Top

BMC Health Services Research

Published in:

Open Access 01-12-2019 | Pathology | Research article

Evaluation of a community of practice for speech-language pathologists in aphasia rehabilitation: a logic analysis

Authors: Christine Alary Gauvreau, Guylaine Le Dorze, Dahlia Kairy, Claire Croteau

Published in: BMC Health Services Research | Issue 1/2019

Abstract

Background

Aphasia is a communication disorder affecting participation. Although there are evidence-based practice recommendations about participation and aphasia rehabilitation, it may be challenging for speech-language pathologists to ensure that rehabilitation activities have an impact on the person’s participation, in part due to time limitations. Participation remains limited after rehabilitation for persons who have aphasia. Communities of practice (CoPs) are a collaborative knowledge transfer strategy that can be used for evidence-based practice implementation. The aim of this study was to describe the components and evaluate a CoP for speech-language pathologists about participation and aphasia rehabilitation.

Methods

Logic analysis was used to determine the adequacy between resources, implemented activities, outputs and short-term outcomes of the CoP. Qualitative and quantitative descriptive data were collected through observation and participants’ logbooks. Outputs and outcomes of the CoP were revealed through thematic analysis and interpretation of descriptive statistics.

Results

Resources including CoP design and educational aims, human and material resources were combined to create various web-based, online and offline activities. Participants invested more time per week than expected in the CoP, shared and created clinical tools and appreciated the array of suggested activities. Participant engagement allowed them to reflect, interact and collaborate with each other. All 13 participants reported they acquired knowledge about clinical tools and 12 mentioned they reflected on their practice. While the CoP was ongoing, six participants noticed evidence-practice gaps, seven prepared to change their practice, and three changed their practice towards including more participation-based considerations.

Conclusions

This study showed that speech-language pathologists can include more participation-based approaches in aphasia rehabilitation as a result of participating in a time-bound, web-based CoP.

Available only for authorised users

Brady MC, Kelly H, Godwin J, Enderby P, Campbell P. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev. 2016;(6). https://doi.org/10.1002/14651858.CD000425.pub4.

World Health Organization: International classification of functioning, disability and health. 2001. http://www.who.int/classifications/icf/en/. Accessed 2 Nov 2018.

United Nations General Assembly: Convention on the rights of persons with disabilities. 2007. http://www.un.org/disabilities/documents/convention/convoptprot-e.pdf. Accessed 4 June 2018.

Laliberté MP, Alary Gauvreau C, Le Dorze G. A pilot study on how speech-language pathologists include social participation in aphasia rehabilitation. Aphasiology. 2016;30(10):1117–33. https://doi.org/10.1080/02687038.2015.1100708.CrossRef

Verna A, Davidson B, Rose T. Speech-language pathology services for people with aphasia: a survey of current practice in Australia. Int J Speech-Lang Pathol. 2009;11(3):191–205. https://doi.org/10.1080/17549500902726059.CrossRef

Torrence JM, Baylor CR, Yorkston KM, Spencer KA. Addressing communicative participation in treatment planning for adults: a survey of US speech-language pathologists. Am J Speech Lang Pathol. 2016;25(3):355–70. https://doi.org/10.1044/2015_AJSLP-15-0049.CrossRef

Dalemans RJP, de Witte LP, Beurskens AJ, van den Heuvel WJA, Wade DT. An investigation into the social participation of stroke survivors with aphasia. Disabil Rehabil. 2010;32(20):1678–85. https://doi.org/10.3109/09638281003649938.CrossRefPubMed

Le Dorze G, Salois-Bellerose E, Alepins M, Croteau C, Hallé M-C. A description of the personal and environmental determinants of participation several years post-stroke according to the views of people who have aphasia. Aphasiology. 2014;28(4):421–39. https://doi.org/10.1080/02687038.2013.869305.CrossRef

Tessier A. L’organisation et la prestation de services de réadaptation pour les personnes ayant subi un accident vasculaire cérébral (AVC) et leurs proches [Organization and provision of rehabilitation services for persons who had a stroke and their relatives]. In: Institut national d'excellence en santé et en services sociaux, editor. Quebec, CAN: Gouvernement du Québec; 2012;8(9): 101 p.

