Flipping Clinical Education for Speech-Language Pathology Students: A Mixed Method Study Exploring the Role of Inquiry-Based Learning in the Development of Critical Thinking Skills

Abstract

Introduction: In speech-language pathology (SLP) education, traditional teaching methods often fail to adequately equip students with the critical thinking and clinical reasoning skills needed to navigate the complexities of clinical practice. SLP students require clinical education that bridges the theory–practice gap by enhancing these essential skills. Set within the complex environment of South African higher education and healthcare, where the need for culturally appropriate and equitable services is required, this study explores the “flipping” of clinical education to better prepare SLP students for real-world challenges. By acknowledging and incorporating the complexities of clinical education and critical thinking, the study explores whether introducing an inquiry-based learning pedagogy promotes the development of critical thinking skills in second- and third-year SLP students in supervised clinical settings. Methods: A longitudinal, convergent, multilevel, and multimethod mixed method research design was employed to conduct a theory-based impact evaluation. Multiple data sets were collected from 7 clinical educators, 16 second-year SLP students, and 11 third-year SLP students at one university. An adapted extended pillar integration process was developed to merge the multiple qualitative and quantitative data sources. Results: The findings indicate that second- and third-year SLP students in the experimental group showed improved critical thinking skills, primarily through enhanced self-reflection skills. In contrast, the control group exhibited a decline in these skills across the year. The results indicate that while critical thinking skills among SLP students did change, inquiry-based learning was not the primary contributing factor. The integration of data from both students and clinical educators using the adapted pillar integration process provides strong evidence that self- reflection is an important factor for developing critical thinking skills. The study emphasises the 3 importance of self-reflection, feedback, the clinical educator–student relationship, positive academic emotions, professionalism, and a strong theoretical foundation for effective engagement in clinical education, leading to enhanced critical thinking skills. Conclusion and implications: The findings contribute to the development of a proposed clinical education framework for the development of critical thinking skills for SLP clinical education. This proposed framework emphasises the importance of developing critical thinking skills through self-reflection, feedback, and the clinical educator–student relationship within the context of student-specific factors. This framework facilitates student and clinical educator engagement in clinical education regardless of the pedagogy employed and supports the development of critical thinking skills and clinical reasoning in SLP students. The study also validated the adapted extended pillar integration process as a reliable and effective tool for integrating multiple data sources in mixed methods research.