Undergraduate speech-language therapy students often find it difficult to see the relevance of theoretical module content, which may negatively influence their motivation to learn. The real world of their future profession can be brought to life in the theory classroom by including authentic case study examples. Video case studies are well suited to illustrating communication disorders and may also be easier to remember and relate to information already in the long-term memory.
This article describes the perceptions of undergraduate students regarding the inclusion of authentic video cases in a theoretical module on developmental communication disorders.
A qualitative, interpretivist research design was followed. Focus-group interviews were conducted with 22 second-year students in the programme B Speech-Language and Hearing Therapy. A modified contextualised content analysis approach was used to analyse interview data.
The use of authentic video cases was perceived positively by participants. Seeing a realistic example of a person with communication difficulties made it easier to understand, remember and engage with the module content. Participants also felt they could more easily imagine themselves in that clinical context, which seemed to (re-) awaken in them a sense of purpose and motivation. Being presented with real-life communication problems made them realise the relevance of their profession. However, participants experienced cognitive overload at times when the processing requirements of a task exceeded their available cognitive capacity.
Video cases are valuable tools to enhance students’ engagement with theoretical content. To avoid cognitive overload, a scaffolded multimedia learning experience needs to be provided.
Undergraduate students in the field of speech-language therapy often find it difficult to apply their theoretical ‘book knowledge’, in other words, to demonstrate competence in a clinical context (Hoben, Varley, & Cox,
Miller’s prism of clinical competence.
Research on multimedia learning suggests that, under certain circumstances, ‘people can learn more deeply from words and pictures than from words alone’ (Mayer,
Video case studies are particularly well suited to illustrating communication disorders, because they allow students to temporarily distance themselves from the real-time requirements of communication interaction and free up cognitive resources needed to engage with language as an object of study. Also, because language is an abstract mental capacity, having a permanent record of a communication interaction with a language-impaired person is valuable to the novice not yet skilled in observing short-lived language behaviour. Video clips from websites such as YouTube are commonly used in lectures but these are seldom recorded with specific educational outcomes in mind and usually depict situations and behaviour that have little in common with the South African context. These limitations are especially problematic when considering the critical role that context and culture play in communication. Against this background, and given that no studies could be sourced on how pre-clinical speech therapy students experience real video cases, funding was obtained to develop a database of authentic case studies of South African children with communication impairment and to pilot its implementation with students. The aim of this article is to describe how students perceived the video cases after they were exposed to them in a theory module on developmental communication impairment.
Benefits of using video cases in health sciences education range from enhancing memory for course content (Cherney et al.,
Medical students’ views on the added value of video cases in comparison to paper cases in a problem-based learning curriculum were examined in a qualitative study by De Leng et al. (
The study followed a qualitative, interpretivist research design, considered appropriate for the purposes of this study because it entails using participants’ ‘words and descriptions to record and investigate aspects of social reality’ (Bless, Higson-Smith, & Sithole,
Participants were enrolled in a 7-week module on communication disorders in specific clinical populations. A total of seven different topics were addressed during 3-h-long weekly lectures (see
Lecture topics and description of presented cases.
Topic number | Topic | Cases |
Length of video |
---|---|---|---|
1 | Intellectual disability | Leah and Ismail | 22 min |
2 | Children in institutionalised care |
Anathi | - |
3 | Paediatric HIV and/or AIDS | Funeka | 12 min |
4 | Auditory processing disorder |
Nicky | - |
5 | Autism spectrum disorders | Emily and Kiaan | 34 min and 10 min |
6 | Visual disabilities | Babalwa and Eva | 18 min and 16 min |
7 | Language learning disorder | Irvin and Kyle | 13 min and 17 min |
, Pseudonyms;
, Video cases could not be obtained for topics 2 and 4 because of ethical and practical challenges.
Participants were selected using purposive sampling. All 30 students who were enrolled in the module in which the videos were piloted were invited to participate in the study at the end of the module. Students were recruited via email and followed up with a text message inviting them to take part in the study and 22 students agreed to take part (male = 1; female = 21; mean age 20 years). Two focus groups were conducted with 9 and 10 students, respectively, in the language preferred by the group (Afrikaans and/or English). Three participants who were not able to attend the scheduled focus group interviews because of unforeseen events were later interviewed individually. In all interviews, an adaptive interview schedule consisting of standardised open-ended questions was used to guide the discussion and ensured consistency between interviewers. Questions were related to themes identified in the literature review on students’ experiences of video cases. Interviews were conducted by two independent persons not involved in students’ clinical training, namely a speech therapist and a PhD student in clinical linguistics, both of whom have experience in qualitative interviewing and are fluent in both Afrikaans and English. Although the same interviewers conducted the focus group and individual interviews using a standardised interview schedule, it is acknowledged that differences in interpersonal dynamics in the two data collection methods may have influenced the nature of responses obtained.
A modified contextualised content analysis approach was used to identify themes addressed by participants. To ensure reliability, the following audit trail was established: all interviews were orthographically transcribed by the author and the first interviewer. Verbal and written feedback was obtained from both interviewers after completion of the interviews, highlighting key aspects of the interview process. The author further immersed herself in the data by reading and re-reading the transcripts and listening to the interviews, and made research memos to record personal insights related to certain sections of text. During this process, several recurring themes were identified and further grouped into four main themes that were coded into the data using Atlas.ti software. To enhance the authenticity of findings, a member check was conducted. All participants were provided with the written transcript of the interview, as well as the preliminary results, and invited to approach the researcher if there were any disagreements regarding interpretation of the data.