10.

Comité d’experts sur l’offre de services de réadaptation post-AVC. Trajectoire de services de réadaptation post-AVC Un continuum centré sur la personne [Trajectory of post-stroke rehabilitation services A person-centered continuum]. In: Ministère de la santé et des services sociaux, editor. Quebec, CAN: Gouvernement du Québec; 2013: 104 p.

11.

Aphasie Québec - Le réseau: Les membres [The members]. 2018. http://aphasiequebec.org/lesmembres.html. Accessed 10 Oct 2018.

12.

American Speech-Language-Hearing Association: Introduction to evidence-based practice. 2017. http://www.asha.org/Research/EBP/. Accessed 23 Mar 2017.

13.

Ratner NB. Evidence-based practice: an examination of its ramifications for the practice of speech-language pathology. Lang Speech Hear Serv Sch. 2006;37(4):257–67. https://doi.org/10.1044/0161-1461(2006/029).CrossRef

14.

McCurtin A, Roddam H. Evidence-based practice: SLTs under siege or opportunity for growth? The use and nature of research evidence in the profession. Int J Lang Commun Disord. 2012;47(1):11–26. https://doi.org/10.1111/j.1460-6984.2011.00074.x.CrossRefPubMed

15.

Foster AM, Worrall LE, Rose ML, O'Halloran R. Turning the tide: putting acute aphasia management back on the agenda through evidence-based practice. Aphasiology. 2013;27(4):420–43. https://doi.org/10.1080/02687038.2013.770818.CrossRef

16.

Fucetola R, Tucker F, Blank K, Corbetta M. A process for translating evidence-based aphasia treatment into clinical practice. Aphasiology. 2005;19(3–5):411–22. https://doi.org/10.1080/02687030444000859.CrossRef

17.

Rose ML, Raymer AM, Lanyon LE, Attard MC. A systematic review of gesture treatments for post-stroke aphasia. Aphasiology. 2013;27(9):1090–127. https://doi.org/10.1080/02687038.2013.805726.CrossRef

18.

Howe T, Davidson B, Worrall L, Hersh D, Ferguson A, Sherratt S, et al. “You needed to rehab … families as well”: family members’ own goals for aphasia rehabilitation. Int J Lang Commun Disord. 2012;47(5):511–21. https://doi.org/10.1111/j.1460-6984.2012.00159.x.CrossRefPubMed

19.

Hersh D, Worrall L, Howe T, Sherratt S, Davidson B. SMARTER goal setting in aphasia rehabilitation. Aphasiology. 2012;26(2):220–33. https://doi.org/10.1080/02687038.2011.640392.CrossRef

20.

Sherratt S, Worrall L, Pearson C, Howe T, Hersh D, Davidson B. “Well it has to be language-related”: speech-language pathologists’ goals for people with aphasia and their families. Int J Speech Lang Pathol. 2011;13(4):317–28. https://doi.org/10.3109/17549507.2011.584632.CrossRefPubMed

21.

Dalemans RJP, de Witte LP, Beurskens AJ, van den Heuvel WJA, Wade DT. Psychometric properties of the community integration questionnaire adjusted for people with aphasia. Arch Phys Med Rehabil. 2010;91(3):395–9. https://doi.org/10.1016/j.apmr.2009.10.021.CrossRefPubMed

22.

Simmons-Mackie N, Kagan A, Victor JC, Carling-Rowland A, Mok A, Hoch JS, et al. The assessment for living with aphasia: reliability and construct validity. Int J Speech-Lang Pathol. 2014;16(1):82–94. https://doi.org/10.3109/17549507.2013.831484.CrossRefPubMed

23.

Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999;30(7):1362–9. https://doi.org/10.1161/01.STR.30.7.1362.CrossRef

24.

Simmons-Mackie N, Raymer A, Armstrong E, Holland A, Cherney LR. Communication partner training in aphasia: a systematic review. Arch Phys Med Rehabil. 2010;91(12):1814–37. https://doi.org/10.1016/j.apmr.2010.08.026.CrossRefPubMed

25.

Simmons-Mackie N, Raymer A, Cherney L. Communication partner training in aphasia: an updated systematic review. Arch Phys Med Rehabil. 2016;97(12):2202–21. https://doi.org/10.1016/j.apmr.2016.03.023.CrossRef

26.

Shrubsole K, Worrall L, Power E, O’Connor DA. Recommendations for post-stroke aphasia rehabilitation: an updated systematic review and evaluation of clinical practice guidelines. Aphasiology. 2017;31(1):1–24. https://doi.org/10.1080/02687038.2016.1143083.CrossRef

27.

Hersh D. How do people with aphasia view their discharge from therapy? Aphasiology. 2009;23(3):331–50. https://doi.org/10.1080/02687030701764220.CrossRef

28.

Hersh D. I can't sleep at night with discharging this lady: the personal impact of ending therapy on speech-language pathologists. Int J Speech-Lang Pathol. 2010;12(4):283–91. https://doi.org/10.3109/17549501003721072.CrossRefPubMed

29.

Kovarsky D. Representing voices from the life-world in evidence-based practice. Int J Lang Commun Disord. 2008;43(S1):47–57. https://doi.org/10.1080/13682820701698036.CrossRefPubMed

30.

Hoover EL, Carney A. Integrating the iPad into an intensive, comprehensive aphasia program. Semin Speech Lang. 2014;35(1):25–37. https://doi.org/10.1055/s-0033-1362990.CrossRef

31.

Chapey R, Duchan JF, Elman RJ, Garcia LJ, Kagan A, Lyon JG, et al. Life participation approach to aphasia: A statement of values for the future. The ASHA Leader. 2000;5(3):4–6. https://doi.org/10.1044/leader.FTR.05032000.4.CrossRef

32.

Rodriguez AD, Worrall L, Brown K, Grohn B, McKinnon E, Pearson C, et al. Aphasia LIFT: exploratory investigation of an intensive comprehensive aphasia programme. Aphasiology. 2013;27(11):1339–61. https://doi.org/10.1080/02687038.2013.825759.CrossRef

33.

Dijkers MP, Murphy SL, Krellman J. Evidence-based practice for rehabilitation professionals: concepts and controversies. Arch Phys Med Rehabil. 2012;93(8 Suppl 2):S164–76. https://doi.org/10.1016/j.apmr.2011.12.014.CrossRefPubMed

34.

Hoffman LM, Ireland M, Hall-Mills S, Flynn P. Evidence-based speech-language pathology practices in schools: findings from a national survey. Lang Speech Hear Serv Sch. 2013;44(3):266–80. https://doi.org/10.1044/0161-1461(2013/12-0041).CrossRefPubMed

35.

Dodd B. Evidence-based practice and speech-language pathology: strengths, weaknesses, opportunities and threats. Folia Phoniatr Logop. 2007;59(3):118–29. https://doi.org/10.1159/000101770.CrossRef

36.

Zipoli RP, Kennedy M. Evidence-based practice among speech-language pathologists: attitudes, utilization, and barriers. Am J Speech Lang Pathol. 2005;14(3):208–20. https://doi.org/10.1044/1058-0360(2005/021).CrossRefPubMed

37.

Desgagné S. Le concept de recherche collaborative: l’idée d’un rapprochement entre chercheurs universitaires et praticiens enseignants [The concept of collaborative research: the idea of a collaboration between researchers and teachers]. Revue des sciences de l'éducation. 1997;23(2):371–93. https://doi.org/10.7202/031921ar.CrossRef

38.

