This SIG 11 Perspectives activity addresses the necessity of a community-informed, strengths-based approach to healthcare service provision for individuals with communication disorders, and the impact of relationally focused reflections on improving conflict-handling skills in graduate speech-language pathology students. The first article by Mills et al., a clinical focus article, challenges the traditional deficit-based approach to addressing health disparities in underserved communities. The authors argue that simply expanding access to clinical services is insufficient and often fails to consider the perspectives and strengths of the communities themselves. Mills et al. advocate for a paradigm shift towards a strengths-based dialogue model. This approach emphasizes understanding the complex factors affecting access to healthcare from the community's viewpoint. Instead of focusing solely on increasing service utilization, the authors propose prioritizing open dialogue to identify and leverage existing community strengths. This shift in perspective allows healthcare professionals to move beyond a provider centric model and engage with communities as partners in developing sustainable solutions.

The authors highlight the limitations of policy changes in addressing structural barriers. While acknowledging the importance of policy, the authors argue that true change requires a deeper understanding of the gap between policy and actual practice. They emphasize the need for frontline professionals, such as physicians and community health workers, to engage in authentic dialogue with communities to identify and address structural barriers effectively. Furthermore, the authors critique the entrepreneurial model often adopted by university clinics, which prioritizes revenue generation over community engagement. This model, they argue, limits the ability of universities to dedicate resources towards building meaningful relationships with communities and addressing structural inequities. The authors conclude by emphasizing the importance of a structural understanding of health disparities. This involves recognizing the interconnectedness of various social determinants of health and working collaboratively with communities to develop holistic solutions that empower individuals and promote well-being.

Hollister et al. (2024) investigate if incorporating reflections on challenging interpersonal situations, called "relationally focused critical incidents," into speech language pathology internships could enhance students' conflict-handling skills. The researchers used a quasi-experimental design with 49 graduate students who were asked to reflect on critical incidents every two weeks for a period of seven weeks. Students' conflict-handling skills were assessed using the Dutch Test for Conflict Handling before and after a 7-week control period, and again after the 7 weeks of biweekly reflections.

The researchers found that completing these reflections did not lead to significant improvements in students' conflict-handling abilities, as measured by the DUTCH instrument. Specifically, there were no significant changes in students' preferences for compromising or problem-solving approaches to conflict. The authors suggest several reasons why this intervention might not have been effective. First, the 7-week reflection period may not have been sufficient to produce measurable changes in complex skills like conflict management. Second, simply asking students to reflect, without providing structured guidance or feedback, may not be enough to promote deep critical thinking and behavioral change.

Despite the lack of significant findings, the authors highlight the importance of professional competency in handling conflict, noting that a significant percentage of speech-language pathology students with performance issues struggle in this area. They suggest that future research could explore the impact of providing more guidance and feedback on student reflections, as well as focusing on specific aspects of conflict management.

Learning Outcomes
You will be able to:

• summarize the benefits of relationally focused clinical incident reflection
• explain a community-informed, strengths-based model of health care service provision

Assessment Type
Self-assessment—Think about what you learned and report on the Completion Form how you will use your new knowledge.

Articles in This Course

1. Implementing Strengths-Based Dialogue to Reframe Clinical Education and Community Engagement by Monique T. Mills, Magdalen Balz, and Daniel Price, published in SIG 11, Volume 8, Issue 5, October 2023
2. Reflecting on Relationally Focused Critical Incidents: Investigating the Use of Reflective Writing to Support Conflict-Handling Skills During Speech-Language Pathology Student Internships by Julia E. Hollister, Keralyn A. Kadir, and Noha S. Daher, published in SIG 11, Volume 9, Issue 1, February 2024