Ethical approval was obtained from the health research ethics committee of the Faculty of Medicine and Health Sciences (N15/10/113) and the Unit for Institutional Research and Planning at Stellenbosch University. Permission to collect case study information was obtained from the Western Cape Departments of Education and Health (20161027–5599). Informed consent was obtained from all participants. All identifying personal information was removed from the written and video cases during editing, and from the interview transcripts, to protect the participants’ privacy. No personal details of participants were revealed to anyone not directly involved in the study. Data were saved in a password-protected computer file to which only the researchers had access. Videos were shown only to the students enrolled in the module and were not available for them to download or distribute.
Findings from the two focus groups and three individual interviews will be discussed together according to the main themes outlined in
Themes identified from focus group discussions on the inclusion of video cases in a theory module in an undergraduate speech therapy curriculum.
‘But for the things that I saw, I can speak about that.’ (Focus group 1, female)
‘And now I understand what they say in the lecture, because I could see it.’ (Focus group 1, female)
The majority of students were of the opinion that video cases made the theoretical module content more memorable, because they now had a mental image that they could refer back to. Having a real example helped them to more fully understand and engage with the theory, and several students recommended that real video cases already be used in first year. Students also reported increased awareness of the communication characteristics of the clinical populations studied and knew better what to expect from their clinical training site the following year. However, they did not yet feel confident in their ability to actually do intervention.
‘Or even if they were to show us the whole long video, then just like stop it every five minutes and say, “Did you see this and this and this? And now look out for this and this and this”. So just to guide your thoughts, so that you’re forced to focus as well.’ (Focus group 1, female)
‘She’d like say okay um they’re prone to echolalia and then she shows us, this is what echolalia is, then she shows three or four, five second videos, then you’re like okay that makes sense now. Instead of saying, remember in the video at the beginning or halfway through then you’re like…no. So yes, it just helps to have a referencing point.’ (Focus group 1, female)
Students felt they would have been able to learn more from the video cases if they had had a better idea of what they were expected to focus their attention on, especially with longer videos. They felt they learned much better and were more engaged with the content when short video clips were integrated into the lecture to demonstrate important concepts, as this helped them to form associations between the theory they heard or read and what they saw. Another way in which students felt the lecturer could better scaffold their learning experience was to let them view the video as a whole but to first give a short explanation and point out specific aspects to look out for. They also expressed a need to see more varied examples of each clinical population for a broader overview and in different contexts.
‘And you see the challenges that they [clients] face and then you realise that as a future therapist you have to be able to do and the skills that you need to have and how you need to go about to facilitate the development of those individual skills.’ (Focus group 2, female)
‘When I watched the videos I asked myself about that one blind boy […] are you emotionally ready for your profession to basically work with these populations? So I think it just sparks that idea of, listen here, you’re on your way somewhere to actually go and make a difference.’ (Focus group 2, male)
Participants found it very motivating to be exposed to real video cases, because they felt it gave them a better understanding of what their future profession entails and the type of clinical problems they will encounter. Given the fact that second-year students still have relatively limited clinical exposure, they valued seeing the ‘bigger picture’ of what they were working towards in their studies. Importantly, having an authentic record of a client–therapist encounter caused many students to identify and reflect on key interpersonal skills (such as patience) needed to be an effective therapist. This allowed them to construct a more realistic view of their chosen profession, their personal preferences (e.g. wanting to work with children) and the personal growth required of them.
‘It’s not just a piece of paper. You get to visually watch the videos and see the actual children and see the actual lecturers giving therapies. It makes a difference to see the techniques and the children.’ (Focus group 2, female)
‘I guess you kind of take it more seriously because it’s like a real thing. This isn’t like a fictional case or whatever, you know, this is like a real person who has gone through these real things, you know, like it’s kind of like you take it more seriously when dealing with people’s lives.’ (Focus group 1, female)
Seeing video cases of actual therapists interacting with actual children with communication impairment made students realise the real-life implications of the content they were dealing with. Although the main goal of viewing the videos were not to analyse the skills of the therapist, students nevertheless viewed the therapist as a role model in interacting with the child. The students also enjoyed the fact that, in most cases, the therapist in the video was also the guest speaker who presented the lecture and that they could learn from them in person.
The use of authentic video cases in an undergraduate theory module was generally perceived very positively by participants in this study. Seeing a realistic example of a person with communication difficulties, reportedly made it easier to understand, remember and engage with the module content. This benefit of having a mental picture to refer back to echoes findings of previous studies (e.g. Cherney,
The purpose for which a video case is used is likely to influence the learning outcome achieved. Participants in this study felt that video cases fostered a greater awareness of the clinical characteristics of different clinical populations, but did not equip them with the practical skills they needed for intervention. To an extent, this finding was to be expected, because the focus of the module was largely introductory in nature and is followed up in third year with a year-long, dedicated clinical training site during which specific clinical skills are acquired. The exposure to authentic video cases seemed nevertheless to be highly motivating to students, partly because it gave them a better understanding of the extent and relevance of speech therapy. In line with findings by De Leng et al. (
The inclusion of authentic video cases in an undergraduate theory module was generally perceived positively by the participants in this study, who felt that theoretical module content was easier to understand and remember when one had a mental image to refer back to. Being presented with real-life communication problems made them realise the relevance of their profession and reflect on the skills they would need to cultivate to be effective therapists. In order to avoid cognitive overload, a scaffolded multimedia learning experience needs to be provided which takes into account students’ working memory and processing limitations. This study presents the subjective views of a specific group of participants at a particular point in time and needs to be followed up with more objective measures to determine if and to what extent the inclusion of video cases influences student performance.
This research was made possible by a Fund for Innovation and Research into Learning and Teaching (FIRLT) grant from Stellenbosch University. The author is sincerely grateful towards every research assistant, speech therapist, teacher or headmaster, parent and child who willingly contributed their time and enthusiasm towards this project.
The author declares that she has no financial or personal relationships that may have inappropriately influenced her in writing this article.