Wenger E, McDermott RA, Snyder W. Cultivating communities of practice: a guide to managing knowledge. Boston: Harvard Business School Press; 2002.

39.

McKellar K, Pitzul K, Yi J, Cole D. Evaluating communities of practice and knowledge networks: a systematic scoping review of evaluation frameworks. EcoHealth. 2014;11(3):383–99. https://doi.org/10.1007/s10393-014-0958-3.CrossRefPubMed

40.

Brousselle A, Champagne F. Program theory evaluation: logic analysis. Eval Program Plann. 2011;34(1):69–78. https://doi.org/10.1016/j.evalprogplan.2010.04.001.CrossRef

41.

Chyung SYY. Foundational concepts for conducting program evaluations. Perform Improv Q. 2015;27(4):77–96. https://doi.org/10.1002/piq.21181.CrossRef

42.

Cooksy LJ, Gill P, Kelly PA. The program logic model as an integrative framework for a multimethod evaluation. Eval Program Plann. 2001;24(2):119–28. https://doi.org/10.1016/S0149-7189(01)00003-9.CrossRef

43.

Knowlton LW, Phillips CC. The logic model guidebook: better strategies for great results. Thousand Oaks: Sage; 2012.

44.

McLaughlin JA, Jordan GB. Logic models: a tool for telling your programs performance story. Eval Program Plann. 1999;22(1):65–72. https://doi.org/10.1016/S0149-7189(98)00042-1.CrossRef

45.

Rush B, Ogborne A. Program logic models: expanding their role and structure for program planning and evaluation. Can J Program Eval. 1991;6(2):95–106.

46.

Brousselle A, Champagne F, Contandriopoulos AP, Hartz Z. L'évaluation: concepts et méthodes [Evaluation: concepts and methods]. Montreal, CAN: Les Presses de l'Université de Montréal; 2011.

47.

Guba EG, Lincoln YS. Competing paradigms in qualitative research. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. Thousand Oaks: Sage; 1994. p. 105–17.

48.

Bandura A. Social learning theory. New York: General Learning Press; 1977.

49.

Lave J, Wenger E. Situated learning: legitimate peripheral participation: Cambridge university press; 1991.CrossRef

50.

Schön DA. The reflective practitioner: how professionals think in action. New York: Basic books; 1983.

51.

Caty ME, Kinsella EA, Doyle PC. Reflective practice in speech-language pathology: a scoping review. Int J Speech-Lang Pathol. 2015;17(4):411–20. https://doi.org/10.3109/17549507.2014.979870.CrossRefPubMed

52.

Rohde A, Worrall L, Le Dorze G. Systematic review of the quality of clinical guidelines for aphasia in stroke management. J Eval Clin Pract. 2013;19(6):994–1003. https://doi.org/10.1111/jep.12023.CrossRefPubMed

53.

Young L, Shrubsole K, Worrall L, Power E. Factors that influence Australian speech-language pathologists’ self-reported uptake of aphasia rehabilitation recommendations from clinical practice guidelines. Aphasiology. 2018;32(6):646–65. https://doi.org/10.1080/02687038.2018.1443201.CrossRef

54.

Ordre des orthophonistes et audiologistes du Québec: Exercer la profession [Practicing as a speech-language pathologist]. 2018. http://www.ooaq.qc.ca/profession/orthophonie#haut. Accessed 1 Oct 2018.

55.

Australian Aphasia Rehabilitation Pathway. 2018. http://www.aphasiapathway.com.au. Accessed 29 Mar 2018.

56.

Alary Gauvreau C, Le Dorze G, Croteau C, Hallé MC. Understanding practices of speech-language pathologists in aphasia rehabilitation: a grounded theory study. Aphasiology. 2019. https://doi.org/10.1080/02687038.2019.1602814.CrossRef

57.

