Factors that Influence Undergraduate Communication Sciences and Disorders Students' Clinical Preferences
The purpose of the current study was to explore factors that influence undergraduate students' clinical preferences. Specifically, the study examined the factors that may relate to undergraduate communication sciences students' knowledge of, and interest in working with older adults. Undergraduate students in communication sciences programs from across Ohio were recruited for participation for an online survey. Data from 152 undergraduate students' from 7 universities and colleges in Ohio were evaluated using descriptive statistics and Pearson Correlation Coefficients. Results indicate that participants had knowledge of older adults and the adult lifespan, but did not feel prepared to demonstrate this knowledge in graduate school. Of the 152 participants, 29 had a clinical preference of working with older adults and most participants did not change their interest after the completion of courses related to older adults. Awareness of facts on aging was related to both quality of relationship between student and older adult and interest in working with older adults. Data suggests, exposing students to older adults and providing educational opportunities related to older adults may impact their decision to work with this population. FACTORS THAT INFLUENCE CLINICAL PREFERENCES 3 Factors that Influence Undergraduate Communication Sciences and Disorders Students' Clinical Preferences In the United States the average adult male lives to be 78 years old and the average female 82 years old. Older adults make up 13% of the population in the United States and this is expected to "increase by 23% by the year 2013" (Searl, Gabel, 2003) Current life expectancy and rates in the population of older adults will thereby increase the number of older adults seeking treatment and services from health care professionals (Searl Gabel, 2003) Of particular interest in the present study is how these changing demographics will affect the speech language pathology profession. According to Brook (2012) of 133,000 certified SLPs employed in the United States in 2011, 54% worked in the school setting, 12.5% worked in hospitals, 9.8% worked in residential health care facilities, and 15.6% worked in a nonresidential health care facility. The number of SLPs working with older adults has increased by roughly 4% over a ten year period. As the older adult population doubles (Searl Gabel, 2003) there will be a greater need for more SLPs to work with this population. Specifically, SLPs will be needed to diagnosis and treat communication disorders related to aging, including: dementia, Alzheimer' and Parkinson's. This necessitates the need to determine the variables that may impact SLPs decisions to work with older adults. Are SLPs' decisions influenced in their undergraduate programs? Studies suggest adjustments in medical and health care training programs may help to increase understanding of the elderly and combat stereotyping of older adults (Gabel, Searl, Fulks, 2003; Kaf, Barboa, Fisher, Snavely, 2011) Little is known about undergraduate communication science students' attitudes towards and interest in working with older adults. As such, the literature reviewed here includes studies FACTORS THAT INFLUENCE CLINICAL PREFERENCES 4 on the attitudes and interest of several groups of professionals, as well as students pursuing degrees in various health care professions. Studies with Health Care Professionals Research shows that experience with older adults impacts, a) attitudes (Bebbington, 1991; Denton, Rodriguez, Hemmer, Harder, Short, Hanson, 2009; Kaf et al. 2011; Lee, Hoerr, Weatherspoon, Schiffman, 2008) and b) students' interest in working with this group (Abbey, Bridges, Elder, Lemcke, Liddle, Thornton, 2006; Eshbaugh et al. 2010; Ferguson, 2012; Lee et al. 2008; Mason, Sanders, 2004) Additionally, studies show that perceived knowledge of older adults has been shown to relate to health care professionals' attitudes towards older adults (Henry, 2011; Varkey, Chutka Lasnick, 2006) and that curriculum relating to older adults impacts student knowledge of, attitudes towards, and interest in working with older adults upon graduating (Cottle Glover, 2007; Gabel et al. 2003; Hughes, Soiza, Chua, Hoyle, MacDonald, Primrose, Seymour, 2008) Experience and Attitudes In studies that have examined the relation between experience and attitudes, results have generally shown that more experience with older adults leads to an increase in positive attitudes. (Bebbington, 1991; Denton et al. 2009; Kaf et al. 2011; Lee et al. 2008) A study conducted by Kaf et al. (2011) compared two groups of undergraduate communication science students' attitudes toward older adults. One group of students participated in a service learning project during which they interacted with older adults and the other group did not. Students were assessed using Kogan's Attitudes Towards Old People