Washington Vision Sometimes when the situation seems desperate—like a dearth of resources to support more students—ingenuity kicks in. Here’s how one graduate program doubled its enrollment. Features
Features  |   January 01, 2015
Washington Vision
Author Notes
  • Kristie Spencer, PhD, CCC-SLP, is associate professor and head of the speech-language pathology graduate admissions committee in the University of Washington Department of Speech and Hearing Sciences. She is an affiliate of ASHA Special Interest Groups 2, Neurophysiology and Neurogenic Speech and Language Disorders, and 15, Gerontology. kas@u.washington.edu
    Kristie Spencer, PhD, CCC-SLP, is associate professor and head of the speech-language pathology graduate admissions committee in the University of Washington Department of Speech and Hearing Sciences. She is an affiliate of ASHA Special Interest Groups 2, Neurophysiology and Neurogenic Speech and Language Disorders, and 15, Gerontology. kas@u.washington.edu×
  • Margaret Rogers, PhD, CCC-SLP, is ASHA’s chief staff officer for science and research. mrogers@asha.org
    Margaret Rogers, PhD, CCC-SLP, is ASHA’s chief staff officer for science and research. mrogers@asha.org×
Article Information
Professional Issues & Training / Features
Features   |   January 01, 2015
Washington Vision
The ASHA Leader, January 2015, Vol. 20, 50-52. doi:10.1044/leader.FTR4.20012015.50
The ASHA Leader, January 2015, Vol. 20, 50-52. doi:10.1044/leader.FTR4.20012015.50
It was 2005, just two years before the bottom fell out of the U.S. economy—but the financial squeeze had already hit the University of Washington’s Department of Speech and Hearing Sciences.
For one thing, there was a university-wide hiring freeze. For another, several faculty members had retired, resulting in reduced research funds and posing challenges to the department’s teaching needs. Meanwhile, the state of Washington faced a critical shortage of speech-language pathologists—along with Alaska, Montana, Idaho and Wyoming—with fewer speech-language pathology training programs than most states.
So, what to do? The graduate program had already reached maximum capacity, accepting 18 to 20 new graduate students each year. So, they got creative. Margaret Rogers, then associate chair, and Christopher Moore, then chair, worked with other faculty and university administrators to carve out 20 to 25 additional slots through a new medically oriented speech-language pathology master’s program.
How did they do it?
The Leader talked with Rogers, now ASHA chief staff officer for science and research, and Kristie Spencer, head of UW’s speech-language pathology graduate admissions committee, about how it all came to be—and how it’s fared since.
With the creation of the MedSLP program, you’ve more than doubled the number of slots for graduate students. That’s significant. How’s it working out?
Spencer: There certainly are some growing pains that come with that. It’s a different experience from a professor’s perspective to have 43 graduate students versus only 18. There’s extra effort required for grading exams and assignments and things of that nature, especially because you need to examine students in a way that’s appropriate for graduate school: case studies and short answers, not multiple-choice questions. But it’s also very, very comforting to know that, every year, we’re graduating such a large and strong cohort that is going to help fill the significant and longstanding gap between the supply and demand for SLPs.
Tell us more about the growing pains.
Spencer: There are always the logistical issues, with additional classes and additional clinical opportunities, and just navigating the logistics of where students will go and when. That’s worked itself out over the years. But a lot of thought and planning went into how to implement a much larger cohort. The very relevant upside is that we are now sending many more students into the community who are ready to provide high-quality services because of their depth of knowledge about treating medically and neurologically compromised individuals.
Could you elaborate more on that void?
Spencer: Because graduate programs in speech-language pathology have been so broadly focused, students haven’t always been able to seamlessly transition into medical environments. And now, because of the additional, more focused coursework and clinical placements, they are much better prepared to go into a skilled nursing facility or an acute or sub-acute hospital and to serve the diversity of clients in those settings.
Margaret, could you talk about how this program came about?
Rogers: The faculty had been concerned about the clinical personnel shortage in Washington state and elsewhere for a long time. A small group of medically oriented faculty began meeting regularly, but we felt our hands were tied with respect to growing the graduate speech-language pathology program. There were no incentives in the university to support such an expansion. We simply didn’t have funds. And there was nobody promising us more funding if we doubled our size.
