Hardin Kathryn, Rossi-Katz Jessica, Busch Scott
Speech, Language, Hearing Sciences Department, Metropolitan State University of Denver, CO.
Good Samaritan Medical Center Foundation, Lafayette, CO.
Am J Speech Lang Pathol. 2025 Jan 13:1-33. doi: 10.1044/2024_AJSLP-24-00126.
PURPOSE: The aim of this study was to gauge the impacts of cognitive empathy training experiential learning on traumatic brain injury (TBI) knowledge, awareness, confidence, and empathy in a pilot study of speech-language pathology graduate students. METHOD: A descriptive quasi-experimental convergent parallel mixed methods design intervention pilot study (QUAL + QUANT) was conducted with a diverse convenience sample of 19 first- and second-year speech-language pathology graduate students who engaged in a half-day TBI point-of-view simulation. The simulation was co-constructed through a participatory design with those living with TBI based on Kolb's experiential learning model and followed the recommendations for point-of-view simulation ethics. After setting goals, participants engaged in four station activities completing cognitive communication activities of daily living, while experiencing manipulations to their sensory systems. Activities included reading while wearing goggles with blurred or double vision, listening with tinnitus and auditory processing disorder, and taking notes during a manipulated college lecture. Participants also interacted with an individual living with TBI and responded to targeted prompts throughout the day. Quantitative outcomes were measured using published TBI knowledge and empathy scales and analyzed with descriptive, parametric and nonparametric statistics, while qualitative data were analyzed through thematic analysis. Data were then triangulated through mixed methods. Mixed methods design quality was ensured by following the Mixed Methods Appraisal Tool (Hong et al., 2018). RESULTS: After experiential learning, significant increases in speech-language pathologist (SLP) TBI knowledge, empathy, and awareness of TBI symptom and symptom impacts were found. Many, but not all, participants also reported changes in clinical confidence. CONCLUSIONS: Cognitive empathy training using experiential learning appears to be a viable method to increase SLP knowledge, empathy, and symptom awareness for TBI clinical care. Future research should replicate the study with different types and locations of speech-language pathology graduate programs to consider TBI empathy training as a standard training method to improve both individual and provider outcomes. PLAIN LANGUAGE SUMMARY: Individuals and families living with traumatic brain injury (TBI) say their providers lack necessary knowledge; do not seem to understand what living with TBI is like; and can be dismissive, uncaring, and lacking empathy. Health care providers do not automatically imagine the world from the patient's perspectives, to "walk in another's shoes"; it takes intentional effort and training. This project attempted to train those specific empathy skills for speech-language pathology graduate students through experiential learning. Experiential learning is a process where people engage in meaningful activities and spend lots of time reflecting on their experiences. Working with people living with TBI, we built a half-day workshop where 19 graduate students completed normal daily activities (such as texting, reading) through different stations that provided insights into what it may be like to have a TBI, such as wearing goggles to induce blurred or double vision, having ringing in their ears (tinnitus), and watching an overwhelming manipulated college video lecture. Afterward, participants listened to a person living with TBI and asked questions. This was important because engaging in activities without interacting with someone living with TBI misses a key idea about listening to and learning from individuals and families. We measured TBI knowledge, empathy, and confidence by looking at surveys pre- and posttraining and reading students' written reflections. Participants reported significant changes in how they think about brain injury and how they will provide clinical care for people living with TBI in the future. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.28098254.
目的:本研究旨在评估认知共情训练体验式学习对言语语言病理学研究生在创伤性脑损伤(TBI)知识、认知、信心和共情方面的影响,这是一项初步研究。 方法:采用描述性准实验收敛平行混合方法设计干预性初步研究(QUAL + QUANT),对19名一、二年级言语语言病理学研究生进行了不同的便利抽样,他们参与了为期半天的TBI视角模拟。该模拟是根据科尔布的体验式学习模型,通过与TBI患者共同参与的设计构建的,并遵循了视角模拟伦理的建议。设定目标后,参与者参与了四个站点活动,完成日常生活中的认知交流活动,同时体验对其感觉系统的操控。活动包括戴着造成视力模糊或重影的护目镜阅读、伴有耳鸣和听觉处理障碍时倾听,以及在一场经过操控的大学讲座中做笔记。参与者还与一名TBI患者互动,并全天回应针对性的提示。使用已发表的TBI知识和共情量表测量定量结果,并通过描述性、参数和非参数统计进行分析,而定性数据则通过主题分析进行分析。然后通过混合方法对数据进行三角互证。通过遵循混合方法评估工具(Hong等人,2018年)确保混合方法设计的质量。 结果:体验式学习后,言语语言病理学家(SLP)的TBI知识、共情以及对TBI症状和症状影响的认知有显著提高。许多(但并非所有)参与者还报告了临床信心的变化。 结论:使用体验式学习进行认知共情训练似乎是一种可行的方法,可以增加SLP在TBI临床护理方面的知识、共情和症状认知。未来的研究应以不同类型和地点的言语语言病理学研究生项目重复该研究,将TBI共情训练视为一种标准训练方法,以改善个人和医疗服务提供者的结果。 通俗易懂的总结:创伤性脑损伤(TBI)患者及其家属表示,他们的医疗服务提供者缺乏必要的知识;似乎不理解TBI患者的生活状况;可能会轻视、漠不关心且缺乏共情。医疗服务提供者不会自动从患者的角度去想象世界,即“设身处地为他人着想”;这需要有意识的努力和训练。本项目试图通过体验式学习为言语语言病理学研究生培训这些特定的共情技能。体验式学习是一个人们参与有意义的活动并花大量时间反思自身经历的过程。我们与TBI患者合作,构建了一个为期半天的工作坊,19名研究生通过不同站点完成正常的日常活动(如发短信、阅读),这些站点能让人了解TBI患者的生活可能是什么样的,比如戴着护目镜造成视力模糊或重影、耳鸣,以及观看一场经过大量操控的大学视频讲座。之后,参与者倾听一名TBI患者的讲述并提问。这很重要,因为只参与活动而不与TBI患者互动就错过了倾听并向患者及其家属学习的关键要点。我们通过查看训练前后的调查问卷以及阅读学生的书面反思来测量TBI知识、共情和信心。参与者报告了他们对脑损伤看法的显著变化,以及他们未来将如何为TBI患者提供临床护理。 补充材料:https://doi.org/10.23641/asha.28098254。
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