Building Knowledge and Confidence: Student Speech Pathologists' Perspectives on Learning About...

Cognitive-communication disorders (CCDs) are common after acquired brain injury (ABI). People with CCD experience communication breakdowns, significantly impacting long-term social, familial, and vocational outcomes. Convers-ABI-lity, a web-based communication partner training intervention, was co-designed with key stakeholders, including people with ABI, their family members, speech pathologists, and other allied health professionals, to address communication breakdowns in everyday interactions. Implementing convers-ABI-lity in student speech pathology clinics may develop student skills and confidence when working with ABI clients, increase access to interventions, improve service delivery, and improve cost efficiency. However, students were not involved in the co-design of convers-ABI-lity, and limited research exists about students' understanding of CCD or how to treat this population.

To explore student speech pathologists' perspectives on their learning of CCD and first impressions of convers-ABI-lity as an overall programme, to understand how to support students using the intervention on future placements.

Ten undergraduate and postgraduate Speech Pathology students from the University of Sydney who were at intermediate or entry-level clinical level participated in semi-structured, in-person qualitative interviews. Interviews focused on three key areas: knowledge and perceptions of CCD, a concurrent think-aloud protocol as students interacted with the convers-ABI-lity programme, and overall feedback on the intervention. Data were analysed using reflexive thematic analysis.

Three themes were identified: (1) Varied learning experiences contribute to different understandings of CCD, ultimately impacting students' clinical confidence; (2) 'The actual program makes sense, I just don't think it really helps me figure out what I would do'; (3) Students need support to not feel 'thrown into' a clinical placement.

These findings highlight the need for greater clinical and academic support for students when implementing a CCD intervention. The implementation of digital health features and the structure of convers-ABI-lity, may effectively support student learning, however adaptations such as therapy demonstration, may further facilitate the use of convers-ABI-lity on placement.

What is already known on this subject Cognitive-communication disorder is highly prevalent and typically the primary focus for intervention following an acquired brain injury. Intervention consists of communication partner training to facilitate everyday interactions for individuals with acquired brain injury. Current evidence-based interventions exist, including the new digital health programme convers-ABI-lity, however there is limited research regarding speech pathology students' perceptions of cognitive-communication disorder and their support needs when applying convers-ABI-lity in a clinical context. What does this study add to existing knowledge Findings from this study demonstrate how different learning experiences through academic units, clinical placements, independent research, or people with lived experience can influence students' understanding of cognitive-communication disorders and their confidence entering a clinical placement with a client with cognitive-communication disorder. Students described how using a digital health programme, such as convers-ABI-lity, helps facilitate their knowledge and preparation when entering placement; however, further supports through examples and observations are needed. What are the clinical applications of this work? Students commencing clinical placements with clients with cognitive-communication disorder need guidance regarding the nature of cognitive-communication disorder and explicit instruction on how to deliver a communication partner training intervention effectively. Greater exposure to cognitive-communication disorder interventions, such as using convers-ABI-lity during academic or clinical contexts, may facilitate the knowledge and learning needs for students.