall / Spring / Summer
1 / 809: Language/Literacy for Young Children / 2 / 705: Counseling in CSD / 2 / 822: General Clinic Practicum / 2
814: Applied Phonology / 2 / 710: Autism Spectrum Disorders / 2
818: Fluency Disorders / 2 / 815: AAC / 2 / Research –
895 (option 2) / 1
822: General Clinic Practicum / 1 / 816: Language/Literacy for School-Age / 2
831: Auditory Assessment Practicum / 1 / 822: General Clinic Practicum / 2 / Elective / 0-3
832A: Critical Thinking in Clinical Practice I / 4 / 832B: Critical Thinking in Clinical Practice II / 4
Elective / 0-3 / HP 801: Interprofessional Evidence-Based Pract / 1
Research – 891 (option 1) / 895 (option 2) / 1
Total Credit Hours / 12+ / Total / 16 / Total / 2+
2 / 810: Motor Speech Disorders / 2 / 817: Voice Disorders / 3 / 823: Medical Practicum / 3
811: Dysphagia / 2 / 821: Educational Practicum / 3 / Elective / 0-3
812: Aphasia / 2 / Research – 892 (option 1) / 899 (option 2) / 1
819: Cognitive Communication Disorders / 2 / Elective / 0-3
822: General Clinic Practicum / 2
832C: Critical Thinking in Clinical Practice III / 4
Research – 891 (option 1) / 899 (option 2) / 1
Total Credit Hours / 15 / Total / 7+ / Total / 3+

THREE EXAMPLES OF INTENTIONAL CHANGES

MADE TO THE WAYS WE ASKED QUESTIONS

Clinic Brainstorming: Questions to Consider:

  1. Describe your client ---- what makes this person unique?
  2. What do you know about the client’s family and relationships?
  3. What personal values do you associate with this client?
  4. Client’s values
  5. Your values
  6. What do you dislike about this client?
  7. What do you like about this client?
  8. What diagnosis does your client have?
  9. What assumptions did you make about your client once you knew her/his diagnosis? Do you still hold those assumptions now?
  10. Do you agree with the diagnosis? Why?
  11. Give an alternative diagnosis that makes sense given what you know about the client.
  12. What treatment approach have you taken with your client?
  13. Why was this approach taken?
  14. What biases and assumptions played a role in your choice of this approach?
  15. What evidence do you have to support your choice? How strong is that evidence?
  16. Describe an alternative approach that makes sense for this client.
  17. How do you incorporate person-centered care in your sessions with this client? What impact do you think this has had?
  18. What progress have you seen so far with this client?
  19. Why do you think the client has made the progress you just described?
  20. What do you think the next steps should be for this client?
  21. What will this client be like when he/she is ready for dismissal from therapy?

Guidelines for the Reflection on Reflections assignment

These are guidelines designed to help you to formulate your reflection. Please note that these are NOT questions that you must answer (in fact, if you simply answer the questions, you will NOT get full credit for the assignment!). Your reflection should be a narrative of approximately 1-2 pages. You should read through all of your weekly reflections prior to writing your paper.

Considering the following questions might help you to formulate your reflection:

  1. What was your overall reaction to this (a class about critical thinking as you begin graduate studies) class?
  2. What was the most important thing that you learned in this class?
  3. What was the most challenging thing about the class for you?
  4. What aspects of this class (i.e., activities, assignments, discussions, etc.) facilitated your successful learning?
  5. What aspects contributed least to your learning?
  6. How is your thinking different now as opposed to the beginning of the semester?
  7. How have your attitudes and beliefs about speech-language pathology changed as a result of your participation in this class?
  8. How have your attitudes and beliefs about yourself changed as a result of your participation in this class?

Evidence-Based Practice

(Students were given two articles to read prior to coming to class. The following sequence shows how we structured discussions around those articles):

  1. Small group discussions (6 groups of 4-5):
  2. Which article had a greater impact on your thinking related to EBP?
  3. Why?
  4. What personal values played a role in your preference?
  5. What assumptions did you make about the authors after reading the two articles, and how did this influence your preference?
  6. How will this impact your clinical practice?
  7. Discuss Starkweather’s assertion that the effectiveness of stuttering therapy is not a question for “science”.
  8. What is his reasoning?
  9. Are there fallacies in his reasoning?
  10. What assumptions does he make?
  11. What values are reflected in his argument?
  12. Draw your conclusions
  13. How did the metaphor of “marriage” impact your understanding of EBP in the Apel & Self article?
  14. Many of you know Dr. Self. What impact did that have on your reading of this article?
  15. What assumptions did the authors make when writing this article?
  16. Come up with a different metaphor that might be used to frame an article about EBP (describe how it fits).
  17. Which article had a greater impact on your thinking related to EBP?
  18. Why?
  19. What personal values played a role in your preference?
  20. What assumptions did you make about the authors after reading the two articles, and how did this influence your preference?
  21. How will this impact your clinical practice?