Purpose: Two disparate models drive American speech-language pathologists' views of evidence-based practice (EBP): the American Speech-Language-Hearing Association's (2004a, 2004b) and Dollaghan's (2007). These models discuss evidence derived from clinical practice but differ in the terms used, the definitions, and discussions of its role. These concepts, which we unify as clinical evidence , are an important part of EBP but lack consistent terminology and clear definitions in the literature. Our objective was to identify how clinical evidence is described in the field. Method: We conducted a scoping review to identify terms ascribed to clinical evidence and their descriptions. We searched the peer-reviewed, accessible, speech-language pathology intervention literature from 2005 to 2020. We extracted the terms and descriptions, from which three types of clinical evidence arose. We then used an open-coding framework to categorize positive and negative descriptions of clinical expertise and summarize the role of clinical evidence in decision making. Results: Seventy-eight articles included a description of clinical evidence. Across publications, a single term was used to describe disparate concepts, and the same concept was given different terms, yet the concepts that authors described clustered into three categories: clinical opinion, clinical expertise, and practice-based evidence, with each described as distinct from research evidence, and separate from the process of clinical decision making. Clinical opinion and clinical expertise were intrinsic to the clinician. Clinical opinion was insufficient and biased, whereas clinical expertise was a positive multidimensional construct. Practice-based evidence was extrinsic to the clinician—the local clinical data that clinicians generated. Good clinical decisions integrated multiple sources of evidence. Conclusions: These results outline a shared language for SLPs to discuss their clinical evidence with researchers, families, allied professionals, and each other. Clarification of the terminology, associated definitions, and the contributions of clinical evidence to good clinical decision-making informs EBP models in speech-language pathology. Supplemental Material: https://doi.org/10.23641/asha.21498546

In health professions education, the hidden curriculum is a set of implicit rules and expectations about how clinicians act and what they value. In fields that are very homogenous, such as rehabilitation professions, these expectations may have outsized impacts on students from minoritized backgrounds. This qualitative study examined the hidden curriculum in rehabilitation graduate programs—speech-language pathology, occupational therapy, and physical therapy—through the perspectives and experiences of 21 students from minoritized backgrounds. Semi-structured interviews explored their experiences with their programs’ hidden curricula. These revealed expectations about ways of being, interacting, and relating. Three overarching themes emerged, each reflecting tensions between conflicting values: (i) blend in but stand out; (ii) success lies in individualism, while de-prioritizing the individual; and (iii) fix the field, using your identities as a tool. When the expectations aligned with students’ expectations for themselves, meeting them was a source of pride. However, when the social expectations clashed with their own culture, dis/ability, gender, or neurotype, these tensions became an additional cognitive burden, and they rarely received mentorship for navigating it. Health professions programs might benefit from fostering students’ critical reflection on their hidden curricula and their fields’ cultural norms to foster greater belonging, agency, and identity retention.

Purpose: Graduate programs often use practicum experience with clients from nonmajority cultures to improve students' cultural responsiveness. Yet, it is not clear whether simply working with a client from a nonmajority culture actually confers this benefit or whether students are thinking about how to include culturally responsive behaviors when they are considering how to address a clinical case. Method: Twenty first-year speech-language pathology graduate students (10 Spanish–English bilinguals, 10 monolingual English speakers) were split into three groups: monolingual experimental ( n = 4), bilingual experimental ( n = 4), and control ( n = 12). The experimental groups completed a structured practicum with bilingual Hispanic/Latino clients. They received a 1-hr training in cultural responsiveness and then implemented a systematic language intervention in English or Spanish. Changes to cultural responsiveness were measured via think-aloud cases, and changes to confidence were measured with published, self-report scales. Reflective journal entries revealed what aspects of the clinical practicum students found most salient. Results: Experience working with bilingual clients did not have a substantial effect on students' confidence in their cultural competence. No substantial change was found in cultural responsiveness on the think-aloud for any group. Cultural responsiveness did not appear to be top-of-mind for the students. Conclusions: Simply working with clients from nonmajority cultures does not create a scenario where cultural responsiveness is likely to improve. Additional targeted, purposeful training in cultural responsiveness is necessary.

Background: Communication is critical to sexuality and sexual health. It is therefore reasonable to assume that acquired communication impairments would impact sexuality, but research is sparse. The research that does discuss these impacts can be difficult to find, as studies are spread across a wide variety of literature bases, and sexual topics are often combined with other concerns. Coupled with clinicians’ discomfort in addressing sexual issues, this leads to a lack of clinical support for patients’ sexual concerns.Aims: This scoping review aimed to map and summarize the existing literature on sexuality and acquired communication impairments.Methods & Procedures: Six databases were searched: CINAHL, PubMed, MEDLINE, PsycINFO, Web of Science and Scopus. To find studies from the literature on acquired communication impairments and their aetiologies that addressed sexuality and communication, a combination of sexuality and communication impairment terms was used. A total of 97 articles met inclusion criteria.Main Contribution: Across aetiologies and literature bases, acquired communication impairments have been found to negatively affect sexuality. However, researchers rarely evaluate the nature of the communication impairment or its effects on sexuality directly. People with communication impairments are more often systematically excluded from acquired disability research on sexuality. Using the reviewed literature, we present recommendations for including sexuality‐related topics in communication disorder research and including people with communication impairments in sexuality‐related research. We also present recommendations for speech–language pathologists to begin incorporating sexuality‐related topics in their clinical practice.Conclusions & Implications: The effects of communication impairments on sexuality are insufficiently researched. The literature that does exist points to substantial impacts. This area of research deserves more concerted attention so that clinicians may have guidance and support in addressing the issue with their clients.WHAT THIS PAPER ADDS: What is already known on the subject: Though researchers have long posited reasons why acquired communication impairments would logically affect sexuality and intimacy, the literature on the topic has been difficult to find. Such research is spread across disorder areas. Sexuality effects are often hidden amid multiple quality‐of‐life indicators, or communication impairment impacts are described as one of many independent variables. What this paper adds to the existing knowledge: This scoping review is the first of its kind to provide an overview of the research into communication impairments’ effects on sexuality. It describes the effects that communication impairments can have on sexuality. What are the potential or actual clinical implications of this work?: This scoping review will help clinicians to find relevant research for their clients’ needs and help researchers conduct more thorough research in this area. It also provides clinical recommendations for helping clients with communication impairments access this important part of life.

Fiberoptic endoscopic evaluations of swallowing (FEES) is as important of a swallowing evaluation as the videoflouroscopic swallow study, but far fewer speech-language pathologists are competent in its use (Ambika, Datta, Manjula, Warawantkar, & Thomas, 2019; Brady & Donzelli, 2013; Pisegna & Langmore, 2016). One hurdle in FEES training is the necessity of practicing transnasal endoscopy on volunteers. The primary aim of this study was to compare the learning effectiveness of practicing transnasal endoscopy via simulation with practice in vivo for a student’s first passes of the endoscope. The end goal of this study was to determine the most cost-effective and feasible means of teaching transnasal endoscopy to graduate clinicians. Twenty-one graduate students practiced transnasal endoscopy in one of three conditions: in vivo, high-fidelity lifelike simulation, low-fidelity non-lifelike simulation. The learning outcomes assessed were speed of endoscopy, student confidence, and simulated patients’ comfort and perception of student skill. There were no significant differences between conditions found for any of these measures. Students in all conditions became more confident after practicing endoscopy, and that confidence was predictive of procedure time. The results of this study indicate that practice with simulation may be an important first step in teaching endoscopy.