Diving into EBP: An Experiment in Conversation Part 4

Alaina: Love of truth...I know I love to look for truth when encountering a description of a new treatment approach. I am gleeful to be skeptical and scour the evidence for flaws before deciding whether or not to try out the approach. But thinking about it, I’m realizing that I’m not yet as practiced in loving truth after I have had a belief take hold. Somewhere in the process of using a certain treatment approach while planning treatment goals, planning sessions, talking with clients’ parents, and seeing clients improve, I come to love the treatment approach. Instead of loving the truth. So, it’s painful when I find myself having to confront a beloved belief in a beloved treatment approach because it isn’t actually working with a specific client. But does it have to be painful? How do we cultivate love of truth--love of engaging in ongoing intellectual confrontation--instead of surrendering to love for a belief?

Diving into EBP: An Experiment in Conversation Part 3

Hannah: That is a big idea. It reminds me of having intellectual virtues, particularly possessing a ‘love of truth.’ Clinical “truth” seems to exist in a slightly different space, though. What I mean is that I have observed clinicians to subscribe to a particular clinical approach (and perhaps even philosophy) and apply it to every individual on her caseload. Given the variability among humans, I am skeptical that one clinical strategy could apply to all. So, would continually confronting a strategy better enable a clinician to arrive at a client-specific truth?

Diving into EBP: An Experiment in Conversation Part 2

Here is a big idea: A person can continually expand his/her concept of any topic by engaging in ongoing intellectual confrontation about that topic.

I wouldn’t have thought to make this statement before now, but recent conversations, with people who have spent years being inspired by the Reggio Emilia approach, have brought this idea to my attention. Where does this idea fit into EBP? It seems like this idea could be the guiding force behind the “clinical expertise” side of the EBP triangle, but this idea feels much more dynamic and exciting than I have ever understood the clinical expertise side of the EBP triangle to be.

Diving into EBP: An Experiment in Conversation Part 1

We were going to write a post about Evidence-Based Practice (EBP). We even started an outline and a few paragraphs; maybe we’ll visit them again in the future. The post just wasn’t working. While EBP is foundational and important to the field of Speech & Language Pathology, we found ourselves wanting to consider its underlying ideas, within multiple frameworks. We learn about “what EBP is” and “how to apply EBP” in clinical practice, but it seems as though the conversation ends there. As you read our blog you may have noticed that the two of us rarely let conversations end “there.” So we decided to experiment with blog conversing. The posts that follow will reflect our ongoing dialogue that dove into EBP. We are not sure where our conversation may go, so enjoy the swim.

Developing a Robust Process for Improvement Part 4 of 4: Improving at Improving

The fill-in-the-blank form that I (Alaina) presented in part 3 may be useful as a robust process for improvement.  Really, its usefulness relies on having your own personal knowledge and experience about strategies you might use to improve.

And now I get metacognitive when I say: the more knowledge you have about the process of improvement, the more you can improve your process of improvement.  So, the last post in this series is a list of related reading on the topic of improving your process of improvement.  Enjoy!

Books:
Adapt: Why Success Always Starts with Failure by Tim Harford
The Art of Learning by Josh Waitzkin
Being Wrong by Kathryn Schulz
Better by Mistake by Alina Tugend

Articles:
Ertmer, D.J., & Ertmer, P.A. (1998).  Constructivist Strategies in Phonological Intervention: Facilitating Self-Regulation for Carryover.  Language, Speech, and Hearing Services in Schools, 29, 67-75.

Websites:
Edge: What have you changed your mind about?
Edge: What scientific concept would improve everybody's cognitive toolkit?
Study Hacks by Cal Newport

Developing a Robust Process for Improvement Part 3 of 4: Fill in the Blanks

As I (Alaina) talked about in part 2, Harford has a theoretical recipe for success by adapting a series of failures.  Ertmer & Ertmer have a theoretically effective method for speech-sound carryover in kids.  Together, they have led me to develop my own robust process for improving my methods as a Speech & Language Pathologist (or in any aspect of life).

The process for improvement I've developed works well for me when I approach it as a fill-in-the-blank form.  Below is an example.  Just to show how it works, I filled it out using the hypothetical case of cooking dinner.

A Robust Process for Improvement (cooking dinner example)

Preparation:

• When I [cook dinner], 
• aspects that don't seem to work are [I often think about trying a new recipe, but then give up].  
• Aspects that do seem to work well are [I like to cook and I have lots of recipe ideas].
• So, I want to start [trying one new recipe per week], 
• because doing so will [make dinner more interesting].  
• In order to generate ideas about how to start [trying one new recipe per week], 
• resources that I can turn to include [(1) blogs where people write about becoming motivated to cook, (2) my own ideas, (3) conversations with my mom and sister, (4) books about cooking, like Julie & Julia by Julie Powell].  

