Clinician training on prelinguistic communication: Investigating techniques within an online approach

Abstract

Translating research evidence into clinical practice is a challenging process that requires careful examination through the lens of implementation science. Clinician training is one core component of implementation science research. While training can take different forms, an online, self-guided approach may be particularly advantageous for delivering training that is effective, efficient, and appealing to a large number of clinicians across a range of geographic areas. For early intervention speech-language pathologists (EI SLPs) who treat young children with physical disabilities, training is needed to support the integration of current evidence surrounding prelinguistic assessment and treatment for this complex clinical population into clinical practice. This dissertation study investigated three training techniques embedded within a self-guided, online training designed to teach EI SLPs one key ingredient (recognizing and recording child behaviors) of two evidence-based protocols for prelinguistic communication assessment. Forty-five EI SLPs from six states across the Pacific Northwest participated in the study. Subjects were randomly assigned to one of three practice conditions (identification, reflection, control), each designed to examine the differential impact of training technique on three primary outcomes: (1) effectiveness (measures of subjects’ knowledge and skill), (2) efficiency (time to complete training modules), and (3) appeal (subjects’ perceptions of training). Results indicated that overall, the training was effective in improving clinician knowledge and skill, but no statistically significant differences were observed by training condition on either measure. A significant effect of condition on time to complete training was observed, with subjects assigned to the control condition requiring significantly less time to complete the training than subjects in the reflection condition. Finally, across conditions all subjects reported high ratings on the overall appeal of the training. Taken together, these results document that the most efficient version of the training (no practice, control condition) was as effective as the more time intensive versions (practice under identification or reflection conditions), but more appealing to EI SLPs who participated in the study. Results from the present study suggest the importance of efficiency and appeal in achieving successful clinician training for moving evidence into practice. Additional considerations for designing online training are offered.