Academic Programs in Audiology & Speech-Language Pathology: Weathering the Changes Ahead ASAHP Annual Conference, October 26, 2012 Shelly Chabon, PhD, CCC-SLP 2012 ASHA President

ASHA Mission & Vision

Where Members Work ASHA Constituency by Primary Employment Facility Source: Year-End Counts (rounded), ASHA Membership and Affiliation, 2010 Schools 50% College/ University 4% Hospital 13% Non Residential Healthcare 18% Other 6% Residential Healthcare 9% ASHA Constituency

Winds of CHANGE The trouble with weather forecasting is that its right too often for us to ignore it & wrong too often for us to rely on it. --Patrick Young

Gusts Ahead for Audiology Growing need for hearing services (aging population) Changing marketplace: u Online hearing aid sales u Perceived lack of affordable services u Pressure to unbundle services u Presence of insurance companies Increasing dependence on technology & internet Changing educational standards u Move from AuD to PhD models u Creation of specialty tracks u Implementation of 4 th year experiences

Gusts Ahead for Speech-Language Pathology Personnel shortages Rising costs of health care Fee-for-service system under fire Outcome-driven reimbursement Increasing caseloads Graduate programs at capacity Educational changes u Value of clinical doctorate u Supervision training & credentials u Specialty certifications

Forecast & Outlook for the Preparation of Future Audiologists & SLPs Move to team-based care Focus on interprofessional collaboration Need to present a solid identity Introduction of new teaching technologies Need to assess cost of/ access to health care In God We Trust – everyone else bring data Change in research priorities Need for more international experiences Increase in diversity of those served Use of online simulation MOCs Credit for experience

STORMS on the Horizon The coldest winter I ever spent was a summer in San Francisco. --Mark Twain

Showers Likely for Health Care & Education Health Care Settings Higher Education Settings Customer Satisfaction Patient ExperienceStudent Experience Cost Reduce service volume; lower delivery cost Tuition costs; other costs Quality Outcomes Health Function; Quality of Life Graduation/ Placement Reduce Length of Stay Cut hospital days, no. of visits, etc. Reduce time to graduation Safety Patient welfare/ Reduce errors/ Reduce unnecessary complications Student welfare/ Conflict resolution/ Violence reduction on campuses Adapted from Johnson, A. (2012) What is the (Preferred) Educational Future in SLP for Health Care Practice? ASHA Changing Healthcare Landscape Summit [presentation]

Pressure to generate more clinical revenue Pressure to increase enrollment Fewer scientists Occasional Turbulence Ahead for the Professions Students question value of advanced degrees Fewer able to practice with under-served populations Increased school debt + decreased salary rates Increased demands from stakeholders Decreased funding to colleges & universities Pressure to place bachelors level students who dont get into grad school

Wind Advisory Increased need to Expand the pipeline for clinicians entering the professions to meet burgeoning needs of schools and clinics Build outreach and provide opportunities for more diverse students Explore the benefits of inter- professional education, credit for prior-learning experiences & innovative clinical education Identify funds for more scholarships Reassess the continuum of education Adjust curricula to teach skills in team-based care Assess value of undergraduate major as well as clinical doctorate Communicate value of graduate degree

DRESSING for the weather There is no such thing as bad weather, just unsuitable clothing. --Alfred Wainwright

Projected Job Growth Clear Skies Ahead for Audiologists Much faster than average growth through 2018 Additional 3,200 audiologists needed 25% increase in job openings

Projected Job Growth Clear Skies Ahead for SLPs Faster than average growth through 2018 Additional 22,100 SLPs needed 19% increase in job openings

Warming Trends Abundance of qualified students High success rates of graduates Personnel shortages translate into high employment availability for graduates Established models continue to produce successful clinicians

Dressing for the Weather: Audiology Prioritize patient centered care u Incentivize measure/value of outcomes u Incorporate patients goals into treatment Adjust curricula to reflect healthcare changes u New reimbursement models u Biotechnology u Use of large data sets to evaluate outcomes & demonstrate value u Preferred practice patterns u Online/blended learning u Interprofessional education

Dressing for the Weather: Speech-Language Pathology Expand clinical paradigm u Adopt ICF framework u Focus on context-based communication effectiveness (vs. on deficit & impairment) Position SLPs as leaders in communication health Develop/enhance quality & outcomes measures Reframe/rebrand the profession Widely disseminate information

Verbal Warming: Questions now being asked Do students understand the ICF framework and will they be prepared to use it to evidence the value and outcomes of their services? Do students understand that their ability to be reimbursed will be based on outcomes and not treatments? Will students be prepared to compete? Is the standard university clinic the right place to learn the best practice?

Verbal Warming: Questions now being asked How should we be responding [to rising health costs & lack of coverage] as a profession? How will we evidence to regulators, health care rating organizations, accrediting bodies, employers, commercial payers and the public the necessity, quality, efficiency & accountability of our services? How can we energize individuals to become catalysts of change? What does the ideal clinician of the future look like?