Standardized Patients in Communication Sciences and DIsorders: Past, Present and Future Directions

Standardized patients (SPs) are increasingly being used with students in the field of communication sciences and disorders (CSD). The purpose of this paper is to describe the use of SPs with CSD students. Challenges to the clinical education of students are described, and a call is made to expand the use of SPs to facilitate student learning of clinical skills and to assess students’ clinical competency

Case Report: Adult Patient with Acquired Apraxia of Speech Secondary to a Stroke in Broca\u27s Area

This open educational resource (OER) is a case report about an adult patient with acquired apraxia of speech secondary to stroke in Broca\u27s area. This case report was originally developed for SPA 6236: Motor Speech Disorders, School of Communication Sciences & Disorders, University of Central Florida, by Richard Zraick, Ph.D., CCC-SLP, F-ASHA. The content was based on output from ChatGPT and generated with the prompt: “Create a fictional case report for an adult patient with acquired apraxia of speech secondary to cerebrovascular accident in Broca’s area.” Others are free to reuse this OER to distribute, remix, adapt, and build upon the material in any medium or format, as long as acknowledgment is given to Richard Zraick and ChatGPT. Please review the license, CC BY 4.0, for more information

Implementation of Basal-Bolus Therapy in Type 2 Diabetes:A Randomized Controlled Trial Comparing Bolus Insulin Delivery Using an Insulin Patch with an Insulin Pen

Background: Barriers to mealtime insulin include complexity, fear of injections, and lifestyle interference. This multicenter, randomized controlled trial evaluated efficacy, safety, and self-reported outcomes in adults with type 2 diabetes, inadequately controlled on basal insulin, initiating and managing mealtime insulin with a wearable patch versus an insulin pen. Methods: Adults with type 2 diabetes (n = 278, age: 59.2 +/- 8.9 years), were randomized to patch (n = 139) versus pen (n = 139) for 48 weeks, with crossover at week 44. Baseline insulin was divided 1:1 basal: bolus. Using a pattern-control logbook, subjects adjusted basal and bolus insulin weekly using fasting and premeal glucose targets. Results: Glycated hemoglobin (HbA1c) change (least squares mean +/- standard error) from baseline to week 24 (primary endpoint) improved (P \u3c 0.0001) in both arms, -1.7% +/- 0.1% and -1.6% +/- 0.1% for patch and pen (-18.6 +/- 1.1 and -17.5 +/- 1.1 mmol/mol), and was maintained at 44 weeks. The coefficient of variation of 7-point self-monitoring blood glucose decreased more (P = 0.02) from baseline to week 44 for patch versus pen. There were no differences in adverse events, including hypoglycemia (three severe episodes per arm), and changes in weight and insulin doses. Subject-reported treatment satisfaction, quality of life, experience ratings at week 24, and device preferences at week 48 significantly favored the patch. Most health care providers preferred patch for mealtime insulin. Conclusions: Bolus insulin delivered by patch and pen using an algorithm-based weekly insulin dose titration significantly improved HbA1c in adults with type 2 diabetes, with improved subject and health care provider experience and preference for the patch

Cepstral analysis of hypokinetic and ataxic voices : correlations with perceptual and other acoustic measures

To investigate the validity of cepstral analyses against other conventional acoustic measures of voice quality in determining the perceptual impression in different motor speech disorders—hypokinetic and ataxic dysarthria, and speech tasks—prolonged vowels and connected speech. Prolonged vowel productions and connected speech samples (reading passages and monologues) from 43 participants with Parkinson disease and 10 speakers with ataxia were analyzed perceptually by a trained listener using GRBAS. In addition, acoustic measures of cepstral peak prominence (CPP), smoothed CPP (CPPs), harmonics-to-noise ratio (HNR), shimmer %, shimmer dB, amplitude perturbation quotient (APQ), relative average perturbation (RAP), jitter, and pitch perturbation quotient (PPQ) were performed. Statistical analysis involved correlations between perceptual and acoustic measures, as well as determination of differences across speaker groups and elicitation tasks. CPP and CPPs results showed greater levels of correlation with overall dysphonia, breathiness, and asthenia ratings than the other acoustic measures, except in the case of roughness. Sustained vowel production produced a higher number of significant correlations across all parameters other than connected speech, but task choice did not affect CPP and CPPs results. There were no significant differences in any parameters across the two speaker groups. The results of this study are consistent with the results of other studies investigating the same measures in speakers with nonmotor-related voice pathologies. In addition, there was an indication that they performed better in relation to asthenia, which might be particularly relevant for the current speaker group. The results support the clinical and research use of CPP and CPPs as a quantitative measure of voice quality in populations with motor speech disorder

Drinking water aromaticity and treatability is predicted by dissolved organic matter fluorescence

Samples from fifty-five surface water resources and twenty-five drinking water treatment plants in Europe, Africa, Asia, and USA were used to analyse the fluorescence composition of global surface waters and predict aromaticity and treatability from fluorescence excitation emission matrices. Nine underlying fluorescence components were identified in the dataset using parallel factor analysis (PARAFAC) and differences in aromaticity and treatability could be predicted from ratios between components Hii (λex/λem= 395/521), Hiii (λex/λem= 330/404), Pi, (λex/λem=290/365) and Pii (λex/λem= 275/302). Component Hii tracked humic acids of primarily plant origin, Hiii tracked weathered/oxidised humics and the “building block” fraction measured by LC-OCD, while Pi and Pii tracked amino acids in the “low molecular weight neutrals” LC-OCD fraction. Ratios between PARAFAC components predicted DOC removal at lab scale for French rivers in standardized tests involving coagulation, powdered activated carbon (PAC), chlorination, ion exchange (IEX), and ozonation, alone and in combination. The ratio Hii/Hiii, for convenience named “PARIX” standing for “PARAFAC index”, predicted SUVA according to a simple relationship: SUVA = 4.0 x PARIX (RMSEp=0.55) Lmg−1m−1. These results expand the utility of fluorescence spectroscopy in water treatment applications, by demonstrating the existence of previously unknown relationships between fluorescence composition, aromaticity and treatability that appear to hold across diverse surface waters at various stages of drinking water treatment

