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 Table of Contents  
PERSPECTIVE ARTICLE
Year : 2021  |  Volume : 40  |  Issue : 1  |  Page : 18-22

Challenges and opportunities for speech and hearing programs: Covid-19 and beyond


Director, Mandke Hearing Services, Pune, Maharashtra, India

Date of Submission09-Jan-2022
Date of Acceptance10-Mar-2022
Date of Web Publication06-Sep-2022

Correspondence Address:
Dr. Kalyani N Mandke
Mandke Hearing Services, 964, Sadashiv Peth, Opp. Brahman Mangal Karyalaya, Pune 411030, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jose.JOSE_1_22

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  Abstract 

The Covid-19 pandemic has disrupted traditional teaching-learning programs across all educational disciplines. The Speech and Hearing training program is no exception. It has provided many opportunities to incorporate online learning in the curriculum and upskilling and reskilling of new technologies. The pandemic has made us think differently. This will be a golden opportunity to have brainstorming discussions with all the stakeholders to discuss their expectations and aspirations towards professional courses like Speech and Hearing programs. This is an opinion piece; Covid-19 and various restrictions have impacted the Speech and Hearing profession, especially training programs. This article intends to initiate a dialogue among professionals that will hopefully enable us to define a strategic roadmap for the recovery of Speech and Hearing services and human resources as we emerge from the pandemic. The pandemic has given new directions towards the delivery of the education model. Various programs have received significant experience about what is doable and not doable modules in the academic program. This is a golden opportunity for all to move away from the traditional educational model and develop a flexible and student-oriented educational program. Are we ready for these challenges?

Keywords: Challenges, remote learning, Covid-19, online


How to cite this article:
Mandke KN. Challenges and opportunities for speech and hearing programs: Covid-19 and beyond. J All India Inst Speech Hear 2021;40:18-22

How to cite this URL:
Mandke KN. Challenges and opportunities for speech and hearing programs: Covid-19 and beyond. J All India Inst Speech Hear [serial online] 2021 [cited 2022 Oct 3];40:18-22. Available from: http://www.jaiish.com/text.asp?2021/40/1/18/355660



The Covid-19 pandemic has disrupted traditional teaching-learning programs across all educational disciplines. The Speech and Hearing training program is no exception. It has been almost 18 months since the first lockdown was announced in India in March 2020; most training programs struggled to transition to virtual classroom teaching and telehealth or clinical teaching model in this period. As we enter a new academic year, our online teaching thus far has primarily been the result of year-long experiments and a lot of trial and error. Some institutes adapted to the “new normal” and moved forward, while, other program administrations are waiting to return to pre-pandemic ways of teaching and learning. It is but natural, as the conventional approach has been their comfort zone. However, embracing the new ways of teaching methods is the need of the hour for all programs.

The pandemic has posed several challenges to Speech and Hearing programs. Even right before the pandemic, online delivery or distance mode teaching of Speech and Hearing courses remained at the level of informal discussions. But today, the covid-19 pandemic has forcefully made it a reality. On the positive side, it has provided many opportunities to incorporate online teaching in the curriculum and brought in new technology. As a result, educational programs across the board are on a different platform. The health care industry has had to adapt to new ways of delivering its services. The skill development of the next generation of professionals has been no exception. The pandemic has made us think differently and has offered a golden opportunity to have brainstorming discussions with all the stakeholders to discuss their expectations and aspirations towards professional courses like Speech and Hearing programs.

This article originated from my informal discussions with various professionals during the lockdown. In this opinion piece, I aim to outline how Covid-19 and multiple restrictions have impacted the Speech and Hearing profession, with a particular focus on the training programs. This article intends to initiate a dialogue among professionals that will hopefully enable us to define a strategic roadmap for the recovery of Speech and Hearing services and human resources as we emerge from the pandemic.

