Trends in the Acquisition of Clinical Reasoning in the Assessment of Speech Sound Disorders: Using the Script Concordance Test.

Purpose: Clinical reasoning is essential for speech–language pathologists (SLPs) when addressing ill‐defined questions in various clinical settings. This study focuses on the acquisition of clinical reasoning skills in SLP students, particularly their evolution with clinical experience. To achieve t...

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Publicado en:International Journal of Language & Communication Disorders (John Wiley & Sons, Inc.) Vol. 60; no. 5; pp. 1 - 15
Autores principales: Chan, Ting‐Fang, Yeh, Li‐Li
Formato: Artículo
Publicado: John Wiley & Sons, Inc. Sep/Oct2025
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: International Journal of Language & Communication Disorders (John Wiley & Sons, Inc.)
      issn: 14606984
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      dt: Sep/Oct2025
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      pub: John Wiley & Sons, Inc.
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        188159232
        10.1111/1460-6984.70105
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        atl: Trends in the Acquisition of Clinical Reasoning in the Assessment of Speech Sound Disorders: Using the Script Concordance Test.
      aug:
        au:
          Chan, Ting‐Fang
          Yeh, Li‐Li
        affil:
          Department of Speech‐Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
          Department of Audiology and Speech‐Language Pathology, MacKay Medical University, New Taipei City, Taiwan
      su:
        Speech disorder diagnosis
        Articulation disorders
        Speech therapists
        Medical logic
        Cronbach's alpha
        Data analysis
        Research funding
        Health occupations students
        Speech therapy education
        Undergraduates
        Questionnaires
        Pilot projects
        Educational tests & measurements
        Descriptive statistics
        Trend analysis
        Quantitative research
        Longitudinal method
        Communicative disorders
        Ability
        Clinical competence
        Conceptual structures
        One-way analysis of variance
        Statistics
        Psychometrics
        Comparative studies
        Data analysis software
        Training
      sug:
        subj:
          Speech disorder diagnosis
          Articulation disorders
          Speech therapists
          Medical logic
          Cronbach's alpha
          Data analysis
          Research funding
          Health occupations students
          Speech therapy education
          Undergraduates
          Questionnaires
          Pilot projects
          Educational tests & measurements
          Descriptive statistics
          Trend analysis
          Quantitative research
          Longitudinal method
          Communicative disorders
          Ability
          Clinical competence
          Conceptual structures
          One-way analysis of variance
          Statistics
          Psychometrics
          Comparative studies
          Data analysis software
          Training
      keyword:
        assessment of speech sound disorders
        clinical reasoning and decision‐making
        script concordance test
      ab: Purpose: Clinical reasoning is essential for speech–language pathologists (SLPs) when addressing ill‐defined questions in various clinical settings. This study focuses on the acquisition of clinical reasoning skills in SLP students, particularly their evolution with clinical experience. To achieve this, the study developed and validated the first cloud‐based script concordance test (SCT) tailored for assessing clinical reasoning skills in SSD diagnosis. Methods: An expert panel of 15 SLPs (average experience of 20.3 years) helped develop and score the SCT, which was administered to 51 undergraduate students (22 sophomores, 18 juniors, and 11 seniors). Statistical analyses examined the predictive role and trend of clinical experience in three dimensions (utility, interpretation, and diagnosis). Results: A significant difference in mean SCT scores was found between the expert panel and student groups (p < 0.05). Trend analysis showed a significant impact of clinical experience on SCT performance across all dimensions (all Fs > 9.91, p < 0.001), with greater experience linked to better reasoning skills. Low‐scoring items highlighted challenges with stimulability testing, indicating a lack of clinical consensus. Conclusions: This study demonstrates that clinical reasoning skills in SSD assessment become more refined with accumulated experience. The SCT developed effectively differentiates reasoning abilities between experts and students, offering a valuable tool for advancing clinical decision‐making in speech–language pathology. These findings have practical implications, empowering SLP educators to design effective training programs and preparing students for the challenges they may face in clinical practice. WHAT THIS PAPER ADDS: What is already known on this subject?The knowledge base of clinical practitioners includes both content and its organization. Clinical reasoning is the cognitive ability to integrate, organize, and interpret information as a key aspect of expertise in evidence‐based practice. Recently, script concordance tests, which use case‐based scenarios to reflect clinical decision‐making processes, have become a popular method for assessing these reasoning skills. What this paper adds to existing knowledge?This study is the first to empirically show that clinical reasoning skills in speech–language pathology, particularly in assessing speech sound disorders, are progressively refined through clinical experience. It highlights that students' reasoning skills during internships appear to be influenced by supervisory clinical approaches, potentially affecting diagnostic abilities. These reasoning skills may improve with further clinical experience or targeted continuing education. Additionally, the study developed the first SCT focused on SSD evaluation, demonstrating its effectiveness in distinguishing between expert and student clinical reasoning and decision‐making abilities. What are the potential or actual clinical implications of this work?A recent goal in clinical education is to make clinical reasoning processes more explicit and structured during training. Creating comprehensive case assessment scripts and designing concrete clinical thinking guidance programs integrated with effective measurement, such as the SCT developed in this study, could serve as teaching objectives for the clinical diagnosis of SSD.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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