Continuing Competence Program

Pier Dialogue Reflection Example Submissions

Competence is the combination of:

These example reflections, submitted by regulated members as part of their CCP submission, all detail how the regulated member’s knowledge, skills, attitudes and/or judgement were positively impacted by the continuing education activities they completed.

Note that in these reflections, the members provided specific information about knowledge gained or changes to practice (i.e., changes to their skills, attitudes, or judgement) that occurred, and included:

  • Practice areas or diagnoses,
  • Population groups, including client age ranges, and/or
  • Specific clinical or nonclinical skills that were impacted.

Note also that these reflections focused on the impact(s) to the members’ own competence, rather than the competence of the peer with whom they had the discussion.

Audiology Reflection Examples:

My supervisor informed me that in Alberta, there needs to be a bilateral hearing loss for a patient to be a candidate for a cochlear implant and that the word discrimination score must be less than 40% in the better ear. This was very helpful as I was not aware of this limitation. As such, she recommended trying a Bi-CROS system with the patient, to see if they perceive any benefit. She also advised me that the patient may NOT find benefit in the system, as he has not been hearing on that side for some time and may find the CROS aid generates too much noise.

The content of the peer conversation aligns with the communicator competency area. The discussion focused on building a therapeutic relationship through positive interactions. We discussed the importance of active listening for establishing trust and rapport. The conversation also emphasized the importance of collaborating with patients and families to ensure plans for future management or intervention are client centered. Active listening and careful consideration of input empowers patients and families to be involved in decision-making. Conscious communication also ensures the approach to care focuses on the areas that are significant to the client and their family. By doing so, we ensure the patient is receiving necessary supports to participate fully in the activities that are meaningful for them. Following our conversation, I have been tailoring my counselling to make the information more meaningful to families.

SLP Reflection Examples:

Scenario: When I started to work with a new parent of a client, we discussed the importance of doing at home practice as it is an important component of speech treatment. After this discussion, the parent was in agreement. After 2-3 sessions at home practice was not done because the parent found that they didn’t have the time. I had a discussion about barriers which could be preventing the homework and we were able to create a plan. However, the following week the homework was still not completed. I spoke with a colleague about how to proceed. The advice they provided to me was discussing with the family if this was the right time for them to receive services and if maybe waiting for treatment could be beneficial, so the family could dedicate themselves to the treatment when it was the ‘right’ time for them.

Impact to competence: As a new graduate, this was the first time I encountered a situation where the family was having a challenging time setting aside some time to practice the weekly strategies and homework which are important to see progress.

[The discussion with my SLP colleague] helped me to remember to spend some extra dedicated time at the start of a treatment block with a family to discuss the specifics of treatment which can help dispel the impression that treatment only occurs during the 1-2 treatment sessions a week. I can help create a plan which is manageable for the family and discussing all the possible barriers before they arise. As well, letting the parent know that I am also available to brainstorm ideas on how to incorporate speech practice that best fits their lifestyle (e.g., 5-10min walking to school), so they may feel comfortable approaching me before it becomes overwhelming.

Overall, this changed my approach and has bettered my relationship with clients and helped with client-centered care.

Scenario: I was struggling with an educational assistant under my supervision because she was not following through on recommendations given by myself, the OT, or the classroom teacher. I met with the EA several times to discuss expectations and write out recommendations. When no action was taken on the part of the EA and no changes were being made in service to the student, I decided to speak to my OT colleague to problem solve this situation.

Impact to competence: After speaking with my colleague, we created a concrete plan for the EA to follow. We provided a chart that included our goal and a variety of activities she could complete to target those goals. A simpler tracking form was provided to help her track tasks and progress more easily. This dialogue with my colleague reminded me to be clearer and more concrete in the language and direction I give to the EAs and SLPAs I work with on a daily basis.

Scenario: I had recently taken on four new clients who stutter, ranging from age 4 to 16. After assessing these clients, identifying their goals, and brushing up on my knowledge of the different treatment approaches available, I developed a proposed treatment plan for each. However, before proceeding with these plans, I wanted input from a colleague who has more expertise than I do in treating fluency disorders.

Impact to competence: The discussion shifted the way that I approach treatment planning for fluency clients. I learned how the treatment approaches and hierarchies presented in the literature need not be rigidly adhered to, and that elements from different approaches can be blended to create personalized treatment plans that are more client/family-centred and more efficient in targeting the client’s specific goals. Through this discussion, I was also introduced to training modules and a fluency community of practice that I plan to get involved with in the new year, which will further build my competencies in this area.

Scenario: I had a patient come to hospital with “failure to thrive,” following [redacted clinical presentation]. The patient was adamant that he did not have any swallowing difficulties despite significant unintentional weight loss, radiographic evidence of active aspiration pneumonia, and significantly limited oral abilities to manage boluses. I contacted an SLP colleague from [redacted] head and neck surgery program to discuss this patient and their current abilities and how the patient was firm on not pursuing PEG tube placement for supplemental feeding should oral feeding no longer be viable or safe. I explained to my colleague the current situation and we discussed trying various methods of bolus presentation to facilitate oral intake, appropriateness of lingual exercises to maintain lingual range of motion and strength, and various approaches to discussing non-oral nutritional supplementation.

Impact to competence: I was able to expand my clinical assessment approaches and provide a modified approach that best serve this patient. I was also able to apply these new concepts to instrumental assessment in order to conduct an effective and safe assessment to determine the best diet recommendation along with two successful maneuvers to help the patient maintain oral feeding function. Furthermore, I was able to have a discussion with the patient regarding meeting nutritional goals and alternates to oral feeds for supplementation, in order to maintain function and meet his goals for activities of daily living.

Non-clinical Examples:

Scenario: My advisor and I discussed two main topics (biweekly mentorship for 6 months established). One of those topics is around leadership and having radically candid, but difficult conversations on the team.

Impact to competence: Together with my advisor, I am learning how to structure my conversations with clinical managers, clinical leads and clinical directors. I led a successful implementation kickoff meeting with one group of S-LPs and have two more such engagements coming up. My advisor is also providing mentorship so that I can develop my leadership skill-set, both within my own team, but also within my practice when communicating with leads across other sites.

Scenario: In the process of developing a new speech-language assessment activity for students in the [specified] program, I wanted to know more about the challenges and successes students typically experience in their clinical placements, and how I might better prepare students in my academic course for completing assessments in their clinical placements through this new activity (providing first year, first semester students with the opportunity to complete, with a partner, an assessment of a real client – not a simulated client or a child already known to have typical speech-language development). By talking with the colleague, I hoped to learn more about some of the challenges that students experienced in their initial placements, and to learn from her insights as a clinical educator how we might help to reduce some of those challenges prior to the students’ first placements, through classroom activities and/or the implementation of this new activity.

Impact to competence: Through our discussion, I learned that students begin their first placements with differing levels of confidence and skill (some have worked as teachers or SLPAs before), despite their having completed the same coursework. Most of them know how to analyze a speech sample and to score and interpret a standardized test, which reinforced the success of activities currently completed in my course, but many struggle with managing behaviour, manipulating the materials used in the assessment (e.g.., test booklets, score forms, toys, recording devices), and maintaining focus on the goals of the assessment. In addition the new assessment activity early in the program, strategies we discussed that could be incorporated into classroom activities prior to the assessment clinic included small group discussion of real scenarios, and role playing, including actual test materials and partners taking on the role of clients with behaviour/attention challenges. I look forward to trying these next year.