The first wave of Covid-19 was a highly unexpected situation that was followed by the lockdown. The term ‘lockdown’ was associated with the industrial sector for years together, but it extended to all walks of life with the pandemic. The education sector did not escape the lockdowns either. Before the first lockdown, most of the training programs were unaware of online teaching methods. The faculty members had never received any formal training in online teaching. There were no university/institute-level resources, and through independent self-learning, everyone became well-versed with various online platforms. However, looking back, in my opinion, most of the self-learning was at the elementary levels. Various online platforms were used in an attempt to simulate physical classroom environments. The learning experience was often reduced to sharing documents, forwarding reference articles, and presenting power points in practice. Nobody had predicted the exact duration of lockdown. Naturally, it was considered as an ad-hoc solution for one semester. So the online lectures were focused on delivering information on the foundation courses and core components of speech and hearing disorders of the programs.

Listening to the speaker in a virtual mode for 45 minutes to one hour is a passive act, and with a limited or restricted view of the teachers and students, keeping them engaged in online activities was a challenge. Sustaining interest and staying focused in online lectures was a difficult task for the students (Gaur et al. 2020; Buja, 2019) and the faculty members. Poor internet signal strength, limited internet data availability, non-availability of personal laptops, and lack of quiet study spaces were significant concerns to both students and faculty members.

Educators recognize that small group sessions, problem-based learning, self-directed learning, and team-based learning are effective models for changing and adapting to the challenging Covid-19 period. However, the processes to implement the same were unclear to the faculty members. As the pandemic duration got extended, many challenges opened the doors of the unknown. Two academic years 2019–2020 and 2020–2021, were at stake. As the Covid-19 pandemic has reshaped our world and left long-lasting effects on our ways of life, the time has come to redefine our pedagogy and reimagine what remote learning or blended teaching approaches could look like.

Remote learning (or distance e-learning) has emerged as a new teaching method to maintain the continuity of the training programs during the Covid-19 pandemic. Distance education/e-learning is defined as using computer technology to deliver training, including online or offline technology-supported learning (Al-Balas et al. 2020; Moore et al. 2011). The origin of the term e-learning is uncertain (Moore et al. 2011); however, it is suggested that the term most likely originated during 1980, within a similar time frame of another delivery mode of online learning. E-learning is defined differently by many authors. E-learning is strictly being accessible using technological tools that are either web-based, web distributed, or web-capable (Moore et al. 2011).

Online learning is an enhanced version of distance learning. Online learning refers to access to learning experiences via the use of some technology. It is the most recent version of distance learning which improves access to educational opportunities for learners. Two main formats are used in online education: asynchronous distance education such as recorded videos, podcasts, and synchronous (live) distance education such as video conferences and virtual classrooms. A combination of the two formats is known as the hybrid type or blended learning. An asynchronous component could allow students more flexibility, and a synchronous feature could facilitate interaction between students and faculty members (Papapanous et al. 2021). The hybrid model may be cost-effective to students and faculty members, especially concerning saving human hours. The last two academic years have given sufficient time to all the training programs to settle in hybrid models, and the time has come to adapt to a hybrid model at the Pan India level.

The program directors should be thinking of proactive ways to use hybrid teaching models in the coming years. The practical training or skill-based education component appeared to be missing or ineffectively delivered during the ongoing pandemic period. Lack of hands-on experience for two consecutive years in the clinical programs may have severe implications for students’ training. Online training and observation of teletherapy sessions may be indispensable in future years. It is time to assess what students have gained or lost in the last two years.

The clinical practicum was replaced with simulation training using videos and online demonstrations. Can simulation activities be a substitute for actual clinical practicum? Currently, there are no directives towards the distribution of simulation practical training hours, teletherapy hours, and hands-on practical hours. Once again, the collective efforts to fine-tune the practical activities indeed call for attention.

The second year of the undergraduate program of Bachelor of Audiology and Speech Language Pathology (B.ASLP) is essentially a foundation program, and core clinical competencies get refined in the third and fourth years of the program. These two years help the students to acquire knowledge and skills related to speech, language, and hearing disorders. This clinical knowledge is essential to prepare future Speech and Hearing professionals. A primary goal of the clinical curriculum is to produce professionals who can deliver an individualized plan, showcase awareness of the best current evidence, have skilful communication with clients, and have well-developed decision-making skills (Buja 2019), which remained unaddressed during this pandemic. One of the reasons was the fear factor associated with delivering clinical services during the pandemic. There is a possibility of discriminationin clinical service delivery due to incorrect information or stigma towards Covid positive cases or Covid-19 cured cases.

