Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Date of Graduation

Fall 2018

Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Communication Sciences and Disorders


Carol C. Dudding

Susan B. Ingram

Cynthia R. O'Donoghue


Survival of preterm and medically-complex infants has dramatically increased over the past thirty years due to significant advances in medical care and technology, however the developmental costs of survival are substantial. Comprehensive care of premature babies is critical and there is a need for more neonatal therapists, including speech-language pathologists (SLPs), with the knowledge and confidence to provide that care.

Students in graduate SLP programs often receive little clinical experience or dedicated coursework in pediatric feeding and swallowing, especially with medically-complex infants. However, hands-on and experiential learning can support the development of the necessary foundational knowledge and confidence of students entering into the profession. High-fidelity human patient simulation can provide this experience with high-risk patients in a risk-free learning environment.

This investigation examined the effect of high-fidelity human patient simulation on student knowledge of and confidence with managing physiologic stability of medically-fragile infants. A sequential, two-phase, embedded mixed methods design was employed. Two cohorts of graduate SLP students participated; the control group (Fall 2017; n = 28) and experimental group (Summer 2018; n = 24) both completed required coursework in pediatric dysphagia. All students completed all requirements of the course and also completed assessment measures at three time points: 1) prior to any didactic instruction, 2) following coursework, and 3) following the intervention. The intervention was either a written case study (control group) or a high-fidelity human patient simulation using the Super Tory® manikin (experimental group). Both conditions used the same case scenario developed by expert SLPs. Rigorous quantitative and qualitative analyses were conducted to examine student knowledge and confidence, as well as perceptions of learning in simulation (experimental group only).

All students improved knowledge performance from pretest to posttest, and there was no significant difference between groups in knowledge at the posttest. There were significant differences between the control and experimental groups on confidence, particularly at the third timepoint. Following the simulation, the experimental group reported higher confidence than the control group with skills requiring hands-on experience. Findings of this investigation support integration of high-fidelity simulation into the SLP graduate curriculum to supplement and complement didactic and clinical training.



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