Evaluating an Intervention to Lower Health Literacy Demand of Graduate Student Clinician Summary Cover Letters to Patients

The American Speech-Language-Hearing Association encourages university programs to cultivate skills related to client health literacy among students. One means of doing so is to train students to write in a way that places lower health literacy demands on clients and their families. This study tested the effectiveness of a health literacy module for improving students’ skills in writing client letters to accompany diagnostic reports. Students in two sections of an advanced graduate seminar in Speech Pathology course were assigned to write cover letters to be sent to a hypothetical client at the UCF Communication Disorders Clinic. Reading grade level calculators of the pretest indicated students wrote at a college level, and the Patient Education Materials Assessment Tool (PEMAT) revealed that students performed worst on literacy elements which are not regularly associated with letter writing, but which can dramatically assist with readability and comprehension: breaking information into chunks, using informative headers, and using visual cues like bullet points, bolding, and font size. Fewer than half of students regularly used plain language and active voice. After completing the module, grade level of student writing had lowered to high school, but no statistically significant differences were found in use of specific literacy elements

Impact of Virtual Simulation and Coaching on the Interpersonal Collaborative Communication Skills of Speech-Language Pathology Students: A Pilot Study

Communication between clinicians, teachers, and family members is a critical skill when addressing and providing for the individual needs of patients. However, graduate students in speech-language pathology (SLP) programs often have limited opportunities to practice these skills prior to or during externship placements. The purpose of this study was to explore the use of virtual-reality based rehearsal with coaching on the interpersonal collaborative communication skills of SLP graduate students when delivering information regarding a singular patient to different stakeholders. Three graduate students completing their third semester in a SLP program participated in the study. Each participant was provided a clinical case scenario and asked to deliver recommendations related to the client’s communication abilities to a single adult avatar portraying either a parent, teacher, or pediatrician. This task was repeated twice to allow assessment of performance across multiple trials. A brief reflection and coaching period was provided between trials with the same avatar. All interactions were scored using the Situation, Background, Assessment, Recommendation, and Communication (SBAR-C) tool. All participants demonstrated improved communication skills between their first and second trial with each avatar as measured by the SBAR-C. Social validity surveys with participants revealed that they found the intervention to be valid and acceptable

Readability, User-Friendliness, and Key Content Analysis of Newborn Hearing Screening Brochures

Readability, user-friendliness, and key content are important components of newborn screening brochure design. Health information at a sixth grade or below reading level, designed for ease of navigation, with easily identifiable “action steps” can help adults with limited literacy skills find, understand, and use health information. The purpose of this study was to quantify the readability, user-friendliness, and key content components of newborn hearing screening brochures. Five readability formulae (FRE, F–K GL, FOG, FORCAST, and SMOG) were used to estimate reading levels of English language EHDI brochures (N = 48). Twenty-three participants assessed brochures for user-friendliness. Three participants assessed brochures to determine if key content elements were included and if so, the ease of locating them. Readers are provided with simple steps to follow during brochure design to maximize the message in parent education materials. This study forms the framework for quality improvement efforts and research-to-practice initiatives in the field

Peer role-play and standardised patients in communication training: a comparative study on the student perspective on acceptability, realism, and perceived effect

<p>Abstract</p> <p>Background</p> <p>To assess the student perspective on acceptability, realism, and perceived effect of communication training with peer role play (RP) and standardised patients (SP).</p> <p>Methods</p> <p>69 prefinal year students from a large German medical faculty were randomly assigned to one of two groups receiving communication training with RP (N = 34) or SP (N = 35) in the course of their paediatric rotation. In both groups, training addressed major medical and communication problems encountered in the exploration and counselling of parents of sick children. Acceptability and realism of the training as well as perceived effects and applicability for future parent-physician encounters were assessed using six-point Likert scales.</p> <p>Results</p> <p>Both forms of training were highly accepted (RP 5.32 ± .41, SP 5.51 ± .44, n.s.; 6 = very good, 1 = very poor) and perceived to be highly realistic (RP 5.60 ± .38, SP 5.53 ± .36, n.s.; 6 = highly realistic, 1 = unrealistic). Regarding perceived effects, participation was seen to be significantly more worthwhile in the SP group (RP 5.17 ± .37, SP 5.50 ± .43; p < .003; 6 = totally agree, 1 = don't agree at all). Both training methods were perceived as useful for training communication skills (RP 5.01 ± .68, SP 5.34 ± .47; 6 = totally agree; 1 = don't agree at all) and were considered to be moderately applicable for future parent-physician encounters (RP 4.29 ± 1.08, SP 5.00 ± .89; 6 = well prepared, 1 = unprepared), with usefulness and applicability both being rated higher in the SP group (p < .032 and p < .009).</p> <p>Conclusions</p> <p>RP and SP represent comparably valuable tools for the training of specific communication skills from the student perspective. Both provide highly realistic training scenarios and warrant inclusion in medical curricula. Given the expense of SP, deciding which method to employ should be carefully weighed up. From the perspective of the students in our study, SP were seen as a more useful and more applicable tool than RP. We discuss the potential of RP to foster a greater empathic appreciation of the patient perspective.</p