Our responsibility is to give equal treatment, but what were the attitudes of student- clinicians and their clinical supervisors? Did we extend any confidence to the student-clinicians to provide clinical services during the high prevalence of Covid 19 positive cases? Did we explain the care and maintenance of various amplification devices during the pandemic? How to perform a diagnostic test? Did we explain how to adapt our routine clinical procedures to make them covid secure and to improve the confidence of both professionals and clients?

The Covid-19 pandemic has disproportionately affected older adults and disabled individuals, who account for our core caseload. The physiological changes among older adults lead to a decline in intrinsic capacities, such as cognitive decline and depressive symptoms (Coskun and Buken 2021). Those conditions might interact at several levels and require an integrated approach to screening, assessing, and managing older adults and disadvantaged groups. Clinical services were compromised significantly, so was the clinical data collection for research activities. The graduate-level research activity for dissertations was heavily hampered during the Covid-19 pandemic. In 2019–2020, students had to settle with limited data and wrap up their unfinished research work to meet the graduation prerequisites. While for the year 2020–2021, the research focus shifted to survey methods and qualitative data collection. Students were forced to settle for only one of the research approaches as the access for face-to-face meetings with the clinical clientele was very minimal. These narrow research activities restricted their exposure to clinical discussions and quantitative research using objective methods.

Yet another facet impacted by the pandemic was the organization of conventions. The Covid-19 had closed the options of face-to-face conventions. Zonal and National conventions are essential and offer an excellent platform to showcase the research activities of professionals and students. These conferences are vital for developing a professional network, job hunts, etc. These activities have come to a standstill since March 2020. Although professionals had opportunities to listen to nationally and internationally renowned speakers and researchers in the field through virtual conventions, the experience is not comparable to platform presentations. Further, many students have missed these opportunities.

Delivery of clinical services and assessment of skills developed during clinical practicum is an ongoing process. Continuous evaluation of competency with some standardized tools is thus essential, and for this purpose, most of the programs have incorporated the Objective Structured Clinical Examination (OSCE) tool.

OSCE is a medical model, and it has blended well in Speech and Hearing programs. The OSCE is a form of performance-based testing used to measure candidates’ clinical competence. During an OSCE, candidates are observed and evaluated as they go through a series of stations. Students interview, examine and treat patients who present with speech and hearing disorders. The OSCE is an approach to assess clinical competence, which is considered an improvement over traditional examination methods. It is a very objective approach emphasizing what candidates can do rather than what they know (Zayyan 2011). The system looks into the application of knowledge rather than the recall of knowledge. Unfortunately, there were compromises in the implementation of OSCE during the pandemic.

2020–21 may be considered an “Unfinished Academic Year” (Covid-19 and Education 2021). Students who move unprepared lack certain fundamental building blocks of knowledge necessary for success, and hence, the assessment of students was very critical. Educational assessment is a process of obtaining valuable information for students, teachers, curricula, programs, and schools. The assessments are done at three levels. Firstly, the assessment for learning in which knowledge and skills are assessed. Second, the assessment while learning where the process and participatory role of students is looked into and thirdly, the assessment of learning where students’ knowledge and understanding as demonstrated by performance on the test is measured (Lynch 2018; OECD 2021).

The examination is a critical part of the higher education process and necessary to provide accurate grades. The University Grants Commission (UGC), India notification had stated categorically that cancelation of examination altogether was not an option (UGC 2021). The UGC said, “academic evaluation of students is a significant milestone in any education system. The performance in examinations gives the students confidence and satisfaction and reflects competence, performance, and credibility necessary for global acceptability” (James 2020; UGC 2021).

It is high time to explore the possibility of a flexible evaluation and examination system. The Open Book Examination (OBE) may be one of the better options. The Indian environment was never in favour of the OBE for various reasons.

Let us look at the strengths of the Online OBE. It gives flexibility to the students to access information “Anytime, Anywhere” (Ashvi and Sahoo 2021). OBE can reduce the students’ fear, anxiety, and stress levels (Michel et al. 2019). It is to be noted that anxiety and emotional block can negatively influence the student’s test performance by diminishing theavailability of working memory resources, thereby leading them to resort to inappropriate cognitive strategies (Grimley et al. 2008).