Carter SM, Ritchie JE, Sainsbury P. Doing good qualitative research in public health: not as easy as it looks. N S W Public Health Bull. 2009;20(8):105–11. https://doi.org/10.1071/NB09018.CrossRefPubMed

58.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef

59.

Li LC, Grimshaw JM, Nielsen C, Judd M, Coyte PC, Graham ID. Use of communities of practice in business and health care sectors: a systematic review. Implement Sci. 2009;4(27). https://doi.org/10.1186/1748-5908-4-27.

60.

Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38–48. https://doi.org/10.4278/0890-1171-12.1.38.CrossRef

61.

Ranmuthugala G, Plumb J, Cunningham F, Georgiou A, Westbrook J, Braithwaite J. How and why are communities of practice established in the healthcare sector? A systematic review of the literature. BMC Health Serv Res. 2011;11(1):273. https://doi.org/10.1186/1472-6963-11-273.CrossRef

62.

Baxter S, Gray C. The application of student-centered learning approaches to clinical education. Int J Lang Commun Disord. 2001;36(S1):396–400. https://doi.org/10.3109/13682820109177918.CrossRefPubMed

63.

Lemire N, Souffez K, Laurendeau MC. Animer un processus de transfert des connaissances: bilan des connaissances et outil d'animation [To facilitate a knowledge transfer process: summary of knowledge and tool for facilitation]. In: Institut national de santé publique du Québec, editor. Quebec, CAN: Gouvernement du Québec; 2009: 59 p.

64.

Evans C, Yeung E, Markoulakis R, Guilcher S. An online community of practice to support evidence-based physiotherapy practice in manual therapy. J Contin Educ Heal Prof. 2014;34(4):215–23. https://doi.org/10.1002/chp.21253.CrossRef

65.

Miao M, Power E, O'Halloran R. Factors affecting speech pathologists’ implementation of stroke management guidelines: a thematic analysis. Disabil Rehabil. 2014;37(8):674–85. https://doi.org/10.3109/09638288.2014.932444.CrossRefPubMed

66.

Barwick MA, Peters J, Boydell K. Getting to uptake: do communities of practice support the implementation of evidence-based practice? J Can Acad Child Adolesc Psychiatry. 2009;18(1):16–29.PubMedPubMedCentral

67.

MacDermid J, Solomon P, Law M, Russell D, Stratford P. Defining the effect and mediators of two knowledge translation strategies designed to alter knowledge, intent and clinical utilization of rehabilitation outcome measures: a study protocol [NCT00298727]. Implement Sci. 2006;1(14). https://doi.org/10.1186/1748-5908-1-14.

68.

Thomson L, Schneider J, Wright N. Developing communities of practice to support the implementation of research into clinical practice. Leadersh Health Serv. 2013;26(1):20–33. https://doi.org/10.1108/17511871311291705.CrossRef

Title: Evaluation of a community of practice for speech-language pathologists in aphasia rehabilitation: a logic analysis
Authors: Christine Alary Gauvreau
Guylaine Le Dorze
Dahlia Kairy
Claire Croteau
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Pathology
Aphasia
Published in: BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-019-4338-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Evaluation of a community of practice for speech-language pathologists in aphasia rehabilitation: a logic analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2019

Effectiveness and cost-effectiveness of a multicomponent intervention to implement a clinical practice guideline for systemic lupus erythematosus: protocol for a cluster-randomized controlled trial

Key factors supporting implementation of a training program for neonatal family- centered care – a qualitative study

Partnering with patients in quality improvement: towards renewed practices for healthcare organization managers?

Data accuracy in the Ontario birth Registry: a chart re-abstraction study

Estimating the effectiveness and cost-effectiveness of establishing additional endovascular Thrombectomy stroke Centres in England: a discrete event simulation

Prevalence, determinants, and characteristics of extemporaneous compounding in Jordanian pharmacies