What Are the QIs, and Why Were They Developed?
The Quality Indicator (QI) self-assessment tool QI Questionnaire and Action Plan was created to help academic and clinical programs develop a shared understanding of and vision for successful integration of research and clinical practice. The QIs are not standards; the tool is intended to stimulate discussion across faculty and students about a program’s integration of research and clinical practice that leads to the creation and implementation of an action plan. There are many different ways to use the QIs, and each program can determine the best way to meet program needs. The QI tool has two parts: a questionnaire and an action plan. The Self-Assessment [PDF] is grouped into five sections: curriculum and department goals, coursework, faculty, students, and clinical practica. The Action Plan [DOC] involves the identification of specific goals based on the results of the QIs and the priorities of a communication sciences and disorders (CSD) program.
The original QIs were developed by ASHA in 2006 as a focused initiative to address the PhD shortage in CSD. The newly revised version is the result of a 3-year ASHA strategic initiative to increase the accessibility and use of research. This initiative included retooling and disseminating the QI tool. A main focus of this charge was to infuse principles of evidence-based practice (EBP) into the QIs to provide a foundation for future clinicians to successfully engage in EBP and to inform clinical decision-making.
This newly launched version reflects many of the suggestions and recommendations of CSD faculty project participants. The revisions are based on information gained from numerous activities, including a review of preferred practices in academic and clinical education, focus groups conducted at the ASHA Convention, peer review, and pilot-program implementation. The final step of the revision process involved fielding a survey to evaluate the results of the pilot program and identifying resources to assist CSD programs. What follows is the experience of one CSD program that participated in the revision of the QIs.
One Department’s Experience
The Communication Disorders Department at Fort Hays State University (FHSU), a teaching-intensive university in western Kansas, participated in the initial review of the QI tool as well as the pilot study. The department was encouraged by university administration to review its curriculum. The department chair and clinical director undertook a review of the QI instrument and determined that the questions and topics covered were pertinent for framing departmental discussions regarding the curriculum and for strategic planning.
During the fall of 2013, the department updated its strategic plan and framed goals to reflect the integration of EBP and increased research interaction between faculty and researchers. For example, one goal was “Create collaborative ongoing research with master’s level and doctoral level faculty within the department.” This particular goal was identified not only because undergraduate and graduate students need to observe departmental faculty working together clinically but also because it was an efficient method to assist tenure-track faculty in developing ongoing and productive lines of research.
In January 2014, the faculty completed the revised QI tool prior to the first departmental meeting. Because of the ongoing curriculum review, a main area of discussion and decision-making involved the continuation, modification, or development of courses. Specifically, the communication disorders faculty identified concerns regarding students’ ability to identify and apply research independently and the degree to which research was integrated into content courses. Goals were identified, prioritized, and organized into an action plan with specific steps and timelines.
As a result of implementing the QI tool and the ensuing faculty discussions, the department instituted a number of changes. During the Spring 2014 semester, clinical faculty took the opportunity to participate in relevant courses or were provided access to online course portals (e.g., BlackBoard Courseshell) to provide continuity between what is taught in academic courses and how it is used by students in the clinical setting. In addition, research within the department appears to be increasing; one faculty member began conducting research at a clinical site during the Fall 2014 semester with the assistance of a clinical faculty member, while other faculty discussed research questions and projects that they would like to pursue. Further, some undergraduate- and graduate-level courses began incorporating research articles and other formats (e.g., case studies) into course syllabi/requirements to provide students with guided opportunities to learn to read and interpret research findings and make the research-to-practice connections.
Challenges and Recommendations
The changes described above have been challenging, yet positive. The QI tool helped the Communications Disorders Department identify and reach consensus on the central changes they wanted to make to the curriculum; the primary area of change centered on the integration of research across all coursework and clinical experiences. The faculty has infused research into relevant course content and clinical experiences of students more effectively and systematically. This transition is time consuming for instructors and has been slow. Clinical supervisors have begun to integrate research principles into the design and implementation of evaluation and intervention programs as a result of their inclusion in research discussions and projects. Students’ use of EBP in clinical decision-making has become a frequent topic in supervisors’ meetings. A challenge is the inclusion of more supervisor-student discussions about using and explaining EBP in clinical decision-making. The department plans to complete the QI tool again during the 2015 Spring semester to compare results to last year and identify improvements or new areas to address.
Additional Feedback From CSD Programs
In addition to identifying and prioritizing needs and goals, some CSD programs used the QI tool to assess the need for programmatic changes. Mary Purdy, of Southern Connecticut State University, reported that the QI self-assessment led to the development of formal faculty/student opportunities (e.g., colloquia) for sharing and discussing current research. Programs also identified a variety of different goals in their action plans. Dr. Purdy, for example, described two goals: (1) provide dedicated opportunities for discussion of contemporary research and clinical topics each semester and (2) have NSSLHA hold monthly meetings to discuss research topics of interest in a productive, yet “fun,” way. Although programs also identified some challenges with the QI tool (e.g., finding time to collaborate, monitoring progress on the action plan), they indicated that completing the self-assessment and creating an action plan helped with integration of research and practice.