This study explored the types and uses of informal, on-the-job learning occurring among American Speech-Language-Hearing (ASHA)-certified Speech-Language Pathologists (SLPs) working in medical settings as part of a rehabilitation team. In addressing this purpose, a qualitative, phenomenological approach to research methodology was used. Participants were selected through a process of purposeful sampling, each meeting the criteria of having earned the Certificate of Clinical Competence in Speech-Language Pathology from ASHA and working in a medical setting as part of a rehabilitation team. Twenty-four SLPs from varying demographic profiles took part in one of three online data collection methods. Nine participants completed a computer-mediated interview, 11 participants completed an online journal entry and 4 participants completed a virtual focus group method. All data collection methods were accomplished via internet technologies. Data analysis was performed through a process of thematic analysis and resulted in four significant findings. First, both internal and external forces triggered SLPs to learn informally in the medical workplace. Also, SLPs went through an individually-determined, goal-directed process when learning informally in the medical workplace. SLPs used a combination of collaboration, workplace experience and research to learn informally in the medical workplace. And finally, SLPs employed informal learning activities for the purpose of meeting personal, patient and organizational needs. / It was recommended that (a) the American Speech- Language-Hearing Association review its professional development policy and consider implementation of a process whereby clinicians can document their goal-directed workplace learning and receive professional development credit for these activities; (b) healthcare organizations recognize, support and reward the informal learning in which their SLPs are already engaging; and (c) SLPs enhance their informal learning in the medical workplace through proactivity, critical reflectivity (of their own and others' learning), and creativity. The significance of this research included the use and support of existing theory in both Adult Education and Human Resource Development. Further, this research represents the first of its kind in investigating informal learning in rehabilitative therapies, specifically Speech-Language Pathology. Peer professions such as Physical and Occupational Therapy may also benefit from this study's conclusions and recommendations, as these professionals work in similar medical contexts. / by Patrick Roy Walden. / Thesis (Ph.D.)--Florida Atlantic University, 2008. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2008. Mode of access: World Wide Web.

An estimated 15 million individuals in the United States have been formally diagnosed with dysphagia, defined as swallowing dysfunction -- the fifth leading cause of death in Americans over the age of 65. Statistical findings indicate that at least 50% of these individuals have limited access to treatment. However, despite the rapid expansion of telepractice (defined as the use of telecommunications technology to provide services at a distance) as a statistically valid online method for the provision of medical and clinical intervention to those without access, telepractice has yet to consistently incorporate online dysphagia service delivery (referred to as tele-dysphagia) into its clinical scope. This investigation compared the outcomes of traditional face-to-face intervention to online tele-dysphagia intervention by measuring the correct and incorrect responses to visual and auditory cues presented by a clinician during dysphagia intervention sessions. Data analysis conducted via t-test indicated that there was no significant difference in the mean scores from tele-dysphagia method (M = 9.67, SD = 3.74) as compared to face-to-face method (M = 9.00, SD = 2.70), t (28) = - 0.56, p = 0.580. Additionally, inter-rater reliability scores were obtained by determining a Cohen’s kappa coefficient in order to measure the degree of agreement between the two raters. Findings indicated a kappa statistic of k=1 for all items, given a 100% agreement for all trials. Additionally, results of a mixed-design analysis of variance suggested a significant within-subject effect with the use of cues, but there were no significant main effects of between-subject factors (gender, delivery type, etiology, or age) on the patients’ responses. Given that there was no significant statistical difference between the two delivery methods and inter-rater reliability scores demonstrated perfect agreement, we can suggest that the online tele-dysphagia method can potentially yield clinical outcomes similar to a traditional face-to-face method. Results from a mixed-design analysis of variance additionally suggested that there is a significant within-subject effect given the use of cues (F (1, 29)=14.99, p = .001) on patients’ responses. However, there were no significant main effects of between-subject factors (gender, delivery type, etiology, or age) on the patients’ responses. It is hoped that the results of this study will lend validity and direction to future attempts to provide much-needed dysphagia intervention via online service methods. Such attempts, in turn, would have the potential to promote increased longevity and quality of life in those populations currently unable to access such services.