Question 1

What are the historical, current, and emerging contexts, challenges, and opportunities for consideration as we prepare the future speech-language pathologist?

The discussion regarding the current context, including the challenges that programs face and the opportunities that exist for education, can be summarized under the categories of (a) academic issues (related to the tension that may occur between the needs of our discipline and profession and the priorities of academic institutions); (b) marketing, recruitment, and retention issues; (c) generational/cultural issues; (d) financial issues; and (e) professional practice issues.

Academic Issues

• Scheduling of practicum
• Providing competency-based learning experiences
• Integrating knowledge, clinical skills, and research
• Recruitment and preparation of PhD faculty
• Faculty workloads may constrain innovation in programs
• Current model of education may be too restrictive
• Flawed perception of how standards guide program development
• Student outcomes may not be explicit
• Need for alternative teaching models (e.g., distance learning, computer-based simulations, sharing of courses, course materials, and learning objects)
• Need for students to be independent and critical thinkers
• Defining the role of the undergraduate program
• What degree should serve as the entry-level degree
• Preparation of specialists versus generalists
• Standards for admission

Marketing/Recruitment/Retention Issues

• The lack of visibility of our profession
• The limited number of males and culturally/ethnically diverse students in the profession
• Limited practicum sites impact enrollment
• Lack of individuals with a PhD may prevent programs from increasing enrollment

Generational/Cultural Issues

• The current models of education may be inappropriate for or devalued by the current generation of students
• The current generation of students' goals, thinking, attitudes, knowledge, skills, and expectations differ from faculty's expectations
• Employment considerations are affected by generational differences
• There is a need to balance educational debt with employment salaries
• Increasing diversity of students (including international students) presents opportunities for a more diverse workforce
• Cultural differences present challenges in regard to language, speaking, and writing styles of faculty/supervisors and students

Financial Issues

• University and program funding limits enrollment in many programs
• Limited financial support for longer and/or more innovative educational models
• Limited ability for university academic programs to provide clinical practicum themselves due to financial constraints
• Financial constraints on clinical programs in the community
• Low salaries and perceived difficult working conditions decrease desire to seek careers in higher education
• Off-campus supervisors may be more likely to want/require payment
• The expense of our programs in relationship to enrollment may draw attention from higher administration settings

Professional Practice Issues

• Employers want clinical fellows to be able to "hit the ground running" when their work setting demands are high
• Our patient/client base is becoming larger and more diverse in regard to age, range and severity of disorders, and ethnicity and cultures
• The scope of practice in speech-language pathology is expanding without elimination of current/past areas of practice
• Professional practice requirements and expectations continue to evolve and increase
• The demand for evidence-based practice is increasing
• There is an opportunity for community collaboration to develop evidence-based practice in light of expertise and resource allocation
• Competition with other allied health professions and increase of doctoral requirements in some

There was agreement that many factors impede predictability, including the following:

• Emerging or ascendant disciplines (e.g., neuropharmacology, behavioral genetics, brain physiology) and breakthroughs in research and biotechnology
• Technology and therapeutic advances (e.g., cochlear implants, auditory verbal therapy)
• Shifts in accreditation practices
• Federal reimbursement policies
• Evolving relationships with allied disciplines
• Educational models (e.g., the 2-year master's program)
• Skills differentiation (those needed by an effective PhD are not the same as those needed by an effective medical clinician and those needed by a school-based SLP)
• Past students entered the field to help people
• Some students enter today because of the job market
• Many students today feel "entitled"
• Some new SLPs ask employers, "What are you going to do for me?"