Telehealth and in-person placements: Same, same, but different. A mixed methods investigation of speech and language...

Telehealth placements in speech and language therapy provide crucial opportunities for both learning and service delivery when clinicians, students and/or clients are separated by factors such as distance or illness. While the use of telehealth placements has increased in recent times, they remain a relatively underexplored phenomenon with limited information available about the perceptions and experiences of practice educators and students.

The aim of this study was to explore experiences of telehealth-delivered speech and language therapy services and tele-supervision from the perspective of speech and language therapy students and practice educators.

This study used a sequential exploratory mixed methods design with a questionnaire study followed by a series of focus groups with Australian speech and language therapy educators and speech pathology students. Different questionnaires were used with students (n = 56) and practice educators (n = 27); each explored perceptions of interaction, engagement and student learning via multiple-choice and open-ended questions. Multiple-choice answers were analysed descriptively; open-ended questions were analysed with qualitative content analysis. The results informed the focus group questions. Separate focus groups were held with students (n = 17) and practice educators (n = 20); each explored student learning and development as well as educator supervisory practices. Data were analysed inductively using thematic network analysis.

Responses from both student and practice educator questionnaires indicated that students develop some different skills on telehealth placements compared to in-person placements and telehealth placements were more suitable for some students compared to others. We constructed 12 basic themes related to student and educator practices, student learning, client care, perceptions about telehealth, and location of educator and student. These were grouped into three organising themes: processes, perceptions, place. The organising themes were summarised into the overarching theme 'telehealth and in-person placements: same, same, but different'.

This study adds to the growing body of literature indicating that telehealth placements can meet student learning needs. It suggests that both educators and students need to learn new skills or adapt their current practices to engage in these placements. This paper includes recommendations for how to manage the different practices required by universities, educators and students to promote successful telehealth placements, particularly when the educator and student are not co-located.

What is already known on this subject Telehealth use has increased dramatically since the COVID-19 pandemic, both for clinical services and student placements in allied health services in general as well as speech and language therapy (SLT). Student placements conducted via telehealth are beneficial for student learning but some skills such as communication and interpersonal interaction develop differently. Placements can involve students delivering clinical services via telehealth and/ or remote student supervision (tele-supervision). What this paper adds to existing knowledge By drawing on the perspectives of students and practice educators, this paper demonstrates that the processes used for supervision, planning and clinical services are different in telehealth compared to in-person placements. It reveals that SLT students and educators have strongly held perceptions about the value and equivalence of telehealth placements that change over the course of a telehealth placement. This paper suggests placements that combine telehealth with tele-supervision are more complex and have fewer opportunities for incidental learning and developing professional workplace skills than placements where the educator and student providing telehealth services are co-located. What are the potential or actual clinical implications of this work? This paper will help universities, professional organisations and practice educators disentangle placements where students deliver services using telehealth from those where students also receive tele-supervision. This work identifies common perceptions about telehealth placements that educators can use to guide discussions with students, and guide the selection of effective work practices for students and educators during telehealth placements.