It was also at a time when the university was financially strapped, as was the state. This financial situation, I think, is common in many states.
Then … lo and behold—a revelation. Thunder struck the streets of Seattle, the clouds parted, and the sun shone down on UW’s Educational Outreach program, now called the Professional and Continuing Education program (historically called adult education at many state universities). In addition to providing the Seattle community with professional development opportunities, this program had recently been sanctioned to offer graduate degrees.
So Chris Moore, our department chair, and I (then associate chair) started having discussions with the deans of the educational outreach program and of arts and sciences to see if they would support an expansion of our graduate speech-language pathology program through Educational Outreach—and, most importantly, to see if they would allow some proportion of those tuition dollars (approximately two-thirds) to remain in our department’s operating budget so that we could adequately support the expansion.
After much financial modeling, planning and meetings, everybody seemed agreeable to this notion. It was kind of a miracle—because to get this many people in a department and in upper administration to agree is rare, especially given the substantial amount of start-up costs and the extent of additional work required of faculty.
But everybody came to see this plan as a win/win/win—for the department, the university and the state. It did require the university to provide significant start-up funds. It certainly helped to sell the idea to point out that we had so many more highly qualified applicants than we could accommodate, and other things like the department’s high ranking and the critical statewide need for more SLPs.
I would strongly encourage faculty at other universities with similar continuing education divisions to explore this expansion avenue. Only efforts such as these will truly make a dent in decreasing the supply-and-demand bottleneck.
Any other tips on getting a program like this going?
Rogers: A critical piece to succeeding with changes like this is to be aware of how the changes are going to be perceived and likely to affect everyone involved. Change management is critical to success. And, that’s not something that I learned in my PhD program or anywhere else in a formal manner—but, without a doubt, the most challenging aspects were all related to managing people’s perceptions and anxiety about change. But now I’m turning this over to Kristie, because I left a year into the program’s implementation and I know that the program has continued to evolve since.
Kristie, have the numbers of students changed or stayed steady over the years?
Spencer: The number of students we accept into the MedSLP program has always ranged between 20 and 25. But the number of applications has increased quite a bit as people learn about the program and its quality. So, to compare: In 2009–2010, we had 63 MedSLP applications, and in the most recent, 2014–2015 period, we had 169. That was just for those who indicated the MedSLP program as their primary program of interest. Across both the core (traditional) and MedSLP programs, we had 354.
What have been some of the benefits that you’ve seen of this program?
Spencer: With hiring freezes and several retirements, our department would have really been in jeopardy without this extra funding. It has enabled us to support several faculty positions, as well as several professional advisors during a period where most other departments lost positions.
How are students’ placements going after graduation?
Spencer: We have a 100 percent employment rate for our graduates. They go everywhere from inpatient/ outpatient rehabilitation centers to long-term care facilities to assisted living facilities, to private practice and outpatient clinics. It’s really varied.
Any sense of the program’s future—Change it? Keep it on the same track?
Spencer: We’re always refining it based on students’ feedback and our own ideas about positive changes. But overall, it’s a wonderfully strong, solid and rigorous program. And we’re in a good place to maintain that standard.
Rogers: Graduating well-prepared students for focused practice in medical settings is becoming increasingly important, especially with the changes in health care. Historically, our profession has been valued in medical settings, partly because of the services we provide, but mostly because of the monetary value we generate in the current fee-for-service reimbursement system. With the shift in health care to pay-for-performance, however, reimbursement is going to be mostly based on the value of those services. Value will likely be measured as a ratio of patient outcomes to cost.
So, if we are educating students in a more focused manner to provide high-quality services to patients with voice, neurological, surgical and other medical conditions, then they’re going to deliver more value to those patients and medical teams, and therefore speech-language services will continue to be in high demand in medical settings.
For example, if we provide services that help to ensure that patients with communication/ swallowing/cognitive disorders (and their caregivers) understand and have strategies to faithfully follow discharge instructions, then our medical colleagues are not going to want to discharge patients with communication disorders without our consult—for fear of readmissions associated with poor adherence to the discharge plan.
More than ever, we need programs to prepare students to hit the floor running and knock the socks off their interprofessional colleagues.
Spencer: Absolutely. Very well stated.
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January 2015
Volume 20, Issue 1