Planning:

• In the process of generating ideas about how to start [trying one new recipe per week], 
• I have come up with these ideas: [(1) start a cooking blog for motivation - but I don't want to. (2) have friends over for dinner once per week - but I prefer not to try out new recipes for company. (3) make a habit that I do the same way each week - this sounds good].  
• I am ready to try [making a habit that I do the same way each week], 
• so my plan is to [making a habit of choosing a recipe first thing on Saturday morning, grocery shopping on Saturday afternoon, and cooking the new recipe for dinner on Sunday].
  
• I am monitoring this plan by [keeping a chart posted on my fridge so that I can check off each successful weekend].  
• I am evaluating the effectiveness of this plan by [whether or not I am successfully trying new recipes].

Review:

• At this point, I have tried [making a habit of choosing a recipe first thing on Saturday morning, grocery shopping on Saturday afternoon, and cooking the new recipe for dinner on Sunday] for [three weeks].
• When I monitored this plan, I noticed [that I made a new recipe for weeks one and two, but not week three].
• When I evaluated this plan, I decided that it [doesn't work], because [last week I forgot to do it in time].
• Next I might try [adding to the plan that I will write in appointments on my calendar for the recipe-choosing, grocery-shopping, and dinner-cooking].

Note that while the form has a first line and a last line, any line of the form might be a valuable starting point. There is no inherent need to start at the top.  In the same vein, the last item in the list is not actually an end point.  More effective results will come from cycling through this planning and review process many times.  Below are two versions of the generic form, either to fill in the blanks, or to use as a questionnaire.

A Robust Process for Improvement (fill-in-the-blank form) Preparation: When I [insert topic of interest],  aspects that don't seem to work are [insert].   Aspects that do seem to work well are [insert]. So, I want to start [insert desired outcome],  because doing so will [insert motivational reasons].   In order to generate ideas about how to start [reinsert desired outcome from line 4],  resources that I can turn to include [insert].   Planning: In the process of generating ideas about how to start [reinsert desired outcome from line 4],  I have come up with these ideas: [insert each idea with an evaluation of its merit].   I am ready to try [insert an idea],  so my plan is to [insert]. I am monitoring this plan by [insert].   I am evaluating the effectiveness of this plan by [insert]. Review: At this point, I have tried [reinsert plan] for [insert period of time]. When I monitored this plan, I noticed [insert]. When I evaluated this plan, I decided that it works / doesn't work, because [insert].  Next I might try [insert].

A Robust Process for Improvement (questionnaire form) Preparation: What is your topic of interest? Currently, when you do things related to your topic of interest, what aspects don't seem to work? What aspects do seem to work well? What is your goal: the thing you want to start doing, related to that topic? Why do you want to start meeting that goal? What resources can you turn to in order to generate ideas about how to start meeting that goal? Planning: After generating ideas about how to start meeting your goal, what ideas do you have? Which of these ideas seem good? Which idea are you ready to try now? What is your plan? How will you monitor this plan so that you know if you are following it? How will you evaluate this plan so that you know how successful it is? Review: How long have you been trying this plan? When you monitored the plan, what did you notice? When you evaluated the plan, what did you see that worked?  What didn't work? What's next?

I encourage you to give it a try!  The fourth, and final part of this post will conclude with some additional resources about processes of improvement.

Developing a Robust Process for Improvement Part 2 of 4: Self-Regulating

In my last post, part 1 of developing a robust process for improvement, I (Alaina) shared Tim Harford's recipe for successfully adapting success from failure.  With that quote reverberating in my head so much, it was bound to bounce off of some of the other ideas I was mulling over.

I'm glad to say that the quote bumped into my thoughts about Ertmer & Ertmer's (1998) article about self-regulated speech-sound carryover.  When I had originally read this article, it was because I wanted to learn a new therapy technique.  As a Speech & Language Pathologist, I was looking for ways to help kids make the leap from being able to produce a new speech sound during structured practice, to being able to use the new speech sound all the time in their spontaneous conversations.  But after reading Adapt I realized that Ertmer & Ertmer's "self-regulation" carryover method in fact follows Harford's same line of logic.

Ertmer & Ertmer's article focuses on helping children discover their own personal strategies for speech-sound carryover.  In it, the SLP uses a constructivist teaching method to help children become self-regulated learners who can plan strategies, try their strategies out, self-monitor, self-evaluate, and plan new strategies based on their self-evaluation.

It turns out that this article is a detailed guide to helping children adapt and reach carryover success, by helping children to notice and learn from the times when they forget to use speech sounds.  But also, in its detail, Ertmer & Ertmer's article has ideas to lend to my ongoing goal of developing a robust process for improvement of my effectiveness as a Speech & Language Pathologist.

Next up, look for part 3 in this series.  I'll be sharing my homemade process of improvement, which combines Harford's ideas and Ertmer & Ertmer's ideas.