Early Observations of Clinical Reasoning During Stimulability Testing Among Voice-Specialized Speech-Language Pathologists: A Pilot Qualitative Study
Elizabeth D. YoungPurpose:
Stimulability testing is a widespread and highly valued behavioral assessment tool for voice-specialized speech-language pathologists (SLPs). However, there is currently no research examining how voice SLPs use stimulability testing to inform their clinical reasoning process and outcomes. This qualitative study was an exploratory examination of the clinical reasoning underlying stimulability testing for voice-specialized SLPs across the experience spectrum within a single geographic area.
Method:
Semistructured interviews were conducted with eight voice-specialized SLPs regarding stimulability testing, including how they used stimulability testing to form clinical outcomes such as candidacy and prognosis for behavioral therapy. Interviews were transcribed and analyzed using reflexive thematic analysis.
Results:
Five themes were generated: “Seeing, hearing, and measuring patient change”; “Learning and trusting what works”; “Thinking it through”; “Putting the pieces together”; and “Connecting with the patient.” Within the “Putting the pieces together” theme, clinicians differed on the utility of stimulability testing as a tool for determining patient candidacy and prognosis for behavioral therapy.
Conclusions:
The SLPs within the current study rely on both analytical and intuitive methods of clinical reasoning during stimulability testing. Further work establishing how SLPs conceptualize stimulability testing and use it to inform clinical reasoning outcomes is needed to support ongoing research and clinical use of this assessment tool.