OBE encourages learning and prepares students for real-world decision-making. In an OBE, a student also seeks answers from various internet sources apart from course textbooks and class notes. Studies have shown that allowing students to access the internet for searching the answers boosts students’ performance and face validity (Ashvi and Sahoo 2021). On the flipside, students tend to avoid their thinking and become reliant on their textbooks due to online OBE (James 2020). Many studies have pointed out that students spend less time preparing for OBE and avoid deep-diving into the books (Grimley et al. 2008; Heijne-Penninga et al. 2010).

Are our academic programs ready to adapt to such a new system? Educators may express their concerns about the dishonesty of the students. We may have to work towards developing the values of honesty, transparency, and trust in examinations. OBE provides an opportunity to evaluate students based on their skills to identify, apply, analyze, and synthesize the information. While making the transition towards OBE, institutes may have to raise their bar of cut-off scores.

It is now time for all the program directors to reflect on undergraduate and graduate curricula, clinical practicum design, and examination systems. Our undergraduate and graduate programs are heavily loaded with content. Speech and Hearing is a clinical program, and so it is imperative that student-clinicians spend more time on hands-on experience. These discussions should involve various stakeholders. Such talks and fine-tuning will be more meaningful as the implementation of the New Education Policy (NEP) 2020 is on the horizon (NEP 2020, 2021).

Section 10.10 of the NEP (2020) promotes Open Distance learning and online programs provided they are accredited. Section 11.9 of NEP (2020) further allows adjusting the structure and lengths of degree programs. It also states that the undergraduate degree will be three or four years, with multiple exit options and appropriate certification. For example, a certificate can be awarded after completing one year in a discipline or a field, including vocational and professional areas. Similarly, a diploma may be granted after two years of study and a Bachelor’s degree after a three-year program while the four-year program will be a multidisciplinary Bachelor’s program. However, NEP (2020) clearly states that a four-year program will be the preferred option (NEP 2020).

Speech and Hearing programs being professional courses; should strictly be four years programs. Approving exit options will open the doors for underqualified human resources. However, eliminating the current 10 months diploma (DHLS) program has been challenging for many years. The debate to discontinue the DHLS program has been on for a very long time. In this regard, the new recommendations in NEP 2020 may bring political pressure on the professionals. Thus, the program directors should be prepared to take a strong position for the degree program.

The NEP 2020 also encompasses certain salient features such as making a program more multidisciplinary which could be advantageous for Speech and Hearing. We can introduce financial and legal literacy teaching modules for budding Speech and Hearing professionals, which will help them to fine-tune their skill sets essential for private practice, advocacy, and leadership.

One cannot ignore section 9.1.1 of NEP 2020, which states, “given the 21st-century requirements, quality higher education must aim to develop good, thoughtful, well-rounded and creative individuals”. It further says that quality higher education must enable personal accomplishment, enlightenment, constructive public engagement, and productive contribution to society. It must prepare students for more meaningful and satisfying lives, work roles and enable economic independence (NEP 2020). The pandemic has given new directions towards the delivery of the education model. Various programs have received significant experience about the doable and the not doable modules in the existing academic programs. This is a golden opportunity to gradually shift from the traditional educational model and develop a flexible and student-oriented educational program. The critical question, however, remains - Are we ready for these challenges?

Acknowledgements

I would like to thank Prof. Krishna, Y. Associate Dean, Manipal College of Health Professions, Professor Dept of Speech and Hearing, Manipal College of health Professions. Manipal Academy of Higher Education, Manipal

Prof. Prakash Boominathan, Professor and Head, Dept of Speech, Language and Hearing Sciences, Sri Ramchandra Faculty of Allied Health Sciences, Porur, Chennai

Prof. Rashmi J. Bhat, Principal and Deputy Director Academics, Dr. SRC Institute of Speech and Hearing, Bangalore for their time and sharing their candid views with me while writing this article. I also extend my thanks to Dr Kanad Mandke, Research Associate, Department of Psychology, University of Cambridge, UK for insightful discussions and his critical comments on the manuscript.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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