Scale and submitted journal entries detailing experiences with older adults. Scores on the attitude scale were compared and results showed that students who participated in the service learning project demonstrated more positive FACTORS THAT INFLUENCE CLINICAL PREFERENCES 5 attitudes towards older adults following the experience. Denton et al. (1991) conducted a study comparing four groups of third year medical students' attitudes towards older adults. Two of the groups completed a one hour long home visit and reflective paper concerning their experience and the other two groups did not. After comparing pre and post tests measuring students' attitudes, results showed the students who completed the home visit demonstrated more positive attitudes towards older adults. A study by Bebbington (1991) surveyed 70 SLPs by mail and participants were asked about their training, year of qualification, amount of teaching received on communication problems experienced by elderly people, and their experience treating older people. Results indicated a relationship between experience with older adults and a more optimistic attitude towards older adults. Experience and Interest In studies that have examined the relation between experience and students' interest in working with older adults, results have generally shown that more experience with older adults leads to an increase in interest of working with this group (Abbey et al. 2006; Eshbaugh et al. 2010; Ferguson, 2012; Mason Sanders, 2004) One study that explored the relationship between undergraduate experiences and interest in working with older adults (Eshbaugh et al. 2010) sampled 237 undergraduate students and found that the more contact students had with non related older adults was positively correlated with the probability of working with older adults in the future. Participants completed an anonymous questionnaire regarding interests in working with older adults. Overall, 24% of students sampled expressed an interest in working with older adults in the future. Abbey et al. 2006 interviewed 14 undergraduate nursing students and 12 registered nurses about clinical placements and experience with older adults. A comparison of responses revealed that both groups of participants agreed that a positive clinical FACTORS THAT INFLUENCE CLINICAL PREFERENCES 6 experience led to broader students' education. Also, results indicated clinical placements and experience with older adults may impact nursing students' decisions to work with this group. A study by Ferguson (2012) examined students' experiences with older adults, among other variables, and interest in working with older adults in a sample of 111 undergraduate and graduate students in social work. Group comparisons of scores on knowledge about the aging process, job opportunities, attitudes towards aging, and experience with older adults indicated that experience with older adults was the best predictor of future decisions to work with this group. In a study conducted by Mason Sanders (2004) 22 social work Masters level students were interviewed about their experiences with working with older adults. Results showed that 12 students reported a desire to work with older adults and 10 did not. The open ended questions revealed that the life experiences students had prior to the social work program influenced their interest in working with older adults. Also, most all of the students agreed that the best way to increase interest in working with older adults is to provide social work students with more experience with this group. Experience, Attitudes, and Interest A study that examined the relation between experience, attitudes, and interest in working with older adults found that more experience with older adults leads to improved attitudes and an increase in interest in working with this group (Lee et al. 2008) The study conducted by Lee et al. (2008) compared two groups of undergraduate communication science students' attitudes towards and interest in working with older adults. One group of students participated in a project during which they interacted with older adults and the other group did not. Students that interacted with older adults were asked to complete three client interviews and a project. A multivariate analysis showed that students who were paired with the older adults had higher FACTORS THAT INFLUENCE CLINICAL PREFERENCES 7 scored attitudes and interest in working with older adults following their experience than students who did not complete the project. Knowledge and Attitudes In studies that have examined the relation between knowledge about older adults and attitudes, results have shown that more knowledge about older adults leads to more positive attitudes (Henry, 2011; Varkey et al. 2006) A study conducted by Henry (2011) compared two groups of undergraduate nursing and nutrition students' knowledge about older adults. One group of students participated in an aging game in which